There are currently few smoking cessation programs aimed at low-income African-American smokers, although smoking prevalence remains relatively high among this group. The proposed project will evaluate the feasibility of using a multi-component, minimal-interaction smoking cessation program in an indigent-care hospital setting. The components of the smoking cessation intervention have been used successfully in other settings and include: a stop-smoking message from the attending physician; a brief counseling session targeting the smoker's readiness to quit and confidence to avoid relapse; self-help materials developed specifically for African- American smokers; and a follow-up telephone call to reinforce the message and provide additional support to the smoker who has returned home. The program will be used in Cooper Green Hospital, the public hospital serving the medically indigent in Jefferson County, Alabama. The evaluation of the Cooper Green Hospital Stop Smoking Program (CGSSP) follows a model appropriate for evaluating new programs, which includes an assessment of program development, installation, implementation and outcomes. A combination of formative, process and outcome evaluation methodologies will be used to determine if: 1) the program components are appropriate to the needs and characteristics of the target audience; 2) the program is set up and implemented as planned; and 3) the program has an impact on smokers. The outcome evaluation will take the form of a randomized, controlled study in which the following hypotheses will be tested: 1) intervention patients will report higher levels of readiness to quit than usual care patients; 2) intervention patients will report higher levels of confidence to remain smoke free than usual care patients; and 3) intervention patients will report higher quit rates than usual care patients, Patients in the study will be interviewed at hospital admission (baseline), hospital discharge, six months post-discharge, and 12 months post-discharge.
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