Brief smoking cessation in acute Welsh hospitals: a realist approach

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  • 2019 Brief smoking

    Accepted author manuscript, 549 KB, PDF document

    Embargo ends: 15/03/20


moking cessation (BSC) in acute hospital settings, through exploration of organizational delivery and the role of healthcare professionals (HCPs). We used a realist approach, with embedded stakeholder engagement, within a large health organization. We conducted interviews (n = 27), a survey (n = 279) and organization documentation review (n = 44). The final programme theory suggests HCPs implement BSC when they value it as part of their role in contributing to improved patient outcomes; this is due to personal and professional influences, such as knowledge or experience. Organizational support, training and working in an environment where BSC is visible as standard care, positively influences implementation. However, the context exerts a strong influence on whether BSC is implemented, or not. HCPs make nuanced judgements on whether to implement BSC based on their assessment of the patient’s responses, the patient’s condition and other acute care demands. HCPs are less likely to implement BSC in dynamic and uncertain environments, as they are concerned about adversely impacting on the clinician–patient relationship and prioritize other acute care requirements. Organizations should actively promote BSC as a core function of the acute hospital setting and improve professional practice through leadership, training, feedback and visible indicators of organizational commitment. HCPs can be persuaded that implementing BSC is an acute care priority and an expectation of standard practice for improving patient outcomes.


  • brief smoking cessation, acute hospital, healthcare professionals, implementation, standard practice, realist evaluation
Original languageEnglish
Number of pages11
JournalHealth Promotion International
Early online date15 Mar 2019
Publication statusE-pub ahead of print - 15 Mar 2019
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