Nav: Home

A talk with a nurse can persuade hospital patients to quit smoking

October 04, 2016

COLUMBUS, Ohio - A short talk with a knowledgeable nurse could be the difference between a smoker stopping for cigarettes or stopping for nicotine gum on her way home from the hospital.

New research shows that self-reported quit rates among hospital patients more than doubled when nurses and other staff were trained to coach patients on how to stop smoking and to make sure they got the help they needed to make it happen, whether that meant counseling, patches, gum or prescription medication.

"They were armed with everything they needed when they left - medication, behavioral tactics, a manual to help them stay on track," said Sonia Duffy, a professor of nursing at The Ohio State University and lead author of the study, which appears in the American Journal of Preventive Medicine.

"Hospitalization is the perfect time to help people quit. They're more motivated and nurses can explain how smoking harms their health, including slowing healing," said Duffy, who also works for the Department of Veterans Affairs Ann Arbor Healthcare System.

The study of 1,528 patients in five community hospitals in Michigan looked at self-reported and lab-confirmed quit rates six months after discharge. Those who'd been treated at three of the hospitals met at least once, but perhaps more, with a nurse who'd undergone a one-hour training on how to help people quit smoking.

Six months after release, 16.5 percent of the smokers from the intervention hospitals said they'd quit, compared to 5.7 percent from the other hospitals. The researchers also looked at lab-confirmed quit rates based on urine tests and found a two-fold difference among patients from intervention hospitals, but that data was not considered statistically significant.

Smoking cessation techniques are not routinely taught in nursing schools and counseling on quitting smoking is spotty in U.S. hospitals, Duffy said.

Those smokers who do get counseling don't always hear about it from a nurse and are often referred to the Tobacco Quit Line, which can be effective but is most frequently used by those who are already highly motivated, Duffy said.

Many smokers, even those who plan to quit, pick smoking right back up the minute they leave the hospital, she said. Getting them started with a quitting plan and tools while they're admitted boosts their chances of success, Duffy said.

"I hope hospital administrators will look beyond telephone quit lines to help people. They work for a select group of people and the rest are falling through the cracks. We have to use a multitude of different approaches to reach people," she said.

"Nurses have the greatest access to patients, they have relationships with patients and they can relate the benefits of quitting to the patient's medical condition."

The program, called "Tobacco Tactics," was designed to meet the standards of the Joint Commission, an independent nonprofit organization that accredits U.S. hospitals. The smoking cessation standards are currently voluntary, but are expected to become mandatory, Duffy said.

The nurse-patient interactions at the Tobacco Tactics hospitals lasted about nine minutes on average, Duffy said. At the other two hospitals, nurses and other staff didn't change their normal approach to caring for patients.

If smokers in Tobacco Tactics hospitals agreed to try, the nurse worked with a doctor to make sure they had whatever tools were best-suited to their addiction. In many cases, that means nicotine replacement therapy. In other cases, smokers quit with the help of an antidepressant or Chantix, a prescription smoking-cessation medication.

Nurses and other staff who went through Tobacco Tactics training were taught strategies that help smokers quit, including identifying triggers and planning strategies to manage cravings (munching on carrots, brushing teeth or going for a walk, for instance.)

Nurses carried a pocket card with reminders on how to help smokers. They learned which quit-smoking aids, including pharmaceutical drugs, were likely to help which type of smoker based on their addiction and past attempts at kicking the habit.

They also supplied patients with brochure on quitting, at minimum. Those who expressed interest could watch a 20-minute DVD or read the Tobacco Tactics manual, an easy-to-read magazine with information about tobacco and health and tips on quitting. They also received a card with the 1-800-QUIT-NOW Tobacco Quit Line number. Physicians in the hospitals were reminded to give patients brief advice to quit.

After they left the hospital, volunteers called them five times in the first month to check in and offer support.

Quit rates in the Tobacco Tactics hospitals and in the control hospitals were slightly lower than quit rates seen in other similar studies. That could be because this study used "real world bedside nurses" and not research nurses whose only job is to do smoking cessation, Duffy said. Her work also was different than much of the previous hospital intervention research because this study included smokers who were in the hospital for all kinds of reasons - not a select group, such as heart patients.
This study, which ran from 2010 to 2013 within Michigan's Trinity Health System, did not include a cost-effectiveness analysis, but that will come next, Duffy said.

The research was supported by the National Heart, Lung and Blood Institute.

CONTACT: Sonia Duffy, (614) 688-5646;

Written by: Misti Crane, (614) 292-5220;

Ohio State University

Related Smoking Cessation Articles:

Smoking cessation program for patients with, without cancer
A tobacco treatment program delivered at a cancer center had average seven-day smoking abstinence rates of about 45% at three- and six-month follow-ups and nearly 44% at the nine-month follow-up, and those rates didn't differ between patients with and without cancer.
Study underscores role of menthol cigarettes in smoking cessation
Researchers cite Big Tobacco's marketing stronghold on African-American smokers among reasons why this group is 12% less likely to quit.
Mindfulness smoking-cessation app can change the brain
Brown University researchers have found that a mindfulness-based smartphone app designed to help people stop smoking was effective at reducing study participants' self-reported daily cigarette consumption.
Can smoking cessation reduce rheumatoid arthritis risk?
In an Arthritis Care & Research analysis of 230,732 women, those who quit smoking many years ago had a lower risk of a certain form of rheumatoid arthritis (RA) compared with women who recently quit.
Smoking cessation may reduce risk of rheumatoid arthritis
Analysis of data from the Nurses' Health Studies demonstrates for first time that behavior change can delay or even prevent the most severe form of rheumatoid arthritis.
Rutgers researchers highlight need for more smoking cessation programs in state prisons
Inmates want to quit smoking but don't have access to smoking cessation programs in state prisons, increasing the risk - especially among black male inmates -- of cancer, heart disease, stroke and other smoking-related diseases, according to Rutgers researchers.
Reducing drinking could help with smoking cessation, research finds
New research has found that heavy drinkers who are trying to stop smoking may find that reducing their alcohol use can also help them quit their daily smoking habit.
Smoking cessation: a genetic mutation involved in relapse
Why is it so difficult to stop smoking? Why do some people relapse months after giving up?
Benefits of smoking cessation medications diminish over time
A new Tel Aviv University study published in Addiction finds that only eight out of 100 smokers who take smoking cessation medications will have benefited from taking smoking medications after one year's time.
Running away from addiction: How exercise aids smoking cessation
New research in mice sheds light on the mechanism underlining exercise's protective effect against nicotine dependence and withdrawal.
More Smoking Cessation News and Smoking Cessation Current Events

Top Science Podcasts

We have hand picked the top science podcasts of 2019.
Now Playing: TED Radio Hour

Why do we revere risk-takers, even when their actions terrify us? Why are some better at taking risks than others? This hour, TED speakers explore the alluring, dangerous, and calculated sides of risk. Guests include professional rock climber Alex Honnold, economist Mariana Mazzucato, psychology researcher Kashfia Rahman, structural engineer and bridge designer Ian Firth, and risk intelligence expert Dylan Evans.
Now Playing: Science for the People

#541 Wayfinding
These days when we want to know where we are or how to get where we want to go, most of us will pull out a smart phone with a built-in GPS and map app. Some of us old timers might still use an old school paper map from time to time. But we didn't always used to lean so heavily on maps and technology, and in some remote places of the world some people still navigate and wayfind their way without the aid of these tools... and in some cases do better without them. This week, host Rachelle Saunders...
Now Playing: Radiolab

Dolly Parton's America: Neon Moss
Today on Radiolab, we're bringing you the fourth episode of Jad's special series, Dolly Parton's America. In this episode, Jad goes back up the mountain to visit Dolly's actual Tennessee mountain home, where she tells stories about her first trips out of the holler. Back on the mountaintop, standing under the rain by the Little Pigeon River, the trip triggers memories of Jad's first visit to his father's childhood home, and opens the gateway to dizzying stories of music and migration. Support Radiolab today at