NCHS Data Brief ■ No. 174 ■ December 2014

u.s. department of health and human services

centers for disease control and prevention

national center for health statistics

Discussions Between Health Care Providers and Their 

Patients Who Smoke Cigarettes

Colleen N. Nugent, Ph.D.; Charlotte A. Schoenborn, M.P.H.; and Anjel Vahratian, Ph.D.

Key findings 

Data from the National 

Health Interview Survey, 

2011–2013

• About one-half of adult 

cigarette smokers had a doctor 

or other health professional talk 

to them about their smoking in 

the past 12 months. 

• Men, younger adults, 

Hispanic adults, and nonHispanic Asian adults were 

less likely than other cigarette 

smokers to have had a health 

professional talk to them about 

their smoking.

• Healthier smokers, younger 

smokers, and those who did 

not smoke cigarettes every 

day were less likely than other 

cigarette smokers to have had a 

health professional talk to them 

about their smoking.

• Cigarette smokers with 

selected health conditions 

linked to smoking were more 

likely than those without these 

conditions to have had a health 

professional talk to them about 

their smoking.

Smoking is the primary cause of preventable death in the United States (1). 

Studies show that a majority of smokers would like to quit (2) and that even 

simple advice from physicians has a positive effect on cessation rates (3). 

Federal and nonprofit agencies have recommended screening and 

identification of smokers by clinicians and health care delivery systems, as 

well as intervention and guidance on quitting (4–6). Studies suggest that 

older persons (2,7–11), women (2,7–9), heavier smokers, and those in poorer 

health (4,7,10–11) are more likely to receive medical advice to quit smoking. 

This report extends earlier research by identifying key population and health 

characteristics associated with those U.S. cigarette smokers aged 18 and over 

who had a health professional talk to them about their smoking. 

Keywords: smoking • screening • prevention • National Health Interview 

Survey

About one-half of adult cigarette smokers had a doctor or 

other health professional talk to them about their smoking, 

although prevalence varied by population subgroup. 

 
NCHS Data Brief ■ No. 174 ■ December 2014

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• Male smokers (45.5%) were less likely than female smokers (58.3%) to have had a doctor or 

other health professional talk to them about their smoking in the past 12 months (Figure 1). 

• The percentage of smokers who had a health professional talk to them about their smoking 

increased with age, from 38.3% of those aged 18–24 to 65.7% of those aged 65 and over.

• Hispanic smokers (38.7%) and non-Hispanic Asian smokers (41.0%) were less likely than 

smokers in other race/ethnicity groups to have had a health professional talk to them about 

their smoking.

For both women and men, the percentage of smokers who had a doctor or 

other health professional talk to them about their smoking in the past 12 

months increased with age. 

• Younger female smokers (aged 18–24 and 25–44) were less likely than older female 

smokers (aged 45–64 and 65 and over) to have had a doctor or other health professional talk 

to them about their smoking in the past 12 months (Figure 2). 

• Less than one-third of male smokers aged 18–24 had a health professional talk to them 

about their smoking, compared with nearly two-thirds of men aged 65 and over.

• Among adult smokers under age 65, women were more likely than men to have had a health 

professional talk to them about their smoking.

• Among smokers aged 65 and over, men (66.1%) and women (65.2%) were equally likely to 

have had a health professional talk to them about their smoking.

 
NCHS Data Brief ■ No. 174 ■ December 2014

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Cigarette smokers in excellent or very good health were less likely than 

those in worse health to have had a health professional talk to them about 

their smoking, regardless of age. 

• For each category of health status, the percentage of smokers who had a doctor or other 

health professional talk to them about their smoking in the past 12 months increased with 

age (Figure 3).

• Among those aged 45–64 and 65 and over, nearly three-quarters of those in fair or poor 

health had a doctor or other health professional talk to them about their smoking, compared 

with about one-half of those in excellent or very good health. 

• Among smokers aged 18–24, just over one-half of those in fair or poor health (53.5%) had 

a health professional talk to them about their smoking, compared with 34.9% of those who 

were in excellent or very good health. Among smokers aged 25–44, those in fair or poor 

health (60.0%) were more likely than those in excellent or very good health (41.1%) to have 

been talked to by a health professional.

 
NCHS Data Brief ■ No. 174 ■ December 2014

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Cigarette smokers who smoked on some days were less likely than those 

who smoked every day to have had a health professional talk to them about 

their smoking, regardless of health status.

• Among both every day and some day smokers, those in excellent or very good health 

were less likely than those in good, fair, or poor health to have had a doctor or other health 

professional talk to them about their smoking in the past 12 months (Figure 4).

• The percentage of cigarette smokers who had a health professional talk to them about their 

smoking was highest for every day smokers in fair or poor health (71.0%) and lowest for 

some day smokers in excellent or very good health (31.9%).

 
NCHS Data Brief ■ No. 174 ■ December 2014

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Cigarette smokers with selected health conditions that have been linked to 

smoking were more likely than smokers without these conditions to have 

had a health professional talk to them about their smoking. 

• Among cigarette smokers who had diabetes or a smoking-related cancer, more than threequarters had a doctor or other health professional talk to them about their smoking in 

the past 12 months, compared with about one-half of smokers who did not have these 

conditions (Figure 5).

• Among smokers who had a respiratory condition or a heart condition, almost 70% had 

a health professional talk to them about their smoking, compared with less than 50% of 

smokers who did not have these conditions.

 

Summary

Increasing tobacco screening in health care settings is a Healthy People 2020 objective (12). This 

report looks at adult cigarette smokers in the general household population and whether a doctor 

or other health professional had talked to them about their smoking in the past 12 months. 

About one-half of all adult cigarette smokers (51.2%) had a doctor or other health professional 

talk to them about their smoking. Cigarette smokers who were male, younger, Hispanic, or 
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NCHS Data Brief ■ No. 174 ■ December 2014

non-Hispanic Asian were less likely than those who were female, older, non-Hispanic white, nonHispanic black, or non-Hispanic other races/multiple races to have had a doctor or other health 

professional talk to them about their smoking. Despite the public health significance of reducing 

smoking among women who either are or may become pregnant (1), women of childbearing age 

(18–44 years) were no more likely than the population overall to have been talked to about their 

smoking. Nondaily smokers, smokers in good or better general health, and those without selected 

health conditions linked to smoking, were less likely than those who smoked daily, were in fair 

or poor health, or had selected health conditions linked to smoking to have had a doctor or other 

health professional talk to them about their smoking.

Overall, results reveal that cigarette smokers are not all treated the same when it comes to 

health professionals talking to them about their smoking. Clinical practice guidelines suggest 

that tobacco interventions delivered in a timely manner can greatly reduce the risk that smokers 

will suffer from smoking-related diseases (4). The present results identify apparent gaps in 

the application of recommendations for the screening of cigarette smokers by health care 

professionals.

Definitions

Cigarette smoker: An adult aged 18 or over who has smoked at least 100 cigarettes in his or her 

lifetime and now smokes cigarettes every day or some days.

Health status: Family respondents were asked to assess the health of all family members, 

specifically, whether their “health in general is excellent, very good, good, fair, or poor?” When 

the sample adult is not the family respondent, this information is proxy-reported.

Heart condition: Includes ever having had coronary heart disease, angina, other heart condition, 

heart attack, stroke, or hypertension. 

Lung condition: Includes current asthma, chronic bronchitis in the past year, and ever having had 

emphysema. Lung cancer was not included in this category. 

Smoking-related cancer: Includes ever having had any of the following cancers for which the 

50th Anniversary Surgeon General’s Report (1) lists a causal link to smoking: bladder, cervix, 

colon, esophagus, kidney, larynx, liver, lung, pancreas, rectum, stomach, and throat.

Data source and methods

The National Health Interview Survey (NHIS) is a nationally representative survey of the civilian 

noninstitutionalized population of the United States. It is conducted continuously throughout 

the year for the Centers for Disease Control and Prevention’s (CDC) National Center for Health 

Statistics (NCHS). NHIS is an in-person interview conducted in the respondent’s home. In 

some instances, follow-up to complete the interview is by telephone. The survey consists of (a) 

a Family Core component, with questions asked about all members of the family; (b) a Sample 

Adult component, which collects additional information from one randomly selected adult per 

family (self-response required); and (c) a Sample Child component, which collects additional 

information about one randomly selected child per family. Data for this analysis come from the 

Sample Adult and Family Core (person file) components of the 2011–2013 NHIS. For more 

information about NHIS, visit http://www.cdc.gov/nchs/nhis.htm. 
NCHS Data Brief ■ No. 174 ■ December 2014

■ 7  ■

All current cigarette smokers were asked, “During the past 12 months, has a doctor or other 

health professional talked to you about your smoking?” Figures show the percentage of current 

smokers who responded “yes” to this question, by selected characteristics. No additional 

questions were asked about the content of the smoking-related conversation. The study population 

included all current cigarette smokers, regardless of whether they had seen a doctor or other 

health professional in the past 12 months. The focus was on identifying cigarette smokers who 

had not had a conversation with a health professional about their smoking; this included both 

those who saw a professional but smoking was not discussed and those who did not seek medical 

care and thus were not exposed to such conversations. 

NHIS is designed to yield a nationally representative sample, and this analysis used weights 

to produce national estimates. The sample design is described in more detail elsewhere (13). 

Point estimates and estimates of corresponding variances were calculated using the SUDAAN 

software package (14) to account for the complex sample design of NHIS. The Taylor series 

linearization method was used for variance estimation. All estimates shown meet the NCHS 

standard for reliability (having a relative standard error less than or equal to 30%). Linear trends 

and differences between percentages were evaluated using two-sided significance tests at the 0.05 

level.

About the authors

Colleen N. Nugent, Charlotte A. Schoenborn, and Anjel Vahratian are with CDC’s National 

Center for Health Statistics, Division of Health Interview Statistics.

References

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pdfs/2014/comprehensive.pdf. 
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Suggested citation

Nugent CN, Schoenborn CA, Vahratian A. 

Discussions between health care providers 

and their patients who smoke cigarettes. 

NCHS data brief, no 174. Hyattsville, MD: 

National Center for Health Statistics. 2014.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Interview Statistics

Marcie L. Cynamon, Acting Director

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