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Introduction: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. Objectives: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. Methods: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25‐item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi‐square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. Results: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical‐surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). Conclusions: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence‐based tobacco cessation programs at the organizational‐level, including post‐discharge active quitting smoking support. Clinical relevance: Three‐quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation should be a top priority in hospitals. In November 2007, a Portuguese teaching hospital carried out a survey to evaluate cessation attitudes, clinical practices and cessation training needs among hospital-based healthcare providers (HCPs). The study also aimed to identify factors associated with cessation attitudes and practices, self-confidence to intervene and awareness of training programs. Method: This is a cross sectional questionnaire-based study including all HCPs. Sample: The study sample covers 424 HCPs, of which 65.4% were females. Mean age of these HCPs was 38.7 ± 10.1 years and the overall response rate was 50.5%. For data analyses, chi-squared tests, McNemar tests and multiple logistic regression models were used. Results: Most physicians and nurses reported 'Asking' and 'Advising' always or often. Other HCPs reported low frequencies of 'Asking' and 'Advising' ( p < 0.001). Systematic 'Asking' was reported less often than 'Advising' ( p < 0.001). Most HCPs did not record cessation practices, lacked specific training, and were not aware of their training needs. Reported self-confidence, positive attitudes and being a physician or non-smoker were the factors that influenced cessation practices the most. Conclusion: The findings suggest that there is reason to doubt that cessation practices are being undertaken effectively. Hospitals should audit smoking status recording, delivery of effective cessation advice and post-discharge support. Cessation indicators should be mandatory in all healthcare settings. To achieve these goals, undergraduate and graduate cessation training must be given higher priority. [ABSTRACT FROM AUTHOR]