Longitudinal Associations of Cigarette Smoking, Smoking Intensity, and Smoking TrajectoriesWith Emergency Room Utilization Among U.S. Adults

Current cigarette smoking among U.S. adults in the Population Assessment of Tobacco and Health Study is linked to higher subsequent emergency room use, with OR 1.128 for any ER visit.

• Why it matters: Longitudinal evidence on how smoking status, intensity, and trajectories relate to later ER utilization is limited, despite smoking being a major driver of U.S. morbidity and mortality.
• What they did: Using Waves 1–6, logistic GEE models (any ER visit and frequent ER use ≥2) and negative binomial models (ER visit count) tested Wave 1–3 smoking measures against next-wave ER outcomes, with trajectory analyses using Wave 1–5 predicting Wave 6.
• The result: Heavier smoking (≥20 cigarettes/day) and each additional cigarette/day predicted higher ER utilization, and trajectory results showed new/intermittent and persistent smokers had higher ER use, while cessation groups did not differ from non-smokers.

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