BACKGROUND AND IMPLEMENTATION CHALLENGES: Tobacco use remains a major risk factor for various diseases and complications, contributing to increased hospitalization and adverse treatment outcomes. Providing inpatients with bedside brief advice and structured tobacco cessation support offers a significant opportunity for them to quit. Despite this, tobacco cessation services are limited in hospitals across India.
INTERVENTION OR RESPONSE: LifeFirst, a hospital-based tobacco cessation program, was implemented in the Medicine and Surgery wards of a municipal tertiary care hospital in Navi Mumbai, India. The programme followed a structured protocol, including bedside screening of all patients, brief advice and behaviour modification counselling based on the transtheoretical model of change. The program extended beyond the hospital stay, offering telephonic counselling at regular intervals for six months post-discharge.
RESULTS AND IMPACT: From July 2021 to March 2024, 11462 adult patients were admitted to the identified wards, with 10175 (89%) screened for tobacco use. Among those, 2108 (21%) were identified as current tobacco users. All tobacco users received brief advice from a LifeFirst counsellor and 1272 (60%) voluntarily enrolled for counselling. Majority were male (98%), with an average age of 39 years. 13% had no formal education, while 31% had primary schooling. The most commonly used tobacco products included tobacco-lime mixture (64%), gutkha (35%), cigarettes (23%), and bidis (8%).
Over the six-month counselling period, 29 patients (2%) died and 14 (1%) opted out. 560 patients (44%) reported successfully stopping tobacco use, 227 (18%) reduced consumption and 358 (28%) were lost to follow-up. The average follow-up rate at each scheduled follow-up was 70%.
CONCLUSIONS: Tailored bedside tobacco cessation counselling with follow-up support is both feasible and effective for hospitalized patients in India. The model can be scaled up across other hospitals after further research; contributing to improved access and health outcomes and reduced tobacco-related morbidity and mortality.