The investigators plan to compare the effectiveness and cost effectiveness of an inpatient smoking cessation intervention for all smokers hospitalized at two urban public hospitals.
Our sites are: Bellevue Hospital Center (a New York City public hospital) and the Manhattan campus of the VA New York Harbor Healthcare System. During hospitalization, all smokers will receive usual care. At the time of discharge, patients will be randomized to one of two arms: multisession telephone counseling by their hospital's smoking cessation staff, or faxed referral to the state Quitline (which will then perform phone outreach as per Quitline protocol). All patients enrolled in the study will receive nicotine replacement therapy. The primary aims are: Aim 1: To compare the effectiveness of the intervention (proactive multisession telephone counseling by in-hospital staff) versus control ('fax-to-quit' Quitline referral). Aim 2: To evaluate and compare the cost-effectiveness of these interventions from a societal perspective and from a payer perspective. The secondary aims are: Secondary Aim 1: To compare outcomes by race/ethnicity, immigrant status, inpatient diagnosis, and location of patient hospitalization Secondary Aim 2: To compare outcomes of the interventions at 6 and 12 months post-discharge Secondary Aim 3: To compare biochemically-verified abstinence rates at 6 months post-discharge Secondary Aim 4: To compare cessation outcomes between those who are known HIV-seropositive and those who are not, and explore possible mediators of cessation in HIV-seropositive patients
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
1,618
Telephone counseling: 7 calls over 6 weeks
referral to state smoking cessation 'quitline' for counseling - 1 call over 2 weeks
VA New York Harbor Healthcare System
New York, New York, United States
Bellevue Hospital Center
New York, New York, United States
Effectiveness of counseling intervention vs. control intervention on smoking cessation rates of participants enrolled in study
To compare the effectiveness of a phone counseling intervention (proactive multisession telephone counseling by in-hospital staff) versus control intervention ('fax-to-quit' Quitline referral)
Time frame: 4 yrs
Comparison of cessation outcomes by sociodemographic subgroups
To compare smoking abstinence rates by race/ethnicity, immigrant status, inpatient diagnosis, and location of patient hospitalization
Time frame: 4yrs
Comparison of cessation rates at 6 and 12 months post-discharge
To compare smoking abstinence rates in the two arms at 6 months and 12 months post-discharge
Time frame: 4yrs
Comparison of biochemically-verified smoking cessation
To compare rates of biochemically-verified smoking abstinence measured at 6 months post-discharge
Time frame: 4 years
Comparison of cessation outcomes between participants who are HIV-seropositive vs. those who are not
To compare cessation outcomes between those who are known HIV-seropositive and those who are not, and explore possible mediators of cessation in HIV-seropositive patients.
Time frame: 2 years
Cost Effectiveness comparison of two smoking cessation interventions.
Evaluate and compare the cost-effectiveness of these interventions from a societal perspective and from a payor perspective. Our hypotheses are that the intervention will have incremental cost-effectiveness ratios consistent with current standards of healthcare value in the United States.
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Time frame: 4 yrs