Automated Telephone Follow-up for Smoking Cessation in Smokers with Coronary Heart Disease: A Randomized Controlled Trial.

Introduction: Smokers with coronary heart disease (CHD) benefit from in-hospital cessation treatment, but relapse is common without ongoing support postdischarge. The purpose of this study was to determine if smoking abstinence would be higher after hospital discharge in smokers who received automated telephone follow-up (ATF) and nurse-counseling, compared with a standard care (SC) control group. Methods: A total of 440 smokers hospitalized with CHD were randomly assigned to the ATF group (n = 216) or to the SC group (n = 224). Participants in the ATF group received automated phone calls 3, 14, 30, 60, 90, 120, 150, and 180 days after hospital discharge. The ATF system posed questions concerning smoking status, confidence in staying smoke-free, and need for assistance. If flagged by the ATF system, a nurse-counselor provided additional counseling by phone. Self-reported continuous smoking abstinence was assessed 26 and 52 weeks postdischarge using intention-to-treat analysis. The main outcome measure was continuous abstinence for weeks 1-26 postdischarge. Results: Participants in the ATF group achieved higher abstinence rates for weeks 1-26 than those in the SC group (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.01 to 2.33). There was no significant difference between groups in abstinence rates for weeks 27-52 (OR = 1.37; 95% CI = 0.89 to 2.09). Conclusions: ATF-mediated follow-up helped smokers with CHD achieve abstinence during the intervention period.There was a trend toward clinically important improvements for weeks 27-52; but between-group differences for this time point did not achieve statistical significance.