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Emergency Department Initiated Treatments for Tobacco (EDITT): A Pilot Study

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Emergency departments (EDs) have strong potential to initiate tobacco interventions with economically disadvantaged populations.

Purpose

We piloted three ED-initiated tobacco interventions and derived parameter estimates for future trials.

Methods

The study enrolled adult patients being treated in an urban ED who were daily smokers. Exclusion criteria included severe illness or pain, isolation (for contagion), altered mental status, an insurmountable language barrier, temporary residence, and lack of telephone access. Subjects in the Bedside + Booster group received motivational counseling by a trained counselor at the bedside, up to three telephone sessions post-visit, and a self-help guide. Subjects in the Faxed Referral group had their personal contact information faxed to the hospital’s tobacco dependence clinic, whereupon they received identical treatment as the Bedside + Booster group, but all sessions occurred over the telephone (i.e., no bedside counseling). The Standard Referral group received the self-help guide and a referral to the hospital’s tobacco dependence clinic. We used a 2:2:1 randomization schedule to maximize our experience with the motivational interventions. Outcomes were assessed at 1 and 3 months.

Results

We enrolled 90 subjects. Of the 36 subjects assigned to the Bedside + Booster condition, 31 (87%) completed bedside counseling and at least one booster session, while 22 (61%) completed the maximum four sessions. Of the 37 subjects assigned to the Faxed Referral group, 28 (76%) completed at least one telephone session, while 19 (51%) completed the maximum four sessions. Quit attempts over the 3 months ranged from 18% (Standard Referral) to 57% (Faxed Referral). Seven-day abstinence was attained by 8% (Bedside + Booster), 14% (Faxed Referral), and 6% (Standard Referral) at 3 months.

Conclusions

Motivational cessation counseling can be feasibly initiated during the ED encounter with minimal medical staff involvement. Adequately powered trials are needed to study ED-initiated interventions that include post-visit follow-up.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Cooper University Hospital, Camden, NJ, USA

    Edwin D. Boudreaux Ph.D. & Brigitte M. Baumann M.D.

  2. Department of Psychiatry, Cooper University Hospital, Camden, NJ, USA

    Edwin D. Boudreaux Ph.D.

  3. Cooper Cancer Institute, Camden, NJ, USA

    Edwin D. Boudreaux Ph.D.

  4. UMDNJ-Robert Wood Johnson Medical School, Camden, NJ, USA

    Edwin D. Boudreaux Ph.D. & Brigitte M. Baumann M.D.

  5. Department of Psychology, LaSalle University, Philadelphia, PA, USA

    Jeneva Perry M.A., Donald Marks M.A. & Susanna Francies M.A.

  6. Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Carlos A. Camargo Jr. M.D., Dr.P.H.

  7. Department of Psychiatry, University of Massachusetts, Worcester, MA, USA

    Douglas Ziedonis M.D.

Authors
  1. Edwin D. Boudreaux Ph.D.
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  2. Brigitte M. Baumann M.D.
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  3. Jeneva Perry M.A.
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  4. Donald Marks M.A.
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  5. Susanna Francies M.A.
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  6. Carlos A. Camargo Jr. M.D., Dr.P.H.
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  7. Douglas Ziedonis M.D.
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Corresponding author

Correspondence to Edwin D. Boudreaux Ph.D..

Additional information

Funding Support: This study was supported by a NIH/NIDA K23 Research Career Award (EDB) grant (DA-16698-01).

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Boudreaux, E.D., Baumann, B.M., Perry, J. et al. Emergency Department Initiated Treatments for Tobacco (EDITT): A Pilot Study. ann. behav. med. 36, 314–325 (2008). https://doi.org/10.1007/s12160-008-9066-3

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  • DOI: https://doi.org/10.1007/s12160-008-9066-3

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