Prevalence of Cigarette Smoking Among Adult Emergency Department Patients in Canada

Author(s): Tolmie, Andrew D.; Erker, Rebecca; Sullivan, Emily; Graham, Thomas; Oyedokun, Taofiq; Stempien, James | Abstract: Introduction: Tobacco smoking is a priority public health concern, and a leading cause of deathand disability globally. While the daily smoking prevalence in Canada is approximately 9.7%,the proportion of smokers amongst emergency department (ED) patients has been found to besignificantly higher. The purpose of this survey study was to determine the smoking prevalence ofadult ED patients presenting to three urban Canadian hospitals, and to determine whether there wasan increased prevalence compared to the general public.Methods: A verbal questionnaire was administered to adult patients aged 18 years and olderpresenting to Royal University Hospital, St. Paul’s Hospital, and Saskatoon City Hospital inSaskatoon, Saskatchewan. We compared patients’ smoking habits to Fagerstrom tobaccodependence scores, readiness to quit smoking, chief complaints, Canadian Triage Acuity Scalescores, and willingness to partake in ED-specific cessation interventions.Results: A total of 1190 eligible patients were approached, and 1078 completed the questionnaire.Adult Saskatoon ED patients demonstrated a cigarette smoking prevalence of 19.6%, which issignificantly higher than the adult Saskatchewan public at 14.65% (Pl0.0001). Out of the smokingcohort, 51.4% indicated they wanted to quit smoking and would partake in ED-specific cessationcounselling, if available. Of the proposed interventions, ED cessation counselling was most popularamongst patients (62.4%), followed by receiving a pamphlet (56.2%), and referral to a smokers’ quitline (49.5%).Conclusion: The higher smoking prevalence demonstrated amongst ED patients highlights theneed for a targeted intervention program that is feasible for the fast-paced ED environment. TrainingED staff to conduct brief cessation counselling and referral to community supports for follow-up couldprovide an initial point of contact for smokers not otherwise receiving cessation assistance.