Smoking cessation after hospital discharge: Factors associated with abstinence

Abstract

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 testing a smoking cessation intervention for 1,357 hospitalized cigarette 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 six months after discharge. Biochemically confirmed abstinence at six 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, 95% 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.