Bassett Research Institute, Cooperstown, New York, USA.
J Hosp Med. 2011 Jan;6(1):E1-8. doi: 10.1002/jhm.641. Epub 2010 Aug 17.
Inpatient smoking cessation may increase the success of quitting smoking post-hospital discharge.
Using a quasiexperimental study design, use of cessation methods, mortality, self-reported abstinence, and quit status 6 months post-hospital discharge were measured to assess the effectiveness of an inpatient smoking cessation program. Subjects were interviewed by telephone 6 months post-hospital discharge. Outcomes for patients who were seen by the inpatient smoking cessation counselor were compared to consecutive patients who were not seen by the counselor. Electronic medical records (EMRs) and administrative data were used to construct baseline measures, comorbidity covariates, pharmaceutical use rates during hospitalization, readmission, and mortality outcomes. Multivariate methods included logistic regression and survival analysis.
At baseline, the study groups varied by mean age, length of stay (LOS), comorbidity index, cardiovascular diagnosis, and acuity. At 6 months post-hospital discharge, the intent to treat estimate for point prevalence abstinence was 16% in the intervention group compared to 10% in the comparison group (P = 0.02) while self-reported quit status in the intervention group was 44% vs. 30% in the comparison group (P = 0.00). The intervention group used more nicotine replacement therapy (NRT) than the comparison group both in-hospital and following discharge. Crude post-hospital discharge mortality was significantly less in the intervention group (0.02) than in the comparison group (0.04). A multivariate survival model, controlling for baseline imbalances, showed a significantly reduced mortality in the intervention group (hazard ratio [HR] = 0.37; P = 0.04).
Inpatient smoking cessation programs effectively improve quit outcomes, NRT use, and mortality post-hospital discharge.
住院戒烟可能会增加出院后戒烟的成功率。
采用准实验研究设计，使用戒烟方法、死亡率、自我报告的戒烟率以及出院后 6 个月的戒烟状态来评估住院戒烟计划的效果。在出院后 6 个月通过电话对患者进行访谈。将接受住院戒烟顾问服务的患者的结果与未接受顾问服务的连续患者进行比较。电子病历（EMR）和管理数据用于构建基线指标、合并症协变量、住院期间药物使用率、再入院和死亡率结果。多变量方法包括逻辑回归和生存分析。
在基线时，研究组在平均年龄、住院时间（LOS）、合并症指数、心血管诊断和严重程度方面存在差异。出院后 6 个月，意向治疗估计的点患病率为干预组 16%，对照组 10%（P=0.02），而干预组的自我报告戒烟率为 44%，对照组为 30%（P=0.00）。干预组在住院期间和出院后使用尼古丁替代疗法（NRT）的比例均高于对照组。干预组的出院后死亡率明显低于对照组（0.02 比 0.04）。一个控制基线不平衡的多变量生存模型显示，干预组的死亡率显著降低（风险比[HR]为 0.37；P=0.04）。
住院戒烟计划有效地改善了出院后的戒烟结果、NRT 使用和死亡率。
