Objectives: Patients who are tobacco users present to the emergency department (ED) with many medical conditions that are causally or potentially causally related to smoking. Previous studies have shown increased cessation rates for patients who accurately perceive that their ED visit is smoking-related. Our study goals were 1) to determine the prevalence of potential smoking-related conditions among tobacco users at a tertiary care academic ED, and 2) to determine which medical conditions are more or less likely to be perceived by patients as smoking-related.
Methods: We included adults≥19 years of age who reported smoking within 30 days of their ED visit, and were enrolled in a randomized controlled trial (ClinicalTrials.gov, NCT01454375) from December 1, 2011 to August 31, 2012. Patients were asked whether they perceived their ED visit to be related to smoking. ED discharge diagnoses were coded as smoking-related or not smoking-related based on the 2004 U.S. Surgeon General's Report.
Results: We included 893 patients (62% male; mean age=40±15), of which 120 (13%) had a visit for a potential smoking-related condition: 6 (5%) of neoplasm, 18 (15%) of cardiovascular disease, 67 (56%) of respiratory disease, 3 (3%) of reproductive complication, 7 (6%) of postoperative complication, 9 (8%) of dental disease, 9 (8%) of peptic ulcer disease, 0 (0%) of eye condition, and 1 (1%) of bony condition. Of the potential smoking-related conditions, 46 (38%) were perceived by patients to be possibly smoking-related: 61% of cardiovascular disease, 33% of neoplasm, 43% of respiratory disease, 22% of dental disease, 14% of postoperative complication, 11% of peptic ulcer disease, and 0% of the remaining conditions.
Conclusion: In this study, 13% of all ED visits among smokers were for a potential smoking-related condition, of which 38% were perceived by patients to be smoking-related. Education to increase awareness of smoking-related conditions may increase cessation rates.
Keywords: health promotion; patient perception; tobacco use.