Efficacy of a Brief Intervention to Improve Emergency Physicians' Smoking Cessation Counseling Skills, Knowledge, and Attitudes

ABSTRACT

The objective of this study was to test whether a brief educational/administrative intervention could increase tobacco counseling by emergency physicians (EPs). Pre-/post-study at eight emergency departments (EDs) with residency programs were carried out. EPs received a 1-hour lecture on the health effects of smoking and strategies to counsel patients. After the lecture, cards promoting a national smokers' quitline were placed in EDs, to be distributed by providers. Providers completed pre-/ post-intervention questionnaires. Patients were interviewed pre-/post-intervention to assess provider behavior. Two hundred eighty-seven EPs were enrolled. Post-intervention, providers were more likely to consider tobacco counseling part of their role, and felt more confident in counseling. Data from 1168 patient interviews and chart reviews showed that, post-intervention, providers were more likely to ask patients about smoking, make a referral, and document smoking counseling. Post-intervention, 30% of smokers were given a Quitline referral card. An educational intervention improved ED-based tobacco interventions. Controlled trials are needed to establish these results' durability.

KEYWORDS:

• Emergency department
• smoking cessation
• tobacco control

The authors wish to thank Steven A. Schroeder, MD, for his vision, guidance, and leadership throughout this project, as well as Arthur L. Kellermann, MD, MPH, Robert A. Lowe, MD, MPH, Michael Menchine, MD, Marilyn Bromley, and the many research assistants at each site.

This project was supported by a grant from the Smoking Cessation Leadership Center of the Robert Wood Johnson Foundation to the American College of Emergency Physicians.

Notes

∗“Other” as reference group.