Journal of General Internal Medicine

, Volume 14, Issue 7, pp 402–408

Smoking status as a vital sign

  • Jasjit S. Ahluwalia
  • Cheryl A. Gibson
  • R. Emmet Kenney
  • Dennis D. Wallace
  • Ken Resnicow
Original Articles

DOI: 10.1046/j.1525-1497.1999.09078.x

Cite this article as:
Ahluwalia, J.S., Gibson, C.A., Kenney, R.E. et al. J GEN INTERN MED (1999) 14: 402. doi:10.1046/j.1525-1497.1999.09078.x

Abstract

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.

Key Words

smoking status vital signs physician counseling inner city African Americans 

Copyright information

© Society of General Internal Medicine 1999

Authors and Affiliations

  • Jasjit S. Ahluwalia
    • 1
    • 2
  • Cheryl A. Gibson
    • 1
  • R. Emmet Kenney
    • 3
  • Dennis D. Wallace
    • 1
  • Ken Resnicow
    • 4
  1. 1.Department of Preventive MedicineUniversity of Kansas Medical CenterKansas City
  2. 2.Department of Internal MedicineUniversity of Kansas School of MedicineKansas City
  3. 3.Internal Medicine Residency ProgramCleveland Clinic FloridaFt. Lauderdale
  4. 4.Department of Behavioral Sciences and Health EducationEmory University Rollins School of Public HealthAtlanta

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