Table 1

Characteristics of included studies

Study	Methods	Participants	Interventions	Outcomes	Notes
Campbell (1991)⁶	Country: UK. Recruitment: Inpatients with smoking-related diseases. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 212 current smokers. Number smoked and age not stated. Most had heart or lung disease. Therapists: Physician and non-specialist counsellor.	1. Intervention: Physician advice Counselling (1×, total not stated, type not stated) NRT (gum, dose 2–4 mg, for 3 months) Follow up (5× @ 2, 3, 5 weeks, 3, 6 months in clinic by counsellor) 2. Comparison: Other (as above, placebo NRT gum) Intensity: 4 NRT: Yes	Abstinence: Sustained abstinence at 6 & 12 months. Validation: Expired air CO.	Heart disease, lung disease and other given separately in analysis by diagnosis.

Campbell (1996)⁷	Country: UK. Recruitment: Inpatients with respiratory or cardiovascular disease. Selected: Prepared to make quit attempt. Randomisation: Method not stated.	Participants: 62 current smokers. Number smoked and age not stated. Approx. 75% had respiratory disease. Therapists: Physician and non-specialist counsellor.	1. Intervention: Physician advice Counselling (1×, total 30-60 min., type information) NRT (patch, dose 17.5–35 mg, for 12 weeks) Follow up (4× @ 2, 4, 8, 12 weeks in clinic by counsellor) 2. Comparison: Other (as above, placebo NRT patch) Intensity: 4 NRT: Yes	Abstinence: Sustained abstinence at 3, 6 &12 months. Validation: Expired air CO.	Only data on inpatients extracted from study. Included in respiratory disease subcategory.

CASIS (1992)¹	Country: USA. Recruitment: Inpatients with coronary artery stenosis confirmed by catheterisation. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 267 current smokers or recent quitters (50%, defined as at least 5 cig/day at any time in previous 2 months). 25 cig/day, age 53 average. 78 had acute MI, 21 recent MI, 152 other symptoms. Therapists: Masters level health educators.	1. Intervention: Counselling (2×, total 40 min., type not stated) Other (self-help materials, relaxation tapes) Follow up (4× @ 1, 3 weeks and 3 months if quit or 2,4 months if did not quit by telephone) 2. Comparison: Advice only Intensity: 4 NRT: No	Abstinence: Sustained abstinence at 6 & 12 months. Validation: Expired air CO.	Patients admitted with MI more likely to be quitters at 6 months (74%). Evidence of interaction between intervention and illness.

De Busk (1994)10	Country: USA. Recruitment: Inpatients with acute MI. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 252 current smokers or recent quitters (proportion not stated, defined as any tobacco use in previous 6 months). Number smoked not stated, age 57 average. First year after MI. Therapists: Physician and nurse.	1. Intervention: Physician advice Counselling (1×, total not stated, type not stated) NRT (“reserved for highly addicted patients”) Other (self-help materials, relaxation tapes) Follow up (8× @ 48 hours, 1 week, and every month for 6 months by telephone) 2. Comparison: Advice only Intensity: 4 NRT: Yes?	Abstinence: Sustained abstinence at 6 & 12 months. Validation: Expired air CO and plasma cotinine.

Dornelas (2000)11	Country: USA. Recruitment: Inpatients with acute MI. Selected: Invited to participate. Randomisation: Number drawn from envelope.	Participants: 100 current smokers. 29 cig/day, age 54 average. Therapists: Psychologist.	1. Intervention: Counselling (1×, total 20 min, type behavioural) Follow up (7× @ <1, 4, 8, 12, 16, 20, 26 weeks by telephone) 2. Comparison: Advice only Intensity: 3 NRT: No	Abstinence: Abstinence at 12 months (point prevalence). Validation: Significant other	Validation by significant other only in 70% of cases.

Lewis (1998)⁸	Country: USA. Recruitment: Inpatients excluding certain cardiac conditions. Selected: Prepared to make quit attempt. Randomisation: Computer-generated code.	Participants: 185 current smokers. 24 cig/day, age 43 average. 12 ICD-9 categories. Therapists: Physician and nurse.	1. Intervention: Physician advice Counselling (1×, total 2–3 min., type information) NRT (patch, dose 22 mg, for 3 weeks + 11 mg for 3 weeks) Other (self-help materials) Follow up (4× @ 1, 3, 6 weeks, 6 months by telephone) 2. Intervention: Physician advice Counselling (1×, total 2–3 min, type information) NRT (patch, placebo) Other (self-help materials) Follow up (4× @ 1, 3, 6 weeks, 6 months by telephone) 3. Comparison: Advice only Intensity: 4 NRT: Yes	Abstinence: Abstinence at 6 months (point prevalence). Validation: Expired air CO.	1 vs 2 for effect of NRT. Not used in behavioural intervention analysis. Highest quit rates found in patients with respiratory disease.

Miller (1997)12	Country: USA. Recruitment: Inpatients excluding obstetric and psychiatric patients. Selected: Prepared to make quit attempt, those wishing to do so alone excluded. Randomisation: Sealed envelope.	Participants: 1942 current smokers. 20 cig/day, age 51 average. 32% with cardiovascular, 12% pulmonary diagnosis. Therapists: Physician and nurse counsellor.	1. Intervention: Physician advice Counselling (1×, total 30 min, type behavioural) Other (self-help materials, relaxation tapes, video) Follow up (4× @ 48 hours, 1 & 3 weeks, 3 months by telephone) 2. Intervention: Physician advice Counselling (1×, total 30 min, type behavioural) Other (self-help materials, relaxation tapes, video) Follow up (1× @ 48 hours by telephone) 3. Comparison Advice only Intensity: 3, 4 NRT: No	Abstinence: Sustained abstinence at 3, 6 & 12 months. Validation: Plasma cotinine or family member corroboration.	1v 3 in intensive comparison, 2v 3 in minimal comparison 12 months abstinence 1+2 v 3 separately for cardiovascular, pulmonary and other diagnosis.

Ortigosa (2000)13	Country: Spain. Recruitment: Inpatients with acute MI. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 90 current smokers. 25 cig/day, age 57 average Therapists: Physician.	1. Intervention: Physician advice Follow up (3× @ 2, 3, 4 weeks by telephone) 2. Comparison: Usual care Intensity: 3 NRT: No	Abstinence: Abstinence at 12 months (point prevalence). Validation: Expired air CO.	Intervention not delivered by specialist counsellor.
Pederson (1991)14	Country: USA. Recruitment: Inpatients with COPD. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 74 current smokers. 25 cig/day, age 53 average. 43% chronic bronchitis, 57% emphysema. Therapists: Non-specialist trained in counselling.	1. Intervention: Physician advice (prior to admission) Counselling (3–9×, total 45–160 min, type information) Other (self-help materials) 2. Comparison: Advice only Intensity: 2 NRT: No	Abstinence: Abstinence at 6 months (point prevalence). Validation: Serum COHb (in sample).	8 deaths excluded, 8 lost to follow up included.

Rigotti (1994)15	Country: USA. Recruitment: Inpatients scheduled for CABS. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 87 current smokers or recent quitters (38%, defined as at least 1 pack / cig in previous 6 months). 33 cig/day, age 58 average. 82% of all CABG surgery. Therapists: Nurse.	1. Intervention: Counselling (3×, total 60 min, type behavioural) Other (self-help materials, video) Follow up (1× @ 1 week by telephone) 2. Comparison: Advice only Intensity: 3 NRT: No	Abstinence: Sustained abstinence at 4, 8 & 12 months. Validation: Salivary cotinine.	Abstinence rates include smokers who had quit prior to surgery.

Rigotti (1997)30	Country: USA. Recruitment: Inpatients in medical or surgical services. Selected: Invited to participate. Randomisation: Method not stated.	Participants: 615 current smokers or recent quitters (proportion not stated, defined as at least 1 cig in previous 1 month). 24 cig/day, age 48 average. 23% had cardiac or pulmonary diagnosis. Therapists: Research assistant and nurse.	1. Intervention: Physician advice (prompt on chart) Counselling (1×, total 15 min, type behavioural) Other (self-help materials) NRT (“some” c.4%) Follow up (1–3× @ 1–3 weeks by telephone) 2. Comparison: Usual care Intensity: 3 NRT: Yes?	Abstinence: Abstinence at 6 months (point prevalence). Validation: Salivary cotinine.	Randomisation by eligibility, then listwise recruitment. 50% of patients could recall being given physician advice.

Simon (1997)⁹	Country: USA. Recruitment: Inpatients undergoing noncardiac surgery. Selected: Prepared to make quit attempt. Randomisation: Sealed envelope.	Participants: 299 current smokers. 20 cig/day, age 54 average. Most cardiovascular or respiratory disease. Therapists: Public health educator.	1. Intervention: Counselling (1×, total 30–60 min, type behavioural) Other (self-help materials, video) NRT (gum, dose not stated, for 3 months) Follow up (5× @ 1–3 weeks 2, 3 months by telephone) 2. Comparison: Advice only Intensity: 4 NRT: Yes	Abstinence: Abstinence at 12 months (point prevalence). Validation: Serum or salivary cotinine or corroboration by significant other.	Approx 65% intervention and 17% control used NRT. Not associated with quitting in either group.

Stevens (1993)28	Country: USA. Recruitment: Inpatients with stay >36 hours excluding postpartum and psychiatric patients. Selected: Invited to participate. Randomisation: Not random (alternated between hospitals on monthly basis).	Participants: 1119 current smokers or recent quitters (5%, defined as smoking regularly at any time in previous 3 months). 20 cig/day, age 44 average. 17% cardiovascular or respiratory diagnosis. Therapists: Masters level cessation counsellors.	1. Intervention: Counselling (1×, total 20 min, type behavioural) Other (self-help materials, video) Follow up (1–2× @ 1–3 weeks by telephone) 2. Comparison: Usual care Intensity: 3 NRT: No	Abstinence: Sustained abstinence at 3 & 12 months. Validation: None (low success in obtaining cotinine returns).	No significant baseline differences between patient characteristics in intervention and control.

Stevens (2000)29	Country: USA. Recruitment: Inpatients with stay >36 hours excluding postpartum and psychiatric patients. Selected: Invited to participate. Randomisation: Not random (alternated between hospitals on monthly basis).	Participants: 1173 current smokers or recent quitters (proportion not stated, defined as smoking regularly at any time in previous 3 months). 19 cig/day, age 47 average. Therapists: Respiratory therapist.	1. Intervention: Counselling (1×, total 20 min, type behavioural) Other (self-help materials, video) Follow up (1× @ 1 week by telephone) 2. Comparison: Usual care Intensity: 3 NRT: No	Abstinence: Sustained abstinence at 12 mo. (sustained for 6 mo.) Validation: None.	Only 68% of intervention group actually offered intervention.

Taylor (1990)16	Country: USA. Recruitment: Inpatients with acute MI. Selected: Invited to participate. Randomisation: Sealed envelope.	Participants: 173 current smokers. 25 cig/day, 58 years average. 10% previous MI. Therapists: Nurse.	1. Intervention: Counselling (1×, total not stated, type behavioural) Other (self-help materials, relaxation tapes) NRT (gum “available”, dose not stated, for not stated) Follow up (6–7× @ 1–3 weeks, every month for 4 months by telephone) 2. Comparison: Usual care. Intensity: 4 NRT: Yes?	Abstinence: Sustained abstinence at 3 & 12 months. Validation: Serum thiocyanate, expired air CO.	Higher loss to follow up in control group increases apparent effect of intervention when using ITT approach. NRT gum prescribed to 5 patients.