Clinical pharmacist’s role in implementing a smoking cessation intervention in a Swiss regional hospital: an exploratory study
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Background Smoking cessation represents one of the best means of preventing smoking-related complications. In recent years, a majority of hospitals have implemented smoke-free policies, making support for smoker patients a necessary and indispensable task. The clinical pharmacist is well-positioned to provide this kind of support, given a good understanding of the medical condition and pharmacotherapy of hospitalized patients and the possibility to acquire specific smoking cessation training. Objectives This study aimed to evaluate the impact of a smoking cessation intervention for hospitalized patients by a clinical pharmacist previously trained for smoking cessation counselling. Setting Internal medicine department of a Swiss regional hospital. Method Smoker patients hospitalized in this department were included in the study from mid-September 2012 to mid-January 2013, according to the inclusion criteria. Moderate-intensity smoking cessation interventions based on smoking counselling and motivational interviewing techniques were used, and a follow-up telephone call at least 1 month after discharge was made. Patients’ pharmacotherapy was analysed with regards to interactions with tobacco smoke. Main outcome measures Motivational stage, abstinence at follow-up, change of readiness to quit between hospital visit and follow-up, patients’ evaluation of the programme, pharmacotherapy interventions. Results One hundred smoker patients were screened, of whom 41 received the intervention and 40 received a follow-up contact. At least 1 month after discharge, the readiness to quit of 53 % of patients improved and 33 % of patients declared themselves abstinent. Even though 35 % of patients declared having mild to moderate withdrawal symptoms in hospital, only 15 % were interested in receiving nicotine replacement therapy. Study participants evaluated the intervention positively. Conclusion A moderate-intensity smoking cessation intervention in hospitalized patients was associated with a higher quit rate than in control groups from other studies, and their readiness to quit generally improved at least 1 month after hospital discharge. A clinical pharmacist trained for smoking cessation counselling can play a key role in providing such interventions, including the assessment of pharmacotherapy interactions with tobacco smoke.
KeywordsClinical pharmacy Drug interactions Hospital Smoking cessation Switzerland Tobacco smoke
The authors are grateful to the medical teams from the internal medicine department for their collaboration, and to the patients participating to this study. The authors are thankful to Prof. Jacques Cornuz and Dr Isabelle Jacot Sadowski for providing us with the documents relative to the University Hospital of Lausanne’s smoking cessation counselling service.
This study was funded by internal funds of the central Pharmacy, as salary for the clinical pharmacist performing the study.
Conflicts of interests
The authors declare no conflicts of interest.
- 1.The health benefits of smoking cessation. U.S. Department of Health and Human Services. Public Health Service. Centers for Disease Control. Center for Chronic Disease Prevention and Health Promotion. Office on Smoking and Health. DHHS Publication No. (CDC) YO-K-116. 1990. http://www.surgeongeneral.gov/library/reports. Accessed 7 Oct 2013.
- 2.World Health Organization (WHO) report on the global tobacco epidemic, 2013 -Enforcing bans on tobacco advertising, promotion and sponsorship. World Health Organization 2013. ISBN 9789240691612 (ePub). http://www.who.int/tobacco/global_report/2013/en/index.html. Accessed 25 Sept 2013.
- 4.Rigotti NA, Clair C, Munafò MR, Stead LF. Interventions for smoking cessation in hospitalized patients. Cochrane Database Syst Rev. 2012; Issue 5. Art. No: CD001837.Google Scholar
- 7.Reid RD, Mullen K-A, D’Angelo MES, Aitken DA, Papadakis S. Smoking cessation for hospitalized smokers: an evaluation of the “Ottawa Model”. Nicot Tob Res. 2010;12(1):11–8.Google Scholar
- 11.Department of clinical pharmacology and toxicology, University Hospital of Geneva. Drug interactions and cytochrome P450 [Service de pharmacologie et toxicologie clinique, Hôpitaux Universitaires Genève. Interactions médicamenteuses et cytochrome P450]. http://pharmacoclin.hug-ge.ch/_library/pdf/cytp450pgp.pdf. Accessed 30 June 2013.
- 13.Fiore MC. Treating tobacco use and dependence: 2008 update U.S. Public Health Service. Clinical practice guideline executive summary. Respir Care. 2008;53(9):1217–22.Google Scholar
- 18.Stop-tabac.ch [Internet]. University of Geneva, Institute of Social and Preventive Medicine [Université de Genève, Institut de médecine sociale et préventive]. http://www.stop-tabac.ch. Accessed 25 Sept 2013.
- 24.Keller R, Radtke T, Krebs H, Hornung R. Tobacco consumption in the Swiss population between 2001 and 2010. Tobacco monitoring – Swiss Tobacco Survey. Summary of the 2011 research report [La consommation de tabac dans la population suisse de 2001 à 2010. Monitorage sur le tabac – Enquête suisse sur le tabagisme. Résumé du rapport de recherche 2011]. http://www.tabakmonitoring.ch/ResultatsConsommation.html. Accessed 25 Sept 2013.