Young people increasingly end up in the emergency department with serious lung complaints. Today, almost all Dutch hospitals are investigating the effect this has on acute care for 24 hours. They are also participating in the study at the Emergency Department (ED) in the Treant Scheper hospital in Emmen and the Wilhelmina Hospital in Assen.
“We are seeing increasingly younger patients who have problems,” says Christien Slotboom, emergency room doctor at the hospital in Emmen. She is standing in a treatment room normally used for serious cases. Now it is quiet. “Sometimes you see it in the lungs, other times in the blood vessels. This shows us that it is related to smoking behavior or nicotine use.”
Slotboom also sees that more and more young people are smoking at the ER in Emmen. In addition to the ‘old-fashioned’ cigarette, vaping and ‘snushing’ are especially popular. Snoring is the use of snus, a kind of tea bag, filled with tobacco or nicotine, which is placed under the upper lip. “Vaping or snuffing no longer stinks like cigarettes, but these other substances actually pose even more danger and that is not well known in the Netherlands.”
To map how many patients use vapes, tobacco or snus and with what complaints they come to the emergency room, research is being conducted in almost all emergency rooms in the Netherlands. To this end, incoming patients receive a questionnaire in which they are asked about their nicotine use.
Patients who smoke are asked, among other things, what they use, how much they use and whether the patient thinks that smoking is related to the illness or injury for which they are currently in the hospital. A doctor then also completes a questionnaire.
“Based on the research, we hope to be able to see how much smoking occurs in the Netherlands and whether the patients who come to the emergency room smoke much more compared to the general population. Or is that what we think and is it not the case at all?”, Slotboom explains.
“So far it’s going well,” say Marieke Vos and Rachel Knol, both doctors in the ER at the Wilhelmina Hospital Assen. They started the investigation at 8:00 this morning. “Patients are motivated to participate.” The doctors explain that all patients over the age of 12 are asked about their nicotine behavior.
If the question is answered ‘yes’, the doctors will advise you to stop using nicotine. The follow-up question when someone has indicated that they smoke, vape or use snus is: Do you want help quitting? If the answer is ‘yes’, the patient is referred to a smoking cessation organization. Where they receive help, for example in the form of personal guidance or group sessions.
In addition to gathering information, it also gives doctors the opportunity to spread the word about quitting smoking advice. “Today we all do that together, consistently, and we will continue to do so,” say the doctors of the Wilhelmina Hospital in Assen. “The ER is a dynamic department. If we have time to give such advice, that is great. But often you do not take that time because it is so busy.”
With the results of the study, doctors will be able to better inform patients in the future about the consequences of nicotine use. “If we can give people the full risks, then the drive for patients to do something about it also increases.”