Introduction
This study determined the effectiveness of the Tobacco Tactics intervention.
Design/setting/participants
This was a pragmatic, quasi-experimental study conducted from 2010 to 2013 and analyzed
from 2014 to 2015 in five Michigan community hospitals; three received the Tobacco
Tactics intervention, and two received usual care. Smokers (N=1,528) were identified
during hospitalization, and sent surveys and cotinine tests after 6 months. Changes
in pre- to post-intervention quit rates in the intervention sites were compared with
usual care control sites.
Intervention
The toolkit for nurses included: (1) 1 continuing education unit contact hour for
training; (2) a PowerPoint presentation on behavioral and pharmaceutical interventions;
(3) a pocket card entitled “Helping Smokers Quit: A Guide for Clinicians”; (4) behavioral
and pharmaceutical protocols; and (5) a computerized template for documentation. The
toolkit for patients included: (1) a brochure; (2) a cessation DVD; (3) the Tobacco
Tactics manual; (4) a 1-800-QUIT-NOW card; (5) nurse behavioral counseling and pharmaceuticals;
(6) physician reminders to offer brief advice to quit coupled with medication sign-off;
and (7) follow-up phone calls by trained hospital volunteers.
Main outcome measures
The effectiveness of the intervention was measured by 6-month 30-day point prevalence;
self-reported quit rates with NicAlert® urinary biochemical verification (48-hour detection period); and the use of electronic
medical record data among non-responders.
Results
There were significant improvements in pre- to post-intervention self-reported quit
rates (5.7% vs 16.5%, p<0.001) and cotinine-verified quit rates (4.3% vs 8.0%, p<0.05) in the intervention sites compared with no change in the control sites. Propensity-adjusted
multivariable analyses showed a significant improvement in self-reported 6-month quit
rates from the pre- to post-intervention time periods in the intervention sites compared
to the control sites (p=0.044) and a non–statistically significant improvement in the cotinine-verified 6-month
quit rate.
Conclusions
The Tobacco Tactics intervention, which meets the Joint Commission standards for inpatient
smoking, has the potential to significantly decrease smoking among inpatient smokers.
Trial Registration
This study is registered at www.clinicaltrial.gov NCT01309217.
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Article Info
Footnotes
This article is part of a theme section titled Implementing Tobacco Cessation Interventions for Hospitalized Smokers
Identification
Copyright
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine
