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Open Access Study protocol

Effectiveness of smoking-cessation interventions for urban hospital patients: study protocol for a randomized controlled trial

Ellie Grossman12*, Donna Shelley13, R Scott Braithwaite12, Iryna Lobach4, Ana Goffin1, Erin Rogers5 and Scott Sherman15

Author Affiliations

1 Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA

2 Bellevue Hospital Center, New York, NY, USA

3 New York University College of Dentistry, New York, NY, USA

4 Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA

5 VA New York Harbor Healthcare System, New York, NY, USA

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Trials 2012, 13:126  doi:10.1186/1745-6215-13-126

Published: 1 August 2012

Abstract

Background

Hospitalization may be a particularly important time to promote smoking cessation, especially in the immediate post-discharge period. However, there are few studies to date that shed light on the most effective or cost-effective methods to provide post-discharge cessation treatment, especially among low-income populations and those with a heavy burden of mental illness and substance use disorders.

Methods/design

This randomized trial will compare the effectiveness and cost-effectiveness of two approaches to smoking cessation treatment among patients discharged from two urban public hospitals in New York City. During hospitalization, staff will be prompted to ask about smoking and to offer nicotine replacement therapy (NRT) on admission and at discharge. Subjects will be randomized on discharge to one of two arms: one arm will be proactive multi-session telephone counseling with motivational enhancement delivered by study staff, and the other will be a faxed or online referral to the New York State Quitline. The primary outcome is 30-day point-prevalence abstinence from smoking at 6-month follow-up post-discharge. We will also examine cost-effectiveness from a societal and a payer perspective, as well as explore subgroup analyses related to patient location of hospitalization, race/ethnicity, immigrant status, and inpatient diagnosis.

Discussion

This study will explore issues of implementation feasibility in a post-hospitalization patient population, as well as add information about the effectiveness and cost-effectiveness of different strategies for designing smoking cessation programs for hospitalized patients.

Trial registration

Clinicaltrials.gov ID# NCT01363245

Keywords:
Hospital; Randomized trial; Smoking cessation; Telephone counseling; Underserved population