Predictors of relapse to smoking within one month after hospitalization

Objective

Identify predictors of relapse back to smoking in patients followed-up for 30 days after hospitalization.

Methods

Data are based on 1,540 adult smokers who were hospitalized at the Medical University of South Carolina (MUSC) between July 1^st and November 31^st 2014 and followed up by phone one month after discharge to assess smoking status. A tobacco-cessation counsellor was available to provide advice on quitting and nicotine-replacement medications. Predictors of relapse back to smoking included: demographic characteristics, discharge diagnosis, smoking history prior to hospitalization, and whether patients were seen by the hospital’s tobacco cessation specialist or not. Everyone was followed-up for 30 days by interactive voice recognition (IVR) system to evaluate smoking status.

Results

There were 6,179 adult hospital admissions 25% of whom were smokers. Of the 1,540 smokers identified, 354 received bedside counselling and 1019 did not. The mean age was 47±16 years and the majority was males (59%). Overall, 82% of patients followed up at one month were back smoking again within one month after discharge. Relapse rates were higher in those who were treated for mental health conditions while hospitalized and in those who smoked more frequently prior to hospitalization. The post-discharge relapse rate was reduced by about 50% in those seen by the bedside counselor.

Conclusion

Relapse back to smoking after hospitalization, even for serious medical problems, is very common. Intervening with patients during their hospital stay reduced relapse to smoking within a month post discharge by half.