OBJECTIVES. Previous research has documented that hospital-based smoking-ce
ssation counseling is efficacious and cost-effective when delivered by rese
arch staff. This study evaluated the implementation and effectiveness of th
is intervention program when delivered by respiratory therapists chosen fro
m the regular hospital staff.
METHODS. A total of 1,173 hospitalized smokers were randomly assigned to ei
ther usual care or a stage-based bedside counseling program supplemented wi
th a videotape, self-help materials, and a follow-up telephone call.
RESULTS. Using an intent-to-treat analysis and counting those lost to follo
w-up as smokers, we did not find a significant difference in outcome betwee
n intervention (14.2% reported being abstinent for greater than or equal to
6 months at the 1-year follow-up) and usual care conditions (13.6% abstine
nce). Process analyses revealed that these results were due to a combinatio
n of failure to reach many patients and reduced effectiveness of respirator
y therapist interventionists compared with experienced professional counsel
ors in a previous study conducted in the same hospitals.
CONCLUSIONS. We recommend implementation of hospital-based smoking-cessatio
n counseling by professional counselors whose primary responsibility is to
deliver the intervention. Recommendations for future research and for innov
ative ways to reach hospitalized smokers who are not receiving intervention