@article {Mullen293, author = {Kerri A Mullen and Douglas G Manuel and Steven J Hawken and Andrew L Pipe and Douglas Coyle and Laura A Hobler and Jaime Younger and George A Wells and Robert D Reid}, title = {Effectiveness of a hospital-initiated smoking cessation programme: 2-year health and healthcare outcomes}, volume = {26}, number = {3}, pages = {293--299}, year = {2017}, doi = {10.1136/tobaccocontrol-2015-052728}, publisher = {BMJ Publishing Group Ltd}, 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 {\textquoteleft}Ottawa Model{\textquoteright} 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.}, issn = {0964-4563}, URL = {https://tobaccocontrol.bmj.com/content/26/3/293}, eprint = {https://tobaccocontrol.bmj.com/content/26/3/293.full.pdf}, journal = {Tobacco Control} }