Nicotine dependence, motivation to quit, and diagnosis in emergency department patients who smoke

Addict Behav. 2006 Feb;31(2):288-97. doi: 10.1016/j.addbeh.2005.05.007. Epub 2005 Jul 1.


Objectives: To assess the effect of diagnosis on motivation to quit in adult smokers in an emergency department (ED).

Methods: A survey of patients visiting two EDs from September to November, 2003. Patients screening positive for smoking completed a Fagerstrom Test for Nicotine Dependence and Ladder of Contemplation. ICD9 codes and disposition status were recorded. Smoking-related diagnoses were drawn from standard sources. Data were analyzed with parametric and non-parametric statistics.

Results: Five hundred and eighty-five were interviewed, median age 40 (interquartile range 29-50); 323 (55%) were female. Ninety percent of all patients were non-White; 69% were uninsured or had Medicaid. Of 152 patients with smoking-related diagnoses, the median Fagerstrom score was 4.7 vs. 4.1 for patients with a non-smoking-related diagnosis (p=0.02, 95% CI for the difference 0.2, 0.9). Patients with smoking-related and non-smoking-related diagnoses had similar levels of motivation to quit (Ladder score, respectively, 5.5 vs. 5.1, p=0.03, 95% CI for difference 0.03, 0.8).

Conclusions: Adult ED smokers exhibit mild-moderate levels of nicotine addiction and interest in quitting. ED-based tobacco control should target all smokers.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Smoking / adverse effects*
  • Smoking / psychology
  • Smoking Cessation / psychology*
  • Smoking Prevention
  • Tobacco Use Disorder / complications*
  • Urban Health