Post-Discharge Smoking Cessation Strategies: Helping HAND 4

This multi-site randomized controlled trial (RCT) will compare the effectiveness of two
models of post-discharge tobacco cessation treatment for adult smokers who are admitted to 3
large hospital systems in 3 U.S. regions (MA, PA, TN). All patients will receive
guideline-based tobacco cessation treatment delivered in hospital by each site's existing
Tobacco Treatment Service that is directed by a study investigator. Patients who plan to quit
smoking after hospital discharge will be randomly assigned to 1 of 2 post-discharge tobacco
treatment interventions and followed at 1, 3, and 6 months. One arm uses bidirectional
electronic referral (eReferral) to the state tobacco quitline. The other arm, Personalized
Tobacco Care Management (PTCM), combines proactive messages delivered by automated
interactive voice response (IVR) phone calls, text messaging, and/or email with health
coaching provided by a hospital-based tobacco counselor. Both groups will receive at least 1
month of nicotine replacement therapy.

Inclusion Criteria:

- 18 years of age or older

- Current cigarette smoker (>=1 cigarette in the week before admission and >=1
cigarette/day when smoking at a baseline rate in the month prior to admission)

- Admitted to a study hospital

- Seen by hospital smoking counselor during inpatient stay

- Plans to try to quit smoking after hospital discharge

Exclusion Criteria:

- Inability to give informed consent or participate in counseling due to serious
cognitive or psychiatric disorder (e.g., dementia, psychosis)

- Life expectancy <12 months

- Medical instability

- No reliable telephone access or inability to use telephone

- Non-English speaking

- Pregnant, breastfeeding, to planning to become pregnant in the next 6 months.