Predictors of engagement in post-discharge quitline counseling among hospitalized smokers

Abstract

Quitlines provide evidence-based tobacco treatment and multiple calls yield higher quit rates. This study aimed to identify subgroups of smokers with greater quitline engagement following referral during hospitalization. Data were from a randomized clinical trial assessing the effectiveness of fax referral (referral faxed to proactive quitline) versus warm handoff (patient connected to quitline at bedside) (n = 1054). Classification and regression trees analyses evaluated individual and treatment/health system-related variables and their interactions. Among all participants, warm handoff, higher ratings of the tobacco treatment care transition, and being older predicted completing more quitline calls. Among patients enrolled in the quitline, higher transition of care ratings, being older, and use of cessation medication post-discharge predicted completing more calls. Three of the four factors influencing engagement were characteristics of treatment within the hospital (quality of tobacco treatment care transition and referral method) and therapy (use of cessation medications), suggesting potential targets to increase quitline engagement post-discharge.

Trial registration: ClinicalTrials.gov NCT01305928.

Keywords: Engagement; Hospitalization; Smoking cessation; Tobacco quitlines; Transitional care.

Conflict of interest statement

Declaration of Interests: None of the authors have institutional or corporate affiliations that conflict with this study, and no financial disclosures were reported by the authors of this paper

Figures

Figure 1.

Classification and regression tree for all participants referred to quitline (n=1054) identifying subgroups of patients with greater adherence to quitline counseling

Figure 2.

Classification and regression tree for participants enrolled in the quitline (n=839) identifying subgroups of patients with greater adherence to quitline counseling