Motivation for stopping tobacco use among emergency department patients

Objectives: To determine the feasibility of new models for reinforcing tobacco-use-cessation interventions initiated in the emergency department (ED). The authors assessed the level of motivation to quit tobacco use among a general population of ED patients; the proportion who receive tobacco-use assessments, information, and interventions from ED providers; and the desired timing of tobacco-use interventions. Methods: Face-to-face interviews with a convenience sample of 376 adult patients receiving care in the ED at the Mayo Clinic in Rochester, Minnesota. Results: Of the 376 participants, 27% (100/376; 95% Cl = 22% to 31%) currently used one or more forms of tobacco. Thirty percent (30/100; 95% CI = 21% to 40%) of tobacco users were in the preparation stage of change for tobacco cessation. The median score on the Contemplation Ladder was 6 (range: 0-10). Twenty-seven percent (27/100; 95% Cl = 19% to 37%) of all tobacco users would have been interested in a tobacco- use treatment after the ED visit, such as telephone-based counseling. Of the current tobacco users either receiving or desiring a tobacco-use intervention, 74% (25/34; 95% CI = 56% to 87%) would be interested in receiving an intervention component after the ED visit. Conclusions: ED patients who use tobacco demonstrate motivation to quit and express interest in receiving interventions to assist them after the ED visit. Previous investigations have observed that ED patients do not attend interventions prescribed after the initial ED encounter. These findings suggest that the development of new models for reinforcing tobacco-use interventions initiated in the ED deserve exploration, such as linking them to a tobacco quitline.