Smoking cessation counseling by emergency physicians: opinions, knowledge, and training needs

Area of Science:

• Emergency Medicine
• Public Health
• Addiction Medicine

Background:

• Smoking cessation interventions are crucial for reducing morbidity and mortality.
• Emergency departments (EDs) are potential settings for initiating smoking cessation support.
• Limited data exists on emergency physicians' (EPs') preparedness and practices regarding smoking cessation.

Purpose of the Study:

• To assess EPs' training and understanding of smoking cessation counseling.
• To evaluate current EPs' practices in screening, counseling, and referring smokers.
• To identify perceived barriers to providing smoking cessation counseling in the ED.

Main Methods:

• A survey was distributed to 256 members of the Colorado Chapter of the American College of Emergency Physicians.
• A 26-item questionnaire assessed training, knowledge, practices, and barriers related to smoking cessation.
• A response rate of 77% (196 physicians) was achieved.

Main Results:

• 55% of EPs lacked formal smoking cessation training, and 65% felt unprepared to counsel patients.
• Only 27% of EPs routinely asked patients to quit smoking.
• Physicians with training were more likely to counsel and refer (34% vs. 20%).
• Key barriers included lack of time, perceived patient disinterest, and belief in ED setting inappropriateness.

Conclusions:

• Emergency physicians generally have insufficient training in smoking cessation.
• Significant barriers hinder the routine implementation of smoking cessation counseling in emergency settings.
• Enhanced training and support are needed to improve ED-based smoking cessation interventions.