Implementation of a Theory-Driven and Evidence-Based Posthospital Discharge Tobacco Cessation Pilot Program

Background: The association of tobacco use and poor health outcomes is well documented. When tobacco users are hospitalized, some temporarily refrain from tobacco use with the aid of nicotine replacement therapy (NRT). However, most are unable to sustain cessation postdischarge. Objective: Investigate whether smoking cessation rates are higher for patients prescribed NRT compared with patients with no NRT (nNRT), 2 months postdischarge. Methods: Participants aged 19-65 years, who smoked ≥1 cigarette/day, were enrolled. Participants were randomly assigned to receive NRT versus nNRT. The primary outcome was self-reported smoking cessation at 2 months. Secondary outcomes were smoking decline and progression in the Transtheoretical Model (TTM) of change. Results: The 2-month cessation rates in the NRT group were 53.8% compared with 57.1% in the nNRT group, p = .86. The NRT group had a 27.7% decline in tobacco use, compared with 8.33% in the nNRT group. Although at 2 months the findings were not statistically significant, they were clinically significant; both groups demonstrated progress toward positive behavior change. Implications for Nursing: Tobacco users should receive NRT on admission and discharge. Additional follow-up intervention strategies based on the TTM stage should be incorporated as a tool to aid cessation.