Article Text

other Versions


Emergency department-initiated tobacco control: a randomised controlled trial in an inner-city university hospital
  1. Bruno Neuner, MD MSE1,
  2. Edith Weiss-Gerlach1,
  3. Peter Miller, PhD2,
  4. Peter Martus, PhD3,
  5. Doreen Hesse MD1,
  6. Claudia Spies MD1
  1. 1 Charité-Universitaetsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, Germany;
  2. 2 Center for Drug and Alcohol Programs, Medical University of South Carolina, Germany;
  3. 3 Charité-Universitaetsmedizin Berlin, Institute of Biostatistics and Clinical Epidemiology, United States
  1. E-mail: bruno.neuner{at}


Objectives: Emergency department (ED) patients show high smoking rates. We investigated the effects of ED-initiated tobacco control (ETC) on the 7-days abstinence at 12 months.

Methods: Randomized-controlled intention-to-treat trial (Trials Registry no.: ISRCTN41527831) in 1,044 patients in an urban ED. ETC consisted of on-site counselling plus up to 4 telephone booster sessions. Controls received usual care. Analysis was by logistic regression.

Results: Overall 630 (60.7%) were males, the median age was 30 years, (range 18 – 81), and the median smoking intensity was 15 (range 1 – 60) cigarettes per day. Five hundred eighty study participants (55.6%) were unmotivated, 331 (31.7%) were ambivalent, and 133 (12.7%) were motivated smokers. ETC (median time 30 (range 1 – 99) minutes) was administered to 472 (91.7% out of 515) randomized study participants. At follow-up, 685 study participants (65.6% of 1,044) could be contacted. Overall, 73 out of 515 (14.2%) in the ETC group were abstinent, whereas 60 out of 529 (11.3%) controls were abstinent (Odds ratio adjusted for age and gender: 1.31 (95%-confidence interval (0.91 – 1.89), p=0.15). Stratified for motivation to change behavior, the adjusted Odds ratios for ETC versus usual care were 1.00 (95%-confidence interval (0.57 – 1.76)) in unmotivated smokers, respectively 1.37 (95%-confidence interval (0.73 – 2.58)) in ambivalent smokers and 2.19 (95%-confidence interval (0.98 – 4.89)) in motivated smokers, p for trend = 0.29.

Conclusions: ETC, in the form of on-site counselling with up to 4 telephone booster sessions, showed no overall effect on tobacco abstinence after 12 month. A non-significant trend for a better performance of ETC in more motivated smokers was observed.

Statistics from


    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.