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Observational Study
. 2020 Jan;35(1):43-50.
doi: 10.1007/s11606-019-05111-6. Epub 2019 Jun 21.

Provider-Patient Discussions About Smoking and the Impact of Lung Cancer Screening Guidelines: NHIS 2011-2015

Jinhai Huo  1 , Tong Han Chung  2 , Bumyang Kim  3 , Ashish A Deshmukh  4 , Ramzi G Salloum  5 , Jiang Bian  5
Affiliations
Observational Study

Provider-Patient Discussions About Smoking and the Impact of Lung Cancer Screening Guidelines: NHIS 2011-2015

Jinhai Huo et al. J Gen Intern Med. 2020 Jan.

Abstract

Background: Clinical practice guidelines for treating tobacco use and lung cancer screening guidelines recommend smoking cessation counseling to current smokers by health care professionals.

Objective: Our objective was to determine the contemporary patterns of current smokers' discussions about smoking with their health care professionals in the USA.

Design, setting, and participants: We conducted an observational study of 30,132 current smokers (weighted sample 40,126,006) for the years 2011 to 2015 using data from the National Health Interview Survey.

Main measures: Our main outcome was the proportion of current smokers who had discussions about smoking with their health care professionals. We used the Cochran-Armitage trend test to evaluate the temporal trends in current smokers' discussions about smoking, and used a multivariable logistic model to determine the predictors of discussions about smoking, controlling for smokers' demographics, health status, and receipts of lung cancer screening.

Key results: Our study found the proportion of current smokers who had discussions about smoking with their health care professionals increased from 51.3% in 2011 to 55.4% in 2015 (P-trend < 0.0001). However, about 15% of current smokers who underwent lung cancer screening did not have or could not recall discussions about smoking with their health care professionals. In multivariable analyses and sensitivity analysis, the predictors of discussions about smoking were being a heavy smoker, receipt of lung cancer screening, being non-Hispanic white, having a physician office visit in the past year, being diagnosed with respiratory conditions, having fair or poor health, and having insurance coverage.

Conclusions: The results demonstrated a steady but slow increase in current smokers' discussions about smoking with their health care professionals in recent years, especially among heavy smokers. More than 40% of current smokers did not have or could not recall any discussions about smoking with their health care professionals.

Keywords: communication; current smoker; lung cancer screening; smoking.

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Conflict of interest statement

The authors declare that they do not have a conflict of interest.

Figures

Figure 1
Figure 1
Trends in the proportion of smokers who had discussions with their health care professional about smoking between 2011 and 2015: National Health Interview Survey.
Figure 2
Figure 2
Trends in the proportion of smokers who had discussions with their health care professional about smoking, stratified by eligibility for lung cancer screening between 2011 and 2015: National Health Interview Survey.
Figure 3
Figure 3
The proportion of smokers who had discussions with their health care professional about smoking, stratified by age group and insurance status: National Health Interview Survey 2011–2015.
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