Smoking cessation for hospitalised smokers: an evaluation of the ‘Ottawa Model’
Robert Reid, Associate Director, Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada and Kerri-Anne Mullen, Manager, Smoking Cessation Network, University of Ottawa Heart Institute, Canada

Abstract
The Ottawa Model for Smoking Cessation (the ‘Ottawa Model’) is an application of the five ‘A’s approach to cessation, customised to the hospital setting. This study evaluated the impact of implementing the Ottawa Model in nine hospitals in eastern Ontario, CANADA. Trained outreach facilitators assisted nine hospitals to implement the Ottawa Model; program delivery was then monitored over a one year period using administrative data and data from a follow-up database. A before-and-after study was conducted to gauge the effect of the Ottawa Model program on cessation rates six months after hospitalisation.

Self-reports of smoking cessation were validated in a sub-sample of patients and all cessation rates were corrected for potential misreporting. Controlling for hospital, the confirmed six month continuous abstinence rate was higher after, than before, introduction of the Ottawa Model (29.4% vs. 18.3%; OR = 1.71; 95% CI = 1.11, 2.64; Z = 2.43; I2 = 0%; P = 0.02). Adoption was more complete in smaller hospitals. Hospital staff were most likely to provide counseling to smokers; cessation medications and post-discharge follow-up were optimised less frequently. Trained outreach facilitators successfully implemented the Ottawa Model leading to significantly higher long-term cessation rates. Attitudinal, managerial and environmental challenges to implementation were identified.

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About the presenters
Dr Robert D. Reid is Associate Director of the Prevention and Rehabilitation Centre at the University of Ottawa Heart Institute, and an Associate Professor in the Faculty of Medicine at the University of Ottawa. Dr Reid is one of Canada’s leading health behaviour change experts, particularly concerning smoking cessation, physical activity promotion and cardiovascular rehabilitation.
He is project director for the Canadian Network of Hospital-Based Smoking Cessation Programs.

Kerri Mullen is the Project Leader for the Ottawa Model for Smoking Cessation program, providing training, assisting in program implementation, and conducting evaluation for hospitals across Canada, as well as presenting on the principles of clinical smoking cessation both nationally and internationally. Kerri received her BSc at the University of Ottawa and went on to complete her MSc. at the University of Illinois at Urbana-Champaign, where she researched behavioural determinants of cardiovascular disease. Since completing her education, she has become specialised in tobacco dependence treatment at the University of Ottawa Heart Institute’s Prevention and Rehabilitation Centre.