Healthcare intervention for preventable risk behaviors: Physicians' advice on smoking cessation in the U.S., 1995 to 2002

Tobacco use, the leading preventable health risk factor, creates a tremendous burden on the health care system each year. Physician's advice to quit smoking has been shown to be an effective component in smoking cessation treatment. We examined the relationships between physician's advice on quitting smoking and an array of patient characteristics, including gender, race/ethnicity, being foreign born, family income, education, occupational group, employment status, veteran status, homeownership, household structure, and level of smoking. Multivariate logistic regression was employed to study a representative national sample of smokers, aged 18 years and greater, who made at least one visit to a physician in the past year, using data from the 1995-96, 1998-99, and 2001-02 Tobacco Supplements of the Current Population Study (TUS-CPS). Moderate but significant increases were observed in receiving physician's advice among current smokers: 55% in 1995-96, 59% in 1998-99, and 63% in 2001-02. Physicians were less likely to give advice to smokers who were younger, foreign born, ethnic/racial minorities, and men; and more likely to give advice to veterans and daily smokers. While smokers of higher occupational status were more likely to receive advice, smokers of higher education did not have an advantage. Income did not influence the likelihood of receiving advice. Effects of social and economic factors on receiving advice did not change over time. Various effects of socioeconomic status indicators suggest that access to health insurance (of better quality) may be an important factor in explaining whether smokers receive physician advice on smoking cessation.