Hospital Stay Represents â€˜Teachable Momentâ€™ For Smokers
Smokers who are hospitalized for any condition are in a perfect place to receive help in quitting, suggest the results of a recent study that offered smoking-cessation help to patients and followed their success for a year.
â€œThe findings strongly suggested that hospitalization presents an excellent teachable moment for virtually all smokers,â€ says lead study author Harry Lando, Ph.D., of the Division of Epidemiology at the University of Minnesota in Minneapolis.
After interviewing 1,477 inpatient smokers, Lando and colleagues offered one of three treatments. Some patients received manuals and resources for smoking cessation, others received manuals plus brief smoking cessation advice from nurses and physicians, and still others received manuals, advice, bedside counseling and several telephone calls from a smoking-cessation counselor after discharge.
The researchers contacted the participants to ask them about their smoking status within a few weeks after discharge and again about a year after discharge. Participants who reported having quit at the 12-month interview were asked to prove it by submitting a saliva sample that was tested for cotinine, a tobacco byproduct.
The researchers then examined whether certain groups of participants (e.g., older vs. younger, men vs. women) were more likely to quit. While certain categories of participants demonstrated higher quit rates than others, the researchers found the hospitalization experience generally benefited most categories of smokers.
â€œThe experience of hospitalization itself led to substantial long-term quitting for virtually all categories of hospitalized smokers,â€ Lando says. The study results are published in the current issue of the journal Nicotine & Tobacco Research.
Those who were the least likely to quit were younger, had not contemplated quitting at the start of the study period and tended to start smoking just after awakening. In contrast, older participants, those who had already started to quit at the beginning of the study, those diagnosed with a smoking-related illnesses, and those who were not likely to smoke first thing in the morning were the most likely to quit.
In the short-term, but not at the 12-month study checkpoint, males had higher quit rates than females, married individuals had higher quit rates than the unmarried, and black participants had lower quit rates than other ethnic groups.
â€œThe lower initial rates of quitting for African-Americans suggest the need for more aggressive promotion of cessation in this population,â€ Lando says, while noting that â€œthe 12-month abstinence rates for African-Americans of 10.4 percent were at least moderately encouraging.â€
The researchers suggest that different smoking cessation approaches may be appropriate for different categories of patients. For example, patients not currently planning to quit, who had the lowest quit rates in the study, may need some extra attention to nudge them to the next stage of quitting readiness. For these pre-contemplators, â€œmotivational interviewing techniques may be particularly appropriate,â€ Lando says.
The researchers say they plan to report the success of the individual treatments in a future study; in this study they focused on the success of the treatments as a whole.