Evaluation of a nurse-delivered smoking cessation intervention for hospitalized patients with cardiac disease

Objective: To determine the effect of a nurse-delivered smoking cessation intervention for hospitalized smokers on smoking cessation rates and smoking cessation self-efficacy at 6 months after enrollment. Design: A quasi-experimental design was used; specifically, a nonequivalent control group design was implemented. Setting: A 450-bed major teaching and research tertiary care hospital, serving patients from across the province of British Columbia, Canada. Subjects: Smokers with a cardiac diagnosis (n = 102) who were admitted to 1 of 2 inpatient cardiac units for medical or surgical treatment. Outcome Measures: Self-reported smoking status and self-reported smoking cessation self-efficacy. Intervention: Two structured, in-hospital contacts, followed by 3 months of telephone support. The interventions focused on problem-solving and reinforcing the patient’s self-efficacy. Results: Of the patients enrolled, 86 completed 6-month follow-up questionnaires. When subjects who were lost to follow-up were assumed to be smokers, 46% of the intervention group, compared with 31% of the control group, were nonsmokers. When key variables were controlled, we found that those subjects in the control group were 3 times more likely to relapse and begin smoking than those who received the intervention. There were no significant differences in follow-up smoking cessation self-efficacy scores in the treatment and control groups. When background variables were controlled, self-efficacy related to positive/social situations and habit/addictive situations were noted to be significantly higher in the intervention group. Conclusion: The findings of this research are encouraging; they suggest that a nurse-delivered smoking cessation intervention improved the smoking cessation rate in patients with cardiac disease. (Heart Lung® 1999;28:55-64)