Associations between Tobacco Use and Tobacco Cessation Pharmacotherapy on Rehospitalizations

This study aimed to assess the associations of smoking status and prescription of smoking cessation medication on rehospitalizations. Tobacco use remains a major public health issue in the United States as it is linked to a broad spectrum of serious diseases. Although intensive inpatient tobacco treatment programs have shown success, the impact of prescription of smoking cessation medications alone on hospital readmissions has not been studied thoroughly.

We conducted a retrospective cohort study of patients from a primary care clinic hospitalized between July 1, 2013 and December 31, 2020. The primary outcomes of interest were rehospitalization rates by smoking status and by smoking cessation medication prescription among current smokers.

Of the 11,164 patients studied, rehospitalization rates at all time points were higher among current and former smokers compared to never smokers. After adjusting for covariates, former and current smokers had higher odds of rehospitalization within 365 days compared with never smokers (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.03-1.25; OR 1.15, 95% CI 1.01-1.31, respectively). Among current smokers, those prescribed tobacco cessation medications had a lower likelihood of rehospitalization within 365 days after adjusting for confounders (OR 0.75, 95% CI 0.56-0.99).

This study confirms that both current and former smokers are at an increased risk for rehospitalization compared with never smokers. Notably, the prescription of tobacco cessation medications is associated with a decreased risk of rehospitalization among current smokers; however, the low prescription rate of these therapies highlights a significant gap in care. Improved treatment of tobacco use during hospitalizations could lower rehospitalization rates.