To describe differences in smoking habits and in physician-patient interactions of Hispanics with chronic obstructive pulmonary disease (COPD).
Random cross-sectional survey of veteran enrollees from the 1999 Large Health Survey with at least 1 visit with an ICD-9 code for COPD. Response rate was 63% and after the “never smokers” were excluded, 89,485 patients were analyzed.
Eighty-seven percent (77,495) categorized themselves as “white,” 9.1% (8,139) as “black,” and 2.7% (2,413) as “Hispanic.” A variety of other ethnicities made up the remaining 1.2%. Hispanics self-reported fewer cardiac comorbidities, but significantly more psychiatric comorbidities than Caucasians or African Americans (AA). Fewer Hispanics were current smokers (20% vs. 28%) and they reported smoking fewer cigarettes per day than the other ethnicities. Nearly 30% of Hispanics reported that they were not asked about tobacco use by their doctor within the last year, compared with 20% of the other two major groups. Approximately 35% of each group reported that they were not advised to quit smoking by their physician within the last year. Only 15% of the Hispanics were referred to a treatment program for smoking cessation, compared with 19% and 22% of Caucasians and AA, respectively. In addition, 37% of the Hispanic population reported that they did not receive any services needed to quit smoking, compared with 31% and 29% of Caucasians and AA, respectively.CONCLUSIONS: Despite having more psychiatric comorbidities, fewer of the Hispanic patients in this cohort with COPD were current smokers than either Caucasians or AA. However, the currently smoking Hispanic patients did not receive, and were not referred to smoking cessation services as often as Caucasian or AA patients.
This significant gap in the management of Hispanic patients with COPD should prompt healthcare providers to more aggressively inquire about smoking status and more actively refer this population to smoking cessation programs.
S.G. Adams, None.