Treatment barriers among younger and older socioeconomically disadvantaged smokers

Patrick J. Hammett, Steven S Fu, Diana J Burgess, David B Nelson, Barbara A Clothier, Jessie E. Saul, John A Nyman, Rachel L Widome, Anne M Joseph

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives: Underutilization of smoking cessation treatments contributes to high rates of smoking in socioeconomically disadvantaged populations. Guided by a conceptual framework, the present study explored how healthcare provider factors, social environment characteristics, and cessation beliefs influence treatment utilization among low-income smokers and whether these associations vary by age. STUDY DESIGN: Analyses were conducted on baseline data from 2406 participants enrolled in a randomized controlled trial that evaluated the effectiveness of a proactive outreach cessation intervention among a sample of younger (18-34 years) and older (35-64 years) smokers enrolled in public healthcare assistance programs. METHODS: Multivariable logistic regression models predicted past year cessation treatment utilization (CTU) among younger and older smokers. Independent variables included measures of healthcare provider factors, social environment characteristics, and cessation beliefs. RESULTS: Younger smokers were less likely to have CTU than older smokers (27.2% vs 36.2%; P <.001). In both groups, number of cigarettes per day, more problems accessing healthcare, receiving medication-related cessation advice, and readiness to quit were positively associated with CTU (P <.05). Among younger smokers, living with another smoker was associated with lower odds of CTU while receipt of cessation advice was associated (P = .033) with higher odds of CTU. CONCLUSIONS: In this sample of low-income smokers, interest in quitting was high but treatment utilization was low. Increasing utilization of cessation treatments via interventions that target issues specific to low-income smokers, including healthcare provider access and advice, the home environment, and motivation to quit, is an important step toward reducing smoking rates in this population.

Original languageEnglish (US)
Pages (from-to)e295-e302
JournalAmerican Journal of Managed Care
Volume23
Issue number9
StatePublished - Sep 2017

Bibliographical note

Funding Information:
Source of Funding: This work was supported by the National Cancer Institute (1R01CA141527-01), National Institutes of Health.

Funding Information:
This work was supported by the National Cancer Institute (1R01CA141527-01), National Institutes of Health. This work was also supported by the Minneapolis VA Center for Chronic Disease Outcomes Research. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.

Publisher Copyright:
© 2017 Materials and Energy Research Center. All Rights Reserved.

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

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