241790 Documentation of tobacco use and assistance with tobacco cessation during ambulatory care visits: Findings from the 2005-2008 national ambulatory medical care survey (NAMCS)

Tuesday, November 1, 2011

Ahmed Jamal, MBBS, MPH , Office on Smoking and Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Shanta R. Dube, PhD, MPH , Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
William S. Pearson, PhD, MHA , National Center For Injury Prevention And Control, Centers for Disease Control and Prevention, Atlanta, GA
Ann Malarcher, PhD, MSPH , Office of Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
Introduction: Tobacco use is a leading cause of preventable disease and death in the United States. The Public Health Services Guideline recommends that healthcare providers assess tobacco use and assist patients in quitting. The purpose of this study is to identify the proportion of outpatient visits with documented tobacco use, as well as referrals for tobacco cessation.

Methods: Data from the 2005-2008 National Ambulatory Medical Care Survey (NAMCS) were utilized to estimate the proportion of office-based physician visits with documented tobacco use. The NAMCS is a national probability sample survey of outpatient visits made to office-based physicians and measures health care utilization across health care providers. The sample included 99,275 outpatient visits among persons aged 15+ years. SUDAAN 10.0.1 was used to conduct the analysis.

Results: From 2005-2008, approximately 3.2 billion outpatient visits among aged 15+ years were made to office-based physicians, of which approximately 344 million were made by current tobacco users. Overall, 37.2% of patient visits did not include any information on tobacco use (2005: 33.1%; 2006: 38.2%; 2007: 41.2%; 2008: 36.4%). Further results on tobacco use and providing assistance with cessation will be presented as they varied with other co-variates (e.g., presence of chronic conditions, insurance type, time spent with physician, etc.).

Conclusions: Preliminary findings suggest that increases are needed in physicians' and health care providers' asking about and documenting tobacco use and assisting patients with tobacco cessation counseling and referrals. Key opportunities for progress include having tobacco cessation as a covered benefit and electronic health records.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Other professions or practice related to public health
Provision of health care to the public
Public health or related education
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
1. Assess the proportion of physician outpatient visits with information on tobacco use as well as the proportion of referrals for assistance with tobacco cessation. 2. Identify and compare the patient-related and physician-related characteristics of visits with known tobacco use status (current vs. non-current). 3. Examine if visits made by current tobacco users are a predictor for referrals to tobacco cessation education, mental health counseling, and screening for depression.

Keywords: Tobacco, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I have extensive experience in disease surveillance and epidemiology. Currently, I am working as an epidemiologist with the Epidemiology branch of the Office on Smoking and Health, CDC. I am also a clinician by training. My expertise includes but not limited to disease surveillance, smoking cessation, tobacco use, tobacco prevention policies, health effects of tobacco, chronic diseases etc.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.