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AJPH First Look, published online ahead of print May 11, 2005
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American Journal of Public Health, 10.2105/AJPH.2004.039909

Research and Practice

Patient Smoking Cessation Advice by Health Care Providers: the Role of Ethnicity, Socioeconomic Status, and Health

Thomas K Houston 1*, Isabel C Scarinci 1, Sharina D Person 1, Paul G Greene 2

1 University of Alabama at Birmingham
2 University of Arkansas for Medical Sciences

* To whom correspondence should be addressed. E-mail: tkhouston{at}uabmc.edu.


  Abstract

Objectives: To examine whether ethnicity is associated with ever receiving smoking advice by health care providers, and then to evaluate whether socioeconomic status and health status are moderators of an association of ethnicity and smoking advice. Methods: We used data Behavioral Risk Factor Surveillance Survey, a population-based cross-sectional survey (Year 2000). Results: After adjusting for the complex survey design, 71% of the 14,089 current smokers reported ever being advised to quit smoking by a provider. Hispanics (57%), African-Americans (64%), and Native Americans (66%) less frequently reported ever being advised to quit compared with Whites (73%, p < 0.01 for each). Ethnic minority status, lower education, and poorer health status remained significantly associated with lower rates of advice to quit after adjustment for number of cigarettes, time from last provider visit, income, comorbidities, health insurance, gender, and age. In stratified analyses, differences between African-Americans and Whites were greater among those with lower income and those without health insurance. Compared with Whites, differences in smoking counseling for both Hispanics and African-Americans were also greater among those with lower education. Conclusion: We found lower rates of smoking cessation advice among ethnic minorities. However, we also found complex interactions of ethnicity with socio-economic factors.

Key Words: Health Professionals, Quality of Care, Race/Ethnicity, Socioeconomic Factors, Tobacco Control, Tobacco




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