Original contribution| Volume 39, ISSUE 5, P554-560, November 2010

Socioeconomic Factors, Hazardous Alcohol Consumption, and Smoking in Patients With Minor Trauma in an Inner-City Emergency Department


      Emergency Department (ED) patients show a high prevalence of hazardous alcohol consumption and smoking. The objective of this study was to determine if socioeconomic factors and smoking status help to optimize screening for hazardous alcohol consumption (HAC) in patients with minor trauma. A survey was conducted in an ED in an inner-city university hospital. A total of 2562 patients with minor trauma were screened for HAC (≥ 8 points in men and ≥ 5 points in women on the Alcohol Use Disorders Identification Test), smoking status, and socioeconomic factors. The median age of participants was 32 years, with 62.1% being male. A total of 84.2% of patients had an Injury Severity Score of 1, indicating minor trauma. Overall, 23.5% of patients showed a pattern of HAC, whereas 46.2% were current smokers. Compared to patients without HAC, those with HAC were characterized by lower incomes, no partnership, living in a single-household, and being unemployed. The strongest discriminative variable for HAC for patients aged ≤ 53 years was smoking status. Gender differences played a role only in patients older than 53 years. Although socioeconomic factors showed a non-equal distribution in patients with respectively without HAC, solely age, gender, and smoking status may provide a successful stratification for alcohol screening and intervention in these patients.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Krug E.G.
        • Sharma G.K.
        • Lozano R.
        The global burden of injuries.
        Am J Public Health. 2000; 90: 523-526
        • Carmen del Rio M.
        • Gomez J.
        • Sancho M.
        • Alvarez F.J.
        Alcohol, illicit drugs and medicinal drugs in fatally injured drivers in Spain between 1991 and 2000.
        Forensic Sci Int. 2002; 127: 63-70
        • Marquet P.
        • Delpla P.A.
        • Kerguelen S.
        • et al.
        Prevalence of drugs of abuse in urine of drivers involved in road accidents in France: a collaborative study.
        J Forensic Sci. 1998; 43 (806–1)
        • Mura P.
        • Kintz P.
        • Ludes B.
        • et al.
        Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study.
        Forensic Sci Int. 2003; 133: 79-85
        • Murray C.J.
        • Lopez A.D.
        Evidence-based health policy—lessons from the Global Burden of Disease Study.
        Science. 1996; 274: 740-743
        • Sjogren H.
        • Bjornstig U.
        • Eriksson A.
        • Ohman U.
        • Solarz A.
        Drug and alcohol use among injured motor vehicle drivers in Sweden: prevalence, driver, crash, and injury characteristics.
        Alcohol Clin Exp Res. 1997; 21: 968-973
        • Smeltzer S.C.
        • Redeker N.S.
        A framework of trauma and trauma recidivism in adolescents and young adults.
        J Trauma Nurs. 1995; 2: 93-99
        • Soderstrom C.A.
        • Smith G.S.
        • Dischinger P.C.
        • et al.
        Psychoactive substance use disorders among seriously injured trauma center patients.
        JAMA. 1997; 277: 1769-1774
        • Smith R.S.
        • Fry W.R.
        • Morabito D.J.
        • Organ Jr, C.H.
        Recidivism in an urban trauma center.
        Arch Surg. 1992; 127: 668-670
        • Sims D.W.
        • Bivins B.A.
        • Obeid F.N.
        • Horst H.M.
        • Sorensen V.J.
        • Fath J.J.
        Urban trauma: a chronic recurrent disease.
        J Trauma. 1989; 29: 940-946
        • D'Onofrio G.
        • Degutis L.C.
        Preventive care in the emergency department: screening and brief intervention for alcohol problems in the emergency department: a systematic review.
        Acad Emerg Med. 2002; 9: 627-638
        • Babor T.F.
        • Higgins-Biddle J.C.
        Alcohol screening and brief intervention: dissemination strategies for medical practice and public health.
        Addiction. 2000; 95: 677-686
        • Fleming M.F.
        • Mundt M.P.
        • French M.T.
        • Manwell L.B.
        • Stauffacher E.A.
        • Barry K.L.
        Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis.
        Alcohol Clin Exp Res. 2002; 26: 36-43
        • Horn K.
        • Leontieva L.
        • Williams J.M.
        • Furbee P.M.
        • Helmkamp J.C.
        • Manley III, W.G.
        Alcohol problems among young adult emergency department patients: making predictions using routine sociodemographic information.
        J Crit Care. 2002; 17: 212-220
        • Wright J.
        • Kariya A.
        Aetiology of assault with respect to alcohol, unemployment and social deprivation: a Scottish accident and emergency department case-control study.
        Injury. 1997; 28: 369-372
        • Pileggi C.
        • Bianco A.
        • Di Stasio S.M.
        • Angelillo I.F.
        Inappropriate hospital use by patients needing urgent medical attention in Italy.
        Public Health. 2004; 118: 284-291
        • Gentilello L.M.
        • Rivara F.P.
        • Donovan D.M.
        • et al.
        Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence.
        Ann Surg. 1999; 230: 473-480
        • Neumann T.
        • Neuner B.
        • Weiss-Gerlach E.
        • et al.
        The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients.
        J Trauma. 2006; 61: 805-814
        • Council of the Berlin Borough of Mitte
        ([Bezirksamt Mitte von Berlin]) (Accessed April 15, 2008)
        • Chan-Pensley E.
        Alcohol-Use Disorders Identification Test: a comparison between paper and pencil and computerized versions.
        Alcohol Alcohol. 1999; 34: 882-885
        • Saunders J.B.
        • Aasland O.G.
        • Babor T.F.
        • de la Fuente J.R.
        • Grant M.
        Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—II.
        Addiction. 1993; 88: 791-804
        • Rist F.
        • Scheuren B.
        • Demmel R.
        • Hagen J.
        • Aulhorn I.
        Der Münsteraner Alcohol Use Disorder Identificaion Test (AUDIT-G-M).
        in: Glöckner-Rist A. Rist F. Küfner H.E. Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES). Zentrum für Umfragen, Methoden und Analysen (ZUMA), Mannheim, Germany2003
        • Cherpitel C.J.
        Analysis of cut points for screening instruments for alcohol problems in the emergency room.
        J Stud Alcohol. 1995; 56: 695-700
        • Neumann T.
        • Neuner B.
        • Gentilello L.M.
        • et al.
        Gender differences in the performance of a computerized version of the alcohol use disorders identification test in subcritically injured patients who are admitted to the emergency department.
        Alcohol Clin Exp Res. 2004; 28: 1693-1701
      1. Allbus Standardkategorien. Allbus Zentrum für Umfragen, Methoden und Analysen (ZUMA), Mannheim, Germany2000
        • German Federal Statistical Office
        ([Statistisches Bundesamt]) (Accessed September 9, 2007)
        • Baker S.P.
        • O'Neill B.
        • Haddon Jr, W.
        • Long W.B.
        The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care.
        J Trauma. 1974; 14: 187-196
        • Ratner B.
        CHAID for specifying a model with illustration.
        in: Statistical modeling and analysis for database marketing: effective techniques for mining big data. CRC Press Inc, Boca Raton, FL2003: 155-166
      2. SPSS 14.0 for Windows. SPSS Inc, Chicago, IL2005
        • Irvin C.B.
        Public health preventive services, surveillance, and screening: the emergency department's potential.
        Acad Emerg Med. 2000; 7: 1421-1423
        • Babcock Irvin C.
        • Wyer P.C.
        • Gerson L.W.
        Preventive care in the emergency department, Part II: Clinical preventive services—an emergency medicine evidence-based review.
        Acad Emerg Med. 2000; 7: 1042-1054
        • Bernstein S.L.
        • Boudreaux E.D.
        • Cydulka R.K.
        • et al.
        Tobacco control interventions in the emergency department: a joint statement of emergency medicine organizations.
        Ann Emerg Med. 2006; 48: e417-e426
        • O'Connell J.
        • Novins D.K.
        • Beals J.
        • et al.
        The relationship between patterns of alcohol use and mental and physical health disorders in two American Indian populations.
        Addiction. 2006; 101: 69-83
        • Witbrodt J.
        • Kaskutas L.A.
        Does diagnosis matter?.
        Am J Drug Alcohol Abuse. 2005; 31: 685-707
        • Whitehead M.
        A typology of actions to tackle social inequalities in health.
        J Epidemiol Community Health. 2007; 61: 473-478