Learning Objectives: describe strategies for successfully providing a collaborative hospital-based smoking cessation program.
Abstract:
Although guidelines call for the provision of smoking cessation services to all patients who smoke, hospitals struggle to identify resources for this service. Santa Clara Valley Medical Center (SCVMC) in San Jose, California, through involvement in a dissemination trial, has developed an innovative partnership for delivering a multi-component inpatient smoking cessation intervention (Staying Free). To provide Staying Free at SCVMC, a physician, working with hospital administration and University-based researchers, screened and counseled patients identified as smokers (Phase 1). Public health personnel provided follow-up counseling and developed strategies for Spanish- and Vietnamese-speaking patients. To sustain the program, a full-time smoking cessation adviser was hired (Phase 2), resulting in increased screening and recruitment of patients. During Phase 1 (6.5 months), patient recruitment M=9.9/month. During Phase 2, patient recruitment M=20/month (first four months). The sample (35% female) was diverse: Latino 43%, African-American 12%, Asian-American 13%, Caucasian 29%. Six-month cessation rates for Phase 1 participants were 22%, counting those lost to follow-up as smokers. For Phase 2, 57% of those contacted (32/56) were not smoking at 48 hours. Although adult smoking rates in Santa Clara County are only 15%, approximately 21% of SCVMC patients are smokers, and over half indicate they want to quit. A university/county hospital/public health system partnership has proved effective in identifying and providing smoking cessation to a diverse group of low-income hospitalized smokers. Hiring a full-time committed individual was critical to success.
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