Smoking Cessation in Hospitalized Smokers
- Conditions
- Smoking Cessation
- Interventions
- Registration Number
- NCT01289275
- Lead Sponsor
- University of California, San Diego
- Brief Summary
When smokers are hospitalized they quit smoking, either voluntarily or involuntarily. Most of them, however, go back to smoking soon after discharge. This study will test an innovative approach which includes dispensing nicotine patches at discharge, providing proactive telephone counseling post discharge, or giving a combination of the two. The interventions are aimed at increasing the long term quit rate of these patients.
The specific aims of the study are to demonstrate the effects of two interventions, dispensing nicotine patches at discharge and providing proactive telephone counseling soon after discharge, on 12-month quit rates of hospitalized smokers in a 2 x 2 factorial design.
- Detailed Description
Most smokers in the U.S. actually do quit smoking when hospitalized, either voluntarily or involuntarily because of hospital's nonsmoking policy. However, the majority of them return to smoking soon after their discharge from the hospital. A hospital stay, therefore, is a "teachable moment" for these patients, a good opportunity to encourage them to lead a smoke-free life after they are discharged. Research, however, has found that brief counseling provided to smokers while they are hospitalized has limited effect. The scientific data clearly show that smokers should be identified at the hospital, provided counseling, and given intensive interventions with follow up extended to 1 month post discharge. Providing such clinical services to these patients will reduce their chance of relapse to smoking and the rate of re-hospitalization. In practice though, hospitals have had difficulty providing even basic bedside counseling with a subgroup of patients, not to mention a much longer follow up post-discharge with all patients.
The proposed study aims to demonstrate that state quitlines can help bridge the gap between the recommendations from existing scientific data and the current practice by hospitals. Quitlines deliver counseling services by telephone. This is convenient for patients because they do not have to go anywhere in order to receive the counseling. Moreover, telephone counseling can be delivered proactively by the counselor.
The potential impact of this study is that if this model is proven effective in a rigorous study design, then it is likely that state quitlines across the U.S. will adopt it and start working with hospitals that are interested in using such as system. If the new JCAHO requirements get adopted, there will be a strong incentive for the hospitals to work with partners like the quitlines that can help provide follow up counseling.
With the proposed project the investigators intend to establish a practical model that lends itself to broader dissemination, while testing the effectiveness of the interventions with the rigor of a randomized design.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1270
- 18 years or older
- Smoke >=6 Cigarettes per day
- English or Spanish speaking
- Valid phone number
- Valid address
- Gave consent to participate in study and evaluation
- Hospital stay of less than 24 hours
- Inability to communicate orally
- Hypersensitivity to nicotine
- Pregnant
- Hospitalized for psychiatric treatment
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Telephone Counseling + Patches Nicotine Patches 5 proactive sessions, 8 weeks patches Telephone Counseling Brief Hospital Counseling Up to 5 proactive counseling sessions Telephone Counseling + Patches Brief Hospital Counseling 5 proactive sessions, 8 weeks patches Telephone Counseling + Patches Telephone Counseling 5 proactive sessions, 8 weeks patches Brief hospital counseling Brief Hospital Counseling brief in hospital counseling, no proactive sessions or patches Telephone Counseling Telephone Counseling Up to 5 proactive counseling sessions Nicotine Patches Nicotine Patches 8 weeks of nicotine patches Nicotine Patches Brief Hospital Counseling 8 weeks of nicotine patches
- Primary Outcome Measures
Name Time Method Percentage of Participants With 30-day Abstinence 6-months post enrollment All participants will receive an assessment Interview 6-months after their initial contact with the Helpline. The interview will cover, as appropriate, tobacco use, use of quitting aids, pattern of quitting (including slips and relapse situations), and satisfaction with the services. The interview will be conducted over the telephone. Intention to treat analysis.
- Secondary Outcome Measures
Name Time Method Self-reported Re-hospitalization 6-months post enrollment 30-day Abstinence 2-months post enrollment All participants will receive an assessment Interview 2-months after their initial contact with the Helpline. The interview will cover, as appropriate, tobacco use, use of quitting aids, pattern of quitting (including slips and relapse situations), and satisfaction with the services. The interview will be conducted over the telephone.
Percentage of Smokers Making a 24-hour Quit Attempt 6-months post enrollment
Trial Locations
- Locations (6)
Univeristy of California, Davis
🇺🇸Davis, California, United States
UCSD Medical Center - Hillcrest
🇺🇸San Diego, California, United States
UCSD - Thornton Hospital
🇺🇸La Jolla, California, United States
Scripps Mercy - Chula Vista
🇺🇸Chula Vista, California, United States
University of California, San Diego: California Smokers' Helpline
🇺🇸San Diego, California, United States
Scripps Mercy - San Diego Campus
🇺🇸San Diego, California, United States