Acute Respiratory Disease as a Fulcrum Point to Quit Smoking: Evaluation of an ED-based Intervention (Intervention)

This study aims to evaluate smoking cessation success rates using the Fagerström Test for Nicotine Dependence (FTND) in smoking cessation treatment. The study has a retrospective design, analyzing data from patients who applied to a smoking cessation clinic to investigate the impact of nicotine dependence severity on quitting success.

Study Overview

• Status: Completed
• Conditions: Smoking Cessation; Emergency Department Visit; Acute Respiratory Infections (ARIs)
• Intervention / Treatment: Behavioral: Smoking cessation support that World Health Organization (WHO) 5A model (Ask, Advise, Assess, Assist, Arrange).

Detailed Description

Emergency departments (EDs) are among the most critical referral centers for individuals with health problems resulting from the direct and indirect effects of smoking. Individuals may be more motivated to change their smoking habits, especially during acute attacks of respiratory diseases. The American College of Emergency Physicians (ACEP) and some organizations recommend that interventions for smoking cessation should be implemented by physicians and nurses in the form of counseling for patients with active smoking who receive treatment for acute respiratory infections (ARI) in EDs. However, interventions for smoking cessation are frequently performed in primary health care institutions and according to studies, a high majority of emergency physicians think that EDs are not the appropriate place for this intervention and are not included in their professional responsibilities.

The effect of nicotine dependence (ND) severity on smoking cessation has been shown in studies. Fagerström Test of Nicotine Dependence (FTND) developed by Fagerström et al. is a widely used tool to measure the ND level of individuals. The Turkish validity and reliability study of the test was conducted by Uysal et al. In the approach to smoking cessation, ND level comes to the forefront in determining personalized intervention strategies. At high levels of addiction, nicotine replacement therapy or pharmacologic support is recommended because the physical and psychological dependence of individuals is more intense. In these cases, motivational counseling and regular follow-up are necessary during the cessation process. At moderate levels of addiction, nicotine replacement products or behavioral therapies are usually recommended, while less pharmacological intervention may be required. At low levels of addiction, behavioral support and counseling may be sufficient for smoking cessation. Pharmacologic treatment is usually not needed in these individuals, but education and awareness-raising methods that support smoking cessation can be used. Intervention with strategies appropriate to the level of ND is a crucial factor in increasing the success of smoking cessation.

When determining the assistance method in individuals who want to quit smoking; WHO recommends five major steps (5A) in smoking cessation treatment. In practice, the "Ask, Advise, Assess, Assist, Arrange" approach is an evidence-based smoking cessation model that has been developed to provide effective interventions in a short time, especially in busy working environments.

This study aimed to examine the effects of short structured interviews with patients who presented to the ED due to ARI on smoking cessation behavior and to follow up for one month. It is aimed to evaluate the applicability of smoking cessation interventions on those with ARI in EDs.

• Study Type: Observational
• Enrollment (Actual): 288

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

A total of 20,928 patients presented to the ED during the specified period and 2,018 of these patients were evaluated with acute respiratory complaints diagnosed with ARI. Of the patients admitted with ARI, 541 reported active smoking. Finally, 288 participants were accepted for the study.

Description

Inclusion Criteria:

• Patients who were active smokers and admitted to the emergency department with acute respiratory system complaints.

Exclusion Criteria:

• Exclusion criteria included individuals under 18 years of age, ASA class III-IV, pregnancy or breastfeeding, communication difficulties such as language barrier or cognitive impairment, psychotic behaviors or history of psychiatric treatment, and initiation of smoking cessation treatment.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Active smokers who attend the emergency depertment with acute respiratory infections	Behavioral: Smoking cessation support that World Health Organization (WHO) 5A model (Ask, Advise, Assess, Assist, Arrange).; Smoking cessation support that World Health Organization (WHO) 5A model (Ask, Advise, Assess, Assist, Arrange).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Smoking cessation success on acute respiratory infections patients based on FTND score	Examine the effects of short structured interviews with patients who presented to the ED due to ARI on smoking cessation behavior. It is aimed to evaluate the applicability of smoking cessation interventions on those with ARI in EDs.	Two periods as first week after intervention and first month after intervention.

Collaborators and Investigators

• Sponsor: Seda Oğuz

Study record dates

Study Major Dates

• Study Start (Actual): November 10, 2016
• Primary Completion (Actual): January 10, 2017
• Study Completion (Actual): January 10, 2017

Study Registration Dates

• First Submitted: April 4, 2025
• First Submitted That Met QC Criteria: April 4, 2025
• First Posted (Actual): April 11, 2025

Study Record Updates

• Last Update Posted (Actual): April 11, 2025
• Last Update Submitted That Met QC Criteria: April 4, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Infections; Emergencies; Respiratory Tract Infections; Respiratory Tract Diseases; Respiration Disorders
• Other Study ID Numbers: SMOKE-21041991

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No