• Priyanka Satish, Aditya Khetan, Dharav Shah, Shuba Srinivasan, Rojith Balakrishnan, Arun Padmanandan, Vittal Hejjaji, Leland Hull, Reema Samuel, and Richard Josephson.
• Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA. priyankaraomed@gmail.com.
• J Gen Intern Med. 2023 Nov 1; 38 (14): 316231703162-3170.

BackgroundLow-middle-income countries face an enormous burden of tobacco-related illnesses. Counseling for tobacco cessation increases the chance of achieving quit outcomes, yet it remains underutilized in healthcare settings.ObjectiveWe tested the hypothesis that utilizing trained medical students to counsel hospitalized patients who use tobacco will lead to an increase in patient quit rates, while also improving medical student knowledge regarding smoking cessation counseling.DesignInvestigator-initiated, two-armed, multicenter randomized controlled trial conducted in three medical schools in India.ParticipantsEligibility criteria included age 18-70 years, active admission to the hospital, and current smoking.InterventionA medical student-guided smoking cessation program, initiated in hospitalized patients and continued for 2 months after discharge.Main MeasuresThe primary outcome was self-reported 7-day point prevalence of smoking cessation at 6 months. Changes in medical student knowledge were assessed using a pre- and post-questionnaire delivered prior to and 12 months after training.Key ResultsAmong 688 patients randomized across three medical schools, 343 were assigned to the intervention group and 345 to the control group. After 6 months of follow up, the primary outcome occurred in 188 patients (54.8%) in the intervention group, and 145 patients (42.0%) in the control group (absolute difference, 12.8%; relative risk, 1.67; 95% confidence interval, 1.24-2.26; p < 0.001). Among 70 medical students for whom data was available, knowledge increased from a mean score of 14.8 (± 0.8) (out of a maximum score of 25) at baseline to a score of 18.1 (± 0.8) at 12 months, an absolute mean difference of 3.3 (95% CI, 2.3-4.3; p < 0.001).ConclusionsMedical students can be trained to effectively provide smoking cessation counseling to hospitalized patients. Incorporating this program into the medical curriculum can provide experiential training to medical students while improving patient quit rates.Trial RegistrationURL: http://www.Clinicaltrialsgov . Unique identifier: NCT03521466.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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