To whom do psychiatrists offer smoking-cessation counseling?

Objective: Individuals with mental illness have high rates of tobacco dependence; however, little is known about what influences a psychiatrist's decision to offer smoking-cessation counseling to smoking patients. Method: Using the National Ambulatory Medical Care Survey, the authors identified 1,610 psychiatric office visits for patients who smoke. They investigated the relationship between patient and visit characteristics and smoking-cessation counseling with logistic regression. Results: Psychiatrists offered cessation counseling at 12.4% of the visits for smoking patients. The adjusted probability of receiving smoking-cessation counseling was significantly higher for those older than 50; for those with a medical diagnosis of obesity, hypertension, or diabetes mellitus; for those in a rural location; and for those having an initial visit. Those with bipolar affective disorder were more likely to receive smoking-cessation counseling than those with depression. Conclusions: Psychiatrists may be missing opportunities to offer smoking-cessation counseling to patients who smoke.