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Prev Chronic Dis. 2017 Oct 5;14:E89. doi: 10.5888/pcd14.160434.

Emergency Department-Initiated Tobacco Control: Update of a Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Author information

1
Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.
2
Krankenhaus der Augustinerinnen, Department of Internal Medicine, Cologne, Germany.
3
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
4
Department of Emergency Medicine, Yale University School of Medicine; Yale Cancer Center; Department of Health Policy, Yale School of Public Health, New Haven, Connecticut.
5
Department of Emergency Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia.
6
University of California Los Angeles, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California.
7
University Hospital of Copenhagen, Rigshospitalet, Department of Urology, Copenhagen, Denmark.
8
Charité - Universitätsmedizin Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Virchow Klinikum and Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Germany. Email: bruno.neuner@charite.de.

Abstract

INTRODUCTION:

A 2012 systematic review and meta-analysis of randomized controlled trials on emergency department-initiated tobacco control (ETC) showed only short-term efficacy. The aim of this study was to update data through May 2015.

METHODS:

After registering the study protocol on the international prospective register of systematic reviews (PROSPERO) in May 2015, we searched 7 databases and the gray literature. Our outcome of interest was the point prevalence of tobacco-use abstinence at 1-month, 3-month, 6-month, or 12-month follow-up. We calculated the relative risk (RR) of tobacco-use abstinence after ETC at each follow-up time separately for each study and then pooled Mantel-Haenszel RRs by follow-up time. These results were pooled with results of the 7 studies included in the previous review. We calculated the effect of ETC on the combined point prevalence of tobacco-use abstinence across all follow-up times by using generalized linear mixed models.

RESULTS:

We retrieved 4 additional studies, one published as an abstract, comprising 1,392 participants overall. The 1-month follow-up point prevalence of tobacco-use abstinence after ETC resulted in an RR of 1.49 (95% confidence interval [CI], 1.08-2.05) across 3 studies; 3-month follow-up, an RR of 1.38 (95% CI, 1.12-1.71) across 9 studies; 6-month follow-up, an RR of 1.09 (95% CI, 0.84-1.41) across 6 studies; and 12-month follow-up, an RR of 1.26 (95% CI, 1.00-1.59) across 3 studies. The effect on the combined point prevalence of abstinence was an RR of 1.40 (95% CI, 1.06-1.86) (P = .02).

CONCLUSION:

ETC is effective in promoting continual tobacco-use abstinence up to 12 months after intervention. ETC may be a critically important public health strategy for engaging hard-to-reach smokers in tobacco-use cessation.

PMID:
28981403
PMCID:
PMC5645196
DOI:
10.5888/pcd14.160434
[Indexed for MEDLINE]
Free PMC Article

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