Background:
India has an estimated one million tobacco-attributable deaths annually. Tobacco cessation treatment is effective among hospitalized patients, but little is known about tobacco use among hospitalized patients in India. This study aims to measure tobacco use, interest in quitting, and cessation after discharge at a Mumbai hospital.

Methods:
Cross-sectional survey of patients 15 and older at a Mumbai hospital. Of 7,889 patients admitted from 11/2015-10/2016, 5,038 were eligible, 2,894 were approached and 2,764 participated. Characteristics of smokers and smokeless tobacco (SLT) users were compared and self-reported cessation was assessed 6 months post-discharge.

Results:
Overall, 6.5% (N=179) of subjects were current smokers and 10.2% (N=284) were current SLT users (N=37 were dual users). Most smokers (81.7%) and SLT users (94.3%) reported daily use. The mean number of tobacco products used was 2 (standard deviation=1). Compared to smokers, SLT users were more often older (52 versus 48 years, p=0.002), female (37% versus 1%, p< 0.001), illiterate (14% versus 6%, p=0.01), and less often employed (52% vs 75%, p< 0.001). SLT users less often reported a past year quit attempt (39% versus 54%, p=0.004) or a plan to stay quit after discharge (42% versus 54%, p=0.04). There were no differences in importance of quitting, confidence, receipt of advice to quit, or treatment use. Just 3% reported evidence-based treatment use. Compared to smokers, SLT users less often agreed that tobacco has harmed them (57% versus 70%, p=0.01). Overall, 28% of tobacco users (25% of smokers and 29% of SLT users) reported having quit at 6 months post-discharge.

Conclusions:
Roughly half of hospitalized tobacco users planned to stay quit after discharge and 28% reportedly succeeded. Interventions to connect hospitalized tobacco users with treatment are clearly needed. SLT users may be especially challenging to engage because SLT is viewed as less harmful.