Factors associated with changes in inpatients’ smoking pattern during hospitalization and one month after discharge: A cohort study

Introduction Smokers are frequent users of healthcare services. Admissions to hospital can serve as a “teachable moment” for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatient...

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Published in:Journal of nursing scholarship 2022-05, Vol.54 (3), p.332-344
Main Authors: Feliu, Ariadna, Ravara, Sofia, Papadakis, Sophia, Enriquez, Marta, Antón, Laura, Saura, Judith, Company, Assumpta, Romero, Olga, Ripoll, Ruth, Ruz, Angels, Precioso, José, Pascoal, Ivone, Videira, Lídia, Correia, Claudia, Ferreira, Soraia, Fernández, Esteve, Martínez, Cristina
Format: Article
Language:English
Subjects:
5As model
Abstinence
Brief interventions
Change agents
Chi-square test
Cigarettes
Clinical practice guidelines
Cohort analysis
Emergency medical care
Europe
Health behavior
Health care
Hospitalization
Hospitals
Intervention
Patients
Questionnaires
Smoking cessation
Sociodemographics
Surgical wards
Tobacco
Women
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Summary:Introduction Smokers are frequent users of healthcare services. Admissions to hospital can serve as a “teachable moment” for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. Objectives The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. Methods A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25‐item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi‐square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. Results Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical‐surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). Conclusions Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence‐based tobacco cessation programs at the organizational‐level, including post‐discharge active quitting smoking support. Clinical relevance Three‐quarters of the inpatients who smoke remain abstinent during hosp
ISSN:1527-6546
1547-5069
DOI:10.1111/jnu.12735