# Comparative Effectiveness of Post-Discharge Strategies for Hospitalized Smokers

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $791,345

## Abstract

Cigarette smoking is the leading preventable cause of death in the U.S. The U.S. Public Health Service
Smoking Cessation Guideline recommends offering effective treatment that includes both medication and
counseling to smokers in all health care settings, including hospitals. Nearly 4 million smokers are hospitalized
each year, and hospital admission offers a “teachable moment” for intervention. In-hospital smoking cessation
intervention is efficacious, but only if contact continues for more than 1 month after discharge. The challenge is
to translate this efficacy research into clinical practice. Sustaining treatment after discharge is the major barrier
to identifying a scalable, sustainable, cost-effective model for U.S. hospitals. Building on our prior work, this
competitive renewal project compares the effectiveness of 2 innovative strategies that aim to sustain treatment
after discharge. Both interventions are integrated into the electronic health record (EHR) and leverage
technology to engage patients and streamline the delivery and uptake of evidence-based tobacco cessation
treatment, but they differ in intensity and resources required. Specific Aim: To compare the effectiveness and
cost-effectiveness of 2 interventions to increase hospitalized smokers’ long-term tobacco abstinence after
discharge. Study Design: A multi-site randomized controlled comparative effectiveness trial will enroll 1350
adult smokers admitted to 3 hospitals in 3 states (MA, PA, and TN). All subjects will have a standardized in-
hospital smoking intervention and be randomly assigned at discharge to Personalized Tobacco Care
Management (PTCM) or Quitline eReferral (eReferral). PTCM, built on our prior work, offers smokers 4
weeks of free nicotine replacement therapy (NRT) in hand at discharge (refillable x 1) and 7 proactive
automated contacts over 3 months via their preference of interactive voice response (IVR) phone calls or text
messages. Each contact promotes cessation and offers access to a tobacco coach based in the health system
who coordinates treatment with the smoker’s health care team via the EHR. eReferral is a less intensive,
lower cost option in which smokers receive a one-time automated referral from the EHR to the state quitline at
discharge. The quitline offers multi-session telephone counseling, 4 weeks of free mailed NRT, and sends a
feedback report to the EHR. Outcomes, assessed at 1, 3, and 6 months after hospital discharge, are: (1)
intervention effectiveness (biochemically-validated past 7-day tobacco abstinence at 6 month follow-up [1o
outcome] and other tobacco abstinence measures); (2) smoking cessation treatment utilization, and (3) cost-
effectiveness (incremental cost per quit). We will explore the interventions’ effects on hospital readmissions
and mortality after discharge. Impact: New National Hospital Quality Measures (NHQM) adopted by Medicare
and Medicaid programs include tobacco treatment measures, giving hospitals an incentive to ...

## Key facts

- **NIH application ID:** 10202694
- **Project number:** 5R01HL111821-10
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** NANCY A RIGOTTI
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $791,345
- **Award type:** 5
- **Project period:** 2012-03-07 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10202694

## Citation

> US National Institutes of Health, RePORTER application 10202694, Comparative Effectiveness of Post-Discharge Strategies for Hospitalized Smokers (5R01HL111821-10). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10202694. Licensed CC0.

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