A randomised controlled trial to evaluate the efficacy of a nurse-provided intervention for hospitalised smokers.
OBJECTIVE
Does the provision of a nurse-based intervention lead to smoking cessation in hospital patients?


METHODS
At tertiary teaching hospital in Newcastle, Australia, 4,779 eligible (aged 18-80, admitted for at least 24 hours, and able to provide informed consent) and consenting (73.4%) in-patients were recruited into a larger cross-sectional survey. 1,422 (29.7%) smokers (in the last 12 months) were randomly assigned to control (n = 711) or intervention group (n = 711). The brief nurse-delivered intervention incorporated: tailored information, assessment of withdrawal, offer of nicotine replacement therapy, booklets, and a discharge letter. Self-reported cessation at 12 months was validated with CO and salivary cotinine.


RESULTS
There were no significant differences between groups in self-reported abstinence at three or 12 months post intervention, based on an intention to treat analysis. At three months, self-reported abstinence was 27.3% (I) and 27.5% (C); at 12 months was 18.5% (I) and 20.6% (C). There were no differences in validation of self-report between intervention and control groups at 12 months.


CONCLUSIONS
This brief nurse-provided in-patient intervention did not significantly increase the smoking cessation rates compared with the control group at either three or 12-month follow-up.


CONCLUSIONS
A systematic total quality improvement model of accountable outcome-focused treatment, incorporating assertive physician-led pharmacotherapy, routine assessment and recording of nicotine dependence (ICD 10 coding), in- and outpatient services and engagement from multidisciplinary teams of health professionals may be required to improve treatment modalities for this chronic addictive disorder.
Nagle
Amanda L
AL
National Heart Foundation of Australia (Hunter), Kotara, New South Wales. amanda.nagle@heartfoundation.com.au
Hensley
Michael J
MJ
Schofield
Margot J
MJ
Koschel
Alison J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome