The purpose of our proposed study is to examine the effectiveness and cost-effectiveness of a smoking- cessation intervention for patients at two urban hospitals. The population of hospitalized patients has a higher prevalence of current smoking than the general population (especially among psychiatric patients);hospitalization represents a time of enforced abstinence and a window of opportunity to get patients motivated and engaged in improving their health. These two hospitals serve primarily low-income communities, where there are particularly high rates of smoking and many barriers to receiving high-quality health cai'e and achieving good health care outcomes. During hospitalization, all enrolled smokers will receive usual care plus brief telephone counseling via an in- hospital connection to the state telephone Quitline. At the time of discharge, patients will be randomized to one of two arms: multisession telephone counseling by their hospital's smoking cessation staff, or faxed referral to the New York State Smokers'Quitline. All patients will receive appropriate nicotine replacement therapy. We hypothesize that the enhanced post-discharge intervention (i.e. telephone counseling by local counselors) will result in greater 12-month smoking abstinence rates than the faxed referral to the state Quitline. Our primary outcome will be smoking abstinence rate (biochemically verified) at 12 months post-discharge. We plan to compare the effectiveness and the cost-effectiveness of these two interventions. Secondary aims will involve explorations of differences in effectiveness in specific patient subgroups, and examination of smoking abstinence outcomes at 3-months and 6-months post-discharge.

Public Health Relevance

Tobacco use is a critical public-health issue;despite a decrease in use over the past decades, the rate of this decrease seems to have slowed. It is a particularly important health issue for groups of lower socioeconomic status and patients with mental illness. Our study aims to determine a low-intensity, easily generalizable smoking-cessation intervention targeting hospitalized populations from these communities.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HL105229-04
Application #
8487435
Study Section
Special Emphasis Panel (ZHL1-CSR-A (S1))
Program Officer
Stoney, Catherine
Project Start
2010-09-20
Project End
2014-11-30
Budget Start
2013-06-01
Budget End
2014-11-30
Support Year
4
Fiscal Year
2013
Total Cost
$932,429
Indirect Cost
$380,696
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016