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: BackgroundThe effectiveness of smoking cessation interventions may be influenced by a variety of patient characteristics, including level of nicotine addiction and readiness to change. We conducted this study to examine the relationship between these characteristics and the frequency of physician-initiated smoking cessation interventions.: MethodsWe identified smokers seen during office visits to 1 of 38 primary care physicians in rural Kansas. Trained students observed the frequency and nature of doctor–patient discussions related to tobacco. Telephone surveys were conducted with these patients 1 to 3 days after the office visit.: ResultsWe completed observations and telephone surveys on 259 smokers. Tobacco-related discussions occurred during 66% of doctor–patient encounters. Although discussions overall were unrelated to a patient’s readiness to quit, specific assistance with smoking cessation was offered less often to precontemplators (15%) than to contemplators (31%) or those preparing to quit (37%) (P < 0.05). While bupropion was discussed with 23% of smokers, nicotine replacement therapy was discussed with 12% and was unrelated to markers of nicotine addiction.: ConclusionsCurrent efforts to promote smoking cessation are only marginally related to patient characteristics. Doctors are missing many opportunities to effectively intervene with patients who are contemplating smoking cessation or preparing to quit. [Copyright &y& Elsevier]

Objectives. The purpose of the study was to determine associations between having a regular source of health care, advice from a physician to quit smoking, and smoking-related behaviors among African American smokers.Methods. A secondary analysis was conducted on data obtained from an intervention study with a posttest assessment of the effectiveness of smoking status as a vital sign. The setting was an adult walk-in clinic at a large inner-city hospital and 879 African American adult current smokers were examined.Results. Among African American smokers, there was an association between having a regular source of health care and planning to quit smoking within the next 30 days (OR = 1.46; 95% CI: 1.04–2.05), receiving physician advice to quit (OR = 1.46; 95% CI: 1.02–2.10), and smoking ≤10 cigarettes a day (OR = 1.42; 95% CI: 1.00–2.03).Conclusions. African American current smokers with a regular source of health care were further along the quitting process than those without a regular source of health care. Our findings indicate a potential benefit of complementing programs that increase physician cessation advice rates with policies that increase rates of health insurance and the likelihood that individuals have a regular source of health care. [Copyright &y& Elsevier]