Tobacco cessation counseling during the inpatient hospital stay: A teachable moment within military medicine

Background/Objective: A limited number of military treatment facilities offer routine tobacco cessation counseling to inpatients. This deficiency in patient care is an oversight of a key ″teachable moment″ within military medicine. The U.S. Naval Hospital Okinawa Health Promotion Department (HPD) has implemented an aggressive inpatient tobacco cessation initiative targeting all patients identified as tobacco users.

Methodology: The HPD has established a direct counseling referral system for all inpatient tobacco users. Referrals are sent by the provider before patient discharge through CHCS, during bi-weekly inpatient rounds, or by phone. After each counseling session, the encounter is documented on the patient's Progress Form in his/her medical chart.

Results: Since implementation of the HPD's inpatient tobacco cessation initiative in January 2007 the hospital has routinely been rated as 100% compliant in tobacco cessation counseling for pneumonia patients identified as tobacco users— meeting a Joint Commission standard. Additionally, over 100 inpatients with various admitting diagnoses and identified as tobacco users received tailored cessation counseling through the HPD during 2007.

Discussion/Conclusion: Communication between providers and tobacco cessation counselors is imperative for an inpatient referral process to be successful. Utilization of on-site tobacco cessation counseling staff to educate inpatients is of relatively little cost to the military hospital and allows other members of the healthcare team to focus efforts on day-to-day patient care.

Recommendations: This low-cost, high-yield initiative could be easily reproduced by other treatment facilities and healthcare systems to increase patient knowledge, decrease illness recovery time, expedite return to readiness, and reduce repeat hospital admissions.