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Development of a Combined Screening and Intervention Program for Emergency Department Patients Who Both Drink and Smoke

Phase 0
18 Years
Not Enrolling
Smoking, Drinking

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Trial Information

Development of a Combined Screening and Intervention Program for Emergency Department Patients Who Both Drink and Smoke

Smoking and drinking are the most common addictions in this country and frequently co-occur.
Among persons who smoke and drink, there appears to be a robust dose-response relationship,
with heavier drinking associated with heavier smoking and vice versa. Additionally, smokers
who are more alcohol dependent often report that smoking is a common way to cope with the
urge to drink.

Research has shown that there is a high prevalence of unmet substance abuse treatment need
among adult Emergency Department (ED) patients. As many as 46% of ED patients have recently
consumed alcohol and a significant number of the 31.6 million ED injury related visits are
alcohol related. The prevalence rate of tobacco use among ED patients is reportedly as high
as 40% and contributes to significant morbidity and mortality.

For many the ED is the only place they can access medical care. Although most
medically-underserved individuals never seek out specialized treatment for smoking or
drinking, each year over 120 million people visit an ED. Since an ED visit may be a
patient's only point of contact with the health care system, it represents an important
opportunity not only to treat their emergent needs, but to screen and provide this
vulnerable population with appropriate alcohol and tobacco use interventions.

The intervention, built upon the Brief Negotiated Interview (BNI) model, aims to help
patients reduce harmful drinking and smoking and will be initiated during an ED visit
followed by 3 follow up COMBINE counseling telephone sessions post ED visit.

The specific aims of the proposed project are to:

Aim 1: To develop an effective brief intervention for smoker- drinkers that is feasible and
acceptable for patients treated in the emergency department

Aim 2: To identify barriers to treatment engagement and factors that facilitate successful
engagement in alcohol and smoking cessation treatment

Inclusion Criteria:

- Adults = or > 18 years old

- English speaking

- Willing and able to give informed consent

- Current daily smoker

- Smokes 5 or more cigarettes daily

- Alcohol screening score =/> than 8 and =< 19

Exclusion Criteria:

- Too ill to consent

- Not interested in quitting drinking and smoking

- Current use of smoking / alcohol use cessation medications / products

- Current involvement in alcohol or smoking treatment program

- Doe not have locator information

Type of Study:


Study Design:

Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Screening

Outcome Measure:

Areas in need of help

Outcome Description:

Descriptive summary of patient reports of areas in need of help as reported during assessments

Outcome Time Frame:

3 months

Safety Issue:


Principal Investigator

Mary K Murphy, PhD

Investigator Role:

Principal Investigator

Investigator Affiliation:

Yale University


United States: Institutional Review Board

Study ID:

1065276 R10701 SAEM



Start Date:

June 2012

Completion Date:

June 2013

Related Keywords:

  • Smoking
  • Drinking
  • smoking
  • drinking
  • BNI
  • counseling intervention
  • emergency department
  • adults
  • Emergencies
  • Smoking



Yale New Haven Hospital Emergency DepartmentNew Haven, Connecticut  06519