Providers' advice concerning smoking cessation: Evidence from the Medical Expenditures Panel Survey

•Nearly 40 million people in the United States are current smokers.•Provider's advice to stop smoking has significant potential to increase cessation rates.•Less than half of current smokers were advised to quit smoking by their healthcare providers.•Provider advice to stop smoking is offered significantly less often than other preventive services.

Importance and objectiveWe estimate how often adult smokers are advised to quit using a nationally representative sample of adults in the United States.Design and participantsData are from the 2012–2013 household component of the United States (US) Medical Expenditures Panel Survey (MEPS).Main outcome measureCurrent smoking and advice to quit offered by providers.ResultsSmoking was reported by 18.26% (CI 17.13%–19.38%) of 2012 MEPS respondents. Less than half of adult smokers (47.24%, CI 44.30%–50.19%) were advised to quit by their physicians although 17.57% (CI 15.37%–19.76%) had not seen a doctor in the last 12 months. Advice to quit was given significantly less often to respondents classified as: aged 18–44 (40.29%), men (40.20%), less educated (42.26%), lower family income (43.51%), Hispanic (33.82%), never married (39.55%), and living outside the northeast. Smoking status at year 2 for patients who had received advice to quit was similar (85.13%: SE 1.62%) to those who had seen a physician but were not advised to quit (81.95%: SE 2.05%). Advice to quit smoking was less common than the use of common medical screening tests.Conclusions and relevanceSmoking cessation advice is given to less than half of current cigarette smokers and it is least likely to be given to the most vulnerable populations. Efforts to reduce smoking are deployed less often than other preventive practices. The rate of advice to quit has not changed over the last decade. Health care providers are missing an important opportunity to affect health behaviors and outcomes.