TY - JOUR
T1 - Do Health Care Providers Differentiate between Daily and Nondaily Smokers when Counseling for Smoking Cessation? Analysis by Race/Ethnicity
AU - Khariwala , S S
AU - Scheuermann, TS
AU - Luo, X
AU - Nollen, N L
AU - Pulvers, K
AU - Siddiqi, Kamran
AU - Sherman, S
AU - Ahluwalia, J S
PY - 2015/12/18
Y1 - 2015/12/18
N2 - Objective: Nondaily smokers (NDS) may not receive cessation counseling
due to perceptions that nondaily smoking is less hazardous and that NDS can
quit unassisted. We investigated differences in provision of guideline-based
cessation services -- i.e., ask, advise, assist, arrange follow-up (“4 A’s”)– by
smoker type (NDS and DS) and race/ethnicity as well as the interaction between
race and smoker type.
Methods: Participants were NDS (smoked 4-24 days in the last 30) and DS
(smoked >25 days in the past month) recruited using an online panel. An online
questionnaire gathered self-reported data from smokers regarding health care
professional-provided tobacco treatment over the last 12 months. The 1587
participants who had at least one doctor visit in the past 12 month included
native NDS, converted NDS, light DS, and heavy DS.
Results: Multivariable analysis showed that, there were no statistically
significant differences on the odds of being asked about smoking between
different types of smokers. However, compared to native nondaily smokers,
Latino and White converted nondaily smokers (Latinos, AOR = 2.02, 95% CI
1.09, 3.74 and Whites, AOR= 2.33, 95% CI 1.27, 4.29), light daily smokers (AOR
= 2.82, 95% CI 1.41, 5.63, and AOR= 3.72, 95% CI, 1.92, 7.22, respectively)
and heavy daily smokers (AOR = 4.11, 95% CI 2.01, 8.43 and AOR = 6.85, 95%
CI 3.39, 13.81, respectively) had increasing odds of reporting being advised to
quit by their health care providers. Among African American smokers, converted
nondaily smokers (AOR = 2.11, 95% CI 1.01, 4.44) and heavy daily smokers
(AOR = 2.92, 95% CI 1.35, 6.28) were more likely to receive assistance in
quitting than native nondaily smokers.
Among African Americans, heavy daily smokers’ had greater odds of having
follow-up arranged compared to native nondaily smokers (AOR=3.06, 95% CI
1.08, 8.70) and among Latinos, these rates were only statistically significant for
converted nondaily smokers compared to native nondaily smokers (AOR= 2.80,
95% CI 1.25, 6.26). Among Whites, light daily smokers had the greatest odds of
having their health care provider arrange follow-up (AOR= 10.81, 95% CI 1.37,
85.12) compared to native nondaily smokers.
Conclusions: Daily smokers report greater engagement by health care
providers compared to NDS with regard to smoking cessation. These findings
such suggest the primary care providers are ascribing less risk to NDS than DS.
Educational efforts are needed to change this tendency among primary care
providers. In addition, the patterns identified were similar across the three ethnic
groups studied here.
AB - Objective: Nondaily smokers (NDS) may not receive cessation counseling
due to perceptions that nondaily smoking is less hazardous and that NDS can
quit unassisted. We investigated differences in provision of guideline-based
cessation services -- i.e., ask, advise, assist, arrange follow-up (“4 A’s”)– by
smoker type (NDS and DS) and race/ethnicity as well as the interaction between
race and smoker type.
Methods: Participants were NDS (smoked 4-24 days in the last 30) and DS
(smoked >25 days in the past month) recruited using an online panel. An online
questionnaire gathered self-reported data from smokers regarding health care
professional-provided tobacco treatment over the last 12 months. The 1587
participants who had at least one doctor visit in the past 12 month included
native NDS, converted NDS, light DS, and heavy DS.
Results: Multivariable analysis showed that, there were no statistically
significant differences on the odds of being asked about smoking between
different types of smokers. However, compared to native nondaily smokers,
Latino and White converted nondaily smokers (Latinos, AOR = 2.02, 95% CI
1.09, 3.74 and Whites, AOR= 2.33, 95% CI 1.27, 4.29), light daily smokers (AOR
= 2.82, 95% CI 1.41, 5.63, and AOR= 3.72, 95% CI, 1.92, 7.22, respectively)
and heavy daily smokers (AOR = 4.11, 95% CI 2.01, 8.43 and AOR = 6.85, 95%
CI 3.39, 13.81, respectively) had increasing odds of reporting being advised to
quit by their health care providers. Among African American smokers, converted
nondaily smokers (AOR = 2.11, 95% CI 1.01, 4.44) and heavy daily smokers
(AOR = 2.92, 95% CI 1.35, 6.28) were more likely to receive assistance in
quitting than native nondaily smokers.
Among African Americans, heavy daily smokers’ had greater odds of having
follow-up arranged compared to native nondaily smokers (AOR=3.06, 95% CI
1.08, 8.70) and among Latinos, these rates were only statistically significant for
converted nondaily smokers compared to native nondaily smokers (AOR= 2.80,
95% CI 1.25, 6.26). Among Whites, light daily smokers had the greatest odds of
having their health care provider arrange follow-up (AOR= 10.81, 95% CI 1.37,
85.12) compared to native nondaily smokers.
Conclusions: Daily smokers report greater engagement by health care
providers compared to NDS with regard to smoking cessation. These findings
such suggest the primary care providers are ascribing less risk to NDS than DS.
Educational efforts are needed to change this tendency among primary care
providers. In addition, the patterns identified were similar across the three ethnic
groups studied here.
U2 - http://austinpublishinggroup.com/family-medicine/online-first.php
DO - http://austinpublishinggroup.com/family-medicine/online-first.php
M3 - Article
VL - 2
SP - 1
EP - 9
JO - Journal of Family Medicine
JF - Journal of Family Medicine
IS - 6
ER -