Plate Nº 74 · recorded October 2, 2026
Health & Medicine ResearchReported finding
New CHEST Guideline Targets Smoking Treatment in Hospitalized Patients
CHEST's new guideline urges clinicians to offer counseling and varenicline to every hospitalized patient who smokes, aiming to cut readmissions and boost quit rates.
By Elena Vasquez3 min read569 words
In brief
- CHEST released a clinical guideline with six evidence-based recommendations for tobacco treatment in hospitalized patients.
- The guideline recommends starting varenicline during hospitalization and counseling of 15 minutes or more over brief advice.
- Published in CHEST (2026), DOI: 10.1016/j.chest.2026.08.038, with Hasmeena Kathuria, M.D., as lead author.
The American College of Chest Physicians (CHEST) has released a new clinical guideline for treating tobacco dependence in hospitalized patients. Published in the journal CHEST, the guideline distills the existing research into six evidence-based recommendations designed to shape key components of inpatient tobacco treatment.
The stakes are considerable. Cigarette smoking remains the leading cause of preventable death in the United States, and smoking rates run especially high among people of lower socioeconomic status and among hospitalized populations. Yet despite tobacco treatment interventions ranking among the most cost-effective strategies in health care, clinicians often underuse them.
A window of opportunity
Hospitalization, the guideline's authors argue, offers a unique chance to intervene. Patients who smoke are already in contact with the health care system, and a hospital stay can serve as the starting point for quitting rather than an interruption of the habit.
"When a patient is hospitalized, there is a real opportunity to initiate tobacco treatment," said Hasmeena Kathuria, M.D., lead author of the guideline.
The recommendations aim to standardize how hospitals approach this opportunity. "Our hope is that the standardized approach will help more clinicians feel comfortable providing counseling and pharmacotherapy to all hospitalized patients who smoke unless they explicitly decline and support continued treatment after discharge," Kathuria said. "Implementing these approaches is likely to improve smoking-cessation outcomes and reduce hospital readmissions."
What the guideline recommends
Of the six recommendations, three stand out as headline measures.
First, the guideline recommends starting varenicline during hospitalization in adults who smoke cigarettes, to promote smoking cessation after discharge. Varenicline is a prescription medication that reduces cravings and the pleasurable effects of nicotine by acting on the same brain receptors nicotine targets.
Second, it recommends dedicated tobacco treatment counseling lasting 15 minutes or more, rather than brief advice under 15 minutes. In other words, a structured conversation with a trained counselor should replace the quick reminder to quit that hospital patients often receive.
Third, the guideline advises that inpatient counseling include a referral to continued treatment after discharge. That could mean a scheduled follow-up contact, or a direct referral — whether in person or through the electronic health record — to a quitline or an outpatient cessation program.
The remaining recommendations round out the guideline's broader framework for inpatient tobacco treatment.
Why standardization matters
The guideline's central logic is simple: hospitalized patients who smoke represent a concentrated, high-risk group, and the hospital stay is a moment when treatment can begin under medical supervision. By standardizing the approach — offering counseling and medication to every hospitalized patient who smokes unless they explicitly decline — the authors hope to remove the inconsistency that currently leaves many patients untreated.
Tobacco treatment, the guideline notes, is among the most cost-effective interventions available in health care. Broader adoption in the inpatient setting could therefore pay dividends in both lives and costs, potentially reducing hospital readmissions linked to smoking-related illness.
As with any clinical guideline, the recommendations synthesize existing evidence rather than presenting new trial data, and their impact will depend on how widely hospitals implement them. Still, the document gives clinicians a clear, evidence-based playbook for a setting where the opportunity to help patients quit has often gone unclaimed.
Publication details: H. Kathuria et al, "Tobacco Treatment in the Inpatient Setting: An American College of Chest Physicians Clinical Practice Guideline," CHEST (2026). DOI: 10.1016/j.chest.2026.08.038
via Medical Xpress (Source)
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