Background: Hospital pharmacists currently play a limited role in the management
of nicotine withdrawal and smoking cessation. Little is known about the hospital
pharmacist’s impact on initiating smoking cessation interventions.
Aim: The aims of this study were to evaluate the effectiveness of hospital pharmacist
initiated smoking cessation intervention (SCI) in increasing the utilisation of Nicotine
Replacement Therapy (NRT) in hospitalised smokers, and in increasing quit rates
Method: This study was conducted in a tertiary referral hospital using the pragmatic
randomised control design. After screening, 100 inpatient smokers were enrolled and
randomised to either the intervention or usual care arm (n=50 for both arms).
Smoking-cessation advice was available to all smokers during their hospital stay
under the smoking management policy, which represented usual care. Those in the
intervention arm received brief SCI from the research pharmacist and were offered
NRT if required. The research pharmacist also facilitated prescription of NRT on
discharge. Prescribing rates of NRT in the hospital and on discharge in both the
groups was compared. Participants were contacted by phone 3 months after
enrolment to assess their 7 day point prevalence of abstinence (PPA) from smoking
and use of NRT post discharge.
Results: A significantly higher proportion (68% vs.12%) of participants in the
intervention arm received NRT on discharge (p<0.001, OR 15.6) and significantly
more participants who received smoking-cessation advice from the hospital
pharmacist continued to use NRT after discharge (OR 3.1). A similar number of
participants in both the groups claimed 7-day PPA after 3-months (18% usual-care vs
15% intervention-arm, p=0.77, OR 0.8).
Conclusions: This study demonstrated that pharmacist led brief SCI can enhance
the utilisation of NRT in hospital and after discharge. Exploring feasible options for a
coordinated, multidisciplinary approach to smoking cessation in hospital and across
the continuum may have a greater impact on long term smoking cessation rates.