***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Recent findings suggest that smokers who are hospitalized experience significant craving for cigarettes . Thus , nicotine replacement therapy ( NRT ) may be a particularly important tool for use during hospitalization . The goal of this study is to evaluate the utilization of the transdermal nicotine patch and /or nicotine gum by hospitalized smokers . The data represented in this article are from 580 smokers who participated in a study of a motivational intervention for smoking cessation that was delivered during hospitalization . The primary outcome for this analysis was use of NRT during hospitalization . The results revealed that , among the entire sample , only 7.1 % of the overall sample used NRT during hospitalization ; 6 % of the hospitalized smokers used the transdermal nicotine patch , and 1.1 % used nicotine gum .  Use of NRT  was significantly greater among patients who reported that they were doing anything to help themselves quit smoking at the time of admission ( OR=4.1 ) , those who were seriously planning to quit smoking within the next 30 days ( OR=2.36 ) , those who were nicotine dependent ( OR=2.81 ) , and those for whom a physician had ever offered to prescribe NRT (OR=1.9).The finding that there is a very low rate of NRT use during hospitalization provides important information to hospital-based care providers and smoking cessation intervention planners . Barriers to NRT use among hospitalized patients should be identified , and strategies design ed to maximize use when appropriate . TheAHCPR Guideline on Smoking Cessation recommends routine use of NRT in health care setting s. Further research is needed to determine why  NRT use was so low . In addition , these data suggest that efforts to increase  NRT use during hospitalization are needed Cigarette smoking is a major risk factor for head and neck cancer , and individuals who continue to smoke past diagnosis and treatment are at elevated risk for further disease . In a r and omized controlled trial , a state of the art provider-delivered smoking cessation intervention was compared to a usual care advice control condition . The intervention consisted of surgeon- or dentist-delivered advice to stop smoking , a contracted quit date , tailored written material s , and booster advice sessions .  Subjects were 186 patients with newly diagnosed first primary squamous cell carcinomas of the upper aerodigestive tract who had smoked cigarettes within the past year . At r and omization , 88.2 % of subjects were current smokers . At 12-month follow-up , 70.2 % of subjects completing the trial ( n = 114 ) were continuous abstainers ; among baseline smokers alone the continuous abstinence ( CA ) rate was 64.6 % . The cotinine validation rate at 12 months was 89.6 % . Modeling techniques were utilized in order to derive expected CA rates , which included noncompleter subjects ( n = 72 ) . The CA rate expected at 1 year for the entire patient population was 64.2 % , and for smokers alone the expected CA rate was 59.4 % . Logistic regression analysis carried out on baseline smokers identified predictors of 12-month CA status . These included medical treatment , stage of change , age , nicotine dependence , and race . The intervention effect was not significant , although the sign of the effect was positive . Based on these findings , we recommend systematic brief advice to stop smoking for head and neck cancer patients , with a stepped care approach for patients less able to quit Background : Smoking is a major public health issue , estimated as causing 120 000 deaths in the UK per year . Smoking cessation is an important aspect of the treatment of many diseases . Nicotine replacement therapy ( NRT ) has been shown to increase cessation rates among healthy volunteers and in general practice , but it is not clear whether it has an effect in hospital patients . Methods : Patients referred by their hospital doctor to the smoking cessation counsellor and who agreed to participate in the study were r and omised to receive either NRT given as a nicotine patch daily and a nicotine inhalator on an as needed basis plus advice and support ( AS+NRT ) , or to receive just advice and support ( AS ) . Cl aims of smoking cessation were vali date d at 1 week , 3 months , 6 months , and 1 year by carbon monoxide ( CO ) breath testing . Results : A total of 245 patients were r and omised , 136 AS+NRT and 109 AS . There were no significant demographic differences between the two groups at baseline . At 1 year 35 ( 14 % ) had sustained cessation confirmed by a CO breath test , 20/136 ( 15 % ) AS+NRT and 15/109 ( 14 % ) AS , p=0.857 . One hundred and ten patients gave up smoking for at least 1 week , 54 % AS+NRT and 33 % AS ( p<0.001 ) . By 6 months there was no significant difference between the two groups ( 22/136 ( 16 % ) AS+NRT and 15/109 ( 14 % ) AS ) . Conclusion : In hospital patients  NRT , given as regular daily patches plus an inhalator to be used as needed , did not add to the smoking cessation rate achieved at 1 year by regular advice and support , despite significantly increasing the cessation rate at 1 week This study reports on the effectiveness of a nurse case-managed smoking cessation program for general hospitalized patients that was continued for 3 years after clinical trials were completed . Patients admitted to the hospital who smoked were offered a smoking cessation program during their hospitalization . The program included physician advice , bedside education and counseling with a nurse specially trained in smoking cessation techniques , take-home material s ( videotape , workbook , and relaxation audiotape ) , nicotine replacement therapy if requested or indicated , and four nurse-initiated post-discharge telephone counseling calls . Of the 2091 patients identified as smokers , 52 % enrolled in the program , 18 % wanted to quit on their own , 20 % did not want to quit , and 10 % were ineligible . The 12-month self-reported cessation rate ( 7-day point prevalence ) was 35 % if patients lost to follow-up were considered smokers , 49 % if not . Patients hospitalized for cancer , cardiovascular , or pulmonary reasons were most likely to participate and had the highest self-reported cessation rates ( 63 % , 57 % , and 46 % , respectively ) . This nurse-managed smoking cessation intervention  was effective when it was put into st and ard hospital practice outside of its originating r and omized clinical trial structure . The program , relatively inexpensive to deliver , appears to be acceptable to the majority of smokers who are hospitalized , result ed in high 1-year cessation rates , and can be extended to hospital employees and their families , work-sites , and communities on a cost-recovery basis OBJECTIVE To assess the level of nicotine replacement , evidence of nicotine toxicity , and withdrawal symptom relief with placebo and 11- , 22- , and 44-mg/d doses of transdermal nicotine . A secondary objective was to assess short- and long-term smoking cessation rates . DESIGN R and omized , double-blind , placebo-controlled inpatient/outpatient trial . SUBJECTS Seventy-one cigarette smokers stratified according to light ( n = 23 ) , moderate ( n = 24 ) , and heavy ( n = 24 ) smoking rates . INTERVENTIONS After baseline measures were obtained , subjects were r and omly assigned to  placebo or an 11- , 22- , or 44-mg/d dose of transdermal nicotine  and admitted to a special hospital unit for intensive inpatient treatment of nicotine dependence . During the 6-day inpatient stay , daily nicotine and cotinine levels were determined from trough and peak blood sample s. Outpatient patch therapy continued for 7 weeks following the hospital stay , and those initially assigned to placebo were r and omly assigned to 11 or 22 mg/d . At week 4 , the dosage of those initially assigned to 44 mg/d was reduced to 22 mg/d . MAIN OUTCOME MEASURES Percentage of replacement of cotinine was calculated by dividing the steady-state levels attained during patch therapy by the corresponding baseline levels . Abstinence from smoking was verified by expired air carbon monoxide . Withdrawal symptoms and nicotine toxicity were assessed daily through question naires during the inpatient stay . Follow-up visits were at 3 , 6 , 9 , and 12 months . RESULTS There was a statistically significant relationship between baseline smoking rate and baseline trough and peak blood cotinine levels ( rs = 0.39 , rs = 0.45 ; P < .001 in both instances ) . A dose-response relationship was observed with higher patch doses , which produced a higher percentage of cotinine replacement and better withdrawal symptom relief . Only one subject ( a light smoker assigned to the 44-mg dose ) developed signs of nicotine toxicity . There was a positive association between the week 2 patch dose and the biochemically confirmed abstinence at the end of patch therapy ( P = .007 ) but not for subsequent follow-up times . A higher percentage of cotinine replacement was associated with the higher 8-week smoking abstinence rate ( P = .03 ) , an association not found at long-term follow-up . CONCLUSION A 44-mg/d dose of nicotine patch therapy appears to be safe for use in heavy smokers . Cigarette smoking rates can be used to estimate the initial nicotine patch dose . Monitoring blood cotinine levels at baseline and steady state can be used for assessing the adequacy of nicotine replacement . Withdrawal symptom relief can be improved with more complete nicotine replacement . Achieving a greater percentage of nicotine replacement may increase the efficacy of nicotine patch therapy BACKGROUND Smokers are at higher risk of cardiopulmonary and wound-related postoperative complications than non-smokers . Our aim was to investigate the effect of preoperative smoking intervention on the frequency of postoperative complications in patients undergoing hip and knee replacement . METHODS We did a r and omised trial in three hospitals in Denmark . 120 patients were r and omly assigned 6 - 8 weeks before scheduled surgery to either the  control ( n=60 ) or smoking intervention ( 60 ) group .  Smoking intervention was counselling and nicotine replacement therapy , and either smoking cessation or at least 50 % smoking reduction . An assessor , who was masked to the intervention , registered the occurrence of cardiopulmonary , renal , neurological , or surgical complications and duration of hospital admittance . The main analysis was by intention to treat . FINDINGS Eight controls and four patients from the intervention group were excluded from the final analysis because their operations were either postponed or cancelled . Thus , 52 and 56 patients , respectively , were analysed for outcome . The overall complication rate was 18 % in the smoking intervention group and 52 % in controls ( p=0.0003 ) . The most significant effects of intervention were seen for wound-related complications ( 5 % vs 31 % , p=0.001 ) , cardiovascular complications ( 0 % vs 10 % , p=0.08 ) , and secondary surgery ( 4 % vs 15 % , p=0.07 ) . The median length of stay was 11 days ( range 7 - 55 ) in the intervention group and 13 days ( 8 - 65 ) in the control group . INTERPRETATION An effective smoking intervention programme 6 - 8 weeks before surgery reduces postoperative morbidity , and we recommend , on the basis of our results , this programme be adopted STUDY OBJECTIVES Smoking cessation for current smokers is a health-care imperative . It is not clear which approaches to smoking cessation are the most effective in the hospital setting and which factors predict long-term abstinence . We hypothesized that a hospital-based smoking cessation program involving behavioral modification and support would provide an effective intervention for smoking cessation . DESIGN Prospect i ve cohort study . SETTING Smoking cessation clinics in a tertiary referral , cardiothoracic hospital . PATIENTS OR PARTICIPANTS Two hundred forty-three smokers and 187 never-smoker control subjects . INTERVENTIONS Smokers underwent specific sessions of individual counseling on behavioral modification , including written information , advice about quit aids , and support during the quit attempt .  Abstinence was confirmed by exhaled carbon monoxide measurements . MEASUREMENTS AND RESULTS Compared to never-smoker control subjects , smokers were more likely to have grown up with a smoking father or siblings , and to currently live or socialize with other smokers . Two hundred sixteen smokers attended at least two sessions of the smoking cessation program . Of these , 25 % were unavailable for follow-up at 12 months and were assumed to be smoking . The point prevalence abstinence rate at 12 months was 32 % . Independent factors associated with abstinence at 12 months were self-belief in quitting ability , having a heart condition , growing up without siblings who smoked , and increasing number of pack-years . CONCLUSIONS This prospect i ve study has demonstrated that this hospital-based smoking cessation program was as effective as programs in other setting s. Social and psychological factors were associated with a greater chance of abstinence A group of 93 coronary patients recently treated with percutaneous transluminal coronary angioplasty ( PTCA ) were r and omly assigned to either an intervention or a control group . Subjects in the intervention group participated in a comprehensive behaviorally oriented program aim ed at achieving significant long-term changes in risk factor-related lifestyle behavior . 
    Output:
    
There was no evidence to judge the effect of very brief ( < 20 minutes ) interventions delivered only during the hospital stay .
Although the interventions increased quit rates irrespective of whether nicotine replacement therapy ( NRT ) was used , the results for NRT were compatible with other data indicating that it increases quit rates .
There was no strong evidence that clinical diagnosis affected the likelihood of quitting .
REVIEW ER 'S CONCLUSIONS High intensity behavioural interventions that include at least one month of follow-up contact are effective in promoting smoking cessation in hospitalised patients .
The findings of the review were compatible with research in other setting s showing that NRT increases quit rates