Tobacco Use Screening and Counseling During Hospital Outpatient Visits Among US Adults, 2005-2010.
BACKGROUND
Physicians and health care providers play an important role in educating their patients about the health risks of tobacco use and in providing effective cessation interventions. Little is known about these practices in hospital outpatient settings. The objective of the study was to assess the prevalence, correlates, and trends of tobacco use screening and cessation assistance offered to US adults during their hospital outpatient clinic visits.


METHODS
Data for aggregated hospital outpatient visits among patients aged 18 years or older (N = 148,727) from the 2005-2010 National Hospital Ambulatory Medical Care Survey were analyzed. Tobacco use screening was defined as documentation of screening for either current tobacco use (cigarettes, cigars, snuff, or chewing tobacco) or no current use on the patient record form. Tobacco cessation assistance was defined as documentation of either tobacco counseling or cessation medications.


RESULTS
Tobacco use screening was reported for 63.0% (estimated 271 million visits) of hospital outpatient visits, and cessation assistance was reported for 24.5% (estimated 17.1 million visits) of visits among current tobacco users. From 2005 through 2010, tobacco use screening (P for trend = .06) and cessation assistance (P for trend = .17) did not change significantly.


CONCLUSIONS
From 2005 through 2010, more than one-third of hospital outpatient visits had no screening for tobacco use, and among current tobacco users, only 1 in 4 received any cessation assistance. Health care providers should consistently identify and document their patients' tobacco use status and provide them with appropriate tobacco cessation assistance. Opportunities also exist to expand the coverage for tobacco cessation.
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mail Stop F79, Atlanta, GA 30341. Email: jze1@cdc.gov.
Ahmed
A
Jamal
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Shanta R
SR
Dube
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Brian A
BA
King
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D003376:Counseling / Q000706:statistics & numerical data* / Q000639:trends; D057286:Electronic Health Records; D005006:Ethnicity / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000706:statistics & numerical data; D011203:Poverty / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult