Inpatient to Outpatient Smoking Cessation Program

Smoking continues to be a major cause of morbidity and accounts for 443,000 deaths annually in the United States. Over the past 15 years public awareness and increased research has helped to decrease the overall smoking rate. Despite these efforts 20% of Americans continue to smoke. Smokers are treated in hospitals more often than nonsmokers (Wilkins, Shields, & Rotermann, 2009). Hospitals provide an opportunity to help smokers become more aware of the potentially devastating health effects of their habit. Most hospital based smoking cessation programs do not follow current evidence based recommendations for depth of smoking cessation education and post hospital follow up. Research on the topic of smoking cessation is extensive and demonstrates that inpatient smoking cessation programs are successful. These programs should focus on individualized education and post discharge follow up. Pharmacologic interventions such as nicotine replacement therapy, bupropion and varenicline are beneficial. Highest quit rates are obtained when personalized education, pharmacologic interventions, and post discharge follow up are combined. The Inpatient to Outpatient Smoking Cessation program aimed to help patients at the University of Utah Hospital quit smoking during their inpatient stay and to remain smoke free after discharge. The objectives of the Inpatient to Outpatient Smoking Cessation Program are as follows: to help hospitalized patients become aware of how smoking contributes to their health, create a discharge cessation plan, provide telephone follow up for one month after discharge, review the inpatient smoking cessation literature, and report to the findings of this program to the Evidence Based Nursing Practice Counsel at the University of Utah. Results: Participants (n=20) were inpatients that were at least 19 years of age and had been smoking at least one cigarette per day prior to hospital admission. Patients received individualized smoking cessation education an average of 1.2 times for 10-30 minutes each episode while in the hospital. Nicotine replacement therapy was offered. These patients were then followed through telephone contact for 4 weeks after discharge. At the conclusion of this program 50% of patients were able to remain smoke free throughout the follow up period. An additional 20% were able to reduce their smoking. These results are impressive when compared to other studies of this type. Significant bias and other factors may have influenced these results. Considering these factors future studies with larger cohort size and length of follow up are needed to verify the outcomes described here. The Inpatient to Outpatient Smoking Cessation program was a success and further demonstrates the need for implementation of more aggressive anti-smoking programs in the inpatient setting. These programs should include post discharge follow up. Follow up is an essential part of helping patients to overcome their addiction to nicotine.