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

Area of Science:

• Public Health
• Clinical Trials
• Behavioral Health

Background:

• Smoking rates are significantly higher in individuals with behavioral health conditions (BHC), ranging from 30-65% compared to the general population.
• Hospital-based tobacco treatment is effective for smoking cessation, yet its efficacy for inpatients with BHC remains understudied.

Purpose of the Study:

• To compare the effectiveness of hospital-initiated tobacco treatment for smoking cessation in patients with BHC versus those without BHC.
• To analyze pooled data from multiple clinical trials to assess quit rates and treatment engagement.

Main Methods:

• Retrospective analysis of data from five hospital-based smoking cessation randomized clinical trials (2011-2016).
• Propensity score matching was used to pair patients with BHC (n=798) with similar patients without BHC from a larger cohort (n=6612).
• Logistic regression analyzed 30-day self-reported smoking abstinence at 6 months post-discharge.

Main Results:

• No significant difference was observed in the uptake of tobacco medications between patients with and without BHC (29.3% vs. 31.5%).
• Patients with BHC were less likely to achieve 6-month abstinence, with odds 30% lower than those without BHC (OR=0.70, p=0.01).
• Nearly 1 in 5 patients with BHC reported abstinence at 6 months.

Conclusions:

• Hospitalized patients with BHC are receptive to tobacco treatment interventions.
• Despite similar engagement, individuals with BHC experience lower long-term smoking abstinence rates post-hospitalization.
• Hospitals represent a viable setting for delivering tobacco treatment to inpatients with BHC, but tailored approaches are needed to improve sustained cessation outcomes.