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Table 2 Prevalence of primary care providers’ advice practices toward quitting a —DocStyles survey, 2011

From: Assessment of compliance with US Public Health Service Clinical Practice Guideline for tobacco by primary care physicians

Characteristic

Ask

Advise

Assist

    

Arrange

 

Asked about smoking

Advised to quit using tobacco b

Prescribed or recommended medication

Recommended coaching or counseling

Recommended coaching or counseling and medication

Recommended using telephone quitlines

Offered any assistance

Scheduled a follow-up

 

% (95% CI)

% (95% CI)

% (95% CI)

% (95% CI)

% (95% CI)

% (95% CI)

% (95% CI)

% (95% CI)

Sex

        

  Men

97.3 (96.0, 98.2)

98.8 (97.8, 99.3)

91.6 (89.3, 93.5)

87.7 (85.5, 89.8)

83.3 (80.5, 86.0)

52.1 (48.8, 55.4)

98.1 (96.9, 98.8)

48.4 (45.1, 51.7)

  Women

96.8 (94.4, 98.1)

98.1 (96.1, 99.1)

95.3 (92.2, 97.2)

88.9 (85.7, 92.1)

87.5 (83.8, 91.3)

59.2 (54.2, 64.2)

98.9 (97.2, 99.6)

47.0 (41.9, 52.1)

Age

        

  26–35

98.6 (94.7, 99.7)

98.6 (94.7, 99.7)

91.7 (85.6, 95.3)

91.8 (86.2, 95.3)

84.8 (78.7, 91.0)

69.4 (61.9, 76.8)

99.3 (95.3, 99.9)

61.2 (53.3, 69.1)

  36–45

98.0 (96.4, 98.9)

98.3 (96.8, 99.1)

92.5 (89.6, 94.6)

88.7 (86.1, 91.4)

84.5 (81.2, 87.9)

52.3 (48.1, 56.5)

98.3 (96.8, 99.1)

48.8 (44.6, 53.0)

  46–55

95.9 (93.2, 97.5)

99.1 (97.3, 99.7)

92.8 (89.0, 95.4)

89.1 (85.8, 92.4)

85.7 (81.4, 89.9)

53.8 (48.5, 59.1)

99.7 (97.9, 100.0)

43.5 (38.3, 48.8)

  ≥56

96.0 (92.5, 97.9)

98.2 (95.4, 99.3)

93.9 (89.1, 96.7)

82.2 (77.2, 87.2)

82.4 (76.6, 88.2)

49.3 (42.8, 55.9)

95.6 (91.9, 97.6)

44.0 (37.5, 50.5)

Race/ethnicity

        

  Non-Hispanic white

97.0 (95.6, 98.0)

98.5 (97.4, 99.1)

94.4 (92.3, 96.0)

88.7 (86.5, 90.8)

87.2 (84.6, 89.9)

53.5 (50.0, 56.9)

98.5 (97.4, 99.1)

44.8 (41.3, 48.2)

  Non-Hispanic black

100.0 (100.0, 100.0)

96.4 (86.8, 99.1)

91.5 (79.4, 96.8)c

83.9 (74.3, 93.6)c

78.7 (67.0, 90.4)c

55.4 (42.3, 68.4)c

96.4 (86.8, 99.1)c

58.9 (46.0, 71.8)c

  Hispanic

96.8 (88.2, 99.2)

98.4 (89.6, 99.8)

93.6 (82.0, 97.9)c

92.1 (82.3, 96.7)c

87.2 (77.7, 96.8)c

42.9 (30.6, 55.1) c

98.4 (89.6, 99.8)c

65.1 (53.3, 76.9)c

  Non-Hispanic other

97.0 (94.5, 98.4)

99.1 (97.2, 99.7)

89.3 (85.7, 92.8)

86.4 (82.8, 90.1)

79.5 (74.9, 84.1)

57.8 (52.5, 63.1)

98.2 (96.0, 99.2)

50.6 (45.2, 56.0)

Primary care provider type

        

  Family/general practitioners

96.1 (94.1, 97.4)

98.6 (97.3, 99.3)

94.0 (91.8, 95.7)

90.4 (87.7, 92.5)

86.0 (83.1, 88.8)

61.1 (57.2, 65.1)

98.8 (97.5, 99.4)

53.1 (49.0, 57.1)

  Internists

98.1 (96.2, 99.0)

98.8 (97.2, 99.5)

90.9 (87.7, 93.3)d

90.0 (86.7, 92.5)

82.5 (78.9, 86.2)d

50.5 (45.7, 55.3)

99.0 (97.5, 99.6)

56.0 (51.2, 60.7)

  Obstetrician/gynecologists

98.0 (95.3, 99.2)

98.0 (95.3, 99.2)

 

79.3 (74.3, 84.3)

 

44.2 (38.1, 50.4)

96.0 (92.8, 97.8)

22.7 (17.5, 27.9)

Teaching privileges

        

  Yes

97.2 (95.6, 98.2)

98.3 (96.9, 99.0)

92.9 (90.3, 94.9)

86.3 (83.7, 89.0)

84.0 (80.8, 87.3)

54.2 (50.3, 58.0)

98.3 (96.9, 99.0)

51.3 (47.5, 55.2)

  No

97.1 (95.4, 98.2)

98.9 (97.6, 99.5)

92.5 (89.9, 94.5)

89.8 (87.4, 92.2)

85.0 (81.9, 88.1)

54.2 (50.3, 58.2)

98.4 (97.0, 99.1)

44.5 (40.6, 48.4)

Type of practice

        

  Individual

97.7 (94.7, 99.1)

99.1 (96.5, 99.8)

91.4 (86.3, 94.6)

86.4 (81.9, 90.9)

80.5 (74.8, 86.2)

48.0 (41.4, 54.6)

96.8 (93.5, 98.5)

50.7 (44.1, 57.3)

  Group

96.9 (95.5, 97.9)

98.6 (97.6, 99.2)

94.1 (91.9, 95.7)

88.8 (86.6, 91.0)

86.4 (83.7, 89.1)

54.7 (51.3, 58.1)

98.9 (97.9, 99.4)

46.6 (43.1, 50.0)

  Hospital/clinic

97.3 (94.1, 98.8)

97.7 (94.7, 99.1)

89.5 (85.2, 93.9)

86.8 (82.3, 91.3)

82.2 (76.8, 87.6)

58.6 (52.1, 65.1)

97.7 (94.7, 99.1)

50.5 (43.8, 57.1)

Years in practice

        

  ≤5

98.2 (93.0, 99.5)

99.1 (93.8, 99.9)

92.2 (85.1, 96.0)

89.9 (84.3, 95.6)

83.3 (76.1, 90.6)

61.5 (52.3, 70.6)

100.0 (100.0, 100.0)

61.5 (52.3, 70.6)

  6–10

96.9 (94.5, 98.3)

98.3 (96.3, 99.2)

91.4 (87.7, 94.1)

90.4 (86.8, 93.0)

82.8 (78.5, 87.0)

57.2 (52.1, 62.4)

98.6 (96.6, 99.4)

50.7 (45.5, 55.9)

  11–20

98.1 (96.4, 99.0)

98.5 (96.9, 99.3)

94.2 (91.2, 96.2)

89.0 (86.2, 91.8)

88.1 (84.7, 91.4)

54.4 (50.0, 58.9)

98.5 (96.9, 99.3)

47.9 (43.4, 52.4)

  ≥21

95.6 (92.7, 97.4)

98.7 (96.7, 99.5)

92.4 (88.3, 95.2)

83.4 (79.3, 87.5)

81.9 (77.0, 86.8)

48.0 (42.5, 53.4)

97.2 (94.7, 98.5)

40.4 (35.1, 45.8)

Number of physicians in practice

        

  1–2

97.8 (95.4, 98.9)

99.7 (97.8, 100.0)

93.1 (89.2, 95.6)

87.0 (83.3, 90.7)

82.6 (78.0, 87.2)

47.5 (42.0, 53.0)

97.8 (95.4, 98.9)

46.5 (41.0, 52.0)

  3–5

96.5 (94.0, 98.0)

97.7 (95.4, 98.8)

91.9 (88.0, 94.6)

87.0 (83.4, 90.5)

83.4 (79.0, 87.8)

51.6 (46.3, 56.9)

98.8 (97.0, 99.6)

47.8 (42.6, 53.1)

  6–10

97.2 (94.2, 98.6)

98.0 (95.2, 99.2)

93.6 (89.0, 96.3)

87.4 (83.3, 91.6)

84.5 (79.3, 89.7)

59.1 (53.0, 65.2)

98.8 (96.3, 99.6)

47.0 (40.7, 53.2)

  11–25

97.2 (93.5, 98.8)

98.3 (95.0, 99.5)

90.8 (85.1, 94.5)

91.2 (86.1, 94.5)

86.3 (80.8, 91.7)

61.9 (54.8, 69.0)

97.8 (94.3, 99.2)

51.4 (44.1, 58.7)

  ≥26

97.0 (92.9, 98.7)

99.4 (95.8, 99.9)

94.7 (89.3, 97.5)

89.6 (85.0, 94.3)

88.6 (83.2, 94.1)

56.7 (49.1, 64.3)

98.2 (94.5, 99.4)

48.8 (41.1, 56.4)

Number of patients per week

        

  1–75

96.7 (93.5, 98.3)

99.2 (96.8, 99.8)

87.4 (82.7, 92.0)

87.6 (83.5, 91.8)

80.8 (75.3, 86.3)

55.4 (49.1, 61.6)

97.1 (94.1, 98.6)

40.9 (34.7, 47.1)

  76–100

97.3 (95.4, 98.4)

98.3 (96.7, 99.2)

93.4 (90.5, 95.5)

89.4 (86.6, 92.1)

86.0 (82.6, 89.4)

58.5 (54.0, 62.9)

98.5 (97.0, 99.3)

48.2 (43.7, 52.7)

  101–150

97.5 (95.3, 98.6)

98.7 (97.0, 99.5)

96.4 (93.6, 98.0)

87.3 (84.0, 90.6)

87.5 (83.8, 91.2)

49.5 (44.6, 54.4)

98.5 (96.7, 99.3)

47.0 (42.0, 51.9)

  ≥151

96.4 (91.6, 98.5)

97.8 (93.5, 99.3)

89.7 (84.0, 95.5)

86.2 (80.5, 92.0)

77.6 (69.7, 85.5)

50.7 (42.4, 59.1)

99.3 (95.0, 99.9)

62.3 (54.2, 70.4)

Total

97.1 (96.0, 97.9)

98.6 (97.7, 99.1)

92.7 (90.9, 94.2)

88.0 (86.2, 89.8)

84.5 (82.3, 86.8)

54.2 (51.4, 56.9)

98.3 (97.4, 98.9)

48.0 (45.2, 50.7)

N

1,217

1,235

929

1,103

847

679

1,232

601

  1. Notes: Physicians were first asked the Advise question: “For tobacco users who visited you over the last year, did you consistently recommend they quit using tobacco?” They were next asked the Ask question: “For patients who visited you over the last year, did you consistently ask and document whether they use tobacco?” The third question was for the Assist component: “For tobacco users who visited you over the last year, did you consistently try to help them quit tobacco by doing any of the following…”; respondents could select all that applied from the possible options: 1) providing coaching or counseling, 2) prescribing or recommending a tobacco cessation medication, or 3) asking them to call a tobacco quitline. The final question asked of primary care providers was for the Arrange component: “For tobacco users who visited you over the last year, did you consistently schedule a follow-up visit to help them quit tobacco?”.
  2. CI confidence interval.
  3. aQuestions asked of tobacco users who visited health care provider over the last year.
  4. bThe sample size for Advise is greater than that for Ask because it was the first question asked of respondents.
  5. cInterpretation may be limited as the sample size was <50.
  6. dWe excluded obstetrician/gynecologists from the medication portion of the analysis because medication recommendations are not uniform across all populations (e.g., infants, children, and pregnant women). Calculations for prescribed or recommended medication, and recommended counseling and medication were obtained from 1,002 obstetrician/gynecologists.