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J Hosp Med. 2018 Nov 1;13(11):774-778. doi: 10.12788/jhm.2997. Epub 2018 Aug 29.

Smoking Cessation After Hospital Discharge: Factors Associated With Abstinence.

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Department of Psychological Science, Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont, USA.
Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Mongan Institute Health Policy Center, Massachusetts General Hospital and Partners HealthCare, Boston, Massachusetts, USA.
School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.


Hospitalization offers tobacco smokers an opportunity to quit smoking, but factors associated with abstinence from tobacco after hospital discharge are poorly understood. We analyzed data from a multisite, randomized controlled trial testin a smoking cessation intervention for 1,357 hospitalized cigaretts smokers who planned to quit. Using multiple logistic regression, we assessed factors identifiable in the hospital that were independently associated with biochemically confirmed tobacco abstinence 6 months after discharge. Biochemically confirmed abstinence at 6 months (n = 218, 16%) was associated with a smoking-related primary discharge diagnosis (Adjusted Odds Ratio [AOR] = 1.98, 95% CI: 1.41-2.77), greater confidence in the ability to quit smoking (AOR - 1.31, 95% CI: 1.07-1.60), and stronger intention to quit (plan to quit after discharge vs. try to quit; AOR = 1.68, CI: 1.19-2.38). In conclusion, smokers hospitalized with a tobacco-related illness and those with greater confidence and intention to quit after discharge are more likely to sustain abstinence in the long term. Hospital clinicians' efforts to promote smoking cessation should target smokers' confidence and motivation to quit.


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