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Yuhua Bao, Ph.D. Naihua Duan, Ph.D. Sarah Fox, Ed.D. UCLA Academy Health Annual Research Meeting

Is Some Physician Advice on Smoking Cessation Better Than No Advice? A n Instrumental Variable Analysis of the 2001 National Health Interview Survey. Yuhua Bao, Ph.D. Naihua Duan, Ph.D. Sarah Fox, Ed.D. UCLA Academy Health Annual Research Meeting June 6, 2004.

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Yuhua Bao, Ph.D. Naihua Duan, Ph.D. Sarah Fox, Ed.D. UCLA Academy Health Annual Research Meeting

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  1. Is Some Physician Advice on Smoking Cessation Better Than No Advice?An Instrumental Variable Analysis of the 2001 National Health Interview Survey Yuhua Bao, Ph.D. Naihua Duan, Ph.D. Sarah Fox, Ed.D. UCLA Academy Health Annual Research Meeting June 6, 2004

  2. One-third smoking patients do not receive any medical advice to quit smoking • Nearly 1/4 of American adults remain smokers in 2001 • Of all the adult smokers, 65% had some contact with health care providers annually. However, • About 1/3 of these smoking patients were not advised to quit by their providers.

  3. Providers lack confidence in the effectiveness of their advice • Various barriers exist in providers’ intervention for smoking cessation • One barrier is providers’ lack of confidence • Disbelief that their advice would deter patients • Belief that successful intervention requires excessive time commitment • Few have studied the effectiveness of provider advice performed in routine practice.

  4. Advice compared to “routine care” Well-defined intervention modalities, certain length of discussion by certain type of providers Advice only Choose between advice and no advice Develop strategies suitable for their own practice Provide advice and additional help as needed Why is evidence from RCTs not enough? RCTs tell the effectiveness of … Practitioners need to …

  5. Data: NHIS 2001 Sample Adult File Adults Who were either current smokers or quit smoking during the last 12 months, and Who had contact with their regular health providers in the past 12 months

  6. Patients advised vs. not advised Source: NHIS 2001 * p<0.1; **p<0.05; ***p<0.01

  7. Use provider advice for diet and physical activity as IVs for smoking cessation advice

  8. Results: Effect of some advice on one-year smoking cessation

  9. Results: Effect of some advice on one-year smoking cessation

  10. Conclusions • Smoking cessation advice as performed in routine care doubles the probability of self-reported abstinence within one year. • Community practitioners should be • Informed of the effectiveness of the way they currently advise, and • encouraged to provide consistent and universal advice

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