title: Prevalence of potential smoking-related conditions among tobacco users in the emergency department and their perception that their visit may be smoking-related.
abstract: OBJECTIVE
  Patients who are tobacco users present to the emergency department (ED) with many medical conditions that are causally or potentially causally related to smoking. Previous studies have shown increased cessation rates for patients who accurately perceive that their ED visit is smoking-related. Our study goals were 1) to determine the prevalence of potential smoking-related conditions among tobacco users at a tertiary care academic ED, and 2) to determine which medical conditions are more or less likely to be perceived by patients as smoking-related.
  
  
  METHODS
  We included adults≥19 years of age who reported smoking within 30 days of their ED visit, and were enrolled in a randomized controlled trial (ClinicalTrials.gov, NCT01454375) from December 1, 2011 to August 31, 2012. Patients were asked whether they perceived their ED visit to be related to smoking. ED discharge diagnoses were coded as smoking-related or not smoking-related based on the 2004 U.S. Surgeon General's Report.
  
  
  RESULTS
  We included 893 patients (62% male; mean age=40±15), of which 120 (13%) had a visit for a potential smoking-related condition: 6 (5%) of neoplasm, 18 (15%) of cardiovascular disease, 67 (56%) of respiratory disease, 3 (3%) of reproductive complication, 7 (6%) of postoperative complication, 9 (8%) of dental disease, 9 (8%) of peptic ulcer disease, 0 (0%) of eye condition, and 1 (1%) of bony condition. Of the potential smoking-related conditions, 46 (38%) were perceived by patients to be possibly smoking-related: 61% of cardiovascular disease, 33% of neoplasm, 43% of respiratory disease, 22% of dental disease, 14% of postoperative complication, 11% of peptic ulcer disease, and 0% of the remaining conditions.
  
  
  CONCLUSIONS
  In this study, 13% of all ED visits among smokers were for a potential smoking-related condition, of which 38% were perceived by patients to be smoking-related. Education to increase awareness of smoking-related conditions may increase cessation rates.
authors.affiliation: *Faculty of Medicine,University of British Columbia,Vancouver,BC.
authors.forename: Amy Po Yu
authors.initials: APY
authors.lastname: Tsai
authors.affiliation: *Faculty of Medicine,University of British Columbia,Vancouver,BC.
authors.forename: Jimmy Po-Nien
authors.initials: JP
authors.lastname: Tsai
authors.affiliation: †Department of Emergency Medicine,University of British Columbia,Vancouver,BC.
authors.forename: Lauren
authors.initials: L
authors.lastname: Stewart
authors.affiliation: †Department of Emergency Medicine,University of British Columbia,Vancouver,BC.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brubacher
authors.affiliation: †Department of Emergency Medicine,University of British Columbia,Vancouver,BC.
authors.forename: Ka Wai
authors.initials: KW
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000367:Age Factors; D001955:British Columbia / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010465:Perception; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
keywords: health promotion; patient perception; tobacco use