Cigarette smoking and emergency care utilization among asthmatic adults in the 2011 Asthma Call-back Survey

Abstract

Objective: Estimate the association between smoking and emergency care in the past 12 months among asthmatic adults in a nationally representative sample. Methods: Using the 2011 Asthma Call-Back Survey, the association between smoking status and emergency department (ED) and urgent visits among asthmatic adults (n = 12 339) was assessed through multivariable logistic regression by a cross-sectional study design. Analyses used survey weights for US population-based estimates. Attributable and population attributable risk were calculated to describe the potential benefits of smoking cessation. Results: Adjusting for potential confounders, during the past 12 months former smokers had 1.30 (95% CI: 0.97, 1.74) times the odds and current smokers had 1.46 (95% CI: 1.05, 2.03) times the odds of visiting the ED compared to never smokers. Former smokers had 1.28 (95% CI: 0.99, 1.65) times the odds and current smokers had 1.29 (95% CI: 0.96, 1.73) times the odds of urgent visits compared to never smokers. Among adult asthmatics, an estimated 9% of ED visits and 6% of urgent visits can be attributed to current smoking while 7% of ED visits and 7% of urgent visits can be attributed to former smoking. Conclusions: Current and former smokers are more likely to need emergency care than never smokers. About 10% of emergency care visits among asthmatics can be attributed to smoking assuming smoking is causally related to emergency care. Long-term effective management of asthma, particularly the prevention and cessation of smoking, could reduce emergency care use and health care costs.

• Emergency department
• healthcare costs
• tobacco use
• uncontrolled asthma
• urgent care

Acknowledgements

Sophie A. Khokhawalla conceived the idea for the manuscript and conducted statistical data analyses. Annie Gjelsvik helped develop the theme and idea of the manuscript. Deborah N. Pearlman and Samantha R. Rosenthal helped develop the conceptual ideas and framework for the manuscript. Samantha R. Rosenthal and Elizabeth W. Triche helped conduct the statistical data analysis and contributed to writing the manuscript. Elizabeth W. Triche supervised the manuscript writing and data analysis. All authors read, edited and approved the final version of the manuscript.

Declaration of interest

The authors report no conflicts of interest.