Tobacco smoking by adult emergency department patients in Australia: a point-prevalence study

Abstract

Objectives and importance of study: Tobacco smoking is the leading single cause of preventable death. International findings suggest that rates of smoking are higher among emergency department (ED) patients than the general population, suggesting that the ED may be a strategic location in which to initiate smoking cessation programs. We aimed to determine the prevalence of smoking among adult ED patients in Australia, their desire for smoking cessation and preferred methods of cessation. Study type: Point-prevalence surveyMethod: A sample of adult ED patients was recruited from two tertiary referral hospital EDs. Participants were asked whether or not they currently smoked. Smokers were asked 15 additional questions, including about their readiness for smoking cessation. Demographics were collected from patients, and ED presentation characteristics were collected from medical records.Results: Of 443 consecutive ED patients, 348 were eligible and 338 consented to participate. Data for 335 participants were available for analysis and 78 (23.3%; 95% confidence interval [CI] 19.1, 28.1) reported being current smokers. The mean age of smokers was 42.1 years, and 64.1% were male. Forty-one per cent (31/75) reported difficulty refraining from smoking, 78.1% (57/73) anticipated health problems because of smoking and 69.7% (53/76) had a desire to quit. Overall, 23/61 (37.7% of smokers) had a desire to cease smoking in the next month. The majority (44/73, 60.3%) were willing to undergo brief counselling. Multisession face-to-face counselling was most commonly preferred (22/55, 40.0%) and more than one-third (20/55, 36.4%) preferred group counselling. A session with an ED doctor (6/55, 10.9%) and multiple telephone-delivered interventions (7/55, 12.7%) were least preferred. Conclusion:Smoking is more prevalent among ED patients than statistics reported for the general population. Delivery of appropriate brief interventions suited to the stage of change should be trialled, along with referral from ED to counselling services.

Predictors of tobacco smoking among acutely ill patients in a Moscow hospital: A cross-sectional study

“…A hospital population comprising 399 Russian cancer patients found that 41.6% were smokers 32 , indicating a higher prevalence compared to the general population, however smoking is a well-known significant risk factor for cancer. Also, among 335 Australian ED patients smoking prevalence was found to be 23%, compared to 18% in the general population 33 . One explanation for the similar prevalences in our study and the general Russian population might be that our hospital population is older compared to the general population described in GATS, which might be due to the negative impact of tobacco use on individual life expectancy.…”

“…Also, GATS showed that older adults generally believe that smoking causes serious illnesses 5 , which again might explain why fewer older adults smoke. The patients in the younger age groups (18-40 and 41-60 years) have a much higher prevalence of smokers compared to the younger age groups in the general population (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) and 45-64 years) 5 , indicating that smoking might have been a contributing factor for somatic illness in the younger patients.…”

The efficacy and safety of varenicline alone versus in combination with nicotine lozenges for smoking cessation among hospitalised smokers (VANISH): study protocol for a randomised, placebo-controlled trial

“…Representing a key risk factor for deaths due to ischaemic heart disease, stroke and cancer, tobacco smoking kills approximately 6 million people globally each year. 1 2 Holding the potential to damage nearly every organ system in the human body, tobacco smoking accounts for 7.8% of the total burden of disease in Australia. 1 2 Despite this, 14% of adults aged 18 years and over smoked daily in 2017–2018.…”

“… 1 2 Holding the potential to damage nearly every organ system in the human body, tobacco smoking accounts for 7.8% of the total burden of disease in Australia. 1 2 Despite this, 14% of adults aged 18 years and over smoked daily in 2017–2018. 2 3…”

“…Furthermore, hospitalised inpatients generally smoke a greater number of cigarettes per day than the general population and have a higher level of nicotine dependence. 1 27 Varenicline is a smoking cessation agent that is targeted towards moderate to heavy smokers. 28–30 Therefore, this group of patients provides an ideal study population for evaluating the efficacy and safety of the combination of varenicline and nicotine lozenges for smoking cessation.…”