title: Efficacy of emergency department-initiated tobacco control--systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of emergency department-initiated tobacco control (ETC).
  
  
  METHODS
  Literature search in 7 databases and gray literature sources. Point prevalence tobacco abstinence at 1-, 3-, 6-, and/or 12-month follow-up was abstracted from each study. The proportionate effect (relative risk) of ETC on tobacco abstinence was calculated separately for each study and follow-up time and pooled, at different follow-up times, by Mantel-Haenszel relative risks. The effects of ETC on combined point prevalence tobacco abstinence across all follow-up times were calculated using generalized linear mixed models.
  
  
  RESULTS
  Seven studies with overall 1,986 participants were included. The strongest effect of ETC on point prevalence tobacco abstinence was found at 1 month: Relative risk (RR) = 1.47 (3 studies) (95% confidence interval [CI]: 1.06-2.06), while the effect at 3, 6, and 12 months was RR = 1.24 (6 studies) (95% CI: 0.93-1.65); 1.13 (5 studies) (95% CI: 0.86-1.49); and 1.25 (1 study) (95% CI: 0.91-1.72). The benefit on combined point prevalence tobacco abstinence was RR = 1.33 (7 studies) (95% CI: 0.96-1.83), p = .08; with RR = 1.33 (95% CI: 0.92-1.92), p = .10, for the 5 studies combining motivational interviewing and booster phone calls.
  
  
  CONCLUSIONS
  ETC combining motivational interviewing and booster phone calls showed a trend toward increased episodically measured tobacco abstinence up to 12 months. More methodologically rigorous trials are needed to effectively evaluate the impact of ETC.
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Münster,  Münster, Germany.
authors.forename: Gwen Lisa
authors.initials: GL
authors.lastname: Rabe
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wellmann
authors.forename: Pantelis
authors.initials: P
authors.lastname: Bagos
authors.forename: Markus A
authors.initials: MA
authors.lastname: Busch
authors.forename: Hans-Werner
authors.initials: HW
authors.lastname: Hense
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
authors.forename: Edith
authors.initials: E
authors.lastname: Weiss-Gerlach
authors.forename: William
authors.initials: W
authors.lastname: McCarthy
authors.forename: Mariana José
authors.initials: MJ
authors.lastname: Gareca Arizaga
authors.forename: Bruno
authors.initials: B
authors.lastname: Neuner
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006801:Humans; D062405:Motivational Interviewing; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D016540:Smoking Cessation; D000074606:Smoking Prevention; D062789:Tobacco Products