Faculty Collaboration Database

Disparities in US Healthcare Provider Screening and Advice for Cessation Across Chronic Medical Conditions and Tobacco Products. J Gen Intern Med 2017 Sep;32(9):974-980

Date

05/05/2017

Pubmed ID

28470547

Pubmed Central ID

PMC5570737

DOI

10.1007/s11606-017-4062-6

Scopus ID

2-s2.0-85018989831 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

BACKGROUND: Disparities in tobacco use are worsening in the United States, disproportionately affecting those with chronic medical conditions. One possible contributor is that physicians may not screen and advise cessation uniformly across patients and/or tobacco products.

OBJECTIVE: This study examined provider communications regarding cigarette and non-cigarette tobacco products among adults with chronic conditions.

DESIGN: Cross-sectional study drawn from two waves (2013-2014) of the National Survey on Drug Use and Health (NSDUH).

PARTICIPANTS: Adults (≥ 18 years) who used tobacco in the past year.

MAIN MEASURES: Prevalence of tobacco use included past-year use of cigarettes, cigars, or smokeless tobacco among those with and without chronic conditions. Chronic conditions included asthma, anxiety, coronary heart disease, depression, diabetes, hepatitis, HIV, hypertension, lung cancer, stroke, and substance abuse. Odds ratio of receipt of screening and advice to quit across chronic condition and tobacco product type were reported. Data were analyzed using logistic regression, controlling for basic sociodemographic factors and number of provider visits.

KEY RESULTS: Adults with anxiety, depression, and substance use disorders had the highest prevalence of past-year cigarette (37.2-58.2%), cigar (9.1-28.0%), and smokeless tobacco (3.1-11.7%) use. Patients with any chronic condition were more likely to receive advice to quit than those without a condition (OR 1.21-2.37, p < 0.01), although the odds were lowest among adults with mental health and substance use disorders (OR 1.21-1.35, p < 0.01). Cigarette smokers were more likely to report being screened and advised to quit than non-cigarette tobacco users (OR 1.54-5.71, p < 0.01).

CONCLUSIONS: Results support the need for provider training to expand screening and cessation interventions to include the growing spectrum of tobacco products. Screening and referral to interventions are especially needed for those with mental health and substance use disorders to reduce the disparate burden of tobacco-related disease and death.

Author List

Keith DR, Stanton CA, Gaalema DE, Bunn JY, Doogan NJ, Redner R, Kurti AN, Cepeda-Benito A, Lopez AA, Morehead AL, Roberts ME, Higgins ST

Author

Alexa Anderson PhD Associate Professor in the Nursing department at University of Wisconsin - Milwaukee

MESH terms used to index this publication - Major topics in bold

Adult
Case-Control Studies
Chronic Disease
Comorbidity
Cross-Sectional Studies
Female
Health Surveys
Healthcare Disparities
Humans
Logistic Models
Male
Mass Screening
Prevalence
Professional-Patient Relations
Risk Factors
Self Report
Smokers
Smoking
Smoking Cessation
Surveys and Questionnaires
Tobacco Products
United States