Article Text

Download PDFPDF

Emergency department-initiated tobacco control: a randomised controlled trial in an inner city university hospital
  1. B Neuner1,
  2. E Weiss-Gerlach1,
  3. P Miller2,
  4. P Martus3,
  5. D Hesse1,
  6. C Spies1
  1. 1
    Department of Anesthesiology and Intensive Care Medicine, Charité – Universitaetsmedizin Berlin, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
  2. 2
    Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3
    Institute of Biostatistics and Clinical Epidemiology, Charité – Universitaetsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
  1. B Neuner, Charité – Universitaetsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany; bruno.neuner{at}charite.de

Abstract

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

Methods: A randomised controlled intention-to-treat trial (trials registry no.: ISRCTN41527831) was conducted with 1044 patients in an urban ED. ETC consisted of on-site counselling plus up to four telephone booster sessions. Controls received usual care. Analysis was by logistic regression.

Results: In all, 630 (60.7%) participants were males, the median age was 30 years (range 18–81) and the median smoking intensity was 15 (range 1–60) cigarettes per day. Overall, 580 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) min) was administered to 472 (91.7% out of 515) randomised study participants. At follow-up, 685 study participants (65.6% of 1044) could be contacted. In the ETC group, 73 out of 515 (14.2%) in the ETC group were abstinent, whereas 60 out of 529 (11.3%) controls were abstinent (OR adjusted for age and gender = 1.31 (95% CI 0.91 to 1.89, p = 0.15). Stratified for motivation to change behaviour, the adjusted ORs for ETC versus usual care were OR = 1.00 (95% CI 0.57 to 1.76) in unmotivated smokers, respectively OR = 1.37 (95% CI 0.73 to 2.58) in ambivalent smokers and OR = 2.19 (95% CI 0.98 to 4.89) in motivated smokers, p for trend = 0.29.

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

View Full Text

Statistics from Altmetric.com

Footnotes

  • Funding: This study was funded by the German Cancer Foundation (Deutsche Krebshilfe), Bonn, Germany (Grant DKH-106730).

  • Competing interests: None.

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.