How People Are Smoking and Quitting in the United States

Abstract

PURPOSE: Tobacco use is associated with numerous illnesses, and treatment of smoking related diseases costs over $190 billion/year in the United States. The purpose of this study is to evaluate what methods ex-smokers used to stop smoking and to see if physicians advise smokers to stop and what methods they recommend. METHODS: A nationally representative telephone survey with random digit dialing was performed on 777 current and ex-smokers. Information was gathered on patient demographics, smoking status, smoking cessation attempts, physician recommendations regarding smoking cessation approaches, methods employed to stop smoking, and associated cessation treatments. Chi square analysis was utilized to compare differences in current smokers and ex-smokers regarding physician recommendations for smoking cessation and cessation approach. RESULTS: Of 777 participants, 284 (37%) were current smokers and 493 (63%)were ex-smokers. Both groups had a similar gender distribution and started smoking at similar ages. Former smokers were older and had higher levels of education compared to current smokers (p<0.0001). Among current smokers, 66% reported that a physician advised them to stop smoking during the previous year, with the cold turkey approach and any evidence based therapy being recommended 19% and 61% of the time, respectively. Nicotine replacement therapy was advised 52% of the time, and medications were advised 40% of the time. Former smokers reported that they were significantly more likely to have attempted a cold turkey approach to smoking cessation (p<0.0001) and less likely to have tried evidencebased therapies to stop smoking compared to current smokers (p<0.0001). CONCLUSIONS: Patients report that that clinicians make inquiries regarding patient smoking status and recommend smoking cessation; however, it appears that many patients are given improper cessation techniques. According to participants, clinicians recommend a 'cold turkey' approach to smoking cessation in 19% of cases, but its success rate is less than 10% at 1 year. Based on the survey results, it is unclear if patient's are receiving appropriate information and/or education regarding smoking cessation therapy. CLINICAL IMPLICATIONS: Greater efforts should be made by clinicians to ensure that patients receive appropriate evidence based therapy for smoking cessation.