Sustained Care Intervention and Postdischarge Smoking Cessation AmongHospitalized Adults A Randomized Clinical Trial

IMPORTANCE Health care systems need effective models to manage chronic diseases like tobacco dependence across transitions in care. Hospitalizations provide opportunities for smokers to quit, but research suggests that hospital-delivered interventions are effective only if treatment continues after discharge. OBJECTIVE To determine whether an intervention to sustain tobacco treatment after hospital discharge increases smoking cessation rates compared with standard care. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial compared sustained care (a postdischarge tobacco cessation intervention) with standard care among 397 hospitalized daily smokers (mean age, 53 years; 48%weremales; 81%were non-Hispanic whites) who wanted to quit smoking after discharge and received a tobacco dependence intervention in the hospital; 92 % of eligible patients and 44 % of screened patients enrolled. The study was conducted from August 2010 through November 2012 at Massachusetts General Hospital. INTERVENTIONS Sustained care participants received automated interactive voice response telephone calls and their choice of free smoking cessationmedication (any type approved by the US Food and Drug Administration) for up to 90 days. The automated telephone call