RT Journal
A1 Regan S, Viana JC, Reyen M, Rigotti NA
T1 PRevalence and predictors of smoking by inpatients during a hospital stay
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD November 26
VO 172
IS 21
SP 1670
OP 1674
DO 10.1001/2013.jamainternmed.300
UL http://dx.doi.org/10.1001/2013.jamainternmed.300
AB Background 
                  Accredited US hospitals prohibit smoking inside hospital buildings. Patients are expected to abstain from smoking throughout their hospitalization, but how many do so is unclear. Smoking by inpatients may compromise patient safety, clinical outcomes, and hospital efficiency.Methods 
                  We conducted an observational study of adult cigarette smokers visited by a tobacco counselor while hospitalized and reached for telephone follow-up in the 2 weeks after discharge. We assessed smoking during the hospital stay at the time of counseling for all patients and at follow-up for those reached. We used generalized linear models to estimate adjusted relative risk (ARR) for smoking while hospitalized, adjusted by patient and admission characteristics.Results 
                  From May 1, 2007, through April 31, 2010, counselors visited 5399 smokers, of whom 14.9% had smoked between admission and the visit. Of 3555 eligible smokers who consented to follow-up, 2185 were reached. Smoking at any time during the hospitalization was reported by 18.4%, less often during winter months than the rest of the year (14.4% vs 19.7%, P = .007). Smoking at any time while hospitalized was less common among those 50 years or older (ARR, 0.74; 95% CI, 0.62-0.88), those admitted to a cardiac unit (0.64; 0.51-0.81), and those intending to quit after discharge (0.46; 0.34-0.63) and more common among those with longer stays (1.36; 1.14-1.62) and those experiencing cigarette cravings (moderate: 1.23; 1.14-1.33; severe: 1.25; 1.18-1.34). Nicotine replacement therapy ordered the day of admission was associated with less smoking before the counselor's visit (ARR, 0.83; 95% CI, 0.72-0.96) but not for the entire hospital stay.Conclusions 
                  Nearly one-fifth of smokers admitted to a smoke-free hospital smoked during their hospital stay. Ordering nicotine replacement therapy routinely at admission and ongoing monitoring of patients' cigarette cravings might reduce smoking among admitted patients.