Although counseling of inpatient smokers is a hospital quality measure, few hospitals assess preparedness of smokers to quit, an important predictor of future quit behaviors. This study aimed to assess the preparedness of hospitalized smokers to quit and its effect on future quit behaviors.
All cardiac inpatients at a single hospital who had given consent were asked questions from the National Health Interview Survey in order to identify lifetime (current and former) smokers. Current smokers were then asked to rate preparedness to quit using the 10‐step Contemplation Ladder, a tool validated in outpatients. A response of 6 (“I definitely plan to quit smoking in the next 6 months”) or higher identifies patients prepared to quit (ie, engaging in quit behaviors). Thirty‐day postdischarge phone interviews were used to assess patients' smoking status, recall of in‐hospital advice, and any quit attempts (ie, cold turkey, nicotine replacement, formal programs). Chi‐square tests were used to assess the effect of preparedness (Ladder score ≥ 6) on quit attempts, recall of advice, and self‐reported abstinence at follow‐up. The effect of advice on quit attempts and self‐reported abstinence was also examined. Statistical significance was defined as P < .05.
From February 2006 to November 2006, 75% of the cardiac inpatients (1766/2364) were interviewed. Of these patients, 59% (1038/1766) were lifetime smokers, 25% of whom (255/1038) were current smokers. Although 76% of these patients were prepared to quit, fewer than 33% of all smokers were at any given step on the Ladder. Of the 60% of current smokers who completed the follow‐up interview (150/255), 59 (41%) stated that they were still not smoking. A smaller but not statistically significant proportion of prepared patients (Ladder score ≥ 6) were still smoking at follow‐up (64 [57%] prepared vs. 21 [67%] not prepared, P = .27). However, prepared patients were significantly more likely to make a quit attempt after discharge (47 [58%] prepared vs. 6 [25%] not prepared, P = .004). The most frequently reported quit attempt was “cold turkey or on their own” [81% (43/53)], whereas use of more successful methods (ie, formal programs, groups, or pharmacologic therapy) was much lower (30% [16/53]). There was no relationship between preparedness and recall of advice (56 [70%] prepared vs. 19 [79%] not prepared, P = .380). Interestingly, patients who were not smoking at follow‐up were more likely to recall receiving advice (18 [23%] not still smoking vs. 2 [7%] still smoking, P = .049).
Many smoking inpatients are prepared to quit. Although these patients are more likely to make a quit attempt, most are using the least effective method, cold turkey. These findings suggests that although hospitalization provides a natural opportunity to intervene, smokers may require rigorous programs tailored to their level of preparedness.
L. M. Shah, None.
To cite this abstract:Shah L. Preparedness of Hospitalized Patients to Quit Smoking. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 58. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/preparedness-of-hospitalized-patients-to-quit-smoking/. Accessed November 19, 2019.