Research has demonstrated that smokers are far more likely to quit if their doctor or other health-care provider advises them to do so, but new research from UC Davis has found that Asian-Americans are not getting the advice as often as the general population.
Elisa K. Tong and Moon S. Chen of the UC Davis Cancer Center reported this month that less than a third of Chinese-Americans, Korean-Americans and Vietnamese-Americans reported receiving quitting advice from their providers in the past year, in contrast to 46 percent of smokers in the general population.
“Advising a patient to quit smoking is considered the standard of care, and it doubles their chances of quitting,” said Tong, an internal medicine physician and tobacco control expert.
A key reason for the disparity, the researchers determined, is that Asian-American smokers were far less likely to see a health-care provider in that period than were California’s general adult population of smokers.
Published in the May/June issue of the American Journal of Health Promotion, the study is the first and largest population-based study of its kind. It was funded with grants from the National Institutes of Health’s John E. Fogarty International Center, the Center to Reduce Cancer Health Disparities at the National Cancer Institute and the California Department of Public Health.
With colleagues from the California Department of Public Health’s Genetic Disease Screening program and UC San Francisco, Tong analyzed California Tobacco Use surveys of nearly 900 Asian-American smokers. Unlike other surveys, in which Asian-Americans surveyed were fluent in English, the Asian-American population-based surveys were conducted in both English and Asian languages for a more representative accounting.
Tong and her colleagues asked two essential questions: what factors were associated with smokers seeing a provider, and of those smokers who did, what factors were associated with them getting advice to quit.
Individuals were asked about their smoking frequency, whether they saw a health-care provider in the past 12 months and, if so, whether the provider advised the smoker to quit. Other socio-demographic information, such as gender, age, education, income and ethnicity, also was collected in the surveys.
As it turned out, less than a third (30.5 percent) of all of the smokers surveyed reported having been advised to quit in the past year. This figure is a product of the proportion of smokers who saw a provider in the past year (50.8 percent) and, of these smokers, the proportion who were advised to quit (60.1 percent). In contrast, for the general population in California, these proportions were 72.1 percent and 63.5 percent respectively, contributing to an overall product of less than half (45.8 percent) of smokers reported having been advised to quit in the past year.
Researchers also learned that of all the smokers who saw a provider, those who had health insurance were more likely to be advised to quit compared to those who did not have health insurance.
“Providers serving these populations may need greater awareness that simply advising smokers to quit is highly effective, and that assistance (counseling and medication) through referral to a telephone quitline does not require health insurance and is free and effective,” the authors wrote.
The California Smokers’ Helpline (1-800-NO-BUTTS) has Asian-language lines for free counseling and educational materials: Chinese (1-800-838-8917), Korean (1-800-556-5564) and Vietnamese (1-800-778-8440).
Tong and colleagues also found that Asian-American smokers reported less provider advice to quit if they did not smoke daily, which can also be very dangerous, especially in terms of cardiovascular health.
“Providers also need to advise all smokers to quit, regardless of smoking frequency,” the authors wrote. “And California’s Asian-Americans are more likely than non-Latino whites in California to be light and intermittent smokers.”