Smoking Cessation Counseling With Inpatients: A Promising Approach for Achieving Tobacco-Free Healthcare Settings

Background: Smoking remains a significant public health concern, leading to detrimental health effects and imposing substantial economic burdens. Within healthcare settings, smoking among inpatients presents additional challenges, as it can worsen existing health conditions and impede recovery. Smoking cessation counseling has emerged as a promising approach to support and guide inpatients in their journey towards tobacco abstinence. However, implementing smoking cessation counseling in inpatient settings poses various challenges, including limited resources, time constraints, staff training, and addressing patient resistance. Strategies to overcome these barriers involve integrating counseling into routine clinical workflows, providing comprehensive training to healthcare providers, utilizing technology-assisted interventions, and fostering interdisciplinary collaborations. The purpose of this study was to engage patients who tested positive for tobacco use but opted out of inpatient counseling services. Methods: A designated list was created on the EPIC system, including all patients who screened positive for smoking. An RT was recruited as a tobacco treatment specialist (TTS) who was assigned 8-hour shifts, four days a week. TTS assessed for nicotine replacement therapy (NRT) to address cravings and provided a 24-hour follow-up to address further cravings and additional NRT or counseling needs. Patients were provided with resources to quit, including electronic referrals to the 800 Quitline for continued outpatient counseling. Contact information for the Quitline was also provided for patients to pursue further counseling services when ready. Results: Results of the study showed that a total of 1,282 patients received smoking cessation counseling. Among them, 192 patients agreed to inpatient counseling referrals with the RN or MD, while 1,254 patients actively participated in the counseling session and accepted resources to quit after discharge. Additionally, 249 patients requested referrals to the 800 Quitline. Conclusions: Despite challenges, implementing comprehensive strategies and engaging dedicated healthcare professionals can lead to successful outcomes, including higher participation rates in counseling sessions and increased acceptance of resources to quit smoking. Continued efforts to improve and expand smoking cessation counseling services are essential for achieving better health outcomes and reducing tobacco-related burdens among inpatients.