Changes in smoking associated with hospitalization: quit rates, predictive variables, and intervention implications

Hospitalization can provide one of the most opportune times to prompt smoking cessation. This study determined the frequency of various smoking cessation related behaviors occurring during and following hospitalization and identified variables associated with these outcomes.

A sample of 526 HMO members who smoked prior to hospitalization and were hospitalized for nonpregnancy related, nonterminal conditions were surveyed to assess the natural history of smoking cessation associated with hospitalization.

Three events were studied: not smoking while hospitalized (51% of subjects), attempting to quit following hospitalization (37%), and smoking status one year after hospitalization (16% abstinent). Similar factors were associated with not smoking in the hospital and quit attempts: older persons and patients with circulatory/respiratory diagnoses were only half as likely to smoke in the hospital as other patients and twice as likely to try to quit. Different variables predicted smoking status at follow-up: heavier smokers were significantly more likely to stop (26% cessation) than light or moderate smokers (10% and 11% cessation, respectively).

The hospital may be an effective setting for smoking cessation programs, especially those aimed at heavy smokers. Research is needed to determine whether smokefree hospital policies alter smoking rates following hospitalization.