Gender and age disparities for smoking-cessation treatment

American Journal of Preventive Medicine
Michael B SteinbergJeffrey L Carson

Abstract

Physicians play a critical role in tobacco-dependence treatment, especially prescribing cessation medications. However, it is unclear whether efforts are meeting recommended standards. This study evaluates the frequency and predictors of tobacco-use identification, counseling for tobacco dependence, and the prescription of cessation medications in a nationally representative sample of physician-patient encounters. More than 58,000 physician-patient ambulatory encounters from the National Ambulatory Medical Care Survey 2001 and 2002 were analyzed in 2004-2005, including patient demographics, diagnoses, tobacco counseling, and prescriptions. Tobacco-use status was identified in 69% of patient encounters, with 16% of those encounters indicating current use. Tobacco counseling occurred in 22.5% of visits by tobacco users, and 2.4% of tobacco users were prescribed cessation medications. These rates are similar to previous analyses in 1991. Patient characteristics associated with being more likely to receive counseling include being a new patient (adjusted odds ratio [OR]=1.34, 95% confidence interval [CI]=1.00-1.77) and having a tobacco-caused diagnosis (OR=2.71, CI=1.95-3.78). Characteristics associated with a lower likelihood of r...Continue Reading

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