Californians Care About Their Healthcare Providers’ Smoking Status

A poll conducted by California’s Thirdhand Smoke Resource Center at San Diego State University found that three out of four Californians believe they should be allowed to choose a doctor or nurse who does not smoke cigarettes. Furthermore, the majority of respondents think they should be informed if a healthcare provider taking care of them smokes cigarettes.

March 8, 2023

By: Leta Dickinson

Thirdhand smoke is the invisible and persistent chemical residue left behind from tobacco smoking that can stick to skin, hair, clothing, and other surfaces. It sometimes can be detected as the smell of stale tobacco smoke or as a visible yellow stain, but more often than not, it is undetectable. Thirdhand smoke shares many of the same chemical compounds as secondhand smoke that are known to cause cancer, heart disease, and affect lung health. Previous studies have found thirdhand smoke in medical facilities, including high-risk settings like neonatal intensive care units where patients are particularly susceptible to the dangers of thirdhand smoke.

Between May and June 2022, over 1,900 adult residents from across California responded to an anonymous online survey. Respondents were between 18 and 84years old (average 32), and 59% were female. Most (84%) cited English as their first language, and most (82%) denied any smoking in the previous 30 days. 

The purpose of this survey was to determine how Californians felt about healthcare providers smoking cigarettes and gauge their awareness of thirdhand smoke in a healthcare context. Respondents were asked if they agreed or disagreed with the following statements: “I should be informed if the doctor or nurse taking care of me smokes cigarettes” and “I should be able to choose a doctor or nurse who does not smoke cigarettes.” 

Participants were asked if they agree or disagree with the following statement:

“I should be able to choose a doctor or nurse who does not smoke cigarettes.”

Support for choosing a nonsmoking healthcare provider was 75% on average, with some regional variability. Respondents from the Central Coast region had the highest level of agreement (82%), while Los Angeles had the lowest level (72%). This may indicate awareness of residents of the dangers of thirdhand smoke. The highest levels of agreement were among people 23 years and younger (79%) and people with Chinese (93%) and Vietnamese (82%) as their first languages. Over half of people who smoke wanted to be able to choose a provider that does not smoke. 

Support for disclosure of healthcare provider smoking status was 55% on average. Again, people 23 years and younger showed a higher level of agreement (62%) along with people with Spanish (68%) and Chinese (66%) as their first language. 

As Californians become increasingly aware of thirdhand smoke and its risks, there appears to be growing interest in its disclosure and prevention, including in healthcare settings. This survey indicates that most Californians want to know and choose healthcare providers that do not smoke cigarettes. 

California has long been a national leader in tobacco control. The results of this survey suggest a new direction for smoking policies: disclosure of tobacco use in healthcare settings to protect Californians from exposure to toxic thirdhand smoke.

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