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Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey.
Nicotine Tob Res. 2008 Aug; 10(8):1277-82.NT

Abstract

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.

Authors+Show Affiliations

Albert Einstein College of Medicine, Albert Einstein Cancer Center, and Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA. sbernste@montefiore.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18686174

Citation

Bernstein, Steven L., et al. "Nicotine Dependence, Motivation to Quit, and Diagnosis Among Adult Emergency Department Patients Who Smoke: a National Survey." Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, vol. 10, no. 8, 2008, pp. 1277-82.
Bernstein SL, Boudreaux ED, Cabral L, et al. Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey. Nicotine Tob Res. 2008;10(8):1277-82.
Bernstein, S. L., Boudreaux, E. D., Cabral, L., Cydulka, R. K., Schwegman, D., Larkin, G. L., Adams, A. L., McCullough, L. B., & Rhodes, K. V. (2008). Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey. Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, 10(8), 1277-82. https://doi.org/10.1080/14622200802239272
Bernstein SL, et al. Nicotine Dependence, Motivation to Quit, and Diagnosis Among Adult Emergency Department Patients Who Smoke: a National Survey. Nicotine Tob Res. 2008;10(8):1277-82. PubMed PMID: 18686174.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: 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 - 2008/8/8/pubmed PY - 2009/1/15/medline PY - 2008/8/8/entrez SP - 1277 EP - 82 JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JO - Nicotine Tob Res VL - 10 IS - 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. SN - 1462-2203 UR - https://www.unboundmedicine.com/medline/citation/18686174/Nicotine_dependence_motivation_to_quit_and_diagnosis_among_adult_emergency_department_patients_who_smoke:_a_national_survey_ L2 - https://academic.oup.com/ntr/article-lookup/doi/10.1080/14622200802239272 DB - PRIME DP - Unbound Medicine ER -