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Cigarette smoking among asthmatic adults presenting to 64 emergency departments
Emergency Medicine Publications and Presentations
  • Robert A. Silverman, Long Island Jewish Medical Center
  • Edwin D. Boudreaux, University of Massachusetts Medical School
  • Prescott G. Woodruff, University of California, San Francisco
  • Sunday Clark, Harvard Medical School
  • Carlos A. Camargo, Jr., Harvard Medical School
UMMS Affiliation
Department of Emergency Medicine
Publication Date
Document Type
Acute Disease; Adolescent; Adult; Asthma; Cohort Studies; Emergency Service, Hospital; Female; Humans; Logistic Models; Male; Middle Aged; Prospective Studies; *Smoking; Socioeconomic Factors
STUDY OBJECTIVES: The emergency department (ED) is an important focal point for asthmatic individuals with uncontrolled illness. Anecdotally, many adults presenting to the ED with acute asthma are active cigarette smokers. The present study determined the prevalence of cigarette smoking among adults presenting to the ED with acute asthma and identified the factors associated with current smoking status. DESIGN: A prospective cohort study conducted as part of the Multicenter Airway Research Collaboration. PATIENTS: A structured interview was performed in 1,847 patients, ages 18 to 54 years, who presented to the ED with acute asthma. SETTING: Sixty-four EDs in 21 US states and 4 Canadian provinces. RESULTS: Thirty-five percent of the enrolled asthmatic patients were current smokers with a median of 10 pack-years (interquartile range, 4 to 20 pack-years), while 23% were former smokers, and 42% were never-smokers. Current smokers comprised 33% of asthmatic patients aged 18 to 29 years, 40% for ages 30 to 39 years, and 33% for ages 40 to 54 (p < 0.001). In a multivariate analysis, the factors independently associated with current smoking status (p < 0.05) were as follows: age 30 to 39 years; white race/ethnicity; non-high school graduate; lower household income; lack of private insurance; no recent inhaled steroid usage; and no history of systemic steroid usage. Although 50% of current smokers admitted that smoking worsens their asthma symptoms, only 4% stated that smoking was responsible for their current exacerbation. CONCLUSIONS: Although cigarette smoke is generally recognized as a respiratory irritant, cigarette smoking is common among adults presenting to the ED with acute asthma. The ED visit may provide an opportunity for patients to be targeted for smoking cessation efforts.
DOI of Published Version
Chest. 2003 May;123(5):1472-9. DOI 10.1378/chest.123.5.1472
At the time of publication, Edwin Boudreaux was not yet affiliated with the University of Massachusetts Medical School.
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Robert A. Silverman, Edwin D. Boudreaux, Prescott G. Woodruff, Sunday Clark, et al.. "Cigarette smoking among asthmatic adults presenting to 64 emergency departments" Vol. 123 Iss. 5 (2003) ISSN: 0012-3692 (Linking)
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