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Thomas K. Houston, MD, MPH, Isabel C. Scarinci, PhD, MPH, Sharina D. Person, PhD and Paul G. Greene, PhD

Thomas K. Houston is with the Deep South Center for Effectiveness Research, the Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. Thomas K. Houston, Isabel C. Scarinci, and Sharina D. Person are with the Department of Medicine, University of Alabama at Birmingham and the University of Alabama at Birmingham Center for Outcomes and Effectiveness Research and Education. Paul G. Greene is with the University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Correspondence: Requests for reprints should be sent to Thomas K. Houston, MD MPH, Assistant Professor of Medicine, 1530 3rd Avenue South, FOT 720B, University of Alabama at Birmingham, Birmingham, AL 35294–3407 (e-mail: tkhouston{at}uabmc.edu).

Objectives. We assessed differences by ethnicity in ever receiving advice from providers to quit smoking. We evaluated whether socioeconomic status and health status were moderators of the association.

Methods. We used 2000 Behavioral Risk Factor Surveillance Survey data, a population-based cross-sectional survey.

Results. After adjusting for complex survey design, 69% of the 14089 current smokers reported ever being advised to quit by a provider. Hispanics (50%) and African Americans (61%) reported receiving smoking counseling less frequently compared with Whites (72%, P<.01 for each). Ethnic minority status, lower education, and poorer health status remained significantly associated with lower rates of advice to quit after adjustment for number of cigarettes, time from last provider visit, income, comorbidities, health insurance, gender, and age. Smoking counseling differences between African Americans and Whites were greater among those with lower income and those without health insurance. Compared with Whites, differences for both Hispanics and African Americans were also greater among those with lower education.

Conclusion. We found lower rates of smoking cessation advice among ethnic minorities. However, we also found complex interactions of ethnicity with socioeconomic factors.

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