Smokers Ages 50+: Who Gets Physician Advice to Quit?
ABSTRACT Smoking-related morbidity and mortality, and benefits associated with quitting, extend across the life span. Health care provider interventions enhance quitting. The present study examined perceived influence of physician advice to quit and characteristics of subjects receiving this advice.
Subjects were 1,454 smokers ages 50+ with at least one physician visit in the past year. Subjects were surveyed at baseline for receipt of and reactions to physician advice to quit and for smoking, health, and demographic characteristics.
Over half of subjects welcomed physician advice to quit, about half said the advice influenced their quitting decision "extremely" or "quite a lot," and about one-third indicated that it increased their confidence in quitting. Physicians were more likely to advise sicker patients, indicated by poorer health status, at least one past year hospitalization, and presence of cardiovascular, cerebrovascular, or respiratory diseases.
Midlife and older smokers reacted generally favorably to physician advice to quit. Physicians were more likely to advise patients with commonly recognized smoking-related diseases. Discrepancies were noted in advice given to sicker vs healthier patients. Additional physician training in less commonly recognized smoking-related illnesses, intervening with healthier patients to prevent disease, and enhancing patients' confidence in quitting may improve outcomes.
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ABSTRACT: In the absence of empirical literature from the resident perspective, this study provided a first assessment of smoking history, knowledge of the risks of smoking, the risks of environmental tobacco exposure, and the benefits of quitting among older (age 50+) nursing home unit residents, as well as readiness to quit, barriers to quitting, frequency of cessation advice by healthcare givers, and quit-attempt history of residents who smoke. Subjects were 25 smokers and 70 non-smokers housed on long-term nursing home units in a county hospital. Results indicated that smoking status for the majority of residents was similar to when they were admitted, although smokers smoked fewer cigarettes (M = 11.6, SD = 9.2) than prior to admission (M = 18.6, SD = 11.8). Smokers were less likely than non-smokers to agree that smoking is harmful to their health. Both smokers and non-smokers were not well informed of the dangers of passive smoke exposure. The majority of smokers were in precontemplation (no interest in quitting within the next 6 months). Fewer than half of residents who smoked reported receiving cessation advice from physicians (40%) or nurses (36%), and no in-house cessation programs were available. These results suggest gaps in knowledge and resources for smoking cessation in this setting and an opportunity for intervention. This study begins to build an evidence base from the residents' perspective that can be used by healthcare providers, administrators, and policy makers in addressing smoking in the nursing home.Nicotine & Tobacco Research 06/2002; 4(2):161-9. DOI:10.1080/14622200210123987 · 2.81 Impact Factor
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ABSTRACT: Little smoking research in the past 20years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics METHOD: In 2012-4, we analyzed 2010 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data from Medicare beneficiaries over age 64 (n=346,674). We estimated smoking rates and the proportion of smokers whose clinicians encouraged cessation. 12% of male and 8% of female respondents aged 65 and older smoke. The rate decreases with age (14% of 65-69, 3% of 85+) and education (12-15% with no high school degree, 5-6% with BA+). Rates are highest among American Indian/Alaskan Native (16%), multiracial (14%), and African-American (13%) seniors, and in the Southeast (14%). Only 51% of smokers say they receive cessation advice "always" or "usually" at doctor visits, with advice more often given to the young, those in low-smoking regions, Asians, and women. For all results cited p<0.05. Smoking cessation advice to seniors is variable. Providers may focus on groups or areas in which smoking is less common or when they are most comfortable giving advice. More consistent interventions are needed, including cessation advice from clinicians. Copyright © 2014. Published by Elsevier Inc.Preventive Medicine 12/2014; 70. DOI:10.1016/j.ypmed.2014.11.020 · 2.93 Impact Factor
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ABSTRACT: Aim: To investigate the success rate and factors aff ecting success at a smoking cessation clinic. Materials and methods: In this study, 608 patients (397 male and 211 female) admitted to a smoking cessation clinic to quit smoking between 1 January 2006 and 1 June 2010 were investigated. Routine biochemical and hematological tests, pulmonary function tests, exhaled carbon monoxide levels, electrocardiographs, and chest X-rays were obtained from all of the patients. Th e questionnaire forms, including the Fagerström Test for Nicotine Dependence (FTND), were fi lled by all of the participants. At the end of months 6, 12, and 18, the smoking cessation success rates were reviewed. Factors contributing to the success rate, causes of smoking, diffi culties encountered in quitting, and factors that increased the desire to smoke were evaluated. SPSS 11 was used in the statistical analyses (chi-square test). P < 0.05 was considered statistically signifi cant. Results: Statistically signifi cant factors included male sex, obtaining physician advice, and an FTND score of ≤6. Inclination was the most common cause of starting to smoke, and the most commonly encountered diffi culty in quitting was irritability and an increased desire to smoke in the postprandial period. Conclusion: Th is study found a smoking cessation success rate of 40.4% over 1 year. Th e clinic was eff ective for smoking cessation. Th e fi ndings from this clinic will be valuable for future tobacco control studies. Sigara bırakma kliniği sonuçları ve başarıyı etkileyen faktörlerin araştırılması Amaç: Bu çalışmada, sigara bırakma (SB) polikliniğimizde başarı oranını ve başarıyı artıran faktörleri araştırmayı amaçladık. Yöntem ve gereç: Çalışmamızda, 1 Ocak 2006 ve 1 Temmuz 2010 tarihleri arasında SB polikliniğimize başvuran 608 (397 erkek, 211 kadın) olgu incelendi. Olgulardan rutin biokimyasal, hematolojik testler, solunum fonksiyon testi, nefes CO ölçümü, elektrokardiografi ve postero-anterior akciğer grafi si istendi. Tüm olgulardan, sigara içme durumu, Fagerström nikotin bağımlılık testi (FTND) ve demografi k bilgilerin yer aldığı poliklinik formunu doldurmaları istendi. Altı, 12 ve 18. ayın sonunda sigara bırakma oranları gözden geçirildi. Başarıyı etkileyen faktörler, sigaraya başlama nedenleri, bırakırken karşılaşılan güçlükler ve sigara içme isteğini artıran faktörler değerlendirildi. İstatistik analizde SPSS 11 (ki-kare testi) programı kullanıldı. P < 0,05 anlamlı kabul edildi. Bulgular: İstatistiksel olarak başarıyı etkiliyen faktörler, erkek cinsiyet, sigara bırakmaları için doktor tavsiyesi alma ve düşük (6 ≤ FTND) bağımlılık olarak saptandı. Sigaraya başlamada en sık neden özenme, sigarayı bırakırken en sık karşılaşılan güçlük sinirlilik ve sigara içme isteğinin en yüksek olarak yemek sonrasında olduğu saptandı. Sonuç: Bu çalışmada başarı oranı bir yıl için % 40,4 olarak bulundu. Sigara bırakma polikliniği, başarılı sigara bırakmada etkin ve önemliydi. Elde edilen bilgilerin tütün konrolü için gelecekte yapılacak çalışmalar için yararlı olacağını düşünmekteyiz.