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Nicotine & Tobacco Research 2008 10(10):1523-1531; doi:10.1080/14622200802326343
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© 2008 Society for Research on Nicotine and Tobacco

Smoking cessation among patients in an emergency chest pain observation unit: Outcomes of the Chest Pain Smoking Study (CPSS)

Beth C. Bock1,1, Bruce M. Becker2, Raymond S. Niaura3, Robert Partridge2, Joseph L. Fava1 and Peter Trask1

1 Centers for Behavioral and Preventive Medicine, The Miriam Hospital Providence, RI
2 Rhode Island Hospital Providence, RI
3 Butler Hospital Providence, RI

Correspondence: Beth C. Bock, Ph.D., The Miriam Hospital, Coro West, 5th Floor, One Hoppin Street, Providence, RI 02903; USA. Tel: 401-793-8020; Fax: 401-793-8078; E-mail: Beth-Bock{at}Brown.edu


  Abstract

This study examines the efficacy of a smoking cessation intervention on abstinence rates and motivation to quit smoking. Participants were adult smokers (N=543) who presented to the emergency department with chest pain and who were admitted to an observation unit for 24-hour observation to rule out myocardial infarction. Participants were randomly assigned to either usual care or a tailored intervention employing motivational interviewing and telephone follow-up. All individuals choosing to quit were offered nicotine patch therapy. Followup assessments were conducted at 1, 3 and 6 months. Abstinence (7-day point prevalence) rates were significantly greater among participants receiving the tailored intervention compared with those given usual care (OR=1.62, 95% CI [1.05–2.50]). The largest difference occurred at 1 month: 16.8% of usual care and 27.3% of the tailored intervention group were abstinent, with differences decreasing over time. One-third f participants who were quit at month 6 were late quitters whose initial abstinence began after the 1-month follow up. In addition to treatment assignment, psychosocial variables including motivation to quit, confidence, reduced temptation to smoke in response to negative affect, and the perception that their chest pain was related to their smoking, were significant predictors of cessation. Tailored interventions are effective in promoting initial quit attempts for emergency chest pain patients admitted to an observation unit. Additional intervention may be needed to assist late quitters and to prevent relapse.

Received: June 18, 2007; Accepted: March 11, 2008
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