52. Smoking cessation in hospitalized patients with comorbidities

Background: Smoking cessation programs in hospitalized patients are effective, with increased smoking cessation indicators and better cost efficiency, when compared to those in outpatients. Hospitalization is an excellent smoking cessation intervention opportunity in different groups of patients with cardiovascular comorbidity being investigated more than any other.

Objective: The purpose of this study was to investigate the efficacy of smoking cessation intervention in hospitalized patients with respiratory comorbidities using increased supportive—counseling and administration of varenicline (full intervention), in relation to the provision of a single inpatient counseling session.

Methods: Smoking cessation was investigated in 100 smoking patients admitted to the 1^st Pulmonary department of the General Hospital of Kavala; upon admission: asthma crisis (17 patients/4♂ & 13♀), chronic obstructive pulmonary disease (COPD) exacerbation (38 patients/32♂ & 6♀) or community pneumonia (45 patients 30♂ & 15♀). Patients during hospitalization were interviewed individually and the smoking history was recorded along with counseling at least one hour daily. Subsequently 44 patients (28♂ & 16♀) were enrolled in full-intervention program, while 56 (38♂ & 18♀) refused to continue after having received a counseling session. Follow up was until until completing six months of joining the program. The finding of abstinence was measuring CO in exhaled air.

Results: The 28 out of the 44 patients receiving the integrated intervention successfully stopped smoking (63.6%) compared to 14 out of 56 (25%) patients which received a single session. More effective integrated intervention was observed in patients with asthma (71.4%), then in patients with community-acquired pneumonia (63%) and in patients with COPD (60%). The successful quitting rate after full intervention was similar in men and women (64.2% and 62.5% respectively).

Conclusions: Complete cessation interventions in hospitalized respiratory patients are particularly successful and therefore beneficial to the health systems and should be considered for integration into the main activities of a pulmonary clinic.

Keywords: Smoking cessation; spirometry; chronic obstructive pulmonary disease (COPD)