A sustained postdischarge smoking cessation intervention was more effective than standard recommendations regarding smoking cessation for hospitalized adults with a desire to quit smoking in the randomized, controlled Hospital-Initiated Assistance for Nicotine Dependence (Helping HAND) trial.
The 198 patients who were assigned to receive sustained care were more likely than the 199 who received standard care to use counseling (37% vs. 23%; relative risk, 1.63) and pharmacotherapy (79% vs. 59%; RR, 1.34) after discharge.
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Sustained care interventions may be the key to helping patients quit smoking.
Those who received sustained care also were more likely to have biochemically validated, 7-day tobacco abstinence at 6 months (26% vs. 15%; RR, 1.71; number needed to treat, 9.4), Dr. Nancy A. Rigotti, who is director of the Tobacco Research and Treatment Center at Massachusetts General Hospital, Boston, and her colleagues reported online Aug. 20 in JAMA.
Patients in the study had a mean age of 53 years. Those assigned to the sustained-care group had an initial inpatient visit and received five supportive, automated, interactive phone calls and their choice of any approved smoking cessation medication or combination of medications for up to 90 days after discharge. The control group received recommendations for postdischarge pharmacotherapy and smoking cessation counseling, the investigators said (JAMA 2014;312:719-28).
"These findings, if replicated, suggest a translatable, low-cost approach to achieving sustained smoking cessation after a hospital stay," they concluded.
This study was supported by the National Heart, Lung, and Blood Institute and the Department of Veterans Affairs, and is part of the Consortium of Hospitals Advancing Research on Tobacco initiative, which is jointly sponsored by the National Cancer Institute, the NHLBI, and other federal agencies. Dr. Rigotti was an unpaid consultant for Pfizer and Alere Wellbeing regarding smoking cessation, received royalties from UpToDate for reviews on smoking cessation, and received travel reimbursement from Pfizer. Several coauthors were paid consultants for or received grants from Pfizer, and one coauthor was a paid consultant on tobacco policy for CVS.