PHYSICIAN ADVICE TO QUIT SMOKING - RESULTS FROM THE 1990 CALIFORNIA TOBACCO SURVEY

objective: To estimate the percentage of California smokers who visit physicians each year and thus determine the extent of the opportunity for physicians to advise their smoking patients to quit; to identify s ociodemographic and other characteristics related to smokers' reportin g that advice was given; and to look for evidence that physician advic e influences quitting behavior. Setting and design: Data were collecte d as part of the 1990 California Tobacco Survey, a large (n = 24,296) population-based telephone survey. Participants: 9,796 current smokers , including 5,5 59 daily smokers who had visited a physician in the pr eceding year. Measurements and main results: Two-thirds of all smokers had visited a physician in the year before the interview, but only ab out 50% of Hispanic and Asian smokers had done so. Multivariate analys is showed that advice at the last visit was independently related to o lder age. higher cigarette consumption, and poorer perceived health. C ompared with smokers never advised to quit by a physician, those advis ed to quit at the last visit were 1.61 (95% confidence interval, 1.31 - 1.98) times more likely to report a quit attempt in the preceding ye ar and 1.90 (95% confidence interval, 1.45 - 2.48) times more likely t o be preparing to quit; however, those advised previously but not at t he last visit showed no more quitting activity than did smokers never advised to quit. Conclusion: Physicians have considerable opportunity to reach all demographic subgroups of the population, but the nature o f the subgroups advised most (those who are older, have high consumpti on of cigarettes, or have poor health) suggests that physicians tend t o treat such advice as a therapeutic rather than a preventive interven tion. Physician advice at the most recent visit encourages patients to think about quitting and probably leads to quit attempts. Thus, it is vital that physicians perform the simple intervention of advising eve ry smoker to quit at every visit.