title: Older adults' contact with health practitioners: is there an association with smoking practices?
abstract: BACKGROUND
  Approximately 12% of the North American population aged 65 and older smoke cigarettes daily. Late-life smokers represent an important population for intervention by health practitioners. The objective of this study was to determine the extent to which contact with health practitioners (dentists or physicians) affects smoking status among older adults.
  
  
  METHODS
  We used data on a probability-based sample of community-dwelling elderly respondents (N = 13,363) from the Canadian 1996-1997 National Population Health Survey. Descriptive statistics were calculated, and multivariate logistic regression analysis was performed to examine the associations between current tobacco use and contact with health care practitioners controlling for potential confounders, especially sociodemographic characteristics, selected health conditions, self-reported health, body mass index, functional status, perceived social support, and psychological distress.
  
  
  RESULTS
  Older adults without a regular physician (adjusted odds ratio [AOR], 1.33; 95% confidence interval [CI], 1.11-1.59), with infrequent physical (AOR, 1.22; 95% CI, 1.07-1.40), and dental (AOR, 2.68; 95% CI, 2.07-3.47) checkups were more likely to be current smokers. Age (younger), church attendance (infrequent), drinking behavior (former or occasional), body mass index (normal weight), and psychological distress were all independently related to current smoking.
  
  
  CONCLUSIONS
  Results indicate that patients' contact with health care providers is strongly negatively associated with smoking. More specific data are needed to learn the frequency with which physicians and dental professionals attempt to modify older individuals' smoking behavior and the degree to which such efforts are effective.
authors.affiliation: School of Community Health, Portland State University, Oregon 97207, USA. kaplanm@pdx.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Kaplan
authors.forename: Jason T
authors.initials: JT
authors.lastname: Newsom
authors.forename: Bentson H
authors.initials: BH
authors.lastname: McFarland
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000704:Analysis of Variance; D001294:Attitude to Health; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D011159:Population Surveillance; D012307:Risk Factors; D012309:Risk-Taking; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires