Background
Federally supported health centers provide primary care services for over 20 million medically underserved patients across the U.S. Health centers are well-positioned to identify patients who smoke and ensure receipt of needed cessation counseling or treatment.
Purpose
Determine the prevalence of current cigarette smoking, desire to quit, and receipt of tobacco-related counseling among a national sample of adult health center patients; identify sociodemographic and health-related factors associated with these measures.
Methods
Data came from the 2009 Health Center Patient Survey and the 2009 National Health Interview Survey. The analytic sample included 3,949 adult health center patients and 27,731 U.S. adults.
Results
Findings showed that 31% of adult health center patients were current smokers, compared with 21% of U.S. adults in general. Among currently smoking health center patients, 83% reported a desire to quit and 68% reported receiving tobacco counseling. In multivariable models, patients had higher odds of wanting to quit if they showed signs of severe mental illness (OR=3.26, 95% CI: 1.19–8.97) and lower odds if they had health insurance (OR=0.43, 95% CI: 0.22–0.86). Patients had higher odds of receiving counseling if they had two or more chronic conditions (OR=2.05, 95% CI: 1.11–3.78) and lower odds if they were Hispanic (OR=0.57-0.34-0.96).
Conclusions
The prevalence of cigarette smoking is substantially higher among health center patients than the U.S. in general. However, most smokers seen in health centers desire to quit smoking. Continued efforts are warranted to reduce tobacco use in this vulnerable segment of the population.