Patient smoking cessation advice by health care providers: the role of ethnicity, socioeconomic status, and health

Am J Public Health. 2005 Jun;95(6):1056-61. doi: 10.2105/AJPH.2004.039909.


Objectives: We assessed differences by ethnicity in ever receiving advice from providers to quit smoking. We evaluated whether socioeconomic status and health status were moderators of the association.

Methods: We used 2000 Behavioral Risk Factor Surveillance Survey data, a population-based cross-sectional survey.

Results: After adjusting for complex survey design, 69% of the 14089 current smokers reported ever being advised to quit by a provider. Hispanics (50%) and African Americans (61%) reported receiving smoking counseling less frequently compared with Whites (72%, P<.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. Smoking counseling differences between African Americans and Whites were greater among those with lower income and those without health insurance. Compared with Whites, differences 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 socioeconomic factors.

MeSH terms

  • Adult
  • Aged
  • Behavioral Risk Factor Surveillance System
  • Counseling / statistics & numerical data*
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Status
  • Humans
  • Income
  • Male
  • Middle Aged
  • Patient Education as Topic / methods
  • Patient Education as Topic / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Smoking Cessation / ethnology
  • Smoking Cessation / statistics & numerical data*
  • Social Class*
  • United States