Changes in smoking associated with an acute health event: theoretical and practical implications

UMMS Affiliation

Department of Psychiatry; Department of Emergency Medicine

Publication Date


Document Type



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.

DOI of Published Version



Ann Behav Med. 2007 Apr;33(2):189-99. Link to article on publisher's site

Journal/Book/Conference Title

Annals of behavioral medicine : a publication of the Society of Behavioral 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