Background and challenges to implementation:
Global Adult Tobacco Survey (GATS), Bangladesh 2009 shows that 44.7% of men and 1.5% of women smoke, while 26.4% of men and 27.9% of women use smokeless tobacco. Only about 50% of smokers who visited physicians for consultation had advice for tobacco cessation in Bangladesh. Many cardiac patients continue to use tobacco even after hospital admission. A nurse based tobacco cessation service was introduced in National Heart Foundation Hospital for the first time in Bangladesh from 2015.

Intervention or response:
359 nurses were trained to deliver brief advice to tobacco user patients before discharge Tobacco use habit of all admitted patients were systematically documented in patient record form and all tobacco users were identified for a brief advice by nurse in the respective wards. All patients who received cessation advice were followed up over telephone after two and six months by nurses.

Results and lessons learnt:
During the study period (Nov 2015 to Feb 2017), a total of 492 men and 30 women received cessation advice from nurses. Among them 374 were smoker and 118 were the smokeless tobacco user. Whether patients received lifestyle related advice from consulting physicians were not explored. At six-month follow-up 199 (39.9%) patients reported that they have quitted. Among smoking tobacco user, 132 (35.3%) patients quitted and among smokeless tobacco user, 65 (55%) patients quitted tobacco.

Conclusions and key recommendations:
A large proportion of patients who received brief tobacco cessation advice remained tobacco free at six months after discharge from hospital. As people are more receptive to advice by health care providers during hospitalization period, a nurse based systematic cessation intervention may have a good impact on quitting tobacco.