Motivation for Stopping Tobacco Use among Emergency Department Patients

Klinkhammer, Martin D.; Patten, Christi A.; Sadosty, Annie T.; Stevens, Susanna R.; Ebbert, Jon O.

doi:10.1111/j.1553-2712.2005.tb00901.x

Cited by 16 publications

(9 citation statements)

References 9 publications

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“…6 In a prior study of emergency room patients, an individual's Ladder score was shown to be significantly associated with a patient's reported intention to quit, number of previous quit attempts, perceived coworker encouragement, and socioeconomic status. 14 …”

Section: Inpatient Interviewmentioning

confidence: 99%

Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers

Shah

King

Basu

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Although smoking cessation counseling for cardiac inpatients is a quality measure, little data exist regarding postdischarge quit attempts in a primarily urban, African American, underserved population. This study aimed to assess preparedness to quit smoking and quit behaviors.METHODS:Smokers on the cardiology service were asked to rate preparedness using the 10‐step Contemplation Ladder. During phone surveys given 30‐days postdischarge, patients reported whether they made quit attempts, method and success of attempts, and recall of receiving advice to quit.RESULTS:From February 2006 through July 2007, 2906 of 3364 of inpatients were interviewed. Fifteen percent (436/2906) were current smokers and 415/436 completed the inpatient assessment. Of these, 75% (310/415) indicated they were prepared to quit. At the 1‐month follow‐up, 67% (276/415) were interviewed and 71% of those patients (195/276) reported making a quit attempt, with most (76%) reporting quitting “cold turkey” (without aid). Compared with less prepared patients, prepared patients were more likely to report making a quit attempt after discharge (77% [163/212] vs. 50% [32/64], P < 0.001) and were successful in that attempt (43% [90/212] vs. 25% [16/64], P = 0.010).CONCLUSIONS:The majority of smokers hospitalized with cardiac disease reported being prepared to quit smoking. Those prepared, and who received advice to quit, were more likely to make a quit attempt and report abstinence than those less prepared. However, most quit attempts were made using the least effective methods. Future studies in a population of primarily African American patients should assess preparedness to quit and target prepared patients with more effective interventions. Journal of Hospital Medicine 2010;5:26–32. © 2010 Society of Hospital Medicine.

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Section: Inpatient Interviewmentioning

confidence: 99%

Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers

Shah

King

Basu

et al. 2010

Journal of Hospital Medicine

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“…Several studies have found that adult smokers in the ED are interested in cessation, and in receiving a cessation intervention while in the ED (13)(14)(15)(16)(17)(18)(19). ED patients have moderate levels of nicotine addiction (13,14), typically smoking 10 cigarettes/day (13,14), and 61% to 79% are in the contemplation or preparation stage of change (17,19).…”

Section: Introduction Backgroundmentioning

confidence: 98%

“…ED patients have moderate levels of nicotine addiction (13,14), typically smoking 10 cigarettes/day (13,14), and 61% to 79% are in the contemplation or preparation stage of change (17,19). In the pediatric ED, up to 75% of parents who smoke want to quit within 6 months (20).…”

Section: Introduction Backgroundmentioning

confidence: 99%

Efficacy of a Brief Intervention to Improve Emergency Physicians’ Smoking Cessation Counseling Skills, Knowledge, and Attitudes

et al. 2009

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The objective of this study was to test whether a brief educational/administrative intervention could increase tobacco counseling by emergency physicians (EPs). Pre-/post-study at eight emergency departments (EDs) with residency programs were carried out. EPs received a 1-hour lecture on the health effects of smoking and strategies to counsel patients. After the lecture, cards promoting a national smokers' quitline were placed in EDs, to be distributed by providers. Providers completed pre-/ post-intervention questionnaires. Patients were interviewed pre-/post-intervention to assess provider behavior. Two hundred eighty-seven EPs were enrolled. Post-intervention, providers were more likely to consider tobacco counseling part of their role, and felt more confident in counseling. Data from 1168 patient interviews and chart reviews showed that, post-intervention, providers were more likely to ask patients about smoking, make a referral, and document smoking counseling. Post-intervention, 30% of smokers were given a Quitline referral card. An educational intervention improved ED-based tobacco interventions. Controlled trials are needed to establish these results' durability.

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“…When children are brought to the emergency department, there is an opportunity for a “teachable moment” in which to give tobacco cessation advice to parents who may be more motivated to quit smoking in order to improve their child's health (Winickoff et al, 2003). In addition, studies have shown that adult emergency department patients are interested in quitting and are willing to engage in a brief tobacco cessation intervention (Bock et al, 2001; Klinkhammer, Patten, Sadosty, Stevens, & Ebbert, 2005). …”

Section: Introductionmentioning

confidence: 99%

A smoking cessation intervention plus proactive quitline referral in the pediatric emergency department: A pilot study

Mahabee‐Gittens

Gordon

Krugh

et al. 2008

Nicotine & Tobacco Research

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The prevalence of adult tobacco users who utilize the emergency department as patients or parents is disproportionately higher than the national average rates of tobacco use. Thus, it is advised that the emergency department be utilized as a venue for providing tobacco cessation counseling to adult tobacco users. Using a randomized control trial design, this pilot study evaluated the effect of a brief tobacco cessation intervention for tobacco using parents of children brought to a pediatric emergency department. Participants received either usual care or a brief tobacco cessation intervention based on the first 2 of the 5A's of the Clinical Practice Guidelines and fax referral to the Quitline. The primary outcome was self-reported repeated point prevalence of tobacco use at 6 weeks and 3 months following the intervention. Secondary aims included number of quit attempts, increases in readiness to quit, comparisons of participants who were successfully retained, and contact rates by Quitline counselors. At 3-month follow-up, compared to the Usual Care Control group, intervention participants were more likely to have made at least one quit attempt (59% vs. 34%; p<.01), be seriously thinking about quitting (68% vs. 37%; p<.001), and have higher Ladder scores (6.2 vs. 5.3; p<.05). Study personnel were able to contact 68% and 52%, respectively, of participants at 6-week and 3-month follow-up. Quitline counselors were unable to reach 54% of participants. Our results reveal increased intentions to quit and trends toward quitting, however we experienced difficulties with participant retention. Suggestions for improvements in point prevalence and retention are given.

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Motivation for Stopping Tobacco Use among Emergency Department Patients

Cited by 16 publications

References 9 publications

Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers

Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers

Efficacy of a Brief Intervention to Improve Emergency Physicians’ Smoking Cessation Counseling Skills, Knowledge, and Attitudes

A smoking cessation intervention plus proactive quitline referral in the pediatric emergency department: A pilot study

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