Disparities in US Healthcare Provider Screening and Advice for Cessation Across Chronic Medical Conditions and Tobacco Products.

Autor: Keith DR; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA. Diana.Keith@uvm.edu., Stanton CA; Westat, Rockville, MD, USA.; Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Washington, DC, USA., Gaalema DE; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA., Bunn JY; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA.; Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA., Doogan NJ; College of Public Health, The Ohio State University, Columbus, OH, USA., Redner R; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA.; Rehabilitation Institute, Southern Illinois University, Carbondale, IL, USA., Kurti AN; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA., Cepeda-Benito A; Department of Psychological Science, University of Vermont, Burlington, VT, USA., Lopez AA; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA., Morehead AL; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA., Roberts ME; College of Public Health, The Ohio State University, Columbus, OH, USA., Higgins ST; Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect St. Rm 1415, Burlington, VT, 05403, USA.
Jazyk: angličtina
Zdroj: Journal of general internal medicine [J Gen Intern Med] 2017 Sep; Vol. 32 (9), pp. 974-980. Date of Electronic Publication: 2017 May 03.
DOI: 10.1007/s11606-017-4062-6
Abstrakt: 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.
Databáze: MEDLINE
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