Integrating Tobacco Dependence Treatment into Hospital Practice Using the Rochester Model

Area of Science:

• Public Health
• Healthcare Management

Background:

• Delivering evidence-based tobacco dependence treatments in hospitals is challenging due to implementation barriers like limited training, time, and administrative support.
• Effective long-term smoking cessation requires both bedside counseling and post-discharge support.

Purpose of the Study:

• To introduce and evaluate the Rochester Model, a novel tobacco treatment program designed to overcome barriers in hospital settings.
• To utilize existing hospital staff and medical students to deliver comprehensive tobacco dependence treatment.

Main Methods:

• The Rochester Model involves staff nurses, mid-level providers, and physicians delivering counseling during patient admission.
• Nurses conduct bedside counseling, provide quitting advice, encourage pharmacotherapy, and serve as unit champions and post-discharge call counselors.
• Post-discharge calls are managed by a combined team of state quitline counselors and a university call team comprising nurses, respiratory therapists, and medical students.

Main Results:

• A total of 385 smoking patients were enrolled after a proof-of-concept period.
• The 7-day point prevalence quit rates at 6 months were 38% (as treated) and 14% (intent-to-treat).
• The program demonstrated significant quit rates at 4 weeks (50% as treated, 23% intent-to-treat) and 3 months (42% as treated, 16% intent-to-treat).

Conclusions:

• The Rochester Model is a preliminary, effective, and affordable tobacco treatment program.
• The model successfully leverages existing hospital staff, including nurses and medical students, to provide comprehensive care.
• Hospitals with limited resources can implement this tobacco treatment program by utilizing their current workforce.