Emergency Department-Based Tobacco Interventions Improve Patient Satisfaction

Objectives: To determine whether receipt of smoking cessation counseling affects satisfaction scores in adult emergency department (ED) smokers. Methods: Secondary analysis of data collected at eight US EDs in 2006. Eligible patients were age 18 years or older, every- or some-day smokers, English or Spanish speaking, able to provide written informed consent, and not actively psychotic. Results: There were 1168 patients interviewed, median age 41 years (interquartile range 29–50), 48.5% female. Receiving a tobacco control intervention was strongly and consistently associated with higher satisfaction scores. Satisfaction scores improved as the number of tobacco control interventions recalled by the patient increased. In multivariate analysis, the number of tobacco control interventions recalled was the only variable associated with higher patient satisfaction (odds ratio 1.24, 95% confidence interval 1.04–1.49). Conclusion: ED patients who report having received a tobacco control intervention are more likely to be satisfied with their care. There is a dose-response relationship between the number of patient-reported tobacco interventions received and the global satisfaction score. Of all providers, only physicians' performance of tobacco control was associated with improved satisfaction scores. Routine screening, intervention, and referral of ED patients for smoking will not harm, and may improve, satisfaction scores. The mechanism underlying this effect is unknown.