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NAQC Newsroom: Research

Associations Between Comorbid Health Conditions and Quit Outcomes Among Smokers Enrolled in a State

Monday, May 14, 2018  
Posted by: Natalia Gromov
Nair US, Bell ML, Yuan NP, Wertheim BC, Thomson CA.
Associations Between Comorbid Health Conditions and Quit Outcomes Among Smokers Enrolled in a State Quitline, Arizona, 2011-2016.
Public Health Rep. 2018 Mar/Apr;133(2):200-206. doi: 10.1177/0033354918764903.

OBJECTIVE: Smokers with comorbid health conditions have a disproportionate burden of tobacco-related death and disease. A better understanding of differences in quit rates among smokers with comorbid health conditions can guide tailoring of quitline services for subgroups. The objective of this study was to examine self-reported tobacco cessation rates among Arizona Smokers' Helpline callers with chronic health conditions (CHCs) and/or a mental health condition (MHC). METHODS:  We analyzed data from quitline telephone callers (n = 39 779) who enrolled in and completed at least 1 behavioral counseling session (ie, coaching call). We categorized callers as CHC only (cardiovascular disease/respiratory-related/cancer; 32%), MHC only (eg, mood/anxiety/substance dependence; 13%), CHC + MHC (25%), or no comorbid condition (30%). We assessed 30-day abstinence at 7-month follow-up for 16 683 clients (41.9%). We used logistic regression analysis to test associations between comorbidity and quit outcomes after controlling for relevant variables (eg, nicotine dependence). RESULTS:  Overall quit rates were 45.4% for those with no comorbid condition, 43.3% for those with a CHC only, 37.0% for those with an MHC only, and 33.3% for those with CHC + MHC. Compared with other groups, the CHC + MHC group had the lowest odds of quitting (adjusted odds ratio = 0.60; 95% confidence interval, 0.52-0.69). CONCLUSION:  Having a comorbid condition was associated with lower quit rates, and smokers with co-occurring CHCs and MHCs had the lowest quit rates. Quitlines should evaluate more intensive, evidence-driven, tailored services for smoking cessation among callers with comorbid conditions.

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