Smoking stage of change and interest in an emergency department-based intervention

UMMS Affiliation

Department of Psychiatry; Department of Emergency Medicine

Publication Date


Document Type



Adolescent; Adult; Counseling; *Emergency Service, Hospital; Female; Health Behavior; Health Care Surveys; Humans; Male; Middle Aged; Motivation; Multivariate Analysis; New Jersey; Patient Acceptance of Health Care; Prospective Studies; Regression Analysis; Smoking Cessation


Emergency Medicine | Psychiatry


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.

DOI of Published Version



Acad Emerg Med. 2005 Mar;12(3):211-8. Link to article on publisher's site

Journal/Book/Conference Title

Academic emergency medicine : official journal of the Society for Academic Emergency Medicine


At the time of publication, Edwin Boudreaux and Douglas Ziedonis were not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID