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Background: At the cantonal hospital of St. Gallen (KSSG) smoking
cessation counselling, as in other hospital settings, is under-utilized.
One reason could be the absent or non-obvious association between
smoking and the actual patient’s diagnosis. We speculated whether
patients from different departments react with different quit rates. Our
aim was to evaluate which factors influence the success of smoking
cessation.
Methods: We retrospectively analyzed the short-time success rate of
645 patients registered to the smoking cessation consultation at the
KSSG between 2006 and 2009. The medical attendance provided
by a trained physician consisted of counselling and optional
pharmacological treatment. Using logistic regression, we tested the influence of various factors (including referring department, diagnosis,
malignancy and motivation assessed with the Prochaska-staging) on
the quit rate 1 month after first consultation.
Results: More than half of 232 patients with a 1-month follow-up quit
smoking (overall estimate quit rates between 2006 and 2009:
31–47%). We did not find any relationship between quit rate and the
department referring the patient (c2-square test: p = 0.827). In addition,
there was no significant difference between quit rates and different
diagnoses. The presence of malignancy had no effect on the quit
success (p = 0.54, OR = 0.8 [0.4–1.8]). On the other hand, motivation
was significantly associated with the success rate. Patients in the
active Prochaska stage have much higher success rates as compared
to the low-motivated patients (p = 0.004, OR: 12.3 [2.6–89.9]).
Conclusion: Success rates after smoking cessation counselling and
treatment seem to be independent of the department referring the
patient and current diagnosis (incl. malignancy) leading to hospital
admission. Motivation is a key factor in the smoking cessation process.
Therefore, medical care givers of all departments should be
encouraged to provide support in smoking cessation to every smoker;
i.e. all patients should systematically get a short intervention at the
time of admission, and motivated patients should be sent for additional intervention.