Hospital-Initiated Smoking Cessation Reduces Deaths and Future Health Care Usage

Great strides have been made over the last 40 years in reducing the number of Canadians who smoke. Yet, smoking tobacco remains a leading cause of preventable illness, hospitalization and death. People who smoke daily average twice as many days in hospital as people who have never been daily smokers. This makes smoking a key driver of overall healthcare usage in Canada.

Hospitalization provides a unique opportunity to intervene with patients and get them on the path to becoming former smokers. The time in hospital is a point at which people are focused on the state of their health and are open to making changes in their lives to improve it.

A recent study from the Ottawa Heart Institute, in collaboration with the Institute for Clinical Evaluative Sciences (ICES), found a hospital-initiated smoking cessation program (the Ottawa Model for Smoking Cessation) reduced mortality and downstream healthcare use.

The Ottawa Model for Smoking Cessation (OMSC) is a systematic approach to helping people quit smoking developed for use in hospitals and other healthcare settings by the Heart Institute. The Ottawa Model has been shown to be highly successful in helping patients quit and is in use in more than 130 hospitals and more than 350 total health care sites across Canada.

The before and after study compared 726 hospitalized smokers who had been treated using the Ottawa Model at one of 14 Ontario hospitals with 641 hospitalized smokers who had not, or who had received "usual care." Results showed that those treated using the Ottawa Model:

• Were more likely to be smoke-free at six-month follow up (35%, versus 20% for usual care)
• Were 50% less likely to be re-admitted to the hospital for any cause and 30% less likely to visit an emergency department in the 30 days following their initial hospitalization
• Were 21% less likely to be re-hospitalized and 9% less likely to visit an emergency department two years following their hospitalization
• Were 40% less likely to die of any cause over two years

“Given the low cost of these interventions, systematic smoking cessation programs that initiate treatments in hospital and attach patients to follow up support should be offered to all patients who smoke,” said Kerri-Anne Mullen, PhD, lead author and program manager for the Ottawa Model for Smoking Cessation Network, and a student scientist at ICES at the time of the study.

“It’s a healthcare no-brainer,” she emphasized. “Strategies like this are cost-effective and will reduce subsequent healthcare use. But most importantly, they are life-saving and will distinctly enhance the well-being of our patients who smoke.”

Additional Recognition for the Ottawa Model

In addition to this latest scientific endorsement of the Ottawa Model, in May, the program was a recipient of the Heather Crowe Smoke-Free Ontario Award. The award from the Ministry of Health and Long-Term Care honours anti-smoking advocates who have made a significant contribution toward achieving a Smoke-Free Ontario.