Are emergency department visits really a teachable moment? Smoking cessation promotion in emergency department.
OBJECTIVE
To compare the effectiveness of smoking cessation counseling in the emergency department (ED) versus in outpatient clinics (OCs) setting.


METHODS
Over a 3-month period, smokers and recent quitters presenting to ED or OCs were questioned about their smoking habits and desire to quit. They also completed the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire and Prochaska's stages of change (PSC) survey. Standardized 5 min counseling session was carried out, and stop smoking pamphlet and phone number of the hospital's smoking cessation unit were given. One month after initial counseling, patients were telephoned, FTND, PSC, desire to quit, and daily cigarette consumption were asked. Data from those unable to be contacted within 6 weeks were excluded from analysis.


RESULTS
Of the 392 patients (197 ED, 195 OC) counseled initially, 340 (87%) were reached for telephone follow-up. Counseling was effective in both groups: FTND and PSC scores had improved, and daily cigarette consumption decreased significantly (17.17-12.49 cigs/day; P=0.000). Smokers counseled in the ED were found more inclined to stop smoking compared with smokers who counseled in OCs, after 1 month of the intervention (95% confidence interval=14.7-7.5%; P=0.051). Only one patient (0.6%) from the ED and 10 (6.6%) from the OC attended the smoking cessation program.


CONCLUSIONS
ED-based counseling for smoking cessation was as effective as that performed in the OC setting. Referral of smokers from the ED to a smoking cessation program was unsuccessful in our patient population.
Ersel
Murat
M
Department of Emergency Medicine, Ege University Hospital, Bornova, Izmir, Turkey. murat.ersel@ege.edu.tr
Kitapcioglu
Gul
G
Solak
Zeynep Ayfer
ZA
Yuruktumen
Aslihan
A
Karahalli
Eylem
E
Cevrim
Ozgur
O
D000293:Adolescent; D000328:Adult; D003142:Communication; D016001:Confidence Intervals; D037001:Directive Counseling; D004636:Emergency Service, Hospital; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D040241:Social Marketing; D011795:Surveys and Questionnaires; D013663:Teaching; D055815:Young Adult