How many smokers are counseled by their doctor to stop smoking?

More than six of 10 smokers ages 15 and older were advised by their doctor to quit smoking during physician visits in 2001–2002.

Percentage of Current Smokers Ages 15 and Older Who Were Advised by a Doctor to Quit Smoking (Among Those Who Visited a Doctor in the Past Year)

Why is this important?

• Tobacco smoking is the single most preventable cause of disease in the United States, leading to 440,000 premature deaths annually and $92 billion in lost productivity (CDC 2005a).
• More than one of five U.S. adults and high school students smoke cigarettes, and about two-thirds visit a physician each year (CDC 2005b; 2005c).
• Smokers who quit smoking reduce their risk of death from heart disease and lung cancer. Pregnant women who quit smoking have better birth outcomes (DHHS 1990).
• Brief physician smoking-cessation counseling (of less than three minutes' duration) has been shown in controlled studies to increase abstinence rates, especially with consistent and repeated advice (USPSTF 2003).

Findings

Among current smokers ages 15 and older who visited a doctor in the past year, the proportion who were advised by their doctor to quit smoking increased from 51 percent during 1992–1993 to 62 percent during 2001–2002 (NCI 2005).

Implications

Physicians currently miss many opportunities to counsel patients about smoking cessation. Even a small improvement can have substantial impact in reducing the burden of disease associated with smoking. Addressing smoking cessation also can increase satisfaction with physician visits by smokers (Conroy et al. 2005).

Improvement Ideas and Resources

The federal government (DHHS 2003) recommends six strategies that "have been demonstrated to be effective as part of a coordinated effort to provide consistent and effective tobacco interventions":

1. Clinics should implement a tobacco-user identification system, which can help increase physician counseling.
2. Health care systems should provide education, resources, and feedback to promote provider interventions.
3. Clinical sites should dedicate staff to provide tobacco dependence treatment and assess the delivery of this treatment in staff performance evaluations.
4. Hospitals should promote policies that support and provide tobacco dependence services.
5. Health plans and insurers should include tobacco dependence treatments (both counseling and pharmacotherapy) as paid or covered services for all subscribers or members of health insurance packages.
6. Health plans and insurers should reimburse clinicians and specialists for delivery of effective tobacco dependence treatments and include these interventions among the defined duties of clinicians.

Measure:

The denominator includes civilian, noninstitutionalized smokers ages 15 and older who visited a physician in the year before the survey. The numerator includes those in the denominator who reported that the doctor advised them to quit smoking. The U.S. Preventive Services Task Force and other medical public health organizations recommend that physicians counsel smokers to stop smoking (USPSTF 2003).

Source:

Results were compiled by the National Cancer Institute (NCI 2005) using data from the triennial Tobacco Use Supplement to the Current Population Survey, a nationally representative household telephone and personal interview survey of the civilian, noninstitutionalized population of the United States ages 15 and older.

References:

* Indicates source of data used in the chart(s).CDC (Centers for Disease Control and Prevention). 2005a. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 1997–2001. Morbidity and Mortality Weekly Report 54(25): 625–8. CDC (Centers for Disease Control and Prevention). 2005b. Cigarette Smoking Among Adults: United States, 2004. Morbidity and Mortality Weekly Report 54(44): 1121–4. CDC (Centers for Disease Control and Prevention). 2005c. Tobacco Use, Access, and Exposure to Tobacco in Media Among Middle and High School Students—United States, 2004. Morbidity and Mortality Weekly Report 54(12): 297–301. Conroy, M. B., N. E. Majchrzak, S. Regan et al. 2005. The Association Between Patient-Reported Receipt of Tobacco Intervention at a Primary Care Visit and Smokers' Satisfaction with Their Health Care. Nicotine & Tobacco Research 7 Suppl 1: S29–34. DHHS (Department of Health and Human Services). 1990. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Rockville, Md.: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. DHHS (Department of Health and Human Services). 2003. Treating Tobacco Use and Dependence: A Systems Approach. Washington, D.C.: U.S. Department of Health and Human Services. * NCI (National Cancer Institute). 2005. Cancer Trends Progress Report: 2005 Update. Bethesda, Md.: National Institutes of Health. USPSTF (U.S. Preventive Services Task Force). 2003. Counseling to Prevent Tobacco Use and Tobacco-Caused Disease: Recommendation Statement. Rockville, Md.: Agency for Healthcare Research and Quality.