Table 2.
Prevalence of primary care providers’ advice practices toward quitting a —DocStyles survey, 2011
| Characteristic | Ask | Advise | Assist | Arrange | ||||
|---|---|---|---|---|---|---|---|---|
| Asked about smoking | Advised to quit using tobacco b | Prescribed or recommended medication | Recommended coaching or counseling | Recommended coaching or counseling and medication | Recommended using telephone quitlines | Offered any assistance | Scheduled a follow-up | |
| % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | |
| Sex | ||||||||
| Men | 97.3 (96.0, 98.2) | 98.8 (97.8, 99.3) | 91.6 (89.3, 93.5) | 87.7 (85.5, 89.8) | 83.3 (80.5, 86.0) | 52.1 (48.8, 55.4) | 98.1 (96.9, 98.8) | 48.4 (45.1, 51.7) |
| Women | 96.8 (94.4, 98.1) | 98.1 (96.1, 99.1) | 95.3 (92.2, 97.2) | 88.9 (85.7, 92.1) | 87.5 (83.8, 91.3) | 59.2 (54.2, 64.2) | 98.9 (97.2, 99.6) | 47.0 (41.9, 52.1) |
| Age | ||||||||
| 26–35 | 98.6 (94.7, 99.7) | 98.6 (94.7, 99.7) | 91.7 (85.6, 95.3) | 91.8 (86.2, 95.3) | 84.8 (78.7, 91.0) | 69.4 (61.9, 76.8) | 99.3 (95.3, 99.9) | 61.2 (53.3, 69.1) |
| 36–45 | 98.0 (96.4, 98.9) | 98.3 (96.8, 99.1) | 92.5 (89.6, 94.6) | 88.7 (86.1, 91.4) | 84.5 (81.2, 87.9) | 52.3 (48.1, 56.5) | 98.3 (96.8, 99.1) | 48.8 (44.6, 53.0) |
| 46–55 | 95.9 (93.2, 97.5) | 99.1 (97.3, 99.7) | 92.8 (89.0, 95.4) | 89.1 (85.8, 92.4) | 85.7 (81.4, 89.9) | 53.8 (48.5, 59.1) | 99.7 (97.9, 100.0) | 43.5 (38.3, 48.8) |
| ≥56 | 96.0 (92.5, 97.9) | 98.2 (95.4, 99.3) | 93.9 (89.1, 96.7) | 82.2 (77.2, 87.2) | 82.4 (76.6, 88.2) | 49.3 (42.8, 55.9) | 95.6 (91.9, 97.6) | 44.0 (37.5, 50.5) |
| Race/ethnicity | ||||||||
| Non-Hispanic white | 97.0 (95.6, 98.0) | 98.5 (97.4, 99.1) | 94.4 (92.3, 96.0) | 88.7 (86.5, 90.8) | 87.2 (84.6, 89.9) | 53.5 (50.0, 56.9) | 98.5 (97.4, 99.1) | 44.8 (41.3, 48.2) |
| Non-Hispanic black | 100.0 (100.0, 100.0) | 96.4 (86.8, 99.1) | 91.5 (79.4, 96.8)c | 83.9 (74.3, 93.6)c | 78.7 (67.0, 90.4)c | 55.4 (42.3, 68.4)c | 96.4 (86.8, 99.1)c | 58.9 (46.0, 71.8)c |
| Hispanic | 96.8 (88.2, 99.2) | 98.4 (89.6, 99.8) | 93.6 (82.0, 97.9)c | 92.1 (82.3, 96.7)c | 87.2 (77.7, 96.8)c | 42.9 (30.6, 55.1) c | 98.4 (89.6, 99.8)c | 65.1 (53.3, 76.9)c |
| Non-Hispanic other | 97.0 (94.5, 98.4) | 99.1 (97.2, 99.7) | 89.3 (85.7, 92.8) | 86.4 (82.8, 90.1) | 79.5 (74.9, 84.1) | 57.8 (52.5, 63.1) | 98.2 (96.0, 99.2) | 50.6 (45.2, 56.0) |
| Primary care provider type | ||||||||
| Family/general practitioners | 96.1 (94.1, 97.4) | 98.6 (97.3, 99.3) | 94.0 (91.8, 95.7) | 90.4 (87.7, 92.5) | 86.0 (83.1, 88.8) | 61.1 (57.2, 65.1) | 98.8 (97.5, 99.4) | 53.1 (49.0, 57.1) |
| Internists | 98.1 (96.2, 99.0) | 98.8 (97.2, 99.5) | 90.9 (87.7, 93.3)d | 90.0 (86.7, 92.5) | 82.5 (78.9, 86.2)d | 50.5 (45.7, 55.3) | 99.0 (97.5, 99.6) | 56.0 (51.2, 60.7) |
| Obstetrician/gynecologists | 98.0 (95.3, 99.2) | 98.0 (95.3, 99.2) | 79.3 (74.3, 84.3) | 44.2 (38.1, 50.4) | 96.0 (92.8, 97.8) | 22.7 (17.5, 27.9) | ||
| Teaching privileges | ||||||||
| Yes | 97.2 (95.6, 98.2) | 98.3 (96.9, 99.0) | 92.9 (90.3, 94.9) | 86.3 (83.7, 89.0) | 84.0 (80.8, 87.3) | 54.2 (50.3, 58.0) | 98.3 (96.9, 99.0) | 51.3 (47.5, 55.2) |
| No | 97.1 (95.4, 98.2) | 98.9 (97.6, 99.5) | 92.5 (89.9, 94.5) | 89.8 (87.4, 92.2) | 85.0 (81.9, 88.1) | 54.2 (50.3, 58.2) | 98.4 (97.0, 99.1) | 44.5 (40.6, 48.4) |
| Type of practice | ||||||||
| Individual | 97.7 (94.7, 99.1) | 99.1 (96.5, 99.8) | 91.4 (86.3, 94.6) | 86.4 (81.9, 90.9) | 80.5 (74.8, 86.2) | 48.0 (41.4, 54.6) | 96.8 (93.5, 98.5) | 50.7 (44.1, 57.3) |
| Group | 96.9 (95.5, 97.9) | 98.6 (97.6, 99.2) | 94.1 (91.9, 95.7) | 88.8 (86.6, 91.0) | 86.4 (83.7, 89.1) | 54.7 (51.3, 58.1) | 98.9 (97.9, 99.4) | 46.6 (43.1, 50.0) |
| Hospital/clinic | 97.3 (94.1, 98.8) | 97.7 (94.7, 99.1) | 89.5 (85.2, 93.9) | 86.8 (82.3, 91.3) | 82.2 (76.8, 87.6) | 58.6 (52.1, 65.1) | 97.7 (94.7, 99.1) | 50.5 (43.8, 57.1) |
| Years in practice | ||||||||
| ≤5 | 98.2 (93.0, 99.5) | 99.1 (93.8, 99.9) | 92.2 (85.1, 96.0) | 89.9 (84.3, 95.6) | 83.3 (76.1, 90.6) | 61.5 (52.3, 70.6) | 100.0 (100.0, 100.0) | 61.5 (52.3, 70.6) |
| 6–10 | 96.9 (94.5, 98.3) | 98.3 (96.3, 99.2) | 91.4 (87.7, 94.1) | 90.4 (86.8, 93.0) | 82.8 (78.5, 87.0) | 57.2 (52.1, 62.4) | 98.6 (96.6, 99.4) | 50.7 (45.5, 55.9) |
| 11–20 | 98.1 (96.4, 99.0) | 98.5 (96.9, 99.3) | 94.2 (91.2, 96.2) | 89.0 (86.2, 91.8) | 88.1 (84.7, 91.4) | 54.4 (50.0, 58.9) | 98.5 (96.9, 99.3) | 47.9 (43.4, 52.4) |
| ≥21 | 95.6 (92.7, 97.4) | 98.7 (96.7, 99.5) | 92.4 (88.3, 95.2) | 83.4 (79.3, 87.5) | 81.9 (77.0, 86.8) | 48.0 (42.5, 53.4) | 97.2 (94.7, 98.5) | 40.4 (35.1, 45.8) |
| Number of physicians in practice | ||||||||
| 1–2 | 97.8 (95.4, 98.9) | 99.7 (97.8, 100.0) | 93.1 (89.2, 95.6) | 87.0 (83.3, 90.7) | 82.6 (78.0, 87.2) | 47.5 (42.0, 53.0) | 97.8 (95.4, 98.9) | 46.5 (41.0, 52.0) |
| 3–5 | 96.5 (94.0, 98.0) | 97.7 (95.4, 98.8) | 91.9 (88.0, 94.6) | 87.0 (83.4, 90.5) | 83.4 (79.0, 87.8) | 51.6 (46.3, 56.9) | 98.8 (97.0, 99.6) | 47.8 (42.6, 53.1) |
| 6–10 | 97.2 (94.2, 98.6) | 98.0 (95.2, 99.2) | 93.6 (89.0, 96.3) | 87.4 (83.3, 91.6) | 84.5 (79.3, 89.7) | 59.1 (53.0, 65.2) | 98.8 (96.3, 99.6) | 47.0 (40.7, 53.2) |
| 11–25 | 97.2 (93.5, 98.8) | 98.3 (95.0, 99.5) | 90.8 (85.1, 94.5) | 91.2 (86.1, 94.5) | 86.3 (80.8, 91.7) | 61.9 (54.8, 69.0) | 97.8 (94.3, 99.2) | 51.4 (44.1, 58.7) |
| ≥26 | 97.0 (92.9, 98.7) | 99.4 (95.8, 99.9) | 94.7 (89.3, 97.5) | 89.6 (85.0, 94.3) | 88.6 (83.2, 94.1) | 56.7 (49.1, 64.3) | 98.2 (94.5, 99.4) | 48.8 (41.1, 56.4) |
| Number of patients per week | ||||||||
| 1–75 | 96.7 (93.5, 98.3) | 99.2 (96.8, 99.8) | 87.4 (82.7, 92.0) | 87.6 (83.5, 91.8) | 80.8 (75.3, 86.3) | 55.4 (49.1, 61.6) | 97.1 (94.1, 98.6) | 40.9 (34.7, 47.1) |
| 76–100 | 97.3 (95.4, 98.4) | 98.3 (96.7, 99.2) | 93.4 (90.5, 95.5) | 89.4 (86.6, 92.1) | 86.0 (82.6, 89.4) | 58.5 (54.0, 62.9) | 98.5 (97.0, 99.3) | 48.2 (43.7, 52.7) |
| 101–150 | 97.5 (95.3, 98.6) | 98.7 (97.0, 99.5) | 96.4 (93.6, 98.0) | 87.3 (84.0, 90.6) | 87.5 (83.8, 91.2) | 49.5 (44.6, 54.4) | 98.5 (96.7, 99.3) | 47.0 (42.0, 51.9) |
| ≥151 | 96.4 (91.6, 98.5) | 97.8 (93.5, 99.3) | 89.7 (84.0, 95.5) | 86.2 (80.5, 92.0) | 77.6 (69.7, 85.5) | 50.7 (42.4, 59.1) | 99.3 (95.0, 99.9) | 62.3 (54.2, 70.4) |
| Total | 97.1 (96.0, 97.9) | 98.6 (97.7, 99.1) | 92.7 (90.9, 94.2) | 88.0 (86.2, 89.8) | 84.5 (82.3, 86.8) | 54.2 (51.4, 56.9) | 98.3 (97.4, 98.9) | 48.0 (45.2, 50.7) |
| N | 1,217 | 1,235 | 929 | 1,103 | 847 | 679 | 1,232 | 601 |
Notes: Physicians were first asked the Advise question: “For tobacco users who visited you over the last year, did you consistently recommend they quit using tobacco?” They were next asked the Ask question: “For patients who visited you over the last year, did you consistently ask and document whether they use tobacco?” The third question was for the Assist component: “For tobacco users who visited you over the last year, did you consistently try to help them quit tobacco by doing any of the following…”; respondents could select all that applied from the possible options: 1) providing coaching or counseling, 2) prescribing or recommending a tobacco cessation medication, or 3) asking them to call a tobacco quitline. The final question asked of primary care providers was for the Arrange component: “For tobacco users who visited you over the last year, did you consistently schedule a follow-up visit to help them quit tobacco?”.
CI confidence interval.
aQuestions asked of tobacco users who visited health care provider over the last year.
bThe sample size for Advise is greater than that for Ask because it was the first question asked of respondents.
cInterpretation may be limited as the sample size was <50.
dWe excluded obstetrician/gynecologists from the medication portion of the analysis because medication recommendations are not uniform across all populations (e.g., infants, children, and pregnant women). Calculations for prescribed or recommended medication, and recommended counseling and medication were obtained from 1,002 obstetrician/gynecologists.