Abstract
Study objective
Cigarette smoking remains the leading cause of preventable death in the United States,
and tobacco use rates are known to be higher among emergency department (ED) patients
than in the general population. Despite recommendations from the Society for Academic
Emergency Medicine and the American College of Emergency Physicians, many emergency
clinicians remain uncertain about the benefits of providing ED-based smoking cessation
interventions. To address this gap in knowledge, we performed a systematic review
of cessation interventions initiated in the adult or pediatric ED setting.
Methods
We conducted an electronic search of the MEDLINE and CINAHL databases through February
2014 and hand searched references from potentially relevant articles. We identified
eligible studies, evaluated bias and validity, and extracted data and synthesized
findings.
Results
Seventeen studies underwent critical appraisal, with 13 included in qualitative synthesis.
The majority (11/13, 85%) of investigations did not report significant differences
in tobacco abstinence between cessation intervention groups. The 2 studies reporting
significant differences in cessation both used motivational interviewing-based interventions.
Two studies evaluated patient satisfaction with ED-based tobacco cessation interventions,
and both reported greater than 90% satisfaction.
Conclusions
Findings indicate that ED visits in combination with ED-initiated tobacco cessation
interventions are correlated with higher cessation rates than those reported in the
National Health Interview Survey. Clear data supporting the superiority of one intervention
type were not identified. Lack of a standardized control group prevented quantitative
evaluation of pooled data, and future research is indicated to definitively evaluate
intervention efficacy.
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Article Info
Publication History
Published online: April 03, 2014
Accepted:
March 25,
2014
Received in revised form:
March 24,
2014
Received:
February 25,
2014
Footnotes
☆Funding: This study did not receive external funding.
☆☆Conflict disclosure: The authors report no conflicts of interest.
★Presentations: An abstract summarizing the results of this study was presented at the Society for Academic Emergency Medicine Annual Meeting in Atlanta, GA, May 2013.
★★Author contributions: MRB and TDS conceived the trial. JHP, TDS, and MRB designed the trial. JHP and TDS collected and extracted the study data. JHP and TDS performed data analyses, provided statistical expertise, and interpreted the study findings. JHP and TDS drafted the manuscript. JHP, TDS, and MRB revised the manuscript for important intellectual content. MRB supervised the conduct of the study. All authors take responsibility for the manuscript as a whole.
Identification
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
