Background. We conducted a structured review of controlled studies on inpat
ient hospital-based smoking cessation interventions.
Methods. Electronic searches were conducted with two different search engin
es, and reference sections of articles located were also reviewed. The RE-A
IM framework was used to organize the review around the issues of reach, ef
ficacy, adoption, implementation, and maintenance of interventions.
Results. Thirty-one intervention articles were located, 20 of which include
d a comparison condition and were included in the review. Overall, a modera
te number of studies (13/20) reported on reach, which was highly variable a
nd limited (30-50% in most studies), while few reported on implementation (
7/20). Longer term cessation results produced relative risk ratios of 0.9-2
.3, with a median of 1.5. Increases in quit rates above the control conditi
on ranged from -1 to 10% (median 4%) among general admission patients and f
rom 7 to 36% (median 15%) among cardiac admission patients. Studies with a
dedicated smoking cessation counselor and 3-5 months of relapse prevention
had a significant impact on cessation rates. Study settings (adoption) were
limited to university, Veterans affairs, and HMO hospitals. Maintenance at
the individual level was variable and related to the presence of a relativ
ely intensive initial intervention and a sustained relapse prevention inter
Conclusions. Efficacious inpatient smoking programs have been developed and
validated. The challenge now is to translate these interventions more wide
ly into practice, given changing hospitalization patterns. (C) 2001 America
n Health Foundation and Academic Press.