ARTICLE CRITIQUE

Smoking Cessation Interventions for Hospitalized Patients With Cardio-pulmonary Disorders

Smoking Cessation Interventions for Hospitalized Patients With Cardio-pulmonary Disorders

Evidence was identified that suggests a number of interventions may be effective in identifying smokers. Some of these may also be effective in supporting smokers to quit once they have been reached? although this evidence is more limited. Effective methods for identifying and/or supporting adults include: the Quality Outcomes Framework (QOF) element of the 2004 GP contract in the UK? the use of primary care records to contact smokers and provide access to cessation services? the use of health equity audit methods to determine whether NHS stop smoking services are reaching disadvantaged smokers? social marketing approaches? tailoring interventions to fit the needs of disadvantaged groups? and combining advice or treatment to stop smoking with other interventions such as cervical screening. (Narsavage? 2009)

However? a weakness of some of the studies identified was that although they identified promising approaches to finding and then supporting smokers? not all of them focussed specifically on disadvantaged groups. Disadvantaged smokers face a number of barriers to accessing services including fear of failure? fear of being judged and lack of knowledge. Pregnant women? particularly disadvantaged pregnant smokers? also experience a number of barriers to seeking support to quit. Evidence suggests that there are a number of effective ways of improving the accessibility of cessation interventions. Training pharmacists and dental professionals to deliver cessation can make effective treatment available to larger numbers of smokers. Workplace interventions can also be successful with manual groups. Some limited evidence also exists that including a drop in or rolling group element to smoking treatment may improve access and outcomes for some smokers. Finally? evidence exists that a number of different forms of incentive schemes? including access to free NRT? can encourage smokers to make a quit attempt. Review findings point to the need for further research in a number of areas? in particular the need to test promising approaches with disadvantaged groups rather than the wider population. A prospective cohort study was conducted in a university-affiliated hospital. (Narsavage? 2009)

A total of 248 smokers admitted with primary cardiac and respiratory conditions received verbal advice (lasting about 1 h) and standard booklets on smoking cessation from a dedicated nurse counsellor. After discharge? participants received follow-up telephone counselling calls every 2 weeks from the same smoking counsellor. The main outcome measure was continued abstinence at 2 months after ...