A new innovative smoking cessation program improves the quality of interventions that smokers receive in the emergency room and other medical settings, according to a Polaris Health Directions study. Substantially more patients received referrals and initiated treatment in comparison to interventions more commonly seen, such as the distribution of informational pamphlets.
With the emergency room (ER) setting frequently the only source of health care for the poor and uninsured—who are also more likely to smoke—these findings represent an opportunity to better address one of the most important modifiable health risk factors plaguing Americans.
The program used in the study merges multiple brief interventions into a single platform: a computer-based assessment, which measures tobacco use, history of quitting attempts and readiness to change; individualized feedback reports; a brief motivational video and the option to receive an automated, faxed referral.
Of the 75 smokers enrolled in the study 30 requested a referral, which triggered the selection of a treatment provider based on the patient’s insurance status and home address. The cessation counselor was then expected to contact the patient within five days to schedule an appointment. Twenty-seven were contacted, of whom six (8% of those enrolled) initiated treatment.
In a similar study of 591 smokers, only one (.2%) initiated treatment following passive referral–smokers are given information on where they can find help–which is the more typical approach in today’s U.S. health care system.
Both patients and health care providers expressed strong satisfaction with the assessment and referral system. ER physicians stated that the assessment report provided information that they had not assessed in 83 percent of the patients, and that 32 patients (43%) had received a referral they would not have otherwise received during routine clinical care.
Polaris is currently extending this research using the Dynamic Assessment and Referral System for Substance Abuse (DARSSA). In a randomized trial at Cooper University Hospital, in New Jersey, and the University of Massachusetts Medical School, Polaris is studying the impact of these comprehensive interventions among alcohol, drug and tobacco users.
For more information on this research or the DARSSA system, send an e-mail to firstname.lastname@example.org.
This project was supported by STTR Award Number 1R41 DA019718 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.