![]() 1-5 Subsequent work has attempted to enhance this effect with smoking interventions that begin in the hospital and continue after discharge. Observational studies have shown that a hospital stay can trigger smoking cessation even in the absence of intervention, especially in patients with cardiovascular and pulmonary disease or in patients having surgery. The value of this idea has been demonstrated over the past decade. Smoking interventions delivered in hospitals and other sites treating patients with chronic medical illness might be particularly effective. A hospitalised smoker must abstain temporarily from tobacco use and is accessible to multiple caretakers who could provide smoking cessation assistance. A hospital stay provides a special incentive for initiating cessation now that the Joint Commission on Accreditation of Healthcare Organizations requires US hospitals to have policies which prohibit smoking. Illness also brings smokers to the health care setting, where providers have an opportunity to encourage cessation. ![]() Illness, especially a tobacco related illness, boosts a smoker's motivation to quit smoking, presumably by increasing a smoker's perceived vulnerability to the health hazards of tobacco use. Far less attention has been paid to settings that deliver more acute medical care, despite the opportunities that these present for changing behaviour. This effort has largely focused on outpatient settings, usually primary care practices. Managed care organisations provide a key channel for delivering smoking cessation interventions to populations. ![]()
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