A smoking cessation program developed at Massachusetts General Hospital increased the proportion of hospitalized smokers who successfully quit smoking after discharge by more than 70 percent.

The system used interactive voice response technology--automated telephone calls--to provide support and stop-smoking medication for three months after smokers left the hospital. The program was the focus of a study published in JAMA.

The program developed by the MGH team provides smokers with a series of interactive automated telephone calls beginning two days after discharge and up to three months’ supply of the patients’ choice of any FDA-approved, stop-smoking medication. At each call, the automated system asked patients to indicate whether they were smoking, gave advice on staying smoke-free, encouraged the proper use of medication and offered medication refills. Participants requesting additional help received a call back from one of the program’s tobacco treatment counselors.

The study enrolled 397 smokers who had been hospitalized at MGH, received tobacco cessation counseling as inpatients, and indicated that they planned to try quitting after discharge. Half of the group was randomly assigned to receive the sustained care program. The other half received standard care, consisting of a recommendation to use a stop-smoking drug and to call the national tobacco quit line (1-800-QUIT-NOW) for support.

At one, three and six months after hospital discharge, participants received assessment calls from study staff, during which they were asked whether they were currently using any tobacco products and whether they had used any stop-smoking medication or tobacco counseling. The six-month follow-up included a biochemical test to confirm participants’ self-reports of not smoking.

At each assessment, more patients in the sustained care group reported not smoking--either during the preceding week or throughout the study period--than did patients in the standard care group. Objective testing of tobacco exposure at six months confirmed abstinence in 26 percent of the sustained care group, compared with 15 percent of the standard care group. The authors note that a likely reason for the difference was that the sustained care group used more tobacco cessation counseling and medication--and used medication for a longer period of time--than did the standard treatment group throughout the study.

“Most smokers want to quit, and being hospitalized gives them an opportunity to do so because they can’t smoke in the hospital. The health problems that led to the hospital admission can give them extra incentive to stop smoking,” said lead author Nancy Rigotti, M.D., director of the Tobacco Research and Treatment Center at MGH. “Many smokers get advice to quit in the hospital, but they are rarely connected to resources to help them stay quit when they return home.”

The study is available here.

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