Changes in smoking associated with an acute health event: theoretical and practical implications.
BACKGROUND
Experiencing a serious adverse behavior-related consequence may motivate behavior change.


OBJECTIVE
To examine how a sentinel health event is associated with changes in smoking.


METHODS
We used a prospective cohort design. Adult emergency department (ED) patients provided demographic data, a smoking history, ratings of quit intentions, and endorsement of self-identified smoking-related health problems. A chart review collected data on acuity, ED disposition, and medical diagnoses. Smoking was reassessed 1 month postvisit. Hierarchical regression analyses were conducted to predict (a) intention to quit, (b) any quit attempt of 24 hr or more, and (3) 7-day abstinence.


RESULTS
Of 717 smokers enrolled, 189 (26%) intended to quit within the next month. Of the 253 participants reached 1 month postvisit, 126 (50%) reported they had attempted to quit, with 44 (19%) reporting 7-day abstinence. After controlling for other predictors, several event-related variables, such as having a smoking-related ED visit and being admitted to the hospital, were strong predictors of outcomes.


CONCLUSIONS
Compared to community-based estimates, many more smokers in our sample attempted to quit and achieved 7-day abstinence. This was especially true among smokers who attributed their ED visit to a smoking-related health problem and who were admitted to the hospital. We discuss the implications for tobacco intervention design in medical settings.
Boudreaux
Edwin D
ED
Department of Emergency Medicine, UMDNJ-Robert Wood Johnson Medical School and Cancer Institute of New Jersey at Cooper University Hospital, Camden, New Jersey 08103, USA. boudreaux-edwin@cooperhealth.edu
Baumann
Brigitte M
BM
Camargo
Carlos A
CA
O'Hea
Erin
E
Ziedonis
Douglas M
DM
D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011446:Prospective Studies; D020377:Self Efficacy; D012720:Severity of Illness Index; D012803:Sick Role; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology / Q000534:rehabilitation*