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The Joint Commission Journal on Quality and Patient Safety

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Smoking cessation


Background: Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking—particularly carbon monoxide exposure— to hospital recovery would stimulate more patient interest in the hospital’s cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. Methods: Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the SM (January–April; n = 323) or the TM (April–November; n = 374) were analyzed. Results: Multivariate regression analysis showed that the TM was associated with significantly greater agreement for follow- up (odds ratio [OR] = 10.83, 95% confidence interval [CI] = 3.66–32.04, p < 0.0001) than the SM. Those patients who received the TM were more willing to try to remain abstinent postdischarge (willingness score = 10, p = 0.0052) and engaged in longer consults (consult time > 10 minutes, p = 0.0075) than SM patients. TM patients also self-reported a higher continuous abstinence rate (OR = 2.07, 95% CI = 1.17–3.66, p = 0.0130] at follow-up than SM. Conclusion: Linking risks of continued smoking, particularly carbon monoxide exposure, to hospital patients’ immediate recovery following discharge in a treatment protocol resulted in longer consult times and increased agreement to follow-up compared to the usual protocol message. The TM was integrated into the hospital tobacco cessation intervention as standard of care.


© 2020 The Authors. Published by Elsevier Inc. on behalf of The Joint Commission.

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