4007.0: Tuesday, November 14, 2000 - Board 5

Abstract #10092

Physician Intervention for Smokers with Acute Respiratory Illness: Inconsistent and Incomplete

Bruce M. Becker, MD, MPH, Community Health, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903, (401) 444-6654, BBecker@Lifespan.org, Beth C. Bock, PhD, Center for Behavioral & Preventive Medicine, Brown University School of Medicine, Miriam Hospital, 128 Summit Avenue, Providence, RI 02906, and Robert Partridge, MD, Emergency Medicine, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.

Objectives: Determine motivation to quit and risk perception among ED patients being treated for Acute Respiratory Illness (ARI) who smoke, and ED physician compliance with AHCPR smoking guidelines. Methods: A survey administered by research assistants to a convenience sample of adults presenting with ARI to the ED of an urban trauma center. Non-English speaking, critically ill, and intoxicated patients were excluded. Data were analyzed using SPSS software. Results: Sixty-four men and 62 women were recruited, of whom half smoked. Of the smokers, 47.6% denied that their illness was made worse by smoking, and 31.7% felt smoking did not affect their health; nevertheless, 63.5% reported that quitting smoking could improve their health. Heavy smokers were more likely to believe that smoking adversely affected their health(r=0.23, p<0.05, CI=0.20-0.44) and that quitting would improve their health (r=0.29, p< .05). Thirty-six percent of smokers were highly motivated to quit, while 59.7% were willing to discuss smoking cessation in the ED. Most (71.4%) were asked about their smoking, but only 31.7% were advised to quit and a mere 9.5% were offered any assistance by ED physicians. Smokers given advice to quit were more likely to believe quitting would improve their health (p<.01) and that their ARI was made worse by smoking (p<.05); they were also more motivated to quit (p<.05). Conclusions: Direct physician advice to quit smoking provided to ED patients with ARI increased smokers’ perception of risk from smoking and their motivation quit. Most were willing to receive an intervention in the ED, and should.

Learning Objectives: Learners will be able to assess motivation to quit smoking, describe the frequency and depth of physician advice for smoking cessation typically given in Emergency Medicine, and understand the need for nicotine dependence intervention in this population of patients

Keywords: Community Health, Tobacco Control

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA