ArticleBMC health services research2014
Teachable moments and missed opportunities for smoking cessation counseling in a hospital emergency department: a mixed-methods study of patient-provider communication.
Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Electronic decision support for treatment of hospitalized smokers: A qualitative analysis of physicians' knowledge, attitudes, and practices.Drug and alcohol dependence · 2019Trial
- Pilot randomised trial of a brief intervention for comorbid substance misuse in psychiatric in-patient settings.Acta psychiatrica Scandinavica · 2016Trial
- Breast cancer diagnosis as a window of opportunity for smoking cessation: analysis of changes in smoking behaviour in 736 smoking breast cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Gaps in smoking cessation counseling administered by healthcare providers to BIPOC gay men who smoke daily in the U.S.Journal of substance use and addiction treatment · 2025Article
- The role of nurses in smoking cessation interventions for patients: a scoping review.BMC nursing · 2024Article
- Cigarette Smoking in Response to COVID-19: Examining Co-Morbid Medical Conditions and Risk Perceptions.International journal of environmental research and public health · 2022Article
- Barriers to implementation of pediatric emergency department interventions for parental tobacco use and dependence: a qualitative study using the theoretical domains framework.Implementation science communications · 2022Article
- Article
- Co-producing an intervention for tobacco cessation and improvement of oral health among diabetic patients in Bangladesh.BMC oral health · 2021Article
- What is the likely impact on surgical site infections in Australian hospitals if smoking rates are reduced? A cost analysis.PloS one · 2021Article
- Association of Cumulative Socioeconomic and Health-Related Disadvantage With Disparities in Smoking Prevalence in the United States, 2008 to 2017.JAMA internal medicine · 2019Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundWhile primary care medical clinics have been the most common setting for the delivery of advice about smoking cessation, the hospital emergency department (ED) is a valuable context for counseling medically underserved tobacco users. We conducted a secondary analysis based on a larger audio-recorded study of patient-provider communication about pain and analgesics in the ED. Within a sample of ED patients with back pain, the purpose of this mixed-methods study was to examine how physicians and nurse practitioners capitalize on "teachable moments" for health education to offer spontaneous smoking cessation counseling in the ED.
methodsPatients presenting to an academic ED with a primary complaint of back pain were invited to participate in a study of patient-provider communication. Audio-recorded encounters were transcribed verbatim. Two coders reviewed each transcript to determine whether smoking was discussed and to build a corpus of smoking-related discussions. We then developed inductively generated coding categories to characterize how providers responded when patients endorsed smoking behavior. Categories were refined iteratively to accommodate discrepancies.
resultsOf 52 patient-provider encounters during which smoking was discussed, two-thirds of the patients indicated that they were smokers. Providers missed opportunities for smoking cessation counseling 70% of the time. Eleven encounters contained teachable moments for smoking cessation. We identified four primary strategies for creating teachable moments: 1) positive reinforcement, 2) encouragement, 3) assessing readiness, and 4) offering concrete motivating reasons.
conclusionsMost providers missed opportunities to offer teachable moments for smoking cessation. In encounters that contained teachable moments, providers employed multiple strategies, combining general advice with motivation tailored to the patient's particular circumstances. Creating motivational links to enhance smoking cessation efforts may be possible with a minimal investment of ED resources.
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