title: Emergency department provider preferences related to clinical practice guidelines for tobacco cessation: a multicenter survey.
abstract: OBJECTIVE
  The objective was to assess current emergency department (ED) provider practices and preferences for tobacco cessation interventions. The ED is an opportune place to initiate smoking cessation interventions. However, little is known about ED provider current practices and preferences for cessation counseling in the ED.
  
  
  METHODS
  This was a survey of ED providers conducted in 2008-2009 (including physicians, nurse practitioners, physician assistants, and nurses), working at least half-time at 10 U.S. academic EDs, regarding adherence to clinical practice guidelines ("5 As") and preferences for cessation interventions/styles. Data analysis occurred in 2012-2013.
  
  
  RESULTS
  The response rate was 64% (800 out of 1,246 completed surveys). Providers reported strongest adherence to asking about patient smoking status, followed by advising, with significant variance by clinical role. Assessing, assisting, and arranging support for patients was low overall. Most frequently used interventions were to provide patients with a list of telephone numbers for stop-smoking counseling (87%), pamphlets on smoking health risks and the benefits of stopping (85%), and referrals to the National Toll-Free Smoker's Quitline (84%). Most providers (80%) were supportive of personally conducting brief (less than 3 minutes) smoking cessation counseling sessions during the ED visit, emphasizing education and encouragement. The least appealing intervention was writing a prescription for nicotine replacement therapies or medications to stop smoking (35%).
  
  
  CONCLUSIONS
  Interventions most likely to be used were brief and delivered with a positive tone and included referral to external resources. The logical next step is to design and test interventions that ED providers find acceptable.
authors.affiliation: The Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Walters
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Reibling
authors.forename: Scott T
authors.initials: ST
authors.lastname: Wilber
authors.forename: Ashley F
authors.initials: AF
authors.lastname: Sullivan
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Gaeta
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Boudreaux
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D014481:United States; D000078329:Workforce
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