Smoking among emergency chest pain patients: motivation to quit, risk perception and physician intervention

The feasibility of the emergency department (ED) as a setting for smoking interventions was examined among 159 adult patients presenting with chest pain (38% were smokers). Subjects had been admitted to a 24-h observation unit (OU) to rule out myocardial infarction. We examined the frequency and extent of physician interventions for smoking using the AHCPR guidelines as a model. We also assessed patients' perceptions of risk from smoking and motivation to quit. Results indicate that ED physicians provided incomplete and inconsistent intervention. While most patients were asked if they smoked, only half were advised to quit, and few were offered assistance with quitting. Perceived risk from smoking was low among almost half of all smokers. However, over three-quarters were willing to receive smoking cessation counseling while in the ED. The ED may be an opportune setting in which to initiate smoking cessation counseling for certain high-risk populations.