Reevaluating the Status Quo: Readiness to Change Lifestyle Behaviors Among Patients who Smoke

Abstract

Background

The emergency department (ED) may present “teachable moments” for lifestyle medicine (LM) patient education about LM pillars, such as smoking, while they wait. Clinicians may assume that these patients are not motivated to change. This study evaluates readiness to change of ED patients concerning smoking.

Methodology

We utilized nested data from the prospective pilot Lifewise prevention study, randomizing lower acuity patients to an evidence-based lifestyle behavior educational video. Patients completed a validated readiness to change (RTC) survey. This analysis used data from before randomization, including patients who did not receive video education. Ordinal logistic regression was used to compare smokers to non-smokers, irrespective of video exposure.

Results

The 105 participants included 63 females and 42 males, with 31% being African American, 66% White, and 21% smokers. Individuals who reported smoking had higher odds of being ready to change their lifestyle behavior (OR 3.75, P = .013), however, participants who smoke exhibited significantly lower confidence levels compared to non-smokers (OR: 0.37, P = .043).

Conclusion

The ED may provide a “teachable moment” and a ripe opportunity for preventive LM education, including tobacco use. The data contradict some practitioners’ assumptions about these patients’ motivation to change.