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This study assessed the role of age, gender, and ethnicity in chart documentation of smoking by primary care providers. Clinic patients (n = 304) were asked their smoking status and medical records were reviewed. Twenty-nine percent of reviewed patients were smokers, 27.6% former smokers, and 43.1% nonsmokers. Providers were more likely to document smoking among males (OR = 4.6; 95% CI = 2.2-9.5), middle-aged patients (OR = 4.0; 95% CI = 1.4-11.0), and smokers (OR = 8.1; 95% CI = 4.1-16.0). Data revealed selective documentation of smoking in males and middle-aged patients by providers, suggesting gender and age bias in the recognition and documentation of this risky behavior. We conclude that providers should screen for smoking in all patients regardless of age or gender.

Background: In an effort to learn more about the smoking behavior of hospital employees, a study was conducted at the University of Kansas Medical Center (KUMC) regarding tobacco usage and secondhand smoke exposure., Methods: An anonymous voluntary survey was distributed to 4177 full-time employees in Kansas City and Wichita during June and July of 1998. Questions included tobacco usage and exposure to secondhand smoke. The survey results were assimilated in a data base, which was analyzed in a variety of ways to arrive at several conclusive findings., Results: Of the 1187 respondents (28. 4%), 35.1% had smoked at least 100 cigarettes in their life (41% of those had at least a 10 pack-year history), and 11.8% currently smoked. The groups with the highest percentage of current smokers were females (12%), blacks (17%), Kansas City campus employees (12%), and nonfaculty (13%). Sixty-seven percent of respondents were exposed to secondhand smoke in the previous week, and 25% were exposed at KUMC., Conclusions: After arriving at the results of this study, recommendations include starting an educational campaign against smoking, promoting cessation programs, moving the current smoking area to a less populated area on campus, and investigating a total campus ban on smoking., (Copyright 2000 American Health Foundation and Academic Press.)

Objective: We conducted this study to determine if a smoking status stamp would prompt physicians to increase the number of times they ask, advise, assist, and arrange follow-up for African-American patients about smoking-related issues.Design: An intervention study with a posttest assessment (after the physician visit) conducted over four 1-month blocks. The control period was the first 2 weeks of each month, while the following 2 weeks served as the intervention period.Setting: An adult walk-in clinic in a large inner-city hospital.Participants: We consecutively enrolled into the study 2,595 African-American patients (1,229 intervention and 1, 366 control subjects) seen by a housestaff physician.Interventions: A smoking status stamp placed on clinic charts during the intervention period.Main Results: Forty-five housestaff rotated through the clinic in 1-month blocks. In univariate analyses, patients were significantly more likely to be asked by their physicians if they smoke cigarettes during the intervention compared with the control period, 78.4% versus 45.6% (odds ratio [OR] 4.28; 95% confidence interval [CI] 3.58, 5.10). Patients were also more likely to be told by their physician to quit, 39.9% versus 26.9% (OR 1.81; 95% CI 1.36, 2.40), and have follow-up arranged, 12.3% versus 6.2% (OR 2.16; 95% CI 1.30, 3.38).Conclusions: The stamp had a significant effect on increasing rates of asking about cigarette smoking, telling patients to quit, and arranging follow-up for smoking cessation. However, the stamp did not improve the low rate at which physicians offered patients specific advice on how to quit or in setting a quit date. [ABSTRACT FROM AUTHOR]