TY - JOUR
T1 - Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke
T2 - A national survey
AU - Bernstein, Steven L.
AU - Boudreaux, Edwin D.
AU - Cabral, Lisa
AU - Cydulka, Rita K.
AU - Schwegman, David
AU - Larkin, Gregory L.
AU - Adams, Annette L.
AU - McCullough, Lynne B.
AU - Rhodes, Karin V.
PY - 2008/8
Y1 - 2008/8
N2 - Patients in hospital emergency departments smoke more than the general population. Smoking profiles of these patients have largely been characterized in small, single-institution cohorts. Our objective was to survey adult smokers visiting a sample of U.S. emergency departments, as part of a study examining the efficacy of an educational intervention on physicians' knowledge, attitudes, and behavior regarding tobacco control. A convenience sample of patients in eight academic emergency departments was surveyed from May to July 2006. Eligible patients were aged 18 years or older, were every- or some-day smokers, spoke English or Spanish, were able to provide written informed consent, and were not actively psychotic. Descriptive statistics are reported using parametric and nonparametric measures. A total of 1,168 patients were interviewed (mean age = 40.7 years); 46.5% were female, 54.4% were uninsured or had Medicaid, and 29.9% had no usual source of care. Patients smoked a median of 10 cigarettes daily, with a median score on the Fagerstrom Test for Nicotine Dependence of 4, and a median score of 5 on the nine-point contemplation ladder, indicating a desire to quit within 6 months. Smokers with a diagnosis of cardiovascular, respiratory, or malignant disease were more interested in quitting than others (median ladder score = 4 vs. 6, p< 001), were more likely to believe they had a smoking-related illness, and were more likely to believe their emergency department visit was related to smoking. Smokers with a presenting complaint of chest pain or dyspnea were more interested in quitting than others (median ladder score = 4 vs. 6, p = .002). Emergency department patients smoked at moderate amounts, with moderate levels of addiction and interest in quitting. Smokers with tobacco-related diagnoses, or who believed their emergency department visit was related to smoking, were more interested in quitting. These findings suggest that the emergency department visit may provide a teachable moment to reach smokers who have tobacco-related problems.
AB - Patients in hospital emergency departments smoke more than the general population. Smoking profiles of these patients have largely been characterized in small, single-institution cohorts. Our objective was to survey adult smokers visiting a sample of U.S. emergency departments, as part of a study examining the efficacy of an educational intervention on physicians' knowledge, attitudes, and behavior regarding tobacco control. A convenience sample of patients in eight academic emergency departments was surveyed from May to July 2006. Eligible patients were aged 18 years or older, were every- or some-day smokers, spoke English or Spanish, were able to provide written informed consent, and were not actively psychotic. Descriptive statistics are reported using parametric and nonparametric measures. A total of 1,168 patients were interviewed (mean age = 40.7 years); 46.5% were female, 54.4% were uninsured or had Medicaid, and 29.9% had no usual source of care. Patients smoked a median of 10 cigarettes daily, with a median score on the Fagerstrom Test for Nicotine Dependence of 4, and a median score of 5 on the nine-point contemplation ladder, indicating a desire to quit within 6 months. Smokers with a diagnosis of cardiovascular, respiratory, or malignant disease were more interested in quitting than others (median ladder score = 4 vs. 6, p< 001), were more likely to believe they had a smoking-related illness, and were more likely to believe their emergency department visit was related to smoking. Smokers with a presenting complaint of chest pain or dyspnea were more interested in quitting than others (median ladder score = 4 vs. 6, p = .002). Emergency department patients smoked at moderate amounts, with moderate levels of addiction and interest in quitting. Smokers with tobacco-related diagnoses, or who believed their emergency department visit was related to smoking, were more interested in quitting. These findings suggest that the emergency department visit may provide a teachable moment to reach smokers who have tobacco-related problems.
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U2 - 10.1080/14622200802239272
DO - 10.1080/14622200802239272
M3 - Article
C2 - 18686174
AN - SCOPUS:49049109099
SN - 1462-2203
VL - 10
SP - 1277
EP - 1282
JO - Nicotine and Tobacco Research
JF - Nicotine and Tobacco Research
IS - 8
ER -