2026 Eastern States Conference

Title: Evaluation of smoking cessation therapy orders in hospitalized patients (STOP) - Phase 2
Authors: Hannah Seo, PharmD; Thom Coco, PharmD, BCPS, CTTS; Christopher Ullo, PharmD, CCRP; Joanna Stanton, PharmD, BCPS; Aneeqa Islam, PharmD, BCPS
Learning objective: Audience members will be able to describe the impact of a standardized nicotine replacement therapy (NRT) order panel on prescribing rates of NRT in the inpatient setting. 
Background/objective: Prescribing rates for NRT are low in our institution (28.5% in-hospital, 15.9% at discharge). After the implementation of an updated, guideline-directed NRT order panel in August 2025, this project aimed to determine if the new panel increased prescribing rates for patients.
Methods: This is an institutional review board approved chart review that assessed NRT prescribing rates in patients admitted to medical-surgical units who identified as active tobacco smokers at a large academic medical center from October 2025 to January 2026. Patients were excluded if they were non-cigarette smokers, expired during admission, received hospice care, admitted to intensive care, pediatric, or psychiatric units, were observation or same-day surgical patients, discharged to rehabilitation or nursing facilities, left against medical advice, or had incomplete documentation. The primary endpoint was the prescribing rates of NRT in patients who identified as active smokers. Secondary endpoints included percentage of patients counseled during index stay, percentage of NRT prescriptions provided at discharge, percentage of patients with a high risk or respiratory disease, number of monotherapy patch or gum orders, percentage of appropriate dose, and number of home NRT continued.
Results: There were a total of 374 out of 1,252 patients that were included and analyzed. The majority of the patients were male, white, and an average age of 58 years old. Most patients did not have high risk comorbidities, but of the ones that did, COPD was the most common. NRT was ordered for 89 patients (23.8%): 75 patch only, 4 gum only, and 10 both. Smoking cessation counseling was documented for 164 patients (43.9%), and NRT discharge prescriptions were written for 12% of patients.
Conclusion: Compared to the previous chart review before the order panel was established, we observed a decrease in inpatient NRT prescribing rates and discharge prescriptions, but there was an increase in counseling rates (36.3% v 43.85%). Further research could explore the impact of pharmacist-led NRT ordering and utilization of an interdisciplinary approach involving the substance use counselors to improve accurate documentation of smoking status and increase utilization of combination therapy.
Self assessment question: True or false: Current guidelines recommend behavioral counseling and combination nicotine replacement therapy to increase success rates of smoking cessation.
a. true
b. false