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Your Environment. Your Health.

Publication Detail

Title: Predicting smoking stage of change among emergency department patients and visitors.

Authors: Boudreaux, Edwin D; Hunter, Gabrielle C; Bos, Karen; Clark, Sunday; Camargo Jr, Carlos A

Published In Acad Emerg Med, (2006 Jan)

Abstract: OBJECTIVES: Little is known about whether emergency department (ED) patients or those who accompany them (visitors) are interested in smoking cessation. The authors hypothesized that several variables would be associated with stage of change, including nicotine dependence, self-efficacy, presence of a smoking-related illness, and anticipated cessation-related health improvement. METHODS: For two 24-hour periods, consecutive patients and visitors aged 18 years and older presenting to four Boston EDs were interviewed. The authors assessed a range of smoking-related constructs. Exclusion criteria included severe illness, cognitive insufficiency, and acute distress. RESULTS: One thousand ten subjects were screened (56% patients, 44% visitors). Two hundred thirty-seven (23%) subjects were current smokers, with 57% being in precontemplation, 31% in contemplation, and 12% in preparation stages. When ordinal regression was used, the variables most strongly associated with stage of change were as follows: self-efficacy (odds ratio [OR] = 5.1; p < 0.001), anticipated cessation-related health improvement (OR = 2.7; p = 0.02), and having a smoking-related health problem (OR = 1.9; p = 0.08). CONCLUSIONS: Because many disenfranchised Americans use the ED as a regular source of health care, increased attention to smoking in the ED setting holds tremendous public health potential. This study's results reinforce the validity of the stage-of-change model within the ED setting. Developers of ED-initiated interventions will have to consider the heterogeneity in stage of change when designing their treatments.

PubMed ID: 16365327 Exiting the NIEHS site

MeSH Terms: Adult; Boston; Emergency Service, Hospital/statistics & numerical data*; Female; Health Knowledge, Attitudes, Practice*; Health Surveys; Humans; Male; Motivation; Multivariate Analysis; Prospective Studies; Regression Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Self Efficacy; Smoking Cessation/psychology; Smoking Cessation/statistics & numerical data*; Visitors to Patients/statistics & numerical data*

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