Smoking: interventions in hospital can help smokers quit

Clinical bottom line (level 2a)

  1. Hospitalised smokers who receive inpatient advice and follow-up for a month are more likely not to be smoking at 6 months than patients who receive standard care (NNT = 10 at 6 months) .
  2. The effects of less intensive interventions are unclear.
Rigotti et al: Cochrane Library 2001; 4 : -
Expires May 2004

The study

Systematic review of all randomised or quasi-randomised controlled trials of
  • Patients: hospitalised patients who were current smokers or recent quitters
  • Intervention: behavioural, pharmacological or multicomponent interventions compared with usual care
  • Outcome: not smoking at 6 months

Articles found in ?all languages using Cochrane Tobacco Addiction Group trials register, Cochrane Controlled Trials Register, Centers for Disease Control Smoking and Health database, CINAHL, to July 2000 (search terms: detailed in text ) and contacting experts in the field for details of conference abstracts and studies in press. Bibliographies of retrieved articles were also checked.

Selection criteria: by 2 independent reviewers, who resolved differences by consensus
Appraisal criteria: by 2 independent reviewers who resolved differences by consensus; using quality of randomisation, loss to follow-up, reporting of smoking cessation
Articles excluded if:
  • follow-up < 6 months
  • patients admitted for psychiatric disorders or substance abuse
  • abstinence rates not reported
15 studies were found - 6 involving physician advice, 7 involving nicotine replacement therapy, 12 offering support by telephone

The evidence

Outcome Time to outcome CER OR
(95% CI)		 NNT
(95% CI)
quit smoking: intensive intervention v. usual care 6 months 262/1493
(17.5%)		 1.82
(1.49 to 2.22) 		10
(7 to 15)

  • There was insufficient evidence to assess the effect of interventions delivered only during hospitalisation.

Citation

  1. Rigotti NA, Munafo MR, Murphy MF, et al: interventions for smoking cessation in hospitalised patients (Cochrane Review). Cochrane Library 2001; 4 : -
Search Terms: smoking and cessation in Cochrane Library
Contributor: Chris Ball, May 2002
Reviewer:

Clinical Question.
Patient hospitalised smokers or recent quitters
Intervention or Exposure cessation programme
Outcome quit smoking at 6 months