Who conceals their smoking status from their health care provider?

Abstract

Introduction: The decline in the social acceptability of tobacco use has the potential consequence that smokers may conceal their smoking from health care providers. Methods:To assess the frequency and correlates of concealing one's smoking status from a health care provider, we analyzed data from the New York Social Environment Study, a crosssectional random-digit -dialed telephone survey of 4,000 adult New York City residents surveyed between June and December 2005 (cooperation rate = 54%). A total of 835 current smokers were asked if they had ever kept their smoking status a secret from a doctor or another health care provider. Multiple items assessed the social unacceptability of smoking. Other potential correlates of smoking status nondisclosure were demographics, health status, frequency of tobacco use, and dependence.Results: Some 8% of respondents ( N = 63) reported ever keeping their smoking status a secret from a health provider. Nondisclosure of smoking status was more common among respondents who perceived high compared with low levels of smoker-related stigma (perceptions that they were devalued because they smoke; odds ratio [ OR ] = 2.83, 95% CI = 1.14 -7.01) and among respondents who reported that smoking was not allowed in their home ( OR = 2.04, 95% CI = 1.01 -4.11) in a multiple logistic regression analysis that adjusted for demographics, health status, frequency of tobacco use, and dependence. No other factors were associated with nondisclosure in this model. Discussion:A small percentage of smokers may conceal their smoking status from their health care providers, and those who do are more likely to perceive their tobacco use to be socially unacceptable.

Disparities Between Blacks and Whites in Tobacco and Lung Cancer Treatment

“…However, patients who continue to smoke after diagnosis are at further risk for perceived stigma as well as barriers to seeking support for quitting tobacco use. In a survey of current smokers living in New York City, participants who perceived high compared with low levels of smoker-related stigma reported being less likely to disclose their smoking status [87]. Social norms, including disapproval of smoking and the poor prognosis for lung cancer patients, are factors in smoking stigma and may explain the heightened stigma experienced by lung cancer patients who are smokers [88].…”

Preparing nurses to intervene in the tobacco epidemic: Developing a model for faculty development and curriculum redesign

“…This is of particular relevance as it is well established that health professionals who smoke are less likely to engage in tobacco related interventions, and on a smoke-free campus such as Loma Linda University, smokers are at risk of experiencing stigma which may represent a barrier to accessing treatment (Stuber and Galea, 2009;Stuber et al, 2008;Tong et al, 2010). Therefore, going forward it will also be critical to identify, acknowledge and address barriers to faculty members' and students' access to on-campus smoking cessation programs and treatment related resources.…”

Evaluation of a programme to increase referrals to stop‐smoking services using Children's Centres and smoke‐free families schemes

“…Figure 1 shows the processes involved in the integrated referral system. Opt-out referral is not without ethical or practical concerns [29][30][31]; however, with a clear remit from the study sponsors to increase dramatically the number of referrals from CCs it was felt by the research team to be a reasonable intervention to test.…”

“…In addition, parents/carers who smoke may have more smokers in their immediate circle of family, co-workers and friends, making quitting more difficult [28]. Identifying smokers can also be challenging, as the stigmatisation of smokers can lead to reluctance by smokers to disclose their smoking status and talk about their smoking, even to health-care professionals [29][30][31]. There is therefore a need to envisage new ways of delivering smoking cessation services to parents/ carers of children, including new settings, tailored and appropriate messages, the collection of better data on smoking and the smoke exposure of children and attention to the timing and delivery of services.…”