Healthcare provider smoking cessation advice among US worker groups

Sylvester Comprehensive Cancer, University of Miami, Miller School of Medicine, PO Box 016069 (R-669), Miami, FL 33143, USA.
Tobacco control (Impact Factor: 5.93). 11/2007; 16(5):325-8. DOI: 10.1136/tc.2006.019117
Source: PubMed


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.
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).
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%).
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.

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Available from: William G Leblanc, Dec 27, 2013
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    • "Moreover, brief physician-implemented counselling interventions can increase the absolute rate of cessation by 1% to 3% (Alba, Murillo, & Castillo, 2013; Stead et al., 2013). However, despite the efforts to promote physician-led interventions for smoking cessation, few clinicians consistently implement them (Huang et al., 2013; Kruger et al., 2012; Lee et al., 2007; Pipe, Sorensen, & Reid, 2009) particularly in Latin American countries (Gigliotti et al., 2013; Juliao et al., 2013; Mejia et al., 2010). Physicians have also reported lack of training to help their patients quit and limited time for counselling during clinic visits (Perez-Stable et al., 2001; Soto Mas et al., 2005; Vogt, Hall, & Marteau, 2005; Warren, Jones, & Chauvin, 2008). "
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    ABSTRACT: Background: Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina.Methods: A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices.Results: Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians' perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5).Conclusions: Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum.
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    • "Since most Operating Engineers are men, unlike women, they may not seek regular health care. Yet even when seen by a health care provider, only 53% of construction workers were advised to quit smoking [9]. Given the high rates of smoking, the interaction between smoking and respirable dust exposure which enhances cancer rates, and lack of access to cessation interventions, an efficacious worksite smoking cessation intervention has the potential to substantially impact the health of Operating Engineers by reducing cancer rates. "
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    • ") , and in dusty environments , a synergistic effect has been noted with respect to occupational lung disease ( Lee et al . , 2007 ) ."
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