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Hospital-Initiated Smoking Cessation Among Patients Admitted with Behavioral Health Conditions

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Abstract

Background

Smoking rates among people living with behavioral health conditions (BHC) range from 30 to 65% and are 2–4 times higher than rates found in the general population. Starting tobacco treatment during a hospital stay is effective for smoking cessation, but little is known regarding treatment response among inpatients with BHC.

Objective

This study pooled data across multiple clinical trials to determine the relative success in quitting among participants with BHC compared to other study participants.

Participants

Adults who smoke (≥ 18 years old) from five hospital-based smoking cessation randomized clinical trials.

Design

A retrospective analysis using data from the electronic health record to identify participants with primary diagnoses related to BHC. Recruitment and data analysis were conducted from 2011 to 2016. We used propensity score matching to pair patients with BHC to those with similar characteristics and logistic regression to determine differences between groups.

Measures

The main outcome was self-reported 30-day abstinence 6 months post-discharge.

Results

Of 6612 participants, 798 patients had a BHC-related primary diagnosis. The matched sample included 642 pairs. Nearly 1 in 3 reported using tobacco medications after hospitalization, with no significant difference between patients with and without BHC (29.3% vs. 31.5%; OR (95% CI) = 0.90 (0.71, 1.14), p = 0.40). Nearly 1 in 5 patients with BHC reported abstinence at 6 months; however, their odds of abstinence were 30% lower than among people without BHC (OR (95% CI) = 0.70 (0.53,0.92), p = 0.01).

Conclusion

When offered tobacco treatment, hospitalized patients with BHC were as likely as people without BHC to accept and engage in treatment. However, patients with BHC were less likely to report abstinence compared to those without BHC. Hospitals are a feasible and promising venue for tobacco treatment among inpatients with BHC. More studies are needed to identify treatment approaches that help people with BHC achieve long-term abstinence.

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Acknowledgements

This study is part of the Consortium of Hospitals Advancing Research on Tobacco (CHART) initiative, jointly sponsored by the National Heart, Lung, and Blood Institute (NHLBI), National Cancer Institute (NCI), National Institute on Drug Abuse (NIDA) and the Office of Behavioral and Social Sciences (OBSSR) (U01 HL105232, PI: Kimber Richter, Ph.D., RC1HL099668, PI: Nancy Rigotti, Ph.D., U01HL105229, PI: Scott Sherman, MD, U01CA159533, PI: Shu-Hong Zhu, Ph.D., and U01DA031515, PI: Kathleen Harrington, MD). We acknowledge the work of all of our CHART colleagues who have contributed to the CHART initiative.

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Authors and Affiliations

  1. Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA

    Erica Cruvinel PhD, Laura Mussulman MA, Taneisha Scheuermann PhD & Kimber Richter PhD

  2. Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA

    Elena Shergina MS & Jianghua He PhD

  3. Department of Population Health, New York University School of Medicine, New York, NY, USA

    Scott Sherman MD

  4. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Kathleen Harrington PhD

  5. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Nancy A. Rigotti PhD

  6. Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA

    Hilary Tindle PhD

  7. Department of Family Medicine and Public Health, University of California, San Diego, CA, USA

    Shu-Hong Zhu PhD

Authors
  1. Erica Cruvinel PhD
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  2. Laura Mussulman MA
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  3. Taneisha Scheuermann PhD
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  4. Elena Shergina MS
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  6. Scott Sherman MD
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  7. Kathleen Harrington PhD
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  8. Nancy A. Rigotti PhD
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  11. Kimber Richter PhD
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Correspondence to Erica Cruvinel PhD.

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Appendix

Appendix

Table 5 Distribution of Behavioral Health Conditions (BHC) Among Patients with Primary Diagnosis of BHC (N = 798)
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Cruvinel, E., Mussulman, L., Scheuermann, T. et al. Hospital-Initiated Smoking Cessation Among Patients Admitted with Behavioral Health Conditions. J GEN INTERN MED (2024). https://doi.org/10.1007/s11606-024-08646-5

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