Wednesday, 20 August 2014

Hospital Discharge a Key Time to Help Smokers Quit

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New study finds that follow-up monitoring and care is crucial


WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

TUESDAY, Aug. 19, 2014 (HealthDay News) -- The weeks after a hospital discharge may be a great time to help smokers quit the habit, and one study suggests a particular program might help.

The program involved giving patients free quit-smoking drugs. It also included automated phone calls that helped them manage their medications, encouraged their efforts to quit and tracked whether they might need more anti-smoking counseling.

The study suggests that hospitalization -- a time when smoking isn't allowed -- "can be used as an opportunity for a lasting intervention for healthier living," said Dr. Peter Spiegler, director of the medical intensive care unit at Winthrop-University Hospital in Mineola, N.Y. He was not involved in the new research.

The study included almost 400 patients and was led by Dr. Nancy Rigotti, of Massachusetts General Hospital in Boston. Patients averaged 53 years of age, and all said that they wanted to quit smoking after they left the hospital.

About half of the patients were enrolled in the specialized quit-smoking program, while the rest were simply discharged from the hospital.

After six months, 26 percent of patients in the program had quit smoking, compared with only 15 percent of those in the standard care group, according to the study published in the Aug. 20 issue of the Journal of the American Medical Association.

The study also boosted by 71 percent the number of patients with confirmed tobacco abstinence for at least six months after discharge from the hospital -- "a standard measure of long-term smoking cessation," the researchers said in a journal news release.

They added that the "intervention appeared to be effective across a broad range of smokers and provided high-value care at a relatively low cost."

Spiegler noted that "hospital admission offers an opportunity for patients to try to stop smoking -- they are in the hospital with an acute illness and many times, it can be directly or indirectly linked to smoking. They no longer have accessibility to tobacco products and treatment for nicotine withdrawal can begin."

Another expert agreed, calling hospitalization a potential "teachable moment" for smokers.

"While hospitalized, patients who smoke are provided the chance to reflect on the strong association between smoking and the reasons for which they were hospitalized," added Patricia Folan, a nurse and director of the Center for Tobacco Control at North Shore LIJ in Great Neck, N.Y.

This type of reflection, "can often lead to an increase in motivation and intent to quit smoking," she said, but "unfortunately, when patients are released from the hospital and return to their usual routine and freedom, a majority of them will return to smoking."

"Considering the overwhelming negative health consequences and the economic cost of tobacco use," post-discharge quit-smoking efforts "will help decrease smoking rates and reduce the death, disease, and disability associated with continued smoking," Folan said. "In addition, quitting smoking after discharge may lead to fewer readmissions, which are costly for hospitals as well as for patients."



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