Effectiveness of the Tobacco Tactics Program in the Trinity Health System

Introduction This study determined the effectiveness of the Tobacco Tactics intervention. Design/setting/participants This was a pragmatic, quasi-experimental study conducted from 2010 to 2013 and analyzed from 2014 to 2015 in five Michigan community hospitals; three received the Tobacco Tactics intervention, and two received usual care. Smokers (N=1,528) were identified during hospitalization, and sent surveys and cotinine tests after 6 months. Changes in pre- to post-intervention quit rates in the intervention sites were compared with usual care control sites. Intervention The toolkit for nurses included: (1) 1 continuing education unit contact hour for training; (2) a PowerPoint presentation on behavioral and pharmaceutical interventions; (3) a pocket card entitled “Helping Smokers Quit: A Guide for Clinicians”; (4) behavioral and pharmaceutical protocols; and (5) a computerized template for documentation. The toolkit for patients included: (1) a brochure; (2) a cessation DVD; (3) the Tobacco Tactics manual; (4) a 1-800-QUIT-NOW card; (5) nurse behavioral counseling and pharmaceuticals; (6) physician reminders to offer brief advice to quit coupled with medication sign-off; and (7) follow-up phone calls by trained hospital volunteers. Main outcome measures The effectiveness of the intervention was measured by 6-month 30-day point prevalence; self-reported quit rates with NicAlert® urinary biochemical verification (48-hour detection period); and the use of electronic medical record data among non-responders. Results There were significant improvements in pre- to post-intervention self-reported quit rates (5.7% vs 16.5%, p