Screening for smokers in four Sydney teaching hospitals

Cardiovascular disease is a major cause of death and a reason for hospital admissions. The hospital stay is a window of opportunity to assist smokers to quit.

Patients from selected wards in four teaching hospitals in Sydney, Australia were screened using a self-completed general health questionnaire. The questionnaire included questions on demographic variables, tobacco and alcohol consumption, attitudes towards tobacco and alcohol use, and a measure of readiness to charge high-risk lifestyle behaviors, based on that proposed by Prochaska and DiClemente [1].

The total number of screening questionnaires completed was 2,815: 78% men and 22% women. The average age of the sample was 44 years, 48% were married or living in a de facto relationship whilst 35% never married, with the rest widowed, separated or divorced. A total of 877 (31%) patients reported smoking: 33% of men and 24% of women screened. Predictors of smoking were sex, age, marital status, education level and socio-economic status. A significant association was found between excessive drinking and smoking. Among the smoking patients, 157 (18%) planned no change in smoking (precontemplation), 379 (43%) were ambivalent about smoking (contemplation), and 334 (38%) were serious about quitting.

As about one third of patients in hospital are smokers, the hospital is an ideal setting for the delivery of brief interventions by a range of health personnel at the patients bedside. The use of a detection instrument measuring levels of intake and readiness to change tobacco use is described, as a practical method for targeting patients in hospital who are at risk or have already developed cigarette-related diseases, such as cardiovascular disease.