Smoking Stage of Change and Interest in an Emergency Department–based Intervention

Objectives: To examine factors associated with motivation to quit smoking and interest in an emergency department (ED)‐based intervention. Methods: Consecutive ED patients 18 years of age and older were interviewed. Severely ill and cognitively disabled patients were excluded. Smoking history, stage of change, self‐efficacy, presence of a smoking‐related illness, interest in an ED‐based smoking intervention, and screening/counseling by the patient's ED provider were assessed. Results: A total of 1,461 of 2,314 patients (64%) were interviewed. A total of 581 (40%) currently smoked, with 21% in precontemplation (no intention to quit), 43% in contemplation (intention to quit but not within the next 30 days), and 36% in preparation (intention to quit within the next 30 days). Approximately 50% indicated a willingness to remain 15 extra minutes in the ED to receive counseling. Only 8% received counseling by their ED provider. A regression analysis showed that greater readiness to change was associated with multiple lifetime quit attempts, presence of a quit attempt in the past 30 days, and higher self‐efficacy. Interest in an ED‐based intervention was more likely among patients who reported higher self‐efficacy. Conclusions: Approximately 50% of smokers reported at least moderate interest in an ED‐based intervention and a willingness to stay 15 extra minutes, but only 8% reported receiving counseling during their ED visit. Considering time and resource constraints, counseling/referral may be best suited for patients characterized by a strong desire to quit, multiple previous quit attempts, high self‐efficacy, a smoking‐related ED visit, and strong interest in ED‐based counseling.