Narotam Sekhsaria Foundation, Mumbai, India.
Division of General Internal Medicine, University of Colorado, Denver, Colorado, United States of America.
PLoS One. 2024 Nov 12;19(11):e0312319. doi: 10.1371/journal.pone.0312319. eCollection 2024.
Hospitalization provides a key opportunity to address tobacco use. Few studies have examined cessation treatment in hospitals in low- and middle-income countries (LMIC). We aimed to measure tobacco abstinence among individuals discharged from a Mumbai hospital after the implementation of cessation counseling compared to abstinence among those discharged pre-implementation.
Pre-post intervention study in the Prince Aly Khan Hospital, Mumbai pre- (11/2015-10/2016) and post-implementation (02/2018-02/2020) of LifeFirst counseling. LifeFirst is multi-session (up to six sessions) counseling extending from hospitalization up to six months post-discharge. Primary analyses compare self-reported 6-month continuous abstinence among hospitalized individuals post-implementation (intervention) with pre-implementation (comparator) using an intent-to-treat approach that includes all participants offered LifeFirst post-implementation in the intervention group. Secondary analyses compare those who received ≥ 1 LifeFirst session with the pre-implementation group.
We enrolled n = 437 individuals pre-implementation (8.7% dual use, 57.7% smokeless tobacco, 33.6% smoking) and n = 561 post-implementation (8.6% dual use, 64.3% smokeless tobacco, 27.1% smoking). Post-implementation, 490 patients (87.3%) accepted ≥ 1 counseling session. Continuous abstinence 6-months post-discharge was higher post-implementation (post: 41.6% vs. pre: 20.0%; adjusted odds ratio [aOR]: 2.86, 95% confidence interval [CI] 1.94-4.21). Those who received LifeFirst had higher odds of continuous abstinence compared to pre-implementation (aOR: 2.95, 95% CI 1.98-4.40).
Post-discharge abstinence was more common after implementation of a multi-session tobacco counseling program for hospitalized patients compared to abstinence among patients hospitalized before implementation. These findings represent observational evidence of a promising association between post-discharge abstinence and a hospital-based tobacco cessation program implemented within routine practice in an LMIC setting.
住院为解决烟草使用问题提供了一个关键机会。很少有研究调查过中低收入国家（LMIC）医院的戒烟治疗。我们旨在测量孟买一家医院实施戒烟咨询后出院的个人的戒烟率，与实施前出院的个人相比。
在孟买的王子艾利克汗医院进行的前后干预研究，在 LifeFirst 咨询实施前（2015 年 11 月至 2016 年 10 月）和实施后（2018 年 2 月至 2020 年 2 月）。LifeFirst 是一种多疗程（最多六疗程）的咨询，从住院到出院后六个月。主要分析采用意向治疗方法，比较实施后（干预组）住院个体的 6 个月持续戒烟率与实施前（对照组）的比较，该方法包括实施后在干预组中接受 LifeFirst 的所有参与者。次要分析比较接受≥1 次 LifeFirst 咨询的人与实施前组的比较。
我们纳入了 n = 437 名实施前的个体（8.7%双重使用，57.7%无烟烟草，33.6%吸烟）和 n = 561 名实施后的个体（8.6%双重使用，64.3%无烟烟草，27.1%吸烟）。实施后，490 名患者（87.3%）接受了≥1 次咨询。出院后 6 个月的持续戒烟率更高（后：41.6%，前：20.0%；调整后的优势比[aOR]：2.86，95%置信区间[CI] 1.94-4.21）。与实施前相比，接受 LifeFirst 的患者有更高的持续戒烟几率（aOR：2.95，95% CI 1.98-4.40）。
与实施前相比，在住院患者中实施多疗程烟草咨询计划后，出院后的戒烟率更高。这些发现代表了在中低收入国家环境中，在常规实践中实施的基于医院的戒烟计划与出院后戒烟之间存在有希望的关联的观察性证据。
