Inpatient Tobacco Cessation Counseling and Treatment: A Survey of U.S.-Based Cardiologists

Hospitalization is an ideal time to provide tobacco cessation counseling, but little is known about current practices of inpatient tobacco treatment in the United States.

The objective of the study was to describe the prevailing practices and perceptions regarding inpatient tobacco cessation treatment and counseling among U.S. Cardiologists.

A 27-question survey was developed, pretested, and administered to 498 cardiologists through the American College of Cardiology CardioSurve program.

In total, 122 (24%) participants responded, of which 100 were eligible and completed the survey, achieving our expected response rate. The sample was generally representative of U.S. cardiologists. Cardiologists reported routinely screening for cigarette use (92%) but only a minority (20%) reported routinely referring patients for additional tobacco cessation support. Most cardiologists (74%) reported using the nicotine patch on occasion, but few ever used varenicline (31%) or bupropion (28%). A minority (12%) reported working at a hospital with an inpatient smoking cessation team, but many (41%) expressed interest in championing such a program. Administrative, financial, and time constraints were commonly reported barriers to successful deployment of an inpatient smoking cessation program.

Although tobacco cessation is critical posthospitalization, most hospitals do not have tobacco cessation teams, and most cardiologists do not assist their patients in quit attempts. Although improving knowledge among cardiologists is important, policy changes to incentivize hospital-wide adoption of such programs is crucial to increase availability.