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In 2014 to 2015, 70.0% 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, and the American Dental Association’s Survey of Dental Practice . 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 12.2 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 based on general practice dentist reports that they or their dental team usually or always personally counsel patients who use tobacco products on tobacco cessation.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
The Tobacco Use Supplement to the Current Population Survey, National Cancer Institute, 1992–2015.
Trends and Most Recent Estimates
Physicians' Advice to Quit Smoking
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
70.0 | 69.0 - 71.0 |
Male
|
68.9 | 67.4 - 70.4 | |
Female
|
71.0 | 69.7 - 72.3 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
70.0 | 69.0 - 71.0 |
Non-Hispanic White
|
71.0 | 69.8 - 72.1 | |
Non-Hispanic Black
|
70.6 | 67.4 - 73.6 | |
Hispanic
|
63.2 | 59.4 - 66.8 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
54.7 | 50.7 - 58.6 |
Ages 25+
|
72.0 | 71.0 - 73.0 | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males, ages 18-24
|
51.4 | 45.4 - 57.5 |
Males, ages 25+
|
71.3 | 69.9 - 72.8 | |
Females, ages 18-24
|
57.9 | 52.6 - 63.0 | |
Females, ages 25+
|
72.6 | 71.3 - 73.8 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
< 200% of the federal poverty level
|
70.0 | 68.3 - 71.5 |
>= 200% of the federal poverty level
|
69.5 | 68.0 - 71.1 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2014 to 2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
74.4 | 72.0 - 76.7 |
High School
|
73.5 | 72.1 - 74.9 | |
Greater than High School
|
70.2 | 68.9 - 71.5 | |
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 | |
Evidence-based Resources
Evidence-based intervention programs are available on the Research-tested interventions (RTIPs) website that promote smoking cessation and provide guidance to quit.
Additional Information on Clinicians' Advice to Quit Smoking
For the public
- Tobacco and Cancer. American Cancer Society.
- Surgeon General’s Reports on Smoking and 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.
- Tobacco Products. U.S. Food and Drug Administration.
For smokers
- Cigarette Smoking: Health Risks and How to Quit (PDQ®)–Patient Version. National Cancer Institute.
- Smokefree.gov. National Cancer Institute.
- Tobacco. National Cancer Institute.
- How to Quit Smoking or Smokeless Tobacco. American Cancer Society.
- North American Quitline Consortium.
- Tips From Former Smokers-Media Campaign. Centers for Disease Control and Prevention.
For health professionals
- Cigarette Smoking: Health Risks and How to Quit (PDQ®) - Health Professional Version. National Cancer Institute.
- Best Practices for Comprehensive Tobacco Control Programs – 2014. Centers for Disease Control and Prevention.
- 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.
- Tobacco use and cessation for cancer survivors: an overview for clinicians. Karam-Hage M, Cinciripini PM, Gritz ER. CA Cancer J Clin. 2014 Jul-Aug;64(4):272-90.
- Stakeholder Research Priorities for Smoking Cessation Interventions within Lung Cancer Screening Programs. An Official American Thoracic Society Research Statement. Kathuria H, Detterbeck FC, Fathi JT et al. Am J Respir Crit Care Med 2017; 196(9):1202-1212.
- Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions. U.S. Preventive Services Task Force.
Scientific reports
- 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.
- 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.
- A Novel Decision Aid to Encourage Smoking Cessation Among Patients at an Urban Safety Net Clinic. Agarwal SD, Kerwin M, Meindertsma J, Wolf AMD. Prev Chronic Dis. 2018;15:E124.
- Prevalence and determinants of cigarette smoking relapse among US adult smokers: a longitudinal study. Alboksmaty A, Agaku IT, Odani S, Filippidis FT. BMJ Open. 2019;9(11):e031676.
- Quitting smoking among adults – United States, 2000–2015. Babb S, Malarcher A, Schauer G, et al. MMWR 2017;65(52):1457–64.
- Reducing Health Risk Behaviors and Improving Depression in Adolescents: A Randomized Controlled Trial in Primary Care Clinics. Bai S, Zeledon LR, D'Amico EJ, et al. J Pediatr Psychol. 2018;43(9):1004-1016.
- Disparities in Smoking Cessation Assistance in US Primary Care Clinics. Bailey SR, Heintzman J, Jacob RL, Puro J, Marino M. Am J Public Health. 2018;108(8):1082-1090.
- Long-Term Outcomes From Repeated Smoking Cessation Assistance in Routine Primary Care. Bailey SR, Stevens VJ, Fortmann SP, et al. Am J Health Promot. 2018;32(7):1582-1590.
- Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy. Bernstein SL, Dziura J, Weiss J, et al. Contemp Clin Trials. 2018;66:1-8.
- Systems change to improve tobacco use identification and referral in the chiropractic setting: a pilot study. Buettner-Schmidt K, Maack B, Larson M, Orr M, Miller DR, Mills K. Chiropr Man Therap. 2018;26:45.
- Weighing the Risks and Benefits of Electronic Cigarette Use in High-Risk Populations. Camenga DR, Tindle HA. Med Clin North Am. 2018l;102(4):765-779.
- An Office-Initiated Multilevel Intervention for Tobacco Smoke Exposure: A Randomized Trial. Collins BN, Lepore SJ, Winickoff JP, et al. Pediatrics. 2018;141(Suppl 1):S75-S86. Erratum in: Pediatrics. 2018;141(6).
- Changes in Specific Substance Involvement Scores among SBIRT recipients in an HIV primary care setting. Dawson-Rose C, Draughon JE, Cuca Y, et al. Addict Sci Clin Pract. 2017;12(1):34.
- Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment. Engle JL, Mermelstein R, Baker TB,et al. Drug Alcohol Depend. 2019;197:149-157.
- Missed Opportunities for Screening and Surveillance of Barrett's Esophagus in Veterans with Esophageal Adenocarcinoma. Hammad TA, Thrift AP, El-Serag HB, Husain NS. Dig Dis Sci. 2019;64(2):367-372.
- Smoking cessation behaviors among older U.S. adults. Henley SJ, Asman K, Momin B, et al. Prev Med Rep. 2019;16:100978.
- Physicians' Recommendations to Medicaid Patients About Tobacco Cessation. Holla N, Brantley E, Ku L. Am J Prev Med. 2018;55(6):762-769.
- Association between race and receipt of counselling or medication for smoking cessation in primary care. Hooks-Anderson DR, Salas J, Secrest S, Skiöld-Hanlin S, Scherrer JF. Fam Pract. 2018;35(2):160-165.
- Development of a Discrete Choice Experiment (DCE) Questionnaire to Understand Veterans' Preferences for Tobacco Treatment in Primary Care. Katz DA, Stewart KR, Paez M, et al. Patient. 2018;11(6):649-663.
- Factor structure and stability of smoking-related health beliefs in the National Lung Screening Trial. Kaufman AR, Koblitz AR, Persoskie A, et al. Nicotine Tob Res. 2016 Mar;18(3):321-9.
- Deaf patient-provider communication and lung cancer screening: Health Information National Trends survey in American Sign Language (HINTS-ASL). Kushalnagar P, Engelman A, Sadler G. Patient Educ Couns. 2018;101(7):1232-1239.
- Leveraging technology to promote smoking cessation in urban and rural primary care medical offices. Mahoney MC, Erwin DO, Twarozek AM, et al. Prev Med. 2018;114:102-106.
- Smoking outcome expectancies predict smoking during voucher-based treatment for smokers with substance use disorders. Murphy CM, Martin RA, Tidey JW, Colby SM, Rohsenow DJ. J Subst Abuse Treat. 2018;90:73-78.
- A Randomized Controlled Trial of an Optimized Smoking Treatment Delivered in Primary Care. Piper ME, Cook JW, Schlam TR, et al. Ann Behav Med. 2018;52(10):854-864.
- Association of E-Cigarette Use With Smoking Cessation Among Smokers Who Plan to Quit After a Hospitalization: A Prospective Study. Rigotti NA, Chang Y, Tindle HA, et al. Ann Intern Med. 2018;168(9):613-620.
- Exploring issues of comorbid conditions in people who smoke. Rojewski AM, Baldassarri S, Cooperman NA et al. Nicotine Tob Res 2016; 18(8):1684-1696.
- Computer-Facilitated 5A's for Smoking Cessation: A Randomized Trial of Technology to Promote Provider Adherence. Satterfield JM, Gregorich SE, Kalkhoran S, et al. Am J Prev Med. 2018;55(1):35-43.
- Smoking Cessation After Hospital Discharge: Factors Associated With Abstinence. Streck JM, Chang Y, Tindle HA, et al. J Hosp Med. 2018;13(11):774-778.
- 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.
Statistics
- The Tobacco Use Supplement to the Current Population Survey. National Cancer Institute.
- The National Health Interview Survey Cancer Control Supplements. National Center for Health Statistics, co-sponsored by the National Cancer institute/DCCPS and the Centers for Disease Control and Prevention/OSH and DCPC.