Socioeconomic Disparities in Telephone-Based Treatment of Tobacco Dependence.
Friday, July 11, 2014
Posted by: Natalia Gromov
Am J Public Health. 2014
Jun 12:e1-e9. [Epub ahead of print]
Disparities in Telephone-Based Treatment of Tobacco Dependence.
Varghese M, Sheffer C,
Stitzer M, Landes R, Brackman SL, Munn T.
Socioeconomic disparities in tobacco dependence treatment outcomes from a free,
proactive telephone counseling quitline were examined. Methods.
Cognitive-behavioral treatment and nicotine patches were delivered to 6626
smokers and socioeconomic differences in demographic, clinical, environmental,
and treatment use factors were examined. Logistic regressions and generalized
estimating equations (GEE) were used to model abstinence and account for
socioeconomic differences in the models. Results.
The odds of achieving long-term abstinence differed by socioeconomic status
(SES). In the GEE model, the odds of abstinence for the highest SES
participants were 1.75 times those of the lowest SES participants. Logistic
regression models revealed no treatment outcome disparity at the end of
treatment, but significant disparities 3 and 6 months after treatment. Conclusions. Although
quitlines often increase access to treatment for some lower SES smokers,
significant socioeconomic disparities in treatment outcomes raise questions
about whether current approaches are contributing to tobacco-related
socioeconomic health disparities. Strategies to improve treatment outcomes for
lower SES smokers might include novel methods to address multiple factors
associated with socioeconomic disparities. (Am J Public Health. Published
online ahead of print June 12, 2014: e1-e9. doi:10.2105/AJPH.2014.301951).