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Who Opted Out of an Opt-Out Smoking-Cessation Programme for Hospitalised Patients?

  • Georges J. Nahhas (a1), K. Michael Cummings (a1), Vince Talbot (a2), Matthew J. Carpenter (a1), Benjamin A. Toll (a3) and Graham W. Warren (a4) (a5)...


Introduction: The Medical University of South Carolina (MUSC) hospital implemented an inpatient opt-out smoking-cessation service where smokers received a mandatory smoking-cessation consult and phone follow-up within 1-month post-discharge.

Aim: To examine predictors of patients who opted-out of bedside counselling or follow-up phone calls.

Methods: Eligible adult cigarette smokers admitted to the MUSC hospital were enrolled in the programme. Opting-out of bedside consult or follow-up calls were assessed separately using log-linear modelling where predictors included patient demographics, length of hospitalisation, insurance type, smoking history, and motivation/confidence to quit.

Results: Of the 38,758 admitted patients (February 2014–May 2015), 6,684 reported currently smoking and were automatically referred to bedside-consult. Approximately 26% of smokers made contact with the counselor, most of whom (83%) accepted the consult. Amongst patients eligible for post-discharge follow-up (n = 3485), 49% responded to the calls. Those who opted-out of the bedside-consult were mostly males (RR = 1.29). Those who did not respond to follow-up calls were younger age (RR = 1.33), with Medicaid/no insurance (RR = 1.17), and had not received a bedside consult (RR = 1.32).

Conclusions: An opt-out smoking-cessation programme was feasible and acceptable to most patients and was able to reach 65% of eligible smokers; 17% opted-out of bedside counselling; <1% asked to be removed from further phone calls.


Corresponding author

Address for correspondence: Georges J. Nahhas, PhD, MPHA 68 President St. Charleston, SC, 29425, USA. Email:


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Journal of Smoking Cessation
  • ISSN: -
  • EISSN: 1834-2612
  • URL: /core/journals/journal-of-smoking-cessation
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