Open AccessSmoking Status as a Vital Sign
Author(s) -
Ahluwalia Jasjit S.,
Gibson Cheryl A.,
Kenney R. Emmet,
Wallace Dennis D.,
Resnicow Ken
Publication year - 1999
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.1999.09078.x
Subject(s) - medicine , smoking cessation , confidence interval , odds ratio , intervention (counseling) , psychological intervention , family medicine , pediatrics , nursing , pathology
OBJECTIVE: We conducted this study to determine if a smoking status stamp would prompt physicians to increase the number of times they ask, advise, assist, and arrange follow‐up for African‐American patients about smoking‐related issues. DESIGN: An intervention study with a posttest assessment (after the physician visit) conducted over four 1‐month blocks. The control period was the first 2 weeks of each month, while the following 2 weeks served as the intervention period. SETTING: An adult walk‐in clinic in a large inner‐city hospital. PARTICIPANTS: We consecutively enrolled into the study 2,595 African‐American patients (1,229 intervention and 1,366 control subjects) seen by a housestaff physician. INTERVENTIONS: A smoking status stamp placed on clinic charts during the intervention period. MAIN RESULTS: Forty‐five housestaff rotated through the clinic in 1‐month blocks. In univariate analyses, patients were significantly more likely to be asked by their physicians if they smoke cigarettes during the intervention compared with the control period, 78.4% versus 45.6% (odds ratio [OR] 4.28; 95% confidence interval [CI] 3.58, 5.10). Patients were also more likely to be told by their physician to quit, 39.9% versus 26.9% (OR 1.81; 95% CI 1.36, 2.40), and have follow‐up arranged, 12.3% versus 6.2% (OR 2.16; 95% CI 1.30, 3.38). CONCLUSIONS: The stamp had a significant effect on increasing rates of asking about cigarette smoking, telling patients to quit, and arranging follow‐up for smoking cessation. However, the stamp did not improve the low rate at which physicians offered patients specific advice on how to quit or in setting a quit date.