scholarly journals P016: Feasibility of a nurse-led smoking cessation intervention in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S70-S70
Author(s):  
A. Tolmie ◽  
R. Erker ◽  
A. Donauer ◽  
E. Sullivan ◽  
T. Graham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Smoking Cessation ◽  
Cigarette Smoking ◽  
Thematic Analysis ◽  
Smoking Prevalence ◽  
Community Support ◽  
Support Programs ◽  
Written Responses ◽  
Smoking Cessation Counselling ◽  
Community Support Programs

Introduction: Cigarette smoking is a leading global cause of morbidity and mortality. Multiple studies internationally have established that cigarette smoking prevalence is higher in emergency department (ED) patients than their respective communities. Previously, we demonstrated the smoking prevalence among Saskatoon ED patients (19.6%) is significantly higher than the provincial average (15.1%), and over 50% of smoking patients would be receptive to ED-specific cessation support. The purpose of this project was to identify nurses’ beliefs regarding smoking cessation in the ED, and barriers to implementing it in the department. Methods: A questionnaire was administered to all nurses employed at St. Paul's Hospital ED in Saskatoon assessing attitudes towards ED cessations, as well as the benefit and feasibility of three potential interventions: brief cessation counselling, referral to community support programs, and distributing educational resources. The questionnaire included Likert scale numerical ratings, and written responses for thematic analysis. Thematic analysis was performed by creating definitions of identified themes, followed by independent review of the data by researchers. Results: 83% of eligible nurses completed the survey (n = 63). Based on Likert scores, ED nurses rarely attempt to provide cessation support, and would be minimally comfortable with personally providing this service. Barriers identified through thematic analysis included time constraints (68.3%), lack of patient readiness (19%), and lack of resources/follow-up (15.9%). Referral to community support programs was deemed most feasible and likely to be beneficial, while counselling within the ED was believed to be least feasible and beneficial. Overall, 93.3% of nurses indicated time and workload as barriers to providing ED cessation support during the survey. Conclusion: Although the ED is a critical location for providing cessation support, the proposed interventions were viewed as a low priority task outside the scope of the ED. Previous literature has demonstrated that multifaceted ED interventions using counselling, handouts, and referrals are more efficacious than a singular approach. While introduction of a referral program has some merit, having professionals dedicated to ED cessation support would be most effective. At minimum, staff education regarding importance of providing smoking cessation therapy, and simple ways to incorporate smoking cessation counselling into routine nursing care could be beneficial.

scholarly journals LO37: Prevalence of cigarette smoking amongst adult emergency department patients

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S20-S21
Author(s):  
A. Tolmie ◽  
R. Erker ◽  
T. Oyedokun ◽  
E. Sullivan ◽  
T. Graham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cigarette Smoking ◽  
Intervention Program ◽  
Smoking Prevalence ◽  
Health Concern ◽  
Chi Square ◽  
Smoking Cessation Counselling ◽  
Chief Complaints ◽  
Statistics Canada ◽  
Emergency Department Patients

Introduction: Tobacco smoking is a priority public health concern, and a leading cause of death and disability globally. While the smoking prevalence in Canada is approximately 13-18%, the proportion of smokers among emergency department (ED) patients has been found to be significantly higher. This disparity primes the emergency department as a critical environment to provide smoking cessation counselling and support. Methods: A verbal questionnaire was administered to adult patients (18+) presenting to Royal University, Saskatoon City, and St. Paul's Hospital ED's. Patients were excluded if they were underage, too ill, or physically/mentally unable to complete the questionnaire independently. Patients’ smoking habits were also correlated with Fagerstrom tobacco dependence scores, chief complaints, Canadian Triage Acuity Scale (CTAS) scores, and willingness to partake in ED specific cessation counselling. Data were analyzed using IBM SPSS software to determine smoking prevalence and compared to Statistics Canada data using chi-square tests. Results: In total, 1190 eligible patients were approached, and 1078 completed the questionnaire. Adult Saskatoon ED patients demonstrated a cigarette smoking prevalence of 19.6%, which is significantly higher than the general adult Saskatchewan public at 15.1% (p < 0.0001). Comparing smoking and non-smoking cohorts, there are no significant differences in CTAS scores (p = 0.60). Of the proposed cessation interventions, ED cessation counselling was most popular among patients (62.4%), followed by receiving a pamphlet (56.2%), and being contacted by a smokers’ quit line (49.5%). Out of the smoking cohort, 51.4% indicated they want to quit smoking, and would be willing to partake in ED-specific cessation counselling, if available. Additionally, 88.1% of current smokers started smoking when they were less than 19 years old. Conclusion: The higher smoking prevalence demonstrated in ED patients highlights the need for a targeted intervention program that is feasible for the fast-paced environment. Quit attempts have been demonstrated to be more efficacious with repeated interventions, which could be achieved by training ED staff to conduct brief motivational interviews and faxing referrals to a smokers' quit line for follow-up. Furthermore, pediatric ED's could be a valuable location for cigarette smoking screening, as the majority began smoking in their adolescence.

scholarly journals Cigar-Smoking-Cessation Interest and Experience among Black Young Adults: A Semi-Structured In-Depth Interview Investigation

2021 ◽  
Vol 18 (14) ◽  
pp. 7309
Author(s):  
Aniruddh Ajith ◽  
Aaron Broun ◽  
Danielle A. Duarte ◽  
Bambi Jewett ◽  
Lilianna Phan ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Thematic Analysis ◽  
Financial Constraints ◽  
Qualitative Data ◽  
Smoking Prevalence ◽  
Healthcare Providers ◽  
Easy Access ◽  
Black African ◽  
Depth Interview ◽  
Cigar Smoking

Although Black/African American populations have high cigar-smoking prevalence, little is known about cigar-smoking cessation among this group. This study explored the perceptions and experiences of cigar-smoking cessation and assistance received from healthcare providers among forty Black young-adult cigar smokers (ages 21–29). Semi-structured in-depth phone interviews were transcribed and coded. Qualitative data were analyzed by using thematic analysis. Participants mostly smoked cigarillos, large cigars, and blunts. Overall, many regular cigarillo smokers reported interest in quitting eventually, while large-cigar and blunt smokers shared less interest in quitting because they perceived low harm from smoking these products. The reasons for cigar-smoking cessation were health concerns and financial constraints. Most of the participants who attempted to quit cigars did not use any cessation aids. The reasons for relapse included nicotine withdrawal, stress, and easy access. Additionally, most participants reported their healthcare providers did not ask whether they smoked cigars, and even when they knew, little assistance for cigar-smoking cessation was provided. Informing Black cigar smokers of the harm of cigar smoking and encouraging healthcare providers to screen for and assist with cigar-smoking cessation may alleviate the health burden of cigar smoking in this population.

Community Support Programs: Review of the Literature

1990 ◽  
Author(s):  
Dennis K. Orthner ◽  
Paula Early-Adams ◽  
David Pollock
Keyword(s):  
Community Support ◽  
Support Programs ◽  
Review Of The Literature ◽  
Community Support Programs

scholarly journals Randomized controlled trial of emergency department initiated smoking cessation counselling and referral to a community counselling service

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 556-564 ◽  
Author(s):  
Ka Wai Cheung ◽  
Ian WH. Wong ◽  
Warren Fingrut ◽  
Amy Po Yu Tsai ◽  
Sally R. Ke ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Counselling Service ◽  
Randomized Controlled ◽  
Smoking Cessation Counselling ◽  
Significant Difference ◽  
Community Counselling

AbstractObjectiveWorldwide, tobacco smoke is still the leading cause of preventable morbidity and mortality. Many smokers develop chronic smoking-related conditions that require emergency department (ED) visits. However, best practices for ED smoking cessation counselling are still unclear.MethodsA randomized controlled trial was conducted to determine whether an “ask, advise, and refer” approach increases 12-month, 30-day quit rates in the stable adult ED smoking population compared to usual care. Patients in the intervention group were referred to a community counselling service that offers a quitline, a text-based program, and a Web-based program. Longitudinal intention-to-treat analyses were performed.ResultsFrom November 2011 to March 2013, 1,295 patients were enrolled from one academic tertiary care ED. Six hundred thirty-five were allocated to usual care, and 660 were allocated to intervention. Follow-up data were available for 70% of all patients at 12 months. There was no statistically significant difference in 12-month, 30-day quit rates between the two groups. However, there was a trend towards higher 7-day quit attempts, 7-day quit rates, and 30-day quit rates at 3, 6, and 12 months in the intervention group.ConclusionIn this study, there was a trend towards increased smoking cessation following referral to a community counselling service. There was no statistically significant difference. However, if ED smoking cessation efforts were to provide even a small positive effect, such an intervention may have a significant public health impact given the extensive reach of emergency physicians.

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