According to the CDC study, about 13 percent of patients in Medicare managed-care programs smoke. Government guidelines require such programs to encourage patients to quit smoking.

The study found, however, that 30 percent of Medicare recipients who smoke were not urged to quit by their doctor or other health-care providers. The report found that minority groups are less likely to be encouraged to stop smoking: More than 72 percent of whites were urged to stop smoking, compared with 68 percent of blacks, 65 percent of Latinos and 54 percent of Asian Americans.

The study was based on information from more than 167,000 people in a study conducted in 1998.

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