An automated program to connect adult current smokers seen in an emergency department to a stop smoking Quitline

This study reports on an automated system to screen, refer, and deliver smoking cessation treatments to adult patients discharged home from two Medical University of South Carolina hospital emergency departments (EDs). The data for this study are based upon 165,443 ED visit records and 85,200 unique patients seen in two EDs between February 2021-May 2025. Adult current smokers discharged home who had a working phone number received an automated interactive voice recognition (IVR) call after 7 to 14 days to connect them to the South Carolina Tobacco Quitline (SCTQ). Five outcomes are described: (1) patients who screened positive for smoking; (2) eligibility for receiving automated IVR calls; (3) reached by phone; (4) interested in getting help to quit; and (5) accepting a referral to the South Carolina Tobacco Quitline (SCTQ). In addition, results of a follow-up survey of 50 patients, 25 who accepted the SCTQ referral and 25 who opted out, contacted four weeks after being seen in the ED was done to assess smoking status and connection to the SCTQ. Among unique patients, the prevalence of cigarette smoking was 17.6%, 89.0% were eligible for the IVR call, 24.0% were reached by phone, 83.6% of those reached expressed interest in receiving help to quit or continue cessation, and 21.8% accepted a referral to the SCTQ. The follow-up study revealed 90% of patients were still smoking approximately four weeks after being seen in the ED. Among patients referred to the SCTQ, 68% reported getting connected to the SCTQ with 10/17 (59%) receiving stop smoking medications. The automated tobacco screening and referral system provides a relatively low-cost strategy for referring current smokers to a stop smoking Quitline, although response to the IVR calls was low, as was acceptance of the referral by patients reached by phone.