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Effectiveness of a hospital-initiated smoking cessation programme: 2-year health and healthcare outcomes
  1. Kerri A Mullen1,
  2. Douglas G Manuel2,
  3. Steven J Hawken2,
  4. Andrew L Pipe1,
  5. Douglas Coyle3,
  6. Laura A Hobler1,
  7. Jaime Younger2,
  8. George A Wells1,
  9. Robert D Reid1
  1. 1University of Ottawa Heart Institute, Ottawa, Ontario, Canada
  2. 2Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  3. 3University of Ottawa, Ottawa, Ontario, Canada
  1. Correspondence to Dr Kerri Anne Mullen, 40 Ruskin Street, H2353, Ottawa, Ontario, Canada K1Y 4W7; kmullen{at}ottawaheart.ca

Abstract

Background Tobacco-related illnesses are leading causes of death and healthcare use. Our objective was to determine whether implementation of a hospital-initiated smoking cessation intervention would reduce mortality and downstream healthcare usage.

Methods A 2-group effectiveness study was completed comparing patients who received the ‘Ottawa Model’ for Smoking Cessation intervention (n=726) to usual care controls (n=641). Participants were current smokers, >17 years old, and recruited during admission to 1 of 14 participating hospitals in Ontario, Canada. Baseline data were linked to healthcare administrative data. Competing-risks regression analysis was used to compare outcomes between groups.

Results The intervention group experienced significantly lower rates of all-cause readmissions, smoking-related readmissions, and all-cause emergency department (ED) visits at all time points. The largest absolute risk reductions (ARR) were observed for all-cause readmissions at 30 days (13.3% vs 7.1%; ARR, 6.1% (2.9% to 9.3%); p<0.001), 1 year (38.4% vs 26.7%; ARR, 11.7% (6.7% to 16.6%); p<0.001), and 2 years (45.2% vs 33.6%; ARR, 11.6% (6.5% to 16.8%); p<0.001). The greatest reduction in risk of all-cause ED visits was at 30 days (20.9% vs 16.4%; ARR, 4.5% (0.4% to 8.7%); p=0.03). Reduction in mortality was not evident at 30 days, but significant reductions were observed by year 1 (11.4% vs 5.4%; ARR 6.0% (3.1% to 9.0%); p<0.001) and year 2 (15.1% vs 7.9%; ARR, 7.3% (3.9% to 10.7%); p<0.001).

Conclusions Considering the relatively low cost, greater adoption of hospital-initiated tobacco cessation interventions should be considered to improve patient outcomes and decrease subsequent healthcare usage.

  • Cessation
  • Health Services
  • Priority/special populations

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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