Factors associated with smoking cessation counseling at clinical encounters: The Behavioral Risk Factors Surveillance System (BRFSS) 2000

Purpose. Characterize factors associated with smoking-cessation counseling in clinical encounters. Design. Cross-sectional analysis of Behavioral Risk Factor Surveillance System (BRFSS) 2000 data. Setting. U.S. households. Subjects. 10,582 smokers (aged ≥ 18 years) reporting one or more clinical encounters during the prior year. Measures. Multivariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for quit advice associated with respondent and encounter variables. Results. Almost 55% of respondents were advised to quit smoking. Young men were advised to quit least often. Increasing age (18-24, 25-39, 40-64, ≥ 65 years) was associated with increasing odds of receiving quit advice (OR = 1.33, CI 1.10-1.61) for men. Other positive associations with quit advice included patient education, BMI, diagnosis of asthma, and private health insurance. Patients seeing physicians had greater odds of being advised to quit smoking (OR = 3.29, CI 2.13-5.06) than those seeing dentists. There was a 4% to 23% chance of receiving quit advice at any given nondental clinical encounter; the odds of such counseling did not rise significantly with the number of visits. Conclusion. Smoking cessation counseling may be provided preferentially on the basis of patient demographics, and often is not provided at all. In a given year, just over half of smoking patients are advised to quit, and such counseling is provided at less than a quarter of clinical encounters.