Journal of General Internal Medicine

, Volume 35, Issue 1, pp 43–50 | Cite as

Provider-Patient Discussions About Smoking and the Impact of Lung Cancer Screening Guidelines: NHIS 2011–2015

  • Jinhai HuoEmail author
  • Tong Han Chung
  • Bumyang Kim
  • Ashish A. Deshmukh
  • Ramzi G. Salloum
  • Jiang Bian
Original Research



Clinical practice guidelines for treating tobacco use and lung cancer screening guidelines recommend smoking cessation counseling to current smokers by health care professionals.


Our objective was to determine the contemporary patterns of current smokers’ discussions about smoking with their health care professionals in the USA.

Design, Setting, and Participants

We conducted an observational study of 30,132 current smokers (weighted sample 40,126,006) for the years 2011 to 2015 using data from the National Health Interview Survey.

Main Measures

Our main outcome was the proportion of current smokers who had discussions about smoking with their health care professionals. We used the Cochran-Armitage trend test to evaluate the temporal trends in current smokers’ discussions about smoking, and used a multivariable logistic model to determine the predictors of discussions about smoking, controlling for smokers’ demographics, health status, and receipts of lung cancer screening.

Key Results

Our study found the proportion of current smokers who had discussions about smoking with their health care professionals increased from 51.3% in 2011 to 55.4% in 2015 (P-trend < 0.0001). However, about 15% of current smokers who underwent lung cancer screening did not have or could not recall discussions about smoking with their health care professionals. In multivariable analyses and sensitivity analysis, the predictors of discussions about smoking were being a heavy smoker, receipt of lung cancer screening, being non-Hispanic white, having a physician office visit in the past year, being diagnosed with respiratory conditions, having fair or poor health, and having insurance coverage.


The results demonstrated a steady but slow increase in current smokers’ discussions about smoking with their health care professionals in recent years, especially among heavy smokers. More than 40% of current smokers did not have or could not recall any discussions about smoking with their health care professionals.


current smoker communication smoking lung cancer screening 



The study was supported by the University of Florida Health Cancer Center Research Pilot Grant through the Florida Consortium of National Cancer Institute Centers Program at the University of Florida (Dr. Huo and Dr. Bian).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


The content is solely the responsibility of the authors and does not necessarily represent the official views of the UF Health Cancer Center.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Jinhai Huo
    • 1
    Email author
  • Tong Han Chung
    • 2
  • Bumyang Kim
    • 3
  • Ashish A. Deshmukh
    • 1
  • Ramzi G. Salloum
    • 4
  • Jiang Bian
    • 4
  1. 1.Department of Health Services Research, Management and Policy, College of Public Health and Health ProfessionsThe University of FloridaGainesvilleUSA
  2. 2.Healthcare Transformation InitiativeThe University of Texas Health Science Center at HoustonHoustonUSA
  3. 3.Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonUSA
  4. 4.Department of Health Outcomes and Biomedical Informatics, College of MedicineUniversity of FloridaGainesvilleUSA

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