URL of this page: http://www.nlm.nih.gov/medlineplus/podcast/transcript092914.html

NLM Director’s Comments Transcript

Helping Smokers Quit: 09/29/2014

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff U.S. National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

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Hospital-discharged smokers (who received automated phone calls and a choice of free medications) stopped smoking more than peers (who received general smoking cessation advice and paid for a pre-selected medication), finds a recent study published in the Journal of the American Medical Association.

The clinical trial, carefully conducted at Massachusetts General Hospital from 2010-2012, compared two groups of 198 and 199 adults who were encouraged to stop smoking following a hospitalization. Smoking cessation was biochemically validated for all participants.

The clinical trial’s intervention group (or the group who received sustained care) was called to encourage smoking cessation at 2, 13, 30, 60, and 90 days following their hospital stay. The authors describe the calls (and we quote): ‘provided advice and support messages that prompted smokers to stay quit, encouraged proper use and adherence to cessation medication, offered medication refills, and triaged smokers to a return telephone call from a live counselor for additional support’ (end of quote).

In the calls, the sustained care group also was encouraged to call a specific counselor (and we quote): ‘if they had low confidence in their ability to stay quit, had resumed smoking but still wanted to quit, needed a medication refill, had problems with a medication, or had stopped using any medication’ (end of quote).

In addition, the sustained care group hand picked their anti-smoking medication from an array of choices, and received a free 30 day medication supply, which was refillable twice for up to 90 days after their treatment began.

In contrast, the control group of smokers (also discharged from Mass General) only received a pre-selected prescription for a smoking cessation medication as well as advice to call a national quit smoking telephone hotline.

The study found after six months 26 percent of the sustained care group stopped smoking for at least a week compared to 15 percent of the control group (who received less assistance and paid for medications.) The authors report these differences are statistically significant.

The study’s ten authors note (and we quote): ‘The intervention used interactive voice response technology to automate telephone calls, providing an efficient, low-cost way to systematically maintain contact with smokers after hospital discharge’ (end of quote).

The authors conclude the findings suggest (and we quote): ‘a translatable, low-cost approach to achieving sustained smoking cessation after a hospital stay’ (end of quote).

More broadly, this study represents a rare, low key, scalable clinical trial that suggests inexpensive efforts to contact ex-smokers are comparatively successful and a hospital discharge can be used to create a sustainable, teachable moment for some patients. The findings also provide some pragmatic strategies for hospitals and clinics.

 Meanwhile, a helpful guide to quitting smoking provided by the American Cancer Society is available in the ‘start here’ section of MedlinePlus.gov’s quitting smoking health topic page. The American Cancer Society also provides a website to help persons counter cravings to smoke as well as how to handle difficult situations in the ‘coping’ section of MedlinePlus.gov’s quitting smoking health topic page.

The National Cancer Institute adds a helpful overview that compares smoking risks with the benefits of quitting within the ‘overviews’ section of MedlinePlus.gov’s quitting smoking health topic page.

MedlinePlus.gov’s quitting smoking health topic page additionally provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials - (perhaps similar to the one at Mass General) - that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about smoking cessation as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s quitting smoking health topic page type ‘quit smoking’ in the search box on MedlinePlus.gov’s home page, then, click on ‘Quitting smoking (National Library of Medicine).’ MedlinePlus.gov also has a comprehensive health topic page on the health risks of smoking.   

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A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.