Effectiveness of the Tobacco Tactics Program in the Department of Veterans Affairs

Background: To improve the delivery of inpatient smoking cessation services, the objective of this study was to implement and evaluate the nurse-administered Tobacco Tactics program among inpatients in three large VA hospitals.

Methods: In this pre- post- non-randomized comparison study, two VAs were the intervention sites, while one VA was the control site (N=1,145). At the intervention sites, research nurses taught the intervention to staff nurses using the Tobacco Tactics toolkit. The provider toolkit included: 1) one contact hour for training for nurses; 2) PowerPoint presentation on behavioral and pharmaceutical interventions; 3) pocket card “Helping Smokers Quit: A Guide for Clinicians;” 4) pharmaceutical and behavioral protocols; and 5) computerized template for documentation. The patient toolkit included: 1) brochure; 2) videotape; 3) Tobacco Tactics manual; 4) pharmaceuticals; 5) 1-800-QUIT-NOW help line card; and 6) follow-up telephone calls. Smokers in both the intervention and control facilities were surveyed at baseline and 6 months after discharge about their smoking habits.

Results: The average age was 55.5 years, most were male (95%) and not married (75%). After adjustment for the propensity of actually receiving the intervention, there were significant improvements in 6-month quit rates from the pre- to the post-intervention time periods in Ann Arbor (p=0.02) and Detroit (p<0.0001) compared to the Indianapolis control site.

Conclusion: The implementation of the Tobacco Tactics program has the potential to decrease smoking and therefore potentially decrease smoking-related morbidity and mortality among smokers admitted to VA hospitals.