Gender and Smoking Cessation Treatment for Hospitalized Smokers

Caruthers, Donna D.

Friday, 26 July 2013: 8:30 AM

Donna D. Caruthers, PhD, RN
Department of Nursing and Allied Health Professions, Indiana University of Pennsylvania, Indiana, PA
Susan E. Bare, MSN, CNM
University of Pittsburgh, Pittsburgh, PA
Roberta M. Fiore, MSN, RN
Office of the Dean, University of Pittsburgh, Irwin, PA

Learning Objective 1: discuss background literature related to gender differences and smoking cessation.

Learning Objective 2: identify smoking related variables that have potential to influence cessation outcomes.

Purpose: Examine gender differences among a sample of hospitalized smokers formerly enrolled in a smoking cessation RCT.

Methods: The primary aim of this secondary analysis, with IRB approval, examined gender differences from data obtained from a RCT of a smoking cessation intervention initiated with hospitalized smokers. Eighty participants were enrolled in an RCT smoking cessation study prior to hospital discharge and provided an enhanced usual care smoking cessation intervention. Following discharge, intervention treatment included 8 additional phone delivered relapse prevention interventions over 3 months. Study variables included carbon-monoxide validated 7-day smoking point-prevalence, self-efficacy for tobacco abstinence, mood, outcome expectancy, tobacco-use characteristics, and socio-demographic information as measured by the Relapse Self-efficacy Questionnaire, Tobacco Self-efficacy Questionnaire, Perceived-Therapeutic Efficacy Scale (Outcome Expectancy) for Tobacco Abstinence, Profile of Mood States (POMS) and a demographic survey. Analysis included t-tests, Chi-Square, ANOVA, and Logistic Regression.

Results: On average, the 48 females and 32 males, evenly randomized to study groups, were 51 years old (SE 1.7), white, and hospitalized for 6 days (SE 1.0 & 0.8). Compared to males, females had significantly higher depression (p < .05), tension/anxiety (p < .032), and anger/hostility (p < .043) with subscales of the POMS. Unlike males, significantly fewer females assigned to the treatment group (C² = 9.34, p < .003) relapsed from tobacco abstinence by the 6-month data collection. Stepwise logistic regression results of tobacco abstinence of males identified longer length of hospital stay as the only predictor of tobacco abstinence six months following discharge (OR 1.6, p < .02, CI 1.1 – 2.4), but the study intervention was the only predictor of tobacco abstinence among women (OR 10.5, p < .007, CI 2-56).

Conclusion: These results differ from the literature with female responding to the relapse prevention intervention. The intervention design potentially influenced the results between genders of this study.

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