Nicotine dependence, motivation to quit, and diagnosis in emergency department patients who smoke

Journal Name: 
Addict Behav
Authors: 
Bernstein,S.L.
Secondary Authors: 
Cannata,M.
Abstract: 
OBJECTIVES: To assess the effect of diagnosis on motivation to quit in adult smokers in an emergency department (ED). METHODS: A survey of patients visiting two EDs from September to November, 2003. Patients screening positive for smoking completed a Fagerstrom Test for Nicotine Dependence and Ladder of Contemplation. ICD9 codes and disposition status were recorded. Smoking-related diagnoses were drawn from standard sources. Data were analyzed with parametric and non-parametric statistics. RESULTS: Five hundred and eighty-five were interviewed, median age 40 (interquartile range 29-50); 323 (55%) were female. Ninety percent of all patients were non-White; 69% were uninsured or had Medicaid. Of 152 patients with smoking-related diagnoses, the median Fagerstrom score was 4.7 vs. 4.1 for patients with a non-smoking-related diagnosis (p=0.02, 95% CI for the difference 0.2, 0.9). Patients with smoking-related and non-smoking-related diagnoses had similar levels of motivation to quit (Ladder score, respectively, 5.5 vs. 5.1, p=0.03, 95% CI for difference 0.03, 0.8). CONCLUSIONS: Adult ED smokers exhibit mild-moderate levels of nicotine addiction and interest in quitting. ED-based tobacco control should target all smokers.
2006
Volume: 
31
Pages: 
288-297
Keywords: 
2950, 40, Adult, Diagnosis, Emergencies, Female, Medicaid, Methods, Motivation, NYC RING, patient, Patients, Smoking, Statistics, survey