Efficacy of initiating tobacco dependence treatment in inpatient psychiatry: A randomized controlled trial

J.J. Prochaska, S.E. Hall, K. Delucchi and S.M. Hall

American Journal of Public Health, 2014, vol. 104, issue 8, 1557-1565

Abstract: Objectives. We evaluated the efficacy of a motivational tobacco cessation treatment combined with nicotine replacement relative to usual care initiated in inpatient psychiatry. Methods. We randomized participants (n = 224; 79% recruitment rate) recruited from a locked acute psychiatry unit with a 100% smoking ban to intervention or usual care. Prior to hospitalization, participants averaged 19 (SD = 12) cigarettes per day; only 16% intended to quit smoking in the next 30 days. Results. Verified smoking 7-day point prevalence abstinence was significantly higher for intervention than usual care at month 3 (13.9% vs 3.2%), 6 (14.4% vs 6.5%), 12 (19.4% vs 10.9%), and 18 (20.0% vs 7.7%; odds ratio [OR] = 3.15; 95% confidence interval [CI] = 1.22, 8.14; P = .018; retention>80%). Psychiatric measures did not predict abstinence; measures of motivation and tobacco dependence did. The usual care group had a significantly greater likelihood than the intervention group of psychiatric rehospitalization (adjusted OR = 1.92; 95% CI = 1.06, 3.49). Conclusions. The findings support initiation of motivationally tailored tobacco cessation treatment during acute psychiatric hospitalization. Psychiatric severity did not moderate treatment efficacy, and cessation treatment appeared to decrease rehospitalization risk, perhaps by providing broader therapeutic benefit.

Keywords: adult; article; controlled clinical trial; controlled study; female; hospital patient; hospital readmission; human; male; mental disease; methodology; patient compliance; psychiatric department; psychological aspect; randomized controlled trial; smoking cessation; statistics; treatment outcome, Adult; Female; Humans; Inpatients; Male; Mental Disorders; Patient Compliance; Patient Readmission; Psychiatric Department, Hospital; Smoking Cessation; Treatment Outcome (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (1)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301403_2

DOI: 10.2105/AJPH.2013.301403

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