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Strategies to Help Adult ED Patients Quit Smoking

This study has been completed.
Information provided by:
National Institute on Drug Abuse (NIDA) Identifier:
First received: February 24, 2006
Last updated: January 10, 2017
Last verified: February 2006
The purpose of this study is to determine whether a brief, focused intervention in the hospital emergency department is effective in helping adults quit smoking.

Condition Intervention
Tobacco Use Drug: transdermal nicotine patches Behavioral: Motivational interview

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Strategies to Help Adult ED Patients Quit Smoking

Resource links provided by NLM:

Further study details as provided by National Institute on Drug Abuse (NIDA):

Primary Outcome Measures:
  • 3-month cessation rate

Secondary Outcome Measures:
  • 3-month quit attempts,
  • daily cigarette consumption,
  • stage of change assessment

Estimated Enrollment: 336
Study Start Date: January 2006
Study Completion Date: May 2008
Primary Completion Date: April 2007 (Final data collection date for primary outcome measure)
Detailed Description:
In urban communities, the prevalence of tobacco use among adults visiting a hospital emergency department (ED) nears 40%, well in excess of the 25% smoking prevalence rate of the general population. Many of these patients lack easy access to primary care, suggesting the ED may be an attractive locus to initiate tobacco cessation efforts. With over 100 million annual visits to U.S. EDs, it may be possible to engage millions of smokers in tobacco cessation efforts. The major purpose of this study is to examine whether a multicomponent intervention delivered in the ED by a Lay Educator to adult smokers interested in quitting is more likely to result in cessation than usual care. A secondary goal is to test whether patients who present to the ED with a tobacco-related illness (as indicated by ICD9 code) are more likely to quit than ED smokers with a non-tobacco-related condition. This will allow us to test the validity of the "teachable moment" as an opportune time to engage patients in considering a behavioral change. The proposed study is a randomized trial of a motivational interview, provision of six weeks' worth of nicotine patches, literature, and post-visit follow-up (Enhanced Care) vs. referral to a cessation clinic (Minimal Care) for ED patients who smoke. Eligibility criteria: age > 21 years, contemplation or preparation stage of change, not admitted to hospital. All patients will undergo a standardized stage of change assessment, and measurements of nicotine dependence and exhaled carbon monoxide. All will receive a cessation fact sheet and referral card to the smoking cessation clinic; the cards of those in the Enhanced Care group will have a specific appointment date and time. The Enhanced Care group will receive a language-appropriate pamphlet discussing smoking cessation. We will record the ICD9 codes associated with each visit. Major outcome measure: cessation within 3 months of the ED visit, stratified by treatment group. Secondary outcome measure: cessation within 3 months of the ED visit, stratified by whether the visit was smoking-related. If smokers receiving Enhanced Care are more likely to quit, then the ED could be considered a new, effective locus for tobacco control, potentially reaching several million smokers. If patients with a smoking-related diagnosis for the ED visit are more likely to quit than those with non-smoking-related ICD9, then this supports the construct of the teachable moment.

Ages Eligible for Study:   21 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • >= 10 cigarettes smoked daily
  • being discharged from the ED
  • contemplation or preparation stage of change
  • speaks English or Spanish

Exclusion Criteria:

  • being admitted to hospital
  • too ill to consent
  Contacts and Locations
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Please refer to this study by its identifier: NCT00297466

United States, New York
Montefiore Medical Center
Bronx, New York, United States, 10467
Sponsors and Collaborators
National Institute on Drug Abuse (NIDA)
Principal Investigator: Steven L. Bernstein, MD Albert Einstein College of Medicine, Inc.
  More Information

Publications automatically indexed to this study by Identifier (NCT Number): Identifier: NCT00297466     History of Changes
Other Study ID Numbers: DA017812
Study First Received: February 24, 2006
Last Updated: January 10, 2017

Keywords provided by National Institute on Drug Abuse (NIDA):
tobacco use
smoking cessation
emergency department

Additional relevant MeSH terms:
Ganglionic Stimulants
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Nicotinic Agonists
Cholinergic Agonists
Cholinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action processed this record on September 21, 2017