No significant difference was observed in the rate of homelessness between men and women in this ED population, which defies the perception that this issue primarily affects men. Public health interventions aimed at homeless populations should consider that both men and women may be equally affected by homelessness.
Objective
Using a physician‐directed, patient “opt‐out” approach to prescriptive smoking cessation in the emergency department (ED) setting, we set out to describe patient actions as they related to smoking cessation behaviors.
Methods
A convenience sample of smokers at 2 Pennsylvania hospital EDs who met inclusion/exclusion criteria were approached to participate in a brief intervention known as screening, treatment initiation, and referral (STIR) counseling that included phone follow‐up. Demographic information, current smoking status, and specific physician prescription and follow‐up recommendations were collected. Approximately 3 months later, patients were contacted to determine current smoking status and actions taken since their ED visit.
Results
One hundred six patients were approached and 7 (6.6%) opted out of the intervention. Patients who did not opt out were evaluated for appropriate use of smoking cessation‐related medications; 35 (35.4%) opted out of the prescription(s) and 6 (6.1%) were not indicated. Twenty‐one (21.2%) patients opted out of ambulatory referral follow‐ups with primary care and/or tobacco treatment program; one (1.0%) was not indicated for referral. Nineteen (32.8%) patients who received prescription(s) for smoking cessation‐related medications initially also followed the prescription(s). Seventeen (22.1%) patients participated in referral follow‐up.
Conclusion
In this small ED pilot, using the STIR concepts in an opt‐out method, few smokers opted out of the smoking cessation intervention. About one‐third of the patients declined prescriptions for smoking cessation‐related medications and less than one‐quarter declined ambulatory referrals for follow‐up. These findings support a willingness of patients to participate in STIR and the benefits of intervention in this setting.
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