Smoking cessation outcomes of referral to a specialist hospital outpatient clinic

Am J Addict. 2015 Sep;24(6):561-70. doi: 10.1111/ajad.12259. Epub 2015 Aug 25.


Background and objectives: Hospital visits are an opportunity to engage smokers in tobacco treatment. However, little is known about engagement in follow-up referrals. The purpose of this study is to report the rates of program engagement and smoking cessation outcomes of patients referred to a specialist outpatient tobacco treatment program after a hospital visit or other referral.

Methods: A retrospective chart review was used to examine the outcomes of 486 participants referred to a hospital-based smoking cessation clinic provided by tobacco treatment specialists. Referral sources, demographics and smoking, medical, psychiatric, and substance use history were obtained. The main outcomes of interest were engagement in the program and 7-day point-prevalence of smoking abstinence.

Results: Sixty-eight percent of participants who were referred to the program were considered "engaged," of which 70% were from hospitals, 4% from community programs, 11% were from general practitioners, and 16% were self-referrals. Thirty-percent (98/331) of engagers were abstinent by time of chart review (30% from the hospital, 8% from community programs, 19% from general practitioners, and 39% of self-referrals). Having quit for 1 month or longer at the past quit attempt, greater confidence in quitting smoking, lower expired carbon monoxide levels at baseline, and greater duration in the program were significant predictors of successful smoking cessation.

Discussion and conclusion: Providing tobacco treatment follow-up and referral for smokers after a hospital visit is important to enhance smoking cessation efforts.

Scientific significance: Referral to evidence-based tobacco treatment after hospital visits is effective. Models of tobacco treatment based on sources of referral should further be explored.

MeSH terms

  • Canada
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital / statistics & numerical data*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Referral and Consultation*
  • Retrospective Studies
  • Smoking Cessation / statistics & numerical data*
  • Treatment Outcome