Healthcare provider smoking cessation advice among US worker groups.
OBJECTIVE
Among workers in dusty occupations, tobacco use is particularly detrimental to health because of the potential synergistic effects of occupational exposures (for example, asbestos) in causing disease. This study explored the prevalence of smoking and the reported smoking cessation discussion with a primary healthcare provider (HCP) among a representative sample of currently employed US worker groups.


METHODS
Pooled data from the 1997-2003 National Health Interview Survey (NHIS) were used to estimate occupation specific smoking rates (n = 135,412). The 2000 NHIS Cancer Control Module was used to determine (among employed smokers with HCP visits) the prevalence of being advised to quit smoking by occupation (n = 3454).


RESULTS
The average annual prevalence of current smoking was 25% in all workers. In 2000, 84% of smokers reported visiting an HCP during the past 12 months; 53% reported being advised by their physician to quit smoking (range 42%-66% among 30 occupations). However, an estimated 10.5 million smokers were not advised to quit smoking by their HCP. Workers with potentially increased occupational exposure to dusty work environments (including asbestos, silica, particulates, etc), at high risk for occupational lung disease and with high smoking prevalence, had relatively low reported discussions with an HCP about smoking cessation, including farm workers (30% overall smoking prevalence; 42% told to quit), construction and extractive trades (39%; 46%), and machine operators/tenderers (34%; 44%).


CONCLUSIONS
The relatively low reported prevalence of HCP initiated smoking cessation discussion, particularly among currently employed workers with potentially synergistic occupational exposures and high current smoking prevalence, needs to be addressed through educational campaigns targeting physicians and other HCPs.
Lee
David J
DJ
Sylvester Comprehensive Cancer, University of Miami, Miller School of Medicine, PO Box 016069 (R-669), Miami, FL 33143, USA. dlee@med.miami.edu
Fleming
Lora E
LE
McCollister
Kathryn E
KE
Caban
Alberto J
AJ
Arheart
Kristopher L
KL
LeBlanc
William G
WG
Chung-Bridges
Katherine
K
Christ
Sharon L
SL
Dietz
Noella
N
Clark
John D
JD
D003376:Counseling / Q000379:methods / Q000706:statistics & numerical data; D004522:Educational Status; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D016273:Occupational Exposure; D016272:Occupational Health; D009790:Occupations; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology