Racial/Ethnic Disparities in Report of Physician-Provided Smoking Cessation Advice: Analysis of the 2000 National Health Interview Survey

López-Quintero, Catalina; Crum, Rosa M.; Neumark, Yehuda

doi:10.2105/ajph.2005.071035

Cited by 98 publications

(86 citation statements)

References 29 publications

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“…Black outpatients less frequently receive advice to quit, and subsequently receive medications less often than white patients. 31,32 A prior study of patients admitted for myocardial infarction indicated that black patients are less likely to be advised to quit smoking, 7 suggesting that this disparity in treatment exists in other inpatient settings. Although the number of black subjects in our study was low, the difference in the odds of treatment is striking.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

et al. 2016

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BACKGROUND: Many smokers admitted for chronic obstructive pulmonary disease (COPD) are not given smoking cessation medications at discharge. The reasons behind this are unclear, and may reflect an interplay of patient characteristics, health disparities, and the receipt of inpatient tobacco control processes. OBJECTIVES: We aimed to assess potential disparities in treatment for tobacco use following discharge for COPD, examined in the context of inpatient tobacco control processes. PARTICIPANTS: Smokers aged ≥ 40 years, admitted for treatment of a COPD exacerbation within the VA Veterans Integrated Service Network 20, identified using ICD-9 discharge codes and admission diagnoses from 2005-2012. MAIN MEASURES: The outcome was any tobacco cessation medication dispensed within 48 hours of discharge. We assessed potential predictors administratively up to 1 year prior to admission. We created the final logistic regression model using manual model building, clustered by site. Variables with p < 0.2 in biviariate models were considered for inclusion in the final model. RESULTS: We identified 1511 subjects. 16.9 % were dispensed a medication at discharge. In the adjusted model, several predictors were associated with decreased odds of receiving medications: older age (OR per year older 0.96, 95 % CI 0.95-0.98), black race (OR 0.34, 95 % CI 0.12-0.97), higher comorbidity score (OR 0.89, 95 % CI 0.82-0.96), history of psychosis (OR 0.40, 95 % CI 0.31-0.52), hypertension (OR 0.75, 95 % CI 0.62-0.90), and treatment with steroids in the past year (OR 0.80, 95 % CI 0.70-0.90). Inpatient tobacco control processes were associated with increased odds of receiving medications: documented brief counseling at discharge (OR 3.08, 95 % CI 2.02-4.68) and receipt of smoking cessation medications while inpatient (OR 5.95,. CONCLUSIONS: Few patients were treated with tobacco cessation medications at discharge. We found evidence for disparities in treatment, but also potentially beneficial effects of inpatient tobacco control measures. Further focus should be on using novel processes of care to improve provision of medications and decrease the observed disparities.

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Section: Discussionmentioning

confidence: 99%

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

et al. 2016

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“…5 We found that light and intermittent smokers were less likely to receive advice from health professionals to quit smoking. Latinos have also been found to receive less advice to quit smoking, 13,14,33 which may be attributable to differences in smoking level after health status is taken into account. 33 Because of the deleterious health effects of smoking and because the odds of successfully quitting are higher when advised by a health professional, 34 it is important that all smokers be advised to quit regardless of smoking level.…”

Section: Discussionmentioning

confidence: 99%

National Trends in Smoking Behaviors Among Mexican, Puerto Rican, and Cuban Men and Women in the United States

et al. 2014

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National trends in smoking behaviors among mexican, puerto rican, and cuban men and women in the united states Ricans and Cubans are also more likely to be current smokers than are Mexicans. 7 Furthermore, although research grounded on a nationally representative sample found that Latinos were approximately 4.5 times more likely to be light smokers than were non-Hispanic Whites, 8 that study provided only aggregated rates for all Latinos and did not differentiate between national origin groups. Gender differences have also been reported among disaggregated Latino groups. A higher prevalence of smoking has been reported among Mexican (25.0%), Puerto Rican (27.6%), and Cuban (24.7%) men than among Mexican (10.4%), Puerto Rican (24.2%), and Cuban (12.4%) women. 7 The lower rates of smoking among women have been consistent in surveys of Latinos. 5,7,9 Results from these studies, although informative, have generally been determined by aggregated Latino data or data from a single survey time point. Although such data are valuable and can demonstrate existing gender differences, national-level trends from Latino nationality groups in the United States add valuable information that have not been previously reported. Previous research has also identified social and environmental factors associated with Latinos' smoking behaviors. Acculturation to mainstream US culture plays a significant role in one's health behaviors, 10 and as Latinos acculturate, their smoking behaviors become similar to those of non-Hispanic Whites. 7Existing research has also revealed that Latinos are less likely to quit smoking, 11 receive tobacco screening, and be advised to quit by a physician than are non-Hispanic Whites. 12---15 A health professionals' advice to quit smoking has been found to increase the likelihood that a smoker will successfully quit. 16,17 Lastly, workplace smoking policies have also influenced smoking prevalence and intensity. 18---20 Work environments adopting a smoke-free policy saw a 14% decrease in individuals' smoking. 21When examining national-level smoking behaviors among Latinos, it is important to account for social and environmental factors such as acculturation, physician advice to quit smoking, and work environment smoking policies, as they may influence smoking behaviors. Existing research on smoking behaviors among Latino national origin groups has been predicated on data from specific regions of the United States. 4,22---25 Although regional data are important for the development of community-level interventions, 4 national-level data provide an overview of the country's progress in tobacco control as well as remaining and emerging challenges for Latinos nationwide. We compared smoking behaviors across 2 periods, about a decade apart, among Mexicans, Puerto Ricans, and Cubans. Our goals in these analyses were (1) to compare Latino national origin groups across 2 periods to examine factors affecting changes in smokingObjectives. We examined trends in smoking behaviors across 2 periods among Mexicans, Puert...

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“…For instance, prior research has noted lower rates of utilization of pharmaceutical aids in smoking cessation among Latino smokers as well as lower likelihoods of receiving physician advice on quitting. 35,36 A small sample of Latino adults in a qualitative inquiry 37 remarked that one of the top reasons for quitting smoking was concern for family and social standing (e.g., setting a good example), and female participants in particular felt that smoking was an "ugly" behavior. In this study, no participants relied on pharmaceutical aids and female smokers turned to traditional remedies and alternative activities-as opposed to physician advice or medical interventionwhen attempting to quit.…”

Section: Discussionmentioning

confidence: 99%

Association between Neighborhood-Level Smoking and Individual Smoking Risk: Maternal Smoking among Latina Women in Pennsylvania

et al. 2015

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Objective. We examined whether or not high maternal smoking rates at the neighborhood level increase the likelihood of individual smoking by Latina women in the three months prior to and during pregnancy, independent of other individual and neighborhood factors.Methods. This study was observational in nature, using linked vital statistics records for 24,443 Latina women in Pennsylvania (2009Pennsylvania ( -2010 and U.S. Census data for 2,398 census tracts. We used multilevel logistic regression models to determine the individual odds of self-reported maternal smoking given different census tract-level rates of maternal smoking in the previous three years (2006)(2007)(2008), adjusting for maternal and census-tract characteristics, including ethnic density, population density, and poverty.Results. Higher levels of maternal smoking at the census-tract level were associated with increased individual odds of smoking among Latina mothers. In the fully adjusted model, a 10% increase in the neighborhood smoking rate was associated with a 1.28 (95% confidence interval 1.22, 1.34) increase in the individual odds of smoking.Conclusion. Latina women living in census tracts where more women have smoked during or immediately prior to pregnancy are themselves at higher risk of smoking during this period.

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Racial/Ethnic Disparities in Report of Physician-Provided Smoking Cessation Advice: Analysis of the 2000 National Health Interview Survey

Cited by 98 publications

References 29 publications

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

Predictors of Pharmacotherapy for Tobacco Use Among Veterans Admitted for COPD: The Role of Disparities and Tobacco Control Processes

National Trends in Smoking Behaviors Among Mexican, Puerto Rican, and Cuban Men and Women in the United States

Association between Neighborhood-Level Smoking and Individual Smoking Risk: Maternal Smoking among Latina Women in Pennsylvania

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