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Recommendation
| Assess the smoking status in all patients routinely, and encourage each, from adolescents to patients over age 65, to quit smoking.
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Evidence:
- A meta-analysis of nine studies found that clinicians who inquired about smoking status were approximately three times more likely (OR, 3.1 [CI, 2.2 to 4.2]) to introduce a smoking cessation intervention (1).
- The 1994 U.S. Surgeon General report “Preventing tobacco use among young people,” reported that 71% of adults who had ever smoked daily were daily users at or before age 18 (74).
- In a cohort study of 7178 healthy elderly men and women of age 65 years or more, persons who continued to smoke had higher rates of mortality as well as cardiovascular and neoplastic disease than former smokers or nonsmokers after 5 years follow-up. The RR of death was 2.1 for men and 1.8 for women among current smokers vs. nonsmokers, whereas the RR of death was 1.5 for men and 1.1 for women among former smokers vs. nonsmokers (6).
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Comments:
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| Edward Ellerbeck, MD, MPH, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Kumanan Wilson, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott. |
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