Who conceals their smoking status from their health care provider?

The decline in the social acceptability of tobacco use has the potential consequence that smokers may conceal their smoking from health care providers. To assess the frequency and correlates of concealing one's smoking status from a health care provider, we analyzed data from the New York Social Environment Study, a cross-sectional random-digit-dialed telephone survey of 4,000 adult New York City residents surveyed between June and December 2005 (cooperation rate = 54%). A total of 835 current smokers were asked if they had ever kept their smoking status a secret from a doctor or another health care provider. Multiple items assessed the social unacceptability of smoking. Other potential correlates of smoking status nondisclosure were demographics, health status, frequency of tobacco use, and dependence. Some 8% of respondents (N = 63) reported ever keeping their smoking status a secret from a health provider. Nondisclosure of smoking status was more common among respondents who perceived high compared with low levels of smoker-related stigma (perceptions that they were devalued because they smoke; odds ratio [OR] = 2.83, 95% CI = 1.14-7.01) and among respondents who reported that smoking was not allowed in their home (OR = 2.04, 95% CI = 1.01-4.11) in a multiple logistic regression analysis that adjusted for demographics, health status, frequency of tobacco use, and dependence. No other factors were associated with nondisclosure in this model. A small percentage of smokers may conceal their smoking status from their health care providers, and those who do are more likely to perceive their tobacco use to be socially unacceptable.