Changes in smoking associated with an acute health event: theoretical and practical implications
Department of Psychiatry; Department of Emergency Medicine
Medical Subject Headings
Adult; Aged; Behavior Therapy; Cohort Studies; Emergency Service, Hospital; Female; Follow-Up Studies; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Intention; Male; Middle Aged; *Motivation; Prospective Studies; Self Efficacy; Severity of Illness Index; *Sick Role; Smoking; Smoking Cessation; Tobacco Use Disorder
Emergency Medicine | Psychiatry
BACKGROUND: Experiencing a serious adverse behavior-related consequence may motivate behavior change.
PURPOSE: To examine how a sentinel health event is associated with changes in smoking. Methods: We used a prospective cohort design. Adult emergency department (ED) patients provided demographic data, a smoking history, ratings of quit intentions, and endorsement of self-identified smoking-related health problems. A chart review collected data on acuity, ED disposition, and medical diagnoses. Smoking was reassessed 1 month postvisit. Hierarchical regression analyses were conducted to predict (a) intention to quit, (b) any quit attempt of 24 hr or more, and (3) 7-day abstinence.
RESULTS: Of 717 smokers enrolled, 189 (26%) intended to quit within the next month. Of the 253 participants reached 1 month postvisit, 126 (50%) reported they had attempted to quit, with 44 (19%) reporting 7-day abstinence. After controlling for other predictors, several event-related variables, such as having a smoking-related ED visit and being admitted to the hospital, were strong predictors of outcomes.
CONCLUSION: Compared to community-based estimates, many more smokers in our sample attempted to quit and achieved 7-day abstinence. This was especially true among smokers who attributed their ED visit to a smoking-related health problem and who were admitted to the hospital. We discuss the implications for tobacco intervention design in medical settings.
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Citation: Ann Behav Med. 2007 Apr;33(2):189-99. Link to article on publisher's site