Smoking stage of change and interest in an emergency department-based intervention.
OBJECTIVE
To examine factors associated with motivation to quit smoking and interest in an emergency department (ED)-based intervention.


METHODS
Consecutive ED patients 18 years of age and older were interviewed. Severely ill and cognitively disabled patients were excluded. Smoking history, stage of change, self-efficacy, presence of a smoking-related illness, interest in an ED-based smoking intervention, and screening/counseling by the patient's ED provider were assessed.


RESULTS
A total of 1,461 of 2,314 patients (64%) were interviewed. A total of 581 (40%) currently smoked, with 21% in precontemplation (no intention to quit), 43% in contemplation (intention to quit but not within the next 30 days), and 36% in preparation (intention to quit within the next 30 days). Approximately 50% indicated a willingness to remain 15 extra minutes in the ED to receive counseling. Only 8% received counseling by their ED provider. A regression analysis showed that greater readiness to change was associated with multiple lifetime quit attempts, presence of a quit attempt in the past 30 days, and higher self-efficacy. Interest in an ED-based intervention was more likely among patients who reported higher self-efficacy.


CONCLUSIONS
Approximately 50% of smokers reported at least moderate interest in an ED-based intervention and a willingness to stay 15 extra minutes, but only 8% reported receiving counseling during their ED visit. Considering time and resource constraints, counseling/referral may be best suited for patients characterized by a strong desire to quit, multiple previous quit attempts, high self-efficacy, a smoking-related ED visit, and strong interest in ED-based counseling.
Boudreaux
Edwin D
ED
Department of Emergency Medicine, Cooper Hospital, One Cooper Plaza, Camden, NJ 08103, USA. boudreaux-edwin@cooperhealth.edu
Baumann
Brigitte M
BM
Friedman
Kim
K
Ziedonis
Douglas M
DM
D000293:Adolescent; D000328:Adult; D003376:Counseling; D004636:Emergency Service, Hospital; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015999:Multivariate Analysis; D009515:New Jersey; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012044:Regression Analysis; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data*