Are physicians asking about tobacco use and assisting with cessation? Results from the 2001-2004 national ambulatory medical care survey (NAMCS).
OBJECTIVE
The objective of this study was to determine if providers asked patients about tobacco and assisted tobacco users with cessation.


METHODS
The data source is the 2001-2004 National Ambulatory Medical Care Survey, which is an annual survey of outpatient visits. The prevalence of "asking" about tobacco use, providing "assistance" with tobacco cessation, and prescription of pharmacotherapy for cessation were estimated. A logistic regression model was fit to the data to determine if any variables were related to "asking" about tobacco use and providing "assistance" with cessation.


RESULTS
Overall, 32% of patient charts did not include information about tobacco use, 81% of smokers did not receive assistance and less than 2% received a prescription for pharmacotherapy. Asking about tobacco use varied with presence of chronic disease, cardiovascular disease counseling, geographical region, whether the physician was the patient's primary provider, time spent with physician, age, and gender. Providing assistance with cessation varied with the presence of chronic diseases, cardiovascular disease counseling, region of the country, provider type, insurance type, and time spent with the physician.


CONCLUSIONS
Methods for improving adherence to the Clinical Practice Guideline for cessation, such as medical school curricula or educational programs for practicing providers, should be examined.
Ferketich
Amy K
AK
The Ohio State University School of Public Health, Columbus, OH 43210, USA. aferketich@sph.osu.edu
Khan
Yosef
Y
Wewers
Mary Ellen
ME
D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000592:standards*; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000592:standards / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology