Method: A study, involving two intervention and two control hospitals, investigated whether a 12-month multi-strategic intervention increased smoking care provision to nicotine dependent inpatients. Intervention strategies included local adaptation, linking into existing processes, training, compliance monitoring and prompts.

Patient surveys (274-347 per experimental condition), medical notes audits (181-228) and staff surveys (229-302) were used to collect outcome data at baseline and follow-up using. Care practices evaluated included: assessment of smoking status; management of withdrawal symptoms; offer and provision of nicotine replacement therapy (NRT) and; linking patients to assistance post-discharge.

Results: A consistent, large, intervention effect was found for the offer and provision of NRT across all three methods of data collection. For example, intervention patient reported offer of NRT increased 34%, from 17% to 51%. Variable intervention effect, across the data collection methods, was found for the other care practices.

Conclusions: Delivery of a multi-strategic intervention is effective in increasing smoking care delivery in hospitals, particularly the provision of NRT.

Implications: Future research should aim to further increase the provision of NRT to hospitalised patients and also focus on methods to increase other aspects of smoking, particularly care related to discharge. This study indicated intensive approaches to guideline dissemination can be effective. Such an approach is required if the intended population health outcomes are to be realised.