Intervening to Promote Tobacco Cessation Following Psychiatric Hospitalization

Cigarette smoking is the leading cause of death and disability in the United States. People with psychiatric disorders consume almost half (44.3%) of all cigarettes smoked in the U.S. and have life spans more than 20 years shorter than the general population. Effective quit smoking treatments for people with psychiatric disorders are sorely needed.When patients are hospitalized for a psychiatric disorder, they are not allowed to smoke. This enforced period of no smoking creates what professionals call "a teachable moment". It provides an excellent opportunity to discuss the prospect of staying quit once the individual leaves the hospital.In our ongoing research, we have developed and tested a Sustained Care quit smoking intervention for smokers engaged in a psychiatric hospitalization. The intervention includes: 1) a professionally-led, motivational counseling session to encourage quitting smoking and increase awareness about available quit smoking resources, 2) a referral to the Texas Tobacco Quitline for phone-based, quit smoking counseling, and 3) an offer of 8 weeks of nicotine patches after leaving the hospital. Our findings from our recently completed clinical trial provide strong support for this Sustained Care intervention.Our aims in the current project are to develop and test a tablet computer-based, motivational counseling intervention that does not require a trained professional counselor. Our goal is to conduct a clinical trial to demonstrate the effectiveness of this tablet-based, Sustained Care intervention for smokers engaged in psychiatric hospitalization. As before, we will provide the same quit smoking resources (Quitline and nicotine patches) upon hospital discharge. If successful, next steps will involve plans to implement this quit smoking intervention in psychiatric hospitals throughout Texas, in order to reduce the burden caused by tobacco-related cancers among the citizens of Texas.

Inclusion Criteria:Male or female patients above the age of 18 capable of providing informed consentCurrent smoker (at least 5 cigarettes/day when not hospitalized)Willing and able to provide informed consent, attend all study visits, and comply with the protocolExclusion Criteria:Mini-Mental State Examination (MMSE) score < 24Current diagnosis of dementia or other cognitive impairment that would limit study participationInability to provide consent for study participation due to his/her inability to demonstrate an understanding of study proceduresCurrent diagnosis of a (non-nicotine) substance use disorder requiring detoxificationNo access to or inability to communicate by phone, or no stable mailing addressPlanned discharge to institutional care (e.g., nursing home, long-term rehabilitation, jail, etc.)Medical contraindication to nicotine patch useCurrently pregnant or breastfeeding