A selective review of smoking cessation interventions in the emergency department

Abstract

Background Emergency department (ED) patients disproportionally smoke compared to the general population and frequently utilize the ED for routine, urgent, and emergent care. Thus, the ED is a target-rich environment for interventions aimed at increasing smoking cessation, especially among vulnerable populations. Promotion of smoking cessation in the ED has the potential to address health inequalities and reach patients that experience significant barriers to accessing preventive care and lifestyle modifications. Topics of review This narrative review presents a concise summary of the major smoking cessation strategies studied in the ED setting for adults, children, and pregnant ED patients. Additionally, this review presents the strategies to increase the uptake of smoking cessation in the ED, as well as an international perspective of smoking cessation efforts in the ED. Past and ongoing efforts to improve smoking cessation among ED patients are discussed, and critical knowledge gaps and research opportunities are highlighted. Conclusion Smoking cessation is both efficacious and feasible during an ED visit, with multiple options available to both adults, children, parents, and pregnant patients. Little standardization among cessation strategies among EDs has been demonstrated, despite the ED being uniquely positioned to address disparities in smoking cessation and contribute towards national smoking cessation goals. During most ED visits, any health care team member can address ongoing tobacco use, and smoking cessation can easily be related to the context of the patient’s presenting complaint. To be effective, health care systems and teams must recognize the ED as a suitable location to engage with patients regarding their knowledge and awareness of ongoing smoking use, and are well suited to provide and initiate effective smoking cessation treatments.

The emergency department: A key pillar in the cancer care continuum

“…The initiation of smoking cessation in the ED is underutilized but is effective in promoting sustained tobacco abstinence. 11 Similarly, the ED is uniquely positioned to address disparities in the uptake of cancer screening as the ED is a target-rich environment for persons nonadherent to national cancer screening recommendations. 12 The diagnosis of cancer when made by proxy of an ED visit represents an increasingly important route of cancer diagnosis.…”

“…This can include supporting and encouraging primary prevention interventions, such as HPV vaccination or smoking cessation. The initiation of smoking cessation in the ED is underutilized but is effective in promoting sustained tobacco abstinence 11 . Similarly, the ED is uniquely positioned to address disparities in the uptake of cancer screening as the ED is a target‐rich environment for persons nonadherent to national cancer screening recommendations 12 …”