Evaluation of long-term results of smoking cessation interventions of patients which are treated in services of the Recep Tayyip Erdoğan University Education and Research Hospital

Objective: It is a scientifically proven fact that smoking is the cause or facilitating factor of many diseases. The economic burden of smoking on society reveals the necessity of developing systematic approaches to combat smoking addiction. There are prohibitions and regulations integrated into social life in our country in order to prevent smoking and reduce smoking addiction. In addition to these, specialized smoking cessation interventions are carried out through smoking cessation outpatient clinics within the health system. In the interventions made by healthcare professionals in the hospital environment, targeting patients who are receiving inpatient treatment in the hospital increases the probability of success in the fight to quit smoking. The physical and psychological environment of the patient receiving medical support in an inpatient setting motivates him or her to quit smoking. Making the smoking cessation intervention to the 'sick' individual increases the persuasiveness. Continuing the support provided to patients in 'real life conditions' after discharge will make it quite possible to quit smoking. There are examples of smoking cessation interventions for inpatients around the world. Our aim in this study is to show a practical example of the success of smoking cessation intervention for patients receiving inpatient treatment in our country. Materials and Methods: In our study, patients who were hospitalized in the inpatient services of Rize Recep Tayyip Erdoğan University Training and Research Hospital between the date of 20.10.2021 and 20.03.2022 for various reasons other than COVID-19 were examined. Smoking cessation intervention was applied to active smokers during bedside visits in the ward. The contact information of the patients was recorded and their follow-up was continued for one year with phone calls after they were discharged. All patients were invited to the smoking cessation outpatient clinic after discharge, in addition to the smoking cessation intervention. Patients who applied to the smoking cessation outpatient clinic were provided with pharmacological treatment support and their follow-up continued for one more year. Patients who declared that they quit smoking at the end of one year were invited to the smoking 9 cessation outpatient clinic for the measurement of exhaled CO (carbon monoxide) level. With the measurement of the exhaled CO level, it was also chemically confirmed that the patients quit smoking. In our study, the long-term results of interventions for patients receiving inpatient treatment for smoking cessation and the factors affecting smoking cessation were examined. Results: Of the 183 patients included in the study, 68.8% were hospitalized in internal branch services, while 31.1% were hospitalized in surgical branch services. Considering the reasons for inpatient treatment, 35% of the patients were hospitalized for pulmonary disease, 29% for metabolic disease, 19% for surgery, and 17% for malignancy. Considering the comorbidities, the most common ones were cardiovascular, pulmonary and metabolic diseases. 65 of the patients applied to the smoking cessation outpatient clinic after discharge, and the follow-up of all patients was continued for one year with phone calls. While the rate of smoking cessation was 48.3% in patients who applied to the smoking cessation outpatient clinic, the rate of smoking cessation was 46.6% in the patients who did not apply to the smoking cessation outpatient clinic and were followed up by phone calls. Considering the number of patients who applied to the emergency department and family physician at the end of one year, it was seen that patients who did not quit smoking applied more and this was statistically significant (p <0.001). In the correlation analysis between the number of cigarettes smoked per day and the number of applications to the emergency department and the family physician of the patients who continued to smoke during the follow-ups, a strong correlation was found between the number of cigarettes smoked per day and the number of applications(p <0.001), and it was seen that as the number of cigarettes consumed per day by patient increases, the application to the health services by patient increases. (correlation coefficient r: 0.678 for emergency admission, r: 0.498 for family physician referral). In the analyzes we conducted in our study, a statistically significant relationship was found between the patients' anxiety and their smoking cessation, and it was observed that patients who quit smoking experienced less anxiety (p:0.024). Among the patients who applied to the smoking cessation outpatient clinic, 15 mg nicotine patch was given to those with low level of addiction according to Fagerström Dependence Level, and 25 mg nicotine patch to those with moderate and high level of addiction. 10 Considering the nicotine patch usage among patients who quit smoking, the smoking cessation success of the patients given 15 mg nicotine patch was found to be higher and statistically significant (p:0.036). Conclusion: In our study, which included smoking cessation interventions for patients receiving inpatient treatment and one-year follow-up after discharge, the success of smoking cessation was 47.2% in the entire population. Patients who cannot quit smoking apply to health institutions more frequently than patients who quit smoking. This shows that the interventions to be initiated in real-life conditions and the continuation of the interventions with strict follow-up on smoking cessation are a cost-effective method in reducing the number of applications. Such interventions need to be supported by new studies and their scope should be expanded. Keywords: inpatient, smoking cessation, follow-up, pharmacological support