Smoking Cessation after Hospital Discharge: Factors Associated with Abstinence
Hospitalization offers tobacco smokers an opportunity to quit smoking, but factors associated with abstinence from tobacco after hospital discharge are poorly understood. We analyzed data from a multisite, randomized controlled trial testing a smoking cessation intervention for 1,357 hospitalized cigarette smokers who planned to quit. Using multiple logistic regression, we assessed factors identifiable in the hospital that were independently associated with biochemically confirmed tobacco abstinence 6 months after discharge. Biochemically confirmed abstinence at 6 months (n = 218, 16%) was associated with a smoking-related primary discharge diagnosis (Adjusted Odds Ratio[AOR] = 1.98, 95% CI: 1.41–2.77), greater confidence in the ability to quit smoking (AOR = 1.31, 95% CI: 1.07–1.60), and stronger intention to quit (plan to quit after discharge vs. try to quit; AOR=1.68, 95% CI: 1.19-2.38). In conclusion, smokers hospitalized with a tobacco-related illness and those with greater confidence and intention to quit after discharge are more likely to sustain abstinence in the long term. Hospital clinicians’ efforts to promote smoking cessation should target smokers’ confidence and motivation to quit.
© 2018 Society of Hospital Medicine
Acknowledgments
The authors are grateful for the hard work of MGH, NSMC, and UPMC’s tobacco treatment services, the hospital providers, and study research staff.
Disclosures
Drs. Rigotti and Park received royalties from UpToDate and have received a research grant from Pfizer regarding smoking cessation. Dr. Rigotti has consulted (without pay) for Pfizer. Dr. Singer has served as a consultant to Pfizer but on a topic separate from smoking cessation. No other authors have conflicts of interest to disclose.
Role of Funding Source: The study was funded by NIH/NHLBI [grant #R01-HL11821]. The funding organization had no role in the study design, collection, analysis, and interpretation of the data, preparation of the manuscript, or decision to submit the manuscript for publication.
Clinical Trial Registration: NCT01714323