To determine whether a smoking cessation intervention of moderate intensity consisting of education and psychological support, with or without pharmacological therapy, associated with follow-up phone calls would increase the smoking cessation rate at 1-year follow-up in hospitalized smokers aged ≤ 70.
This randomized trial comparing a smoking cessation intervention to usual care took place at Laval Hospital, the Quebec Heart and Lung Institute. The intervention included: (1) a strong quit smoking message from the treating physician; (2) self-help motivational quitting or relapse prevention materials; (3) brief cessation counseling; (4) the use of nicotine replacement therapy when indicated; and (5) follow-up support. Patients in the usual care group were not given any specific instructions on how to stop smoking. Self-reported abstinence from smoking was recorded and validated by urinary cotinine measurement. The primary outcome was cessation rate at 1-year follow-up.
468 patients were screened; 196 were randomized. We found no difference in smoking cessation rates at 12-month follow-up (intervention: 30%; control: 28%; number needed to treat: 41; lower bound of the 95% confidence interval: 13). Similar results were obtained from patients whose smoking status was validated at 12-month follow-up by urinary cotinine measurement (intervention: 33%; control: 35%). In logistic regression analyses, length of stay and dependence to nicotine were the only significant predictors of smoking cessation at 12-month follow-up.
A smoking cessation intervention of moderate intensity delivered in a tertiary cardio-pulmonary centre did not increase the smoking cessation rate at 1-year follow-up.
The effect of a smoking cessation intervention of higher intensity should be investigated. Recent studies suggest that enhanced follow-up after hospital discharge is a key element of a successful smoking cessation program.
Yves Lacasse, None.