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Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease

Award Number: R01HL156851
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease - PROJECT SUMMARY Tobacco use remains the leading cause of death in the United States and contributes to more than 7 million hospitalizations annually. Hospitalization offers a critical window for intervention: hospital policies prohibit smoking, patients are highly motivated to quit, and societal guidelines recommend that clinicians should counsel patients and prescribe smoking cessation pharmacotherapy (SCP) to virtually all smokers. Nevertheless, only 22% of patients are ever prescribed SCP while hospitalized and only 1% of patients are prescribed guideline-concordant SCP. This failure ultimately contributes to a 70-80% smoking relapse rate, most of which occurs within a few days of hospital discharge – well before outpatient follow-up can occur. If we are to capitalize on the opportunity that hospitalization provides to maximize smoking cessation treatment and outcomes, new strategies are needed to overcome the low uptake of guideline-concordant SCP by physicians and patients. To address this problem, we propose to deploy a nurse practitioner-led, hospital- based tobacco treatment team to: 1) prescribe individually tailored and guideline-concordant SCP; 2) counsel and motivate patients to use SCP properly; and 3) and manage a mobile phone-based text-messaging system to keep patients motivated and adherent to SCP. Our preliminary data suggest that such an approach is feasible and acceptable to patients, physicians, and hospital administrators. In Aim 1, we will perform a parallel-group implementation-effectiveness randomized trial among 424 hospitalized smokers with a cardiopulmonary disease in a large tertiary hospital. We will compare rates of SCP use and smoking cessation between patients who received the intervention and those who did not. In Aim 2, we will measure the economic value of the intervention from both a hospital and payer perspective to better inform hospital and insurance policies and sustainability. In Aim 3, we will perform qualitative interviews with patients, physicians, staff members, and hospital administrators to evaluate the acceptability and sustainability of our strategies. We hypothesize that our intervention will: improve guideline-concordant SCP use; increase 6- month smoking cessation rates; be acceptable to patients, clinicians, and administrators; and be cost-effective and sustainable. Our multi-disciplinary team has broad experience in cardiopulmonary medicine, tobacco treatment, implementation science, medication adherence, qualitative methods, health economics, and text message technology. At the conclusion of this grant, our team will develop a detailed, evidence-informed implementation guide for a hospital-based tobacco treatment team. Ultimately, we anticipate the knowledge gained from this study will facilitate widespread and effective hospital-based tobacco treatment so that more patients lead lives free from tobacco and cardiopulmonary disease.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	000	3	2/24/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $648,468 )
2024	2024	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	003	3	6/17/2024	NON-COMPETING CONTINUATION	$52,936
2024	2024	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	002	3	3/28/2024	NON-COMPETING CONTINUATION	$0
2024	2024	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	001	3	2/29/2024	NON-COMPETING CONTINUATION	$595,532
2024	2023	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	000	2	10/13/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $648,468

Issue Date FY: 2023 ( Subtotal = $672,304 )
2023	2023	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	001	2	3/23/2023	NON-COMPETING CONTINUATION	$672,304
2023	2022	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT STREET	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	000	1	11/23/2022	NEW	$0
														Subtotal = $672,304

Issue Date FY: 2022 ( Subtotal = $736,010 )
2022	2022	BAYSTATE MEDICAL CENTER, INC.	759 CHESTNUT ST	SPRINGFIELD	MA	01199	HAMPDEN	USA	Cardiovascular Diseases Research	000	1	3/8/2022	NEW	$736,010
														Subtotal = $736,010

Grand Total All Awards = $2,056,782

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Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease

Award Number: R01HL156851

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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