4101.5: Tuesday, November 14, 2000 - Board 1

Abstract #5879

Adjusted smoking prevalence among adults with a smoking-related disease: The third National Health and Nutrition Examination Survey (NHANES-III), United States, 1988-1994

Ralph S. Caraballo, PhD, Office on Smoking and Health; National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. N.E., mailstop K-50, Atlanta, GA 30341, 770-488-5732, rfc8@cdc.gov and Gary A. Giovino, PhD, Department of Cancer Prevention; Epidemiology and Biostatistics, Roswell Park Cancer Institute, Elmer Carlton St, Buffalo, NY 14263.

The objective of this study was to describe the prevalence of cigarette smoking (self-reported and biochemically validated with serum cotinine) among adults who were previously told by a physician they had one of the following smoking-related conditions: stroke, heart attack, congestive heart failure, a related cancer, chronic bronchitis, or emphysema. The NHANES-III survey is a nationally representative cross-sectional survey of the U.S. population that included 16,131 participants aged 17 years. Smoking prevalences were adjusted by age, sex, and race or ethnicity. Persons reporting a history of stroke, heart attack, congestive heart failure, a smoking-related cancer, chronic bronchitis, or emphysema had a higher self-reported smoking prevalence (48.6%; 95% CI=3.7) than persons with none of these conditions (32.4%; 95% CI=1.5). Specifically, persons with congestive heart failure (48.9%; 95% CI=5.1 vs. 33.7%; 95% CI=1.5), chronic bronchitis (47.8%; 95% CI=4.6 vs. 32.9%; 95% CI=1.5), or emphysema (63.0%; 95% CI=6.6 vs. 33.4%; 95% CI=1.5) had a higher smoking prevalence than persons without those conditions. For each disease, biochemically validated estimates did not differ from self-reported estimates. Persons who had a stroke, a heart attack, chronic bronchitis, or emphysema were more likely to smoke ³20 cigarettes per day than persons in the comparison group. Approximately 40%-60% of patients with a smoking-related disease still smoke after being told they have a chronic disease. Increased physician counseling on smoking cessation, greater patient understanding of the effect of smoking on their disease, and increased pharmacologic treatment of nicotine dependence are needed.

Learning Objectives: At the conclusion of the section, the participant should be able to identify differences in cigarette smoking between persons with a smoking-related disease and persons without those conditions, to understand that most patients with smoking-related diseases do not quit after being told by a physician they have a chronic disease

Keywords: Smoking, Chronic Diseases

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA