Integrating smoking cessation into routine care in hospitals-a randomized controlled trial

Aims To evaluate the effectiveness of a pharmacist‐led multi‐component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. Design Randomized, assessor‐blinded, parallel‐group trial. Setting Three tertiary public hospitals in Australia. Participants A tota...

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Published in:	Addiction (Abingdon, England) England), 2016-04, Vol.111 (4), p.714-723
Main Authors:	Thomas, D., Abramson, M. J., Bonevski, B., Taylor, S., Poole, S. G., Paul, E., Weeks, G. R., Dooley, M. J., George, J.
Format:	Article
Language:	eng
Subjects:	Australia Clinical trials Counseling Follow-Up Studies Health Promotion - methods Hospitals Hospitals, Public Humans Inpatients Pharmacists Program Evaluation randomized controlled trial Single-Blind Method Smoking cessation Smoking Cessation - statistics & numerical data Tertiary Care Centers Tobacco Use Cessation Products Tobacco Use Disorder - drug therapy Tobacco Use Disorder - therapy Treatment Outcome
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Summary:	Aims To evaluate the effectiveness of a pharmacist‐led multi‐component smoking cessation programme (GIVE UP FOR GOOD) compared with usual care in hospitalized smokers. Design Randomized, assessor‐blinded, parallel‐group trial. Setting Three tertiary public hospitals in Australia. Participants A total of 600 adult in‐patient smokers [mean ± standard deviation (SD), age 51 ± 14 years; 64% male] available for 12 months follow‐up. Interventions Multi‐component hospital pharmacist‐led behavioural counselling and/or pharmacotherapy provided during hospital stay, on discharge and 1 month post‐discharge, with further support involving community health professionals (n = 300). Usual care comprised routine care provided by hospitals (n = 300). Measurements Two primary end‐points were tested using intention‐to‐treat analysis: carbon monoxide (CO)‐validated 1‐month sustained abstinence at 6‐month follow‐up and verified 6‐month sustained abstinence at 12‐month follow‐up. Smoking status and pharmacotherapy usage were assessed at baseline, discharge, 1, 6 and 12 months. Findings Sustained abstinence rates for intervention and control groups were not significantly different at both 6 months [11.6% (34 of 294) versus 12.6% (37 of 294); odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.55–1.50] and 12 months [11.6% (34 of 292) versus 11.2% (33 of 294); OR = 1.04, 95% CI = 0.63–1.73]. Secondary end‐points, self‐reported continuous abstinence at 6 and 12 months, also agreed with the primary end‐points. Use of pharmacotherapy was higher in the intervention group, both during hospital stay [52.3% (157 of 300) versus 42.7% (128 of 300); P = 0.016] and after discharge [59.6% (174 of 292) versus 43.5% (128 of 294); P
ISSN:	0965-2140 1360-0443