Learning Objectives: Explain the impact of providing smoking cessation interventions at key teachable moments among emergency chest pain patients
Abstract: Objective: To examine the efficacy of providing brief counseling for smoking cessation to emergency chest pain patients admitted for 24-hour observation to rule out myocardial infarction.
METHODS: Smokers (n=211) admitted to the Observation Unit (OU) were given brief physician advice to quit smoking plus nicotine replacement (patch) if they decided to quit. Half of all subjects were randomly assigned to receive a single 45-minute counseling session using motivational interviewing (MI). Most subjects were male (55%), 65% were non-Latino whites and average education level was 11.7 (SD=2.8) years. Most subjects were employed full time (63%) or retired (21%).
RESULTS: Over 90% of those eligible, enrolled. Overall cessation rates at three and six months were 23.2% and 21.1% respectively. Subjects receiving the additional counseling session were significantly more likely to set a quit date while in the hospital (5% vs. 24.6%, p<0.01). At one month follow-up, subjects given the MI counseling showed higher confidence (6.1 vs. 5.9, p<0.05) and motivation to quit (4.7 vs. 3.1, p<0.01) compared to other subjects. Among continuing smokers (n=162) those given MI counseling smoked fewer cigarettes per day (10.9, SD=8.0) compared to other subjects (16.5, SD=11.6).
Discussion: Each year over 1 million smokers will be admitted to an OU with chest pain. Although 90% of these will ultimately rule out for myocardial infarction, interventions for smoking cessation delivered during this admission appear to capture the smoker’s attention, capitalizing on the teachable moment and helping to motivate them to quit smoking.
Back to Ideas on Cessation
Back to Cessation, Nicotine, and the Science of Addiction
Back to The 2002 National Conference on Tobacco or Health