Smoking Cessation Program Using Nicotine Patches Linking Hospital to the Community

Objective: To compare the quit rates achieved by participants in a smoking cessation program, initiated in hospital using nicotine patches and continued in either the community pharmacy or hospital setting, with quit rates in a minimal intervention group. Setting: The medical and surgical units at The Queen Elizabeth Hospital (TQEH), a major teaching hospital located in the western suburbs of Adelaide, South Australia. Participants: Inpatients aged over 18 years who smoked 10 or more cigarettes per day. Of 306 smokers screened, 102 were enrolled. Study Procedures: Participants were randomised to either the minimal intervention arm (n = 33), the hospital‐based program (n = 35), or the community pharmacy‐based program (n = 34). The minimal intervention group received written materials and advice about quitting. The two intervention arms started with a consultation with the research pharmacist and participants were commenced on nicotine patches and were followed after discharge with weekly counselling visits with either the researcher in an outpatient clinic or a community‐based pharmacist. Patches were supplied for $15.00 per week for up to 16 weeks. Exhaled carbon monoxide measurements to confirm abstinence were performed whenever possible. Continuous and point prevalence of abstinence from smoking were assessed 3, 6 and 12 months after enrolment. Results: There was a statistically significant difference in the point prevalence of abstinence between groups at 12 months with 38%, 24% and 4.6% abstinence in the hospital, community pharmacy and minimal intervention arms respectively (X2 = 7 .145, df = 2, p = 0.031 ). The differences seen in continuous abstinence at 12 months (24%, 19% and 4.6% respectively) did not reach statistical significance. Conclusion: A hospital‐based smoking cessation program initiated with nicotine patches was equally effective whether continued by hospital‐ or community‐based pharmacists and was superior to minimal intervention without nicotine patches.