title: National Ambulatory Medical Care Survey: tobacco intervention practices in outpatient clinics.
abstract: Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use.
authors.affiliation: Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS 39213, USA. tjpayne1@umc.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Payne
authors.forename: Chieh-I
authors.initials: CI
authors.lastname: Chen
authors.forename: Christine L
authors.initials: CL
authors.lastname: Baker
authors.forename: Sonali N
authors.initials: SN
authors.lastname: Shah
authors.forename: Chris L
authors.initials: CL
authors.lastname: Pashos
authors.forename: Luke
authors.initials: L
authors.lastname: Boulanger
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003376:Counseling; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011320:Primary Health Care; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D014481:United States