More Hospitals Help Inpatients Quit Smoking

In an editorial recently published in The Joint Commission Journal on Quality and Patient Safety, UW-CTRI Director Dr. Michael Fiore and UW-CTRI Outreach Director Rob Adsit wrote about their optimism that more hospital staff will seize the opportunity to help inpatients quit tobacco use.

Approximately 20% of 3,705 hospitals are now reporting their performance on the tobacco cessation measure set, according to The Joint Commission. While this is an improvement since the release of the 2008 Clinical Practice Guideline: Treating Tobacco Use and Dependence, there is still much work to be done, they wrote.

“A binding rule that incentivizes compliance would likely dramatically improve the percentage of inpatients who get help to quit smoking,” Fiore said. “It takes resources for hospitals to meet, measure, and demonstrate compliance.”

In the paper, Fiore and Adsit pointed to two landmark policy changes that encourage hospitals to help inpatients quit smoking:

  1. In 2012, The Joint Commission released its Tobacco Cessation Performance Measure Set. While this set a standard, it was voluntary for hospitals to report on the tobacco measures.
  2. The Affordable Care Act (ACA) in 2010 mandated that insurers provide coverage for evidence-based prevention services, including smoking cessation, without barriers or co-pays. In 2014, the Departments of Health and Human Services, Labor, and the Treasury jointly released guidance that insurers will be in compliance with the ACA’s prevention requirement to cover tobacco-use counseling and medications if they, for example, provided without cost sharing or prior authorization:
    1. Two courses of tobacco dependence treatment per year (2 “quit attempts”), with each course of treatment including at least 4 tobacco cessation counseling sessions (telephone, group, or individual), each at least 10 minutes long.
    2. Any of the 7 FDA–approved medications to quit smoking for a 90-day treatment regimen when prescribed by a health care provider.

“Fortunately, with these 2 policy advances, along with advances in research and electronic health records, I’m hopeful more hospitals will help their patients quit smoking this year than ever before,” Adsit said.

Fiore MC, Adsit R. Will Hospitals Finally “Do The Right Thing”? Providing Evidence-Based Tobacco Dependence Treatments to Hospitalized Patients Who Smoke. The Joint Commission Journal on Quality and Patient Safety. 2016. May;42(5):207-8.