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Healthcare provider smoking cessation advice among US worker groups
  1. David J Lee1,2,
  2. Lora E Fleming1,2,
  3. Kathryn E McCollister2,
  4. Alberto J Caban2,
  5. Kristopher L Arheart2,
  6. William G LeBlanc2,
  7. Katherine Chung-Bridges2,
  8. Sharon L Christ3,
  9. Noella Dietz1,
  10. John D Clark III1
  1. 1Sylvester Comprehensive Cancer, University of Miami, Miller School of Medicine, PO Box 016069 (R-669), Miami, FL 33143, USA
  2. 2Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, PO Box 016069 (R-669), Miami, FL 33143, USA
  3. 3University of North Carolina at Chapel Hill, Odum Institute for Research in Social Science, Manning Hall, CB#3355, Chapel Hill, NC 27599-3355, USA
  1. Correspondence to:
 David J Lee PhD
 University of Miami School of Medicine, Department of Epidemiology and Public Health, PO Box 016069 (R-669), Miami, FL 33101, USA; dlee{at}


Objective: Among workers in dusty occupations, tobacco use is particularly detrimental to health because of the potential synergistic effects of occupational exposures (for example, asbestos) in causing disease. This study explored the prevalence of smoking and the reported smoking cessation discussion with a primary healthcare provider (HCP) among a representative sample of currently employed US worker groups.

Methods: Pooled data from the 1997–2003 National Health Interview Survey (NHIS) were used to estimate occupation specific smoking rates (n = 135 412). The 2000 NHIS Cancer Control Module was used to determine (among employed smokers with HCP visits) the prevalence of being advised to quit smoking by occupation (n = 3454).

Results: The average annual prevalence of current smoking was 25% in all workers. In 2000, 84% of smokers reported visiting an HCP during the past 12 months; 53% reported being advised by their physician to quit smoking (range 42%–66% among 30 occupations). However, an estimated 10.5 million smokers were not advised to quit smoking by their HCP. Workers with potentially increased occupational exposure to dusty work environments (including asbestos, silica, particulates, etc), at high risk for occupational lung disease and with high smoking prevalence, had relatively low reported discussions with an HCP about smoking cessation, including farm workers (30% overall smoking prevalence; 42% told to quit), construction and extractive trades (39%; 46%), and machine operators/tenderers (34%; 44%).

Conclusion: The relatively low reported prevalence of HCP initiated smoking cessation discussion, particularly among currently employed workers with potentially synergistic occupational exposures and high current smoking prevalence, needs to be addressed through educational campaigns targeting physicians and other HCPs.

  • BRFSS, Behavioral Risk Factor Surveillance System
  • HCP, healthcare provider
  • JCAHO, Joint Commission on Accreditation of Healthcare Organizations
  • NCHS, National Center for Health Statistics
  • NCQA, National Committee for Quality Assurance
  • NHIS, National Health Interview Survey
  • occupational health
  • National Health Interview Survey
  • tobacco use

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