Are physicians asking about tobacco use and assisting with cessation? Results from the 2001-2004 national ambulatory medical care survey (NAMCS)

Objective. The objective of this study was to determine if providers asked patients about tobacco and assisted tobacco users with cessation. Methods. The data source is the 2001-2004 National Ambulatory Medical Care Survey, which is an annual survey of outpatient visits. The prevalence of "asking" about tobacco use, providing "assistance" with tobacco cessation, and prescription of pharmacotherapy for cessation were estimated. A logistic regression model was fit to the data to determine if any variables were related to "asking" about tobacco use and providing "assistance" with cessation. Results. Overall, 32% of patient charts did not include information about tobacco use, 81% of smokers did not receive assistance and less than 2% received a prescription for pharmacotherapy. Asking about tobacco use varied with presence of chronic disease, cardiovascular disease counseling, geographical region, whether the physician was the patient's primary provider, time spent with physician, age, and gender. Providing assistance with cessation varied with the presence of chronic diseases, cardiovascular disease counseling, region of the country, provider type, insurance type, and time spent with the physician. Conclusions. Methods for improving adherence to the Clinical Practice Guideline for cessation, such as medical school curricula or educational programs for practicing providers, should be examined. (c) 2006 Elsevier Inc. All rights reserved.