title: Effectiveness of smoking-cessation interventions for urban hospital patients: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Hospitalization may be a particularly important time to promote smoking cessation, especially in the immediate post-discharge period. However, there are few studies to date that shed light on the most effective or cost-effective methods to provide post-discharge cessation treatment, especially among low-income populations and those with a heavy burden of mental illness and substance use disorders.
  
  
  METHODS
  This randomized trial will compare the effectiveness and cost-effectiveness of two approaches to smoking cessation treatment among patients discharged from two urban public hospitals in New York City. During hospitalization, staff will be prompted to ask about smoking and to offer nicotine replacement therapy (NRT) on admission and at discharge. Subjects will be randomized on discharge to one of two arms: one arm will be proactive multi-session telephone counseling with motivational enhancement delivered by study staff, and the other will be a faxed or online referral to the New York State Quitline. The primary outcome is 30-day point-prevalence abstinence from smoking at 6-month follow-up post-discharge. We will also examine cost-effectiveness from a societal and a payer perspective, as well as explore subgroup analyses related to patient location of hospitalization, race/ethnicity, immigrant status, and inpatient diagnosis.
  
  
  CONCLUSIONS
  This study will explore issues of implementation feasibility in a post-hospitalization patient population, as well as add information about the effectiveness and cost-effectiveness of different strategies for designing smoking cessation programs for hospitalized patients.
  
  
  BACKGROUND
  Clinicaltrials.gov ID# NCT01363245.
authors.affiliation: Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA. ellie.grossman@nyumc.org
authors.forename: Ellie
authors.initials: E
authors.lastname: Grossman
authors.forename: Donna
authors.initials: D
authors.lastname: Shelley
authors.forename: R Scott
authors.initials: RS
authors.lastname: Braithwaite
authors.forename: Iryna
authors.initials: I
authors.lastname: Lobach
authors.forename: Ana
authors.initials: A
authors.lastname: Goffin
authors.forename: Erin
authors.initials: E
authors.lastname: Rogers
authors.forename: Scott
authors.initials: S
authors.lastname: Sherman
mesh_terms: D003362:Cost-Benefit Analysis; D003376:Counseling; D017048:Health Care Costs; D006779:Hospitals, Public / Q000191:economics; D006786:Hospitals, Urban / Q000191:economics; D015277:Hotlines; D006801:Humans; D007297:Inpatients; D008507:Medically Underserved Area; D009042:Motivation; D009519:New York City / Q000453:epidemiology; D010351:Patient Discharge; D012107:Research Design; D012907:Smoking / Q000191:economics / Q000208:ethnology; D016540:Smoking Cessation / Q000191:economics / Q000208:ethnology / Q000379:methods*; D000074606:Smoking Prevention; D013997:Time Factors; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000191:economics / Q000208:ethnology / Q000628:therapy*; D016896:Treatment Outcome; D035862:Vulnerable Populations