Association Between Unplanned 30-Day Hospital Readmission, Smoking Status, and Exposure to an Inpatient Tobacco...

Studies show that cigarette smoking increases the risk of unplanned hospital readmissions with some evidence that delivery of smoking cessation treatments to patients during hospitalization can reduce readmissions. In this article, we report the results of an observational cohort study that explored the association between smoking status at the time of admission and 30-day unplanned hospital readmissions as well as the moderating effects of exposure to an inpatient tobacco treatment program (TTP).

Data for the study come from: electronic health records, TTP data, and statewide healthcare utilization data. The association between smoking status and 30-day unplanned readmissions is examined in 44,669 adult patients admitted to five hospitals in South Carolina. Propensity score balancing and logistic regression were utilized to adjust for a wide range of covariates. The moderating effects of exposure to an inpatient TTP were assessed in 4,041 patients who were classified as exposed to different levels of the service (i.e., high, medium, any exposure, and none).

Patients who currently or formerly smoked cigarettes had a higher odds of 30-day unplanned readmission compared to never smokers after adjustment for covariates (current smoker vs. never OR = 1.22; 95% CI = 1.12% to 1.32%; former smoker vs. never OR = 1.13; 95% CI = 1.05% to 1.22%). Patients exposed to the TTP had lower odds of having an unplanned readmission compared to no exposure, but none of the differences were statistically significant at the p < .05 level.

Current and past cigarette smoking is a risk factor for unplanned hospital readmissions.

Current and past cigarette smoking is a risk factor for 30-day unplanned hospital readmissions even after adjustment for a diverse set of patient characteristics and clinical variables. The moderating impact of exposure to different elements of the tobacco treatment services (i.e., bedside consult and post-discharge calls) on 30-day unplanned readmissions was in the predicted direction, showing lower rates of unplanned readmissions, but was not statistically different from the no exposure comparison condition.