Problem/Objective: Kentucky ranks number one in the nation in cigarette use with nearly one-third of adults identifying as smokers. Public health officials and healthcare professionals have an opportunity to play a critical role in reducing tobacco use; even brief advice from a health professional has been shown to successfully increase quit attempts. Providers in the hospital setting have a unique opportunity to intervene with patients at multiple times during their stay.

Methods: A committee of state-level organizations was formed in order to plan and implement a survey and pilot project. The committee includes the American Heart Association, Kentucky Cancer Program, Kentucky Hospital Association, Kentucky Medical Association, Health Care Excel, and the Tobacco Prevention and Cessation Program. Adapted from an existing JCAHO survey, a web-version was created and administered to Kentucky hospitals.

Results: Preliminary data indicates that most hospitals ask and document patient tobacco use status; however, a wide range of cessation practices exists. Many hospitals permit physicians to write exemption orders allowing patients to use tobacco during their hospital stay. Very few hospitals have standing orders for NRT or pharmacotherapy. Staff training on provision of cessation counseling is rare. The survey data is guiding the creation of a systems-based approach to addressing tobacco use for all patients in the hospital setting.

Conclusions: Pilot hospitals have been selected to participate based on their interest, administrative support, geographic location and size. The project aims to provide a blueprint of services, referral sources, resources, and educational training programs for hospitals.