Smokers in rural communities face significant challenges that must be addressed. A multilevel model centered on improving access to health care system resources while addressing intrinsic and community/social factors might enhance smoking-cessation interventions and programs in rural communities.

BACKGROUND:The efficacy of smoking cessation interventions for hospital patients has been well described, but we know little regarding implementation and outcomes of real‐world programs.OBJECTIVE:To describe the services provided and outcomes of an academic medical center‐based tobacco treatment service (UKanQuit) located in the Midwestern United States.METHOD:This is a descriptive observational study. Both quantitative and qualitative data of all patients treated by UKanQuit over a 1‐year period were analyzed.RESULTS:Among 513 patients served, average interest in quitting was 7.9, standard deviation (SD) 2.9 on a scale of 0 to 10. More than 1 in 4 had been given an in‐hospital medication to ameliorate withdrawal prior to seeing a counselor. Counselors recommended medication changes for 1 in 3 patients, helped 73% set a goal for quitting or reducing tobacco use, and fax referred 56% to quitlines. Six‐month follow‐up (response rate, 46%) found a 7‐day abstinence rate of 32% among respondents for an intent‐to‐treat abstinence rate of 15%. Post‐discharge, 74% made at least one serious quit attempt, 34% had used a quit smoking medication, but only 5% of those referred to the quitline reported using it.CONCLUSIONS:In a hospital setting, interest in quitting is high among smokers who requested to see a tobacco counselor but administration of inpatient medications remains low. Many smokers are making unassisted quit attempts post‐discharge because utilization of cessation medications and quitline counseling were low. Fax‐referral to quitline may not, on its own, fulfill guideline recommendations for post‐discharge follow‐up. Journal of Hospital Medicine 2010;. © 2010 Society of Hospital Medicine.

This study demonstrates that smokers will remain engaged in long-term counseling designed to address the chronic nature of nicotine dependence.

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