title: Efficacy of an emergency department-based multicomponent intervention for smokers with substance use disorders.
abstract: The efficacy of brief emergency department (ED)-based interventions for smokers with concurrent alcohol or substance use is unknown. We performed a subgroup analysis of a trial enrolling adult smokers in an urban ED, focusing on subjects who screened positive for alcohol abuse or illicit drug use. Subjects receiving usual care (UC) were given a smoking cessation brochure; those receiving enhanced care (EC) got the brochure, a brief negotiated interview, 6 weeks of nicotine patches, and a telephone call. Follow-up occurred at 3 months. Of 340 subjects in the parent study, 88 (25.9%) reported a substance use disorder. At 3 months, substance users receiving EC were more likely to be tobacco-abstinent than those receiving UC (14.6% versus 0%, p = .015), and to self-identify as nonsmokers (12.5% v. 0%, p = .03). This finding suggests that concurrent alcohol or substance use should not prevent initiation of tobacco dependence treatment in the ED.
authors: Montefiore Medical Center, Albert Einstein College of Medicine, Albert Einstein Cancer Center, Bronx, NY, USA. Steven.bernstein@yale.edu
authors: Steven L
authors: SL
authors: Bernstein
authors: Polly
authors: P
authors: Bijur
authors: Nina
authors: N
authors: Cooperman
authors: Saba
authors: S
authors: Jearld
authors: Julia H
authors: JH
authors: Arnsten
authors: Alyson
authors: A
authors: Moadel
authors: E John
authors: EJ
authors: Gallagher
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D003131:Combined Modality Therapy; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D062405:Motivational Interviewing; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013997:Time Factors; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome