Disparities in Receipt of Tobacco Cessation Advice Among U.S. Adult Healthcare Patients Who Use Tobacco.

Introduction: Healthcare systems could reduce disparities in the toll of tobacco use by advising all patients who use tobacco to quit. This study examined U.S. adult population-based estimates of past-year tobacco use and of healthcare provider advice to quit tobacco and disparities in these rates across sociodemographic and substance use characteristics. Methods: Cross-sectional data from the 2015-2019 National Survey on Drug Use and Health were used to estimate the rates of tobacco use and tobacco cessation advice as a function of patient sociodemographic characteristics and other substance use. Results: A total of 28% of U.S. adult healthcare patients reported past-year tobacco use. Only 52% of them recalled receiving tobacco cessation advice from healthcare providers. Tobacco use was elevated among people with co-occurring substance use or disorders; men; non-Hispanic White people; those identifying as lesbian, gay, or bisexual; those with incomes below $30,000; those with no college degree; those in rural areas; and those with non-Medicare or no insurance. Rates of receiving quitting advice were lower among people who use alcohol or cannabis; those with cannabis use disorder; men; minoritized racial/ethnic groups; those with incomes below $30,000; and those in urban areas. Conversely, people with no college degree and public insurance and those with alcohol or illicit drug use disorder reported higher advising rates. Conclusions: Some groups with high tobacco use prevalence receive quitting advice at low rates. Healthcare provider advice to quit tobacco may not reach all patients who use tobacco, particularly those with co-occurring alcohol or cannabis use or cannabis use disorder.