title: Tobacco smoking by adult emergency department patients in Australia: a point-prevalence study.
abstract: Objectives and importance of study: Tobacco smoking is the leading single cause of preventable death. International findings suggest that rates of smoking are higher among emergency department (ED) patients than the general population, suggesting that the ED may be a strategic location in which to initiate smoking cessation programs. We aimed to determine the prevalence of smoking among adult ED patients in Australia, their desire for smoking cessation and preferred methods of cessation.
  
  
  METHODS
  Point-prevalence survey Method: A sample of adult ED patients was recruited from two tertiary referral hospital EDs. Participants were asked whether or not they currently smoked. Smokers were asked 15 additional questions, including about their readiness for smoking cessation. Demographics were collected from patients, and ED presentation characteristics were collected from medical records.
  
  
  RESULTS
  Of 443 consecutive ED patients, 348 were eligible and 338 consented to participate. Data for 335 participants were available for analysis and 78 (23.3%; 95% confidence interval [CI] 19.1, 28.1) reported being current smokers. The mean age of smokers was 42.1 years, and 64.1% were male. Forty-one per cent (31/75) reported difficulty refraining from smoking, 78.1% (57/73) anticipated health problems because of smoking and 69.7% (53/76) had a desire to quit. Overall, 23/61 (37.7% of smokers) had a desire to cease smoking in the next month. The majority (44/73, 60.3%) were willing to undergo brief counselling. Multisession face-to-face counselling was most commonly preferred (22/55, 40.0%) and more than one-third (20/55, 36.4%) preferred group counselling. A session with an ED doctor (6/55, 10.9%) and multiple telephone-delivered interventions (7/55, 12.7%) were least preferred.
  
  
  CONCLUSIONS
  Smoking is more prevalent among ED patients than statistics reported for the general population. Delivery of appropriate brief interventions suited to the stage of change should be trialled, along with referral from ED to counselling services.
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia, tracey.weiland@svha.org.au.
authors.forename: Tracey
authors.initials: T
authors.lastname: Weiland
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital Melbourne, Victoria, Australia; Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia.
authors.forename: George A
authors.initials: GA
authors.lastname: Jelinek
authors.affiliation: Department of Emergency Medicine, Austin Health, Melbourne, Victoria, Australia.
authors.forename: Simone E
authors.initials: SE
authors.lastname: Taylor
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia; Department of Emergency Medicine, Austin Health, Melbourne, Victoria, Australia.
authors.forename: David McD
authors.initials: DM
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology