Factors associated with the degree of motivation to quit smoking in patients followed by pharmacists at a university hospital in southeastern Brazil

Abstract

Objectives: To describe the clinical role of pharmacists in the management of hospitalized smokers and to assess the factors associated with the degree of motivation to quit smoking in patients followed by pharmacists at a university hospital in southeastern Brazil. Methods: A cross-sectional study, carried out from April 2020 to April 2021, in a Brazilian teaching hospital. Patients admitted to this hospital who express a desire to quit smoking or are in severe nicotine withdrawal are referred for evaluation, in which their degree of motivation for smoking cessation is determined, and a brief approach to smoking cessation is performed, in which the pharmacists provide unique health guidance at the bedside on cigarette use, such as the harmful effects of cigarettes, benefits of quitting smoking, methods of quitting smoking and tips for not relapse, how to quit smoking, analyzed by pharmacists at the edge of the bed. Pharmacists assess the dose of nicotine that should be prescribed according to the number of cigarettes used by patients and intervene on dose adjustment with a physician when necessary. A description of the pharmacist’s performance, descriptive analysis of the variables and the difference in the distribution of variables in the groups “preparation for action” and “contemplation and pre-contemplation” were performed through univariate analysis using the chi-square test of Pearson. Results: Sixty-five smokers participated in the study. All patients received a single brief guidance on smoking cessation. A total of 26 patients (40.0%) had a degree of motivation to prepare for the action, and of these patients 15 (42.9%) were female (Odds ratio – OR 1.295 and Confidence interval CI 0.477 – 3.521 ); 13 (41.9%) were aged <59 years (OR 1.167; CI: 0.432 - 3.151); 21 (44.7%) had multimorbidity (OR: 2.1; CI: 0.645 – 6.840); 4 (25.0%) required pharmaceutical intervention (OR: 0.409; CI: 0.116 – 1.448) and 14 (60.9%) tried to quit smoking before admission (OR: 3.759; CI: 1.284 – 11.005). Conclusion: A high prevalence of patients with a degree of motivation to prepare for smoking cessation action was detected. A statistically significant association was identified between the degree of motivation, preparation for action and history of smoking cessation attempt.