A Randomized Trial of a Multicomponent Cessation Strategy for Emergency Department Smokers

摘要: ACADEMIC EMERGENCY MEDICINE 2011; 18:575–583 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives:  The objective was to determine efficacy of an emergency department (ED)-based smoking cessation intervention. Methods:  This study a randomized trial conducted from January 2006 September 2007 at urban ED that treats 90,000 adults per year. Discharged who smoked least 10 cigarettes day were 1) usual care, receiving brochure; or 2) enhanced brochure, motivational interview (MI), nicotine patches, and phone call 3 days. Interventions performed peer educator trained in tobacco treatment. Blinded follow-up 3 months. Results:  A total 338 subjects enrolled, mean (±SD) age 40.2 (±12.0) years, 51.8% female, 56.5% either self-pay Medicaid. Demographic clinical variables comparable between groups. Enhanced care arms showed similar rates 3 months (14.7% vs. 13.2%, respectively). proportion making quit attempt (69.2% 66.5%) decrease daily cigarette use (five one; all p > 0.05) also similar. In logistic modeling, factors associated with quitting included any tobacco-related International Classification Diseases, ninth revision (ICD-9), code visit (odds ratio [OR] = 3.42, 95% confidence interval [CI] = 1.61 7.26) subject belief (OR = 2.47, CI = 1.17 5.21). Conversely, reported having preexisting illness less likely 0.22, CI = 0.10 0.50). Conclusions:  primary endpoint negative, reflecting higher-than-expected rate control group. Subjects whose tobacco-related, based on physician diagnosis perception, more than twice as quit. These data suggest even low-intensity screening referral may prompt substantial numbers smokers