Prospective study of predictors of continuous smoking abstinence after hospital discharge

INTRODUCTION: Smoking after discharge from the hospital increases the risk of adverse health outcomes such as unplanned hospital readmissions. This prospective study explores predictors of self-reported continuous smoking abstinence in adult patients 6 weeks after hospital discharge. METHODS: The study population includes 985 adult currently smoking patients, admitted to the hospital between March and December 2021, who were discharged home following their hospital stay and followed up 6 weeks later to reassess smoking status. Electronic health records (EHRs) were used to measure potential predictors of smoking abstinence and included patient demographic factors (age, gender, race, insurance status), clinical characteristics (i.e. length of hospital stay, Charlson Comorbidity score, and other comorbidities such as alcohol or other substance use disorders), and exposure to the hospital's tobacco treatment program (TTP). RESULTS: Among the 985 patients reached for follow-up, 21.1% reported continuous abstinence from cigarette use 6 weeks after hospital discharge. In adjusted analyses, significant predictors of smoking abstinence included being male (adjusted odds ratio, AOR=1.5; 95% CI: 1.0-2.1), older age (AOR=1.02; 95% CI: 1.0-1.04), fewer years smoking (AOR=0.97; 95% CI: 0.95-0.99), and longer hospital stay length (AOR=1.42; 95% CI: 1.1-1.8). A diagnosis of substance use disorder was also associated with lower odds of abstinence (AOR=0.37; 95% CI: 0.2-0.7) while exposure to the TTP was not associated with smoking abstinence at follow-up. CONCLUSIONS: Patients requiring longer hospitalizations were more likely to report smoking abstinence after discharge.