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In 2018 to 2019, 69.5% of adult smokers who had seen a physician during the past 12 months reported being advised by that doctor to quit smoking.
Background
Clinicians’ advice to quit smoking can, by itself, increase quit attempts and quit success and can have even greater impact if coupled with cessation counseling and/or medication. In addition, even brief clinical interventions have been shown to be cost effective in increasing smokers’ motivation to quit.
Clinical guidelines recommend clinicians utilize the “5 A’s” (ask, advise, assess, assist, and arrange) when screening for tobacco use and providing cessation interventions. For patients ready to quit, clinicians can provide cessation assistance and support, including medication, counseling, referral to treatment extenders, and follow-up. For patients who are not yet ready to quit, clinicians can instead provide a brief intervention designed to promote the motivation to quit. 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. Many individual pharmacies and one national pharmacy chain have decided not to sell tobacco products, recognizing that the sale of tobacco products is not compatible with their important role in health care.
Measure
The percentage of adult smokers (aged 18 years and older) who have seen a physician in the past 12 months and report that the physician advised them to quit smoking.
Healthy People 2030 Target
- Increase to 66.6 percent the proportion of adult smokers who receive advice to quit from a health professional.
This Healthy People 2030 (HP2030) goal is focused on all health professionals, including a medical doctor, dentist, or other health professional, and the chosen data source for this goal is the National Health Interview Survey. 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, and data presented are drawn from the Tobacco Use Supplement to the Current Population Survey. Therefore, the data presented in this report cannot be directly compared to the HP2030 objective.
Healthy People 2030 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 Harmonized Data, National Cancer Institute, 1992–2019.
Trends and Most Recent Estimates
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
69.5 | 68.3 - 70.8 |
Male
|
67.9 | 66.1 - 69.6 | |
Female
|
71.2 | 69.4 - 72.8 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
69.5 | 68.3 - 70.8 |
Non-Hispanic White
|
71.0 | 69.4 - 72.5 | |
Non-Hispanic Black
|
67.3 | 63.5 - 70.9 | |
Hispanic
|
60.9 | 56.5 - 65.2 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
55.9 | 48.8 - 62.8 |
Ages 25+
|
71.5 | 70.4 - 72.7 | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males, ages 18-24
|
54.0 | 43.4 - 64.3 |
Males, ages 25+
|
70.2 | 68.5 - 71.8 | |
Females, ages 18-24
|
58.0 | 48.1 - 67.4 | |
Females, ages 25+
|
72.9 | 71.3 - 74.4 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
< 200% of the federal poverty level
|
68.5 | 66.6 - 70.3 |
>= 200% of the federal poverty level
|
70.5 | 68.4 - 72.4 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2018 to 2019) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
71.6 | 68.3 - 74.7 |
High School
|
72.1 | 70.3 - 73.8 | |
Greater than High School
|
70.9 | 69.2 - 72.5 | |
Additional Information on Clinicians' Advice to Quit Smoking
- Tobacco and Cancer. American Cancer Society.
- Surgeon General’s Reports on Smoking and Tobacco Use. Centers for Disease Control and Prevention.
Quitting Resources
- Smokefree.gov. National Cancer Institute.
- Cigarette Smoking: Health Risks and How to Quit (PDQ®)–Patient Version. National Cancer Institute.
- What You Need to Know About Quitting Smoking: Advice from the Surgeon General. Centers for Disease Control and Prevention.
- How to Quit Using Tobacco. American Cancer Society.
- Tips From Former Smokers-Media Campaign. Centers for Disease Control and Prevention.
- Tobacco Control Evidence-Based Programs Listing. National Cancer Institute.
- Healthcare Provider Resources: Smoking and Tobacco Use. Centers for Disease Control and Prevention.
- Cigarette Smoking: Health Risks and How to Quit (PDQ®) - Health Professional Version. National Cancer Institute.
- Treating Tobacco Use and Dependence: 2008 Update. Agency for Healthcare Research and Quality.
- Best Practices for Comprehensive Tobacco Control Programs – 2014. Centers for Disease Control and Prevention.
- Tobacco Use. Million Hearts.
- Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons. U.S. Preventive Services Task Force.
- Interventions to Increase Adherence to Medications for Tobacco Dependence. Hollands GJ, Naughton F, Farley A, Lindson N, Aveyard P. Cochrane Database Syst Rev. 2019;8(8):CD009164.
- 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.
- 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.
- Disparities in Cessation Behaviors Between Hispanic and Non-Hispanic White Adult Cigarette Smokers in the United States, 2000-2015. Babb S, Malarcher A, Asman K, et al. Prev Chronic Dis. 2020; 17:190279.
- 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.
- 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).
- Community Pharmacy Personnel Interventions for Smoking Cessation. Carson‐Chahhoud KV, Livingstone‐Banks J, Sharrad KJ, et. al. Cochrane Database Syst Rev. 2019;2019(10).
- 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.
- Nurse Counseling as Part of a Multicomponent Tobacco Treatment Intervention: An Integrative Review. Keller KG, Lach HW. J Addict Nurs. 2020;31(3):161-179.
- 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.
- Kids Safe and Smokefree (KiSS) Multilevel Intervention to Reduce Child Tobacco Smoke Exposure: Long-Term Results of a Randomized Controlled Trial. Lepore SJ, Collins BN, Coffman DL, et al. Int J Environ Res Public Health. 2018;15(6)
- 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.
- Effectiveness of decision aids for smoking cessation in adults: a quantitative systematic review. Moyo F, Archibald E, Slyer JT. JBI Database System Rev Implement Rep. 2018;16(9):1791-1822.
- How To Support Smoking Cessation In Primary Care And The Community: A Systematic Review Of Interventions For The Prevention Of Cardiovascular Diseases. Odorico M, Le Goff D, Aerts N, Bastiaens H, Le Reste JY. Vasc Health Risk Manag. 2019;15:485-502.
- 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.
- 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.
- Smokers' Receipt of Cessation Advice from Healthcare Professionals in National Samples of People Diagnosed with HIV and the General Population. Timberlake DS, Nwosisi NG. Subst Use Misuse. 2020;55(7):1079-1085.
- 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.