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Effectiveness of a smoking cessation program among hospitalized patients in Singapore

Tan Tock Seng Hospital, Singapore, Singapore

PURPOSE: An admission to hospital provides an opportunity to help patients stop smoking. The aim of this study is to determine the effectiveness of a smoking cessation programme among hospitalized patients in a general hospital in Singapore.

METHODS: This is a randomized-controlled trial conducted in a university-affiliated urban hospital. Four hundred smokers hospitalized with primary cardiac and respiratory conditions were enrolled and equivalent number of patients were randomly allocated into treatment and control groups. In addition to routine medical and nursing care, the treatment group received brief verbal advice (lasting about 30 minutes) and standard booklets on smoking cessation from a dedicated nurse counsellor. After hospital discharge, participants received follow-up telephone counselling calls every 2 weeks from the same smoking counsellor. The control group received routine care without the above smoking cessation intervention. The main outcome measure was continuous abstinence at one month after hospital discharge as determined by self-reports and carbon monoxide (CO) breath testing.

RESULTS: There was no significant difference in the following covariates between the 2 groups at baseline: demographics, smoking history, readiness to quit, and medical history. Using intention-to-treat analysis, at one month post-discharge, 67 (33.5%) of the treatment group remained abstinent compared to 49 (24.5%) of controls (P=0.047). The mean number of cigarettes smoked per day was 4.6 and 7.3 among the treatment and control groups respectively (P=0.001). The mean CO reading among treatment and control groups was 3.9 versus 5.1 respectively (P=0.206).

CONCLUSION: The smoking cessation intervention provided for patients during and following hospitalisation resulted in significantly higher rates of continuous abstinence as well as smoking reduction at one month after hospital discharge.

CLINICAL IMPLICATIONS: The inclusion of smoking cessation services as part of routine care during and following hospitalization may help actively smoking patients to attempt and sustain an attempt to quit.

DISCLOSURE: K.C. Ong, None.