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In 2010 to 2011, 64.4% of adult smokers who had seen a physician during the past 12 months reported being advised by that doctor to quit smoking.
Introduction
Clinicians’ advice to quit smoking can by itself contribute 5 to 10 percentage points toward quitting among smoking patients and much more if coupled with behavioral therapy and pharmacological treatment of nicotine addiction. In addition, even minimal clinical interventions have been shown to be cost effective in increasing smokers’ motivation to quit.
If a patient wants to quit, the national guidelines recommend that the clinician follow the “5 A’s” (ask, advise, assess, assist, and arrange). For patients who are not yet ready to quit, the clinician should instead provide a brief intervention designed to promote the motivation to quit. Experts have suggested that a wide variety of clinicians, including dentists, physicians, and other health professionals such as pharmacists, can effectively implement brief strategies to increase future quit attempts. In fact, many individual pharmacies and one national pharmacy chain have decided not to sell tobacco products, recognizing that the sale of tobacco products conflicts with the role of pharmacies as public health facilities.
Measure
The percentage of adult smokers (aged 18 years and older) who have seen a physician or dentist in the past 12 months and report that the physician or dentist advised them to quit smoking.
Healthy People 2020 Target
The Healthy People 2020 (HP2020) targets are developed based on the National Center for Health Statistics survey of physicians and hospitals. In contrast, the data presented in the Cancer Trends Progress Report are based on reports from patients regarding whether they received smoking cessation advice from their physicians or dentists. Therefore, the data presented in this report cannot be directly compared to the HP2020 objectives. Nevertheless, patient self-report data is a valuable measure of how clinicians’ advice to quit smoking is changing over time.
HP2020 includes targets for physicians’ advice to quit smoking in office-based ambulatory care settings and in hospital ambulatory care settings. The HP2020 objective is for adult smokers to receive tobacco cessation counseling at 21.1 percent of visits to physicians’ offices, and at 24.9 percent of hospital visits . HP2020 also includes targets for dentists’ advice to quit smoking in dental care settings. The HP2020 objective is for patients who use tobacco products to receive cessation counseling at 39.3 percent of dental care visits.
HP2020 targets for clinicians’ advice to quit smoking in substance abuse care settings are still in development.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Data Source
The Tobacco Use Supplement to the Current Population Survey, National Cancer Institute, 1992–2011.
Trends and Most Recent Estimates
Physicians' Advice to Quit Smoking
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
64.4 | (63.4 - 65.3) |
Male
|
62.7 | (61.3 - 64.0) | |
Female
|
65.8 | (64.6 - 66.9) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
64.4 | (63.4 - 65.3) |
Non-Hispanic White
|
65.1 | (64.0 - 66.2) | |
Non-Hispanic Black
|
62.1 | (58.8 - 65.4) | |
Hispanic
|
59.3 | (55.6 - 63.0) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
50.3 | (46.8 - 53.9) |
Ages 25+
|
66.2 | (65.3 - 67.2) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males Ages 18-24
|
43.9 | (38.2 - 49.5) |
Males Ages 25+
|
65.3 | (64.0 - 66.7) | |
Females Ages 18-24
|
55.6 | (51.1 - 60.1) | |
Females Ages 25+
|
67.0 | (65.9 - 68.2) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
64.6 | (63.0 - 66.2) |
>=200% of federal poverty level
|
64.4 | (63.1 - 65.7) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
66.5 | (64.1 - 68.9) |
High School
|
67.6 | (66.0 - 69.1) | |
Greater than High School
|
65.0 | (63.7 - 66.3) | |
Dentists' Advice to Quit Smoking
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
30.4 | (29.3 - 31.5) |
Male
|
32.5 | (30.8 - 34.2) | |
Female
|
28.4 | (27.1 - 29.7) | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
30.4 | (29.3 - 31.5) |
Non-Hispanic White
|
29.8 | (28.6 - 31.0) | |
Non-Hispanic Black
|
34.5 | (30.6 - 38.4) | |
Hispanic
|
29.7 | (25.0 - 34.4) | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
31.1 | (27.2 - 35.1) |
Ages 25+
|
30.2 | (29.0 - 31.4) | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males Ages 18-24
|
31.3 | (25.6 - 36.9) |
Males Ages 25+
|
32.6 | (30.9 - 34.4) | |
Females Ages 18-24
|
30.9 | (26.1 - 35.6) | |
Females Ages 25+
|
27.9 | (26.5 - 29.3) | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
32.4 | (30.5 - 34.3) |
>=200% of federal poverty level
|
29.0 | (27.5 - 30.5) | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2010 to 2011) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
33.3 | (29.3 - 37.3) |
High School
|
30.3 | (28.4 - 32.2) | |
Greater than High School
|
29.6 | (28.0 - 31.1) | |
Additional Information on Clinicians' Advice to Quit Smoking
For smokers
- Guide to Quitting Smoking. American Cancer Society.
- Free Help to Quit Smoking. National Cancer Institute.
- Smokefree.gov. National Cancer Institute.
- North American Quitline Consortium.
For the public
- Tobacco & Cancer. American Cancer Society.
- Surgeon General’s Reports on Smoking and Tobacco Use. Centers for Disease Control and Prevention.
- 2000 Surgeon General’s Report – Reducing Tobacco Use. Centers for Disease Control and Prevention.
- 50 Years of Progress: A Report of the Surgeon General, 2014. U.S. Department of Health and Human Services.
- Surgeon General.gov. Initiatives – Tobacco. U.S. Department of Health and Human Services.
- Tobacco Products. U.S. Food and Drug Administration.
For health professionals
- Tobacco-Free Pharmacy Laws and Trends in Tobacco Retailer Density in California and Massachusetts. American Public Health Association (04/01/2016) Vol. 106, No. 4, P. 679 Jin, Yue; Lu, Bo; Klein, Elizabeth G.; et al.
- Best Practices for Comprehensive Tobacco Control Programs – 2014. Centers for Disease Control and Prevention.
- Counseling and Interventions to Prevent Tobacco Use and Tobacco-Caused Disease in Adults and Pregnant Women. April 2009. U.S. Preventive Services Task Force.
- Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update. U.S. Public Health Service.
Scientific reports
- A comparison of cessation counseling received by current smokers at US dentist and physician offices during 2010-2011. Agaku IT, Ayo-Yusuf OA, Vardavas CI. Am J Public Health 2014 Aug;104(8):e67-75.
- Socioeconomic disparity in provider-delivered assistance to quit smoking. Browning KK, Ferketich AK, Salsberry PJ, Wewers ME. Nicotine Tob Res. 2008;10(1):55–61.
- Use of tobacco cessation treatments among young adult smokers: 2005 National Health Interview Survey. Curry SJ, Sporer AK, Pugatch O, Campbell RT, Emery S. Am J Public Health 2007;97:1464–69.
- Quitting smoking among adults --- United States, 2001—2010. Malarcher A, Dube S, Shaw L, Babb S, Kaufmann R. MMWR 2011;60(44):1513–19.
- Efficacy of smoking-cessation interventions for young adults: a meta-analysis. Suls JM, Luger TM, Curry SJ, Mermelstein RJ, Sporer AK, An LC. Am J Prev Med. 2012;42(6):655–62.
- Monograph 12: Population Based Smoking Cessation Proceedings of a Conference on What Works to Influence Cessation in the General Population. U.S. Public Health Service and the National Cancer Institute.
Statistics
- Healthy People 2020, 2020 Topics & Objectives – Tobacco Use.
- The Tobacco Use Supplement to the Current Population Survey. National Cancer Institute.
- Tobacco Use Supplement – New, Updated, & Modified Files. National Cancer Institute.