The Effectiveness of a Directly Mailed Smoking Cessation Intervention to Australian Discharged Hospital Patients

Background. The objective was to assess the effectiveness of a directly mailed smoking cessation intervention to discharged hospital patients. Methods. A randomized controlled trial was used. In the 2 weeks after discharge, smokers in the intervention group were sent by mail a personally addressed letter from their medical consultant urging them to quit plus a self-help quitting manual, and smokers in the control group received usual care. Patients were surveyed about their smoking status at 6 and 12 months after discharge. A total of 1858 discharged patients responded to both questionnaires. The main outcome measures were self-reported smoking in past week at 6 and 12 months after discharge. Quitters at 12 months were biochemically tested for evidence of smoking. Results. The results failed to show that smoking cessation advice directly mailed to a broad cross-section of discharged hospital patients who smoke led to smoking cessation. However, the intervention increased cessation among smokers with medical conditions for which quitting is highly relevant. In general, patients who were more likely to quit were older, had entered the hospital as an emergency case, and had a medical diagnosis for which quitting is highly relevant. Conclusions. This study suggests that hospital patients who smoke and are also diagnosed with conditions which call for quitting are more likely to quit if they receive from their consultant a personalized letter advising them to quit and a self-help manual.