• B C Bock, B Becker, R Monteiro, R Partridge, S Fisher, and J Spencer.
• Centers for Behavioral and Preventive Medicine, The Miriam Hospital, RISE Bldg., 164 Summit Avenue, Providence, RI 02906, USA. Beth_Bock@Brown.edu
• Prev Med. 2001 Feb 1;32(2):175-81.

BackgroundAcute Respiratory Illness accounts for over 12 million visits to emergency departments in the United States each year. Between one-fourth and one-half of these patients are smokers. We examined the frequency of physician intervention for smoking cessation among acute respiratory illness patients in the emergency department, and examined the influence of physician intervention on patients' perceived risk from smoking and motivation to quit.MethodsThis study was conducted in the emergency department of a large inner-city hospital. Adult smokers (n = 63) presenting with symptoms of acute respiratory illness were surveyed by exit interview while in the emergency department. The frequency and extent of physician interventions for smoking were examined using the Agency for Health Care Policy and Research guidelines as a model. We also assessed patients' perceptions of risk from smoking, the presence of other household smokers, and the patients' motivation to quit.ResultsEmergency department physicians provided incomplete and inconsistent intervention for smoking. While most patients reported being asked if they smoked, only half of smokers were advised to quit. Only 9% were offered any assistance with quitting. Risk perception was generally low, however, the majority of smokers were willing to receive on-site smoking cessation counseling while in the emergency department.ConclusionsThe small sample size in this study requires that results be interpreted with caution. However, the findings of this study suggest that the emergency department setting may provide a unique "teachable moment" in which to initiate smoking cessation counseling for this high-risk population.Copyright 2001 American Health Foundation and Academic Press.

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