Bernstein Steven L, Boudreaux Edwin D, Cabral Lisa, Cydulka Rita K, Schwegman David, Larkin Gregory L, Adams Annette L, McCullough Lynne B, Rhodes Karin V
Albert Einstein College of Medicine, Albert Einstein Cancer Center, and Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.
Nicotine Tob Res. 2008 Aug;10(8):1277-82. doi: 10.1080/14622200802239272.
Patients in hospital emergency departments smoke more than the general population. Smoking profiles of these patients have largely been characterized in small, single-institution cohorts. Our objective was to survey adult smokers visiting a sample of U.S. emergency departments, as part of a study examining the efficacy of an educational intervention on physicians' knowledge, attitudes, and behavior regarding tobacco control. A convenience sample of patients in eight academic emergency departments was surveyed from May to July 2006. Eligible patients were aged 18 years or older, were every- or some-day smokers, spoke English or Spanish, were able to provide written informed consent, and were not actively psychotic. Descriptive statistics are reported using parametric and nonparametric measures. A total of 1,168 patients were interviewed (mean age = 40.7 years); 46.5% were female, 54.4% were uninsured or had Medicaid, and 29.9% had no usual source of care. Patients smoked a median of 10 cigarettes daily, with a median score on the Fagerstrom Test for Nicotine Dependence of 4, and a median score of 5 on the nine-point contemplation ladder, indicating a desire to quit within 6 months. Smokers with a diagnosis of cardiovascular, respiratory, or malignant disease were more interested in quitting than others (median ladder score = 4 vs. 6, p<.001), were more likely to believe they had a smoking-related illness, and were more likely to believe their emergency department visit was related to smoking. Smokers with a presenting complaint of chest pain or dyspnea were more interested in quitting than others (median ladder score = 4 vs. 6, p = .002). Emergency department patients smoked at moderate amounts, with moderate levels of addiction and interest in quitting. Smokers with tobacco-related diagnoses, or who believed their emergency department visit was related to smoking, were more interested in quitting. These findings suggest that the emergency department visit may provide a teachable moment to reach smokers who have tobacco-related problems.
医院急诊科的患者吸烟率高于普通人群。这些患者的吸烟情况在很大程度上是在小型单机构队列中进行描述的。我们的目标是对访问美国急诊科样本的成年吸烟者进行调查，作为一项研究的一部分，该研究旨在检验一项教育干预措施对医生在烟草控制方面的知识、态度和行为的有效性。2006年5月至7月，对8个学术急诊科的患者进行了便利抽样调查。符合条件的患者年龄在18岁及以上，为每日或有时吸烟的吸烟者，说英语或西班牙语，能够提供书面知情同意书，且无活动性精神病。使用参数和非参数测量方法报告描述性统计数据。共采访了1168名患者（平均年龄 = 40.7岁）；46.5%为女性，54.4%未参保或参加医疗补助计划，29.9%没有固定的医疗服务来源。患者每天吸烟的中位数为10支，尼古丁依赖的Fagerstrom测试中位数得分为4，在九点思考阶梯上的中位数得分为5，表明有在6个月内戒烟的意愿。诊断为心血管、呼吸或恶性疾病的吸烟者比其他人更有戒烟意愿（思考阶梯中位数得分 = 4对6，p<0.001），更有可能认为自己患有与吸烟相关的疾病，也更有可能认为自己因吸烟而就诊急诊科。以胸痛或呼吸困难为主诉的吸烟者比其他人更有戒烟意愿（思考阶梯中位数得分 = 4对6，p = 0.002）。急诊科患者吸烟量适中，成瘾程度和戒烟意愿适中。患有与烟草相关诊断的吸烟者，或认为自己因吸烟而就诊急诊科的吸烟者，更有戒烟意愿。这些发现表明，急诊科就诊可能为接触有烟草相关问题的吸烟者提供一个可教育的时机。
