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APHA Scientific Session and Event Listing

Rakhi Khatri, MD, MPH¹, Arthur Hoffman, MD, MPH², Janet L. Johnson, PhD³, David Goldberg, MD¹, James O. Prochaska⁴, and Megan Mills, PhD². (1) Section of Preventive Medicine, John Stroger hospital of Cook County, 1900 W. Polk Street, 9th floor, Chicago, IL 60612, 312-864-4465, rkhatri@uic.edu, (2) Internal Medicine, Rush University Medical Centre, 1653 W. Congress, Chicago, IL 60612, (3) Pro-Change Behavior Systems, Inc., P.O. Box 755, West Kingston, RI 02892, (4) University of Rhode Island, 2 Chafee Road, Kingston, RI 02881

The concept of stage is commonly assessed in smoking research and interventions. Due to mandated no smoking hospital policies, the underlying stage of readiness to quit smoking may not be reflected by the temporary abstinence. This study was undertaken to determine the best algorithm for staging hospitalized smokers. Methods: 102 hospitalized smokers completed a bedside, computer-based questionnaire assessing demographics and Transtheoretical Model (TTM) constructs. Three staging algorithms were tested with the questions: In the week before coming to the hospital, were you seriously thinking about quitting smoking? (Algorithm 1) Currently, are you seriously thinking about quitting smoking? (Algorithm 2) Are you willing to (continue to) make an attempt to quit smoking starting now? (Algorithm 3). The stage was reassessed 2-weeks post-discharge using the standard staging algorithm. Each of the three staging algorithms was studied in terms of its relationship to the expected patterns of the TTM constructs of decisional balance and temptation and its ability to predict the stage at 2 weeks. Results: Participants were 61% male, 74% African American, and 20% Caucasian. 70% of participants were unemployed with 64% reporting an annual income less than $20,000. The three algorithms showed similar, yet not identical, relationships with the other TTM constructs. The traditional staging algorithm (Algorithm 2), however, was the least predictive of the smokers' stage at 2 weeks. Conclusion: The traditional staging algorithm may not appropriately stage hospitalized smokers. The other staging algorithms need to be studied in larger samples to determine their internal and external validity.

Learning Objectives:

• 1.Recognize that temporary abstinence in the hospital does not reflect smokers underlying readiness to quit.
• 2.Identify 3 different ways of staging hospitalized smokers
• 3.Recognize the need for developing and testing alternative algorithms for smokers in hospitals

Keywords: , Smoking Cessation

Presenting author's disclosure statement:

Not Answered