DEMOGRAPHIC BIAS IN PHYSICIAN SMOKING CESSATION COUNSELING

To determine if smoking cessation counseling is affected by physician or patient demographics, patient exit interviews and chart audits were administered between January 1991, and February 1992, in an inner-cit y teaching clinic. Patients who received medical care on an ongoing ba sis in the clinic were eligible for the study, Patients with dementia or inability to verbally communicate in English were excluded. Accordi ng to patient self-report, 26% (167) of the 642 patients who participa ted were never asked about smoking, Of the 168 current smokers, 23% (3 9) were never advised to quit, Male patients were more likely to repor t being asked about smoking on the day of the clinic visit (odds ratio = 2.37, 95% confidence interval [CI] = 1.62 to 3.46). Male smokers we re more likely to report being advised to quit (odds ratio 2.39, 95% C I = 1.25 to 4.58), as were white smokers (odds ratio 3.66, 95% CI = 1. 37 to 9.82), According to patient report (smokers and nonsmokers), whi te physicians were more apt to ask about smoking on the day of the cli nic visit (odds ratio = 2.68, 95% CI = 1.31 to 5.48), Physician and pa tient demographic characteristics may significantly influence the rate of smoking cessation counseling. Additional studies are needed to con firm the presence of such biases.