| Gender and age disparities for smoking-cessation treatment. | |
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MedLine Citation:
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PMID: 16627128 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: 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. METHODS: 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. RESULTS: 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 receiving medication include female gender (OR=0.45, CI=0.22-0.90) and age 65 and above (OR=0.14, CI=0.03-0.63), while a tobacco-caused diagnosis (OR=3.91, CI=1.64-9.29) and patient prompting (OR=15.31, CI=3.36-69.8) were associated with higher likelihood of receiving medications. CONCLUSIONS: Despite increasing national attention, the identification of tobacco status, counseling rates, and the use of cessation medications by physicians are low and unchanged from 1991. Women and elderly tobacco users were much less likely to receive prescriptions for cessation medications, while patients requesting treatment and those with tobacco-caused diagnoses were more likely. Further educational and public health campaigns are needed to encourage the use of these effective medications, especially in women and the elderly. |
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Authors:
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Michael B Steinberg; Ayse Akincigil; Cristine D Delnevo; Stephen Crystal; Jeffrey L Carson |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-03-23 |
Journal Detail:
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Title: American journal of preventive medicine Volume: 30 ISSN: 0749-3797 ISO Abbreviation: Am J Prev Med Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-04-21 Completed Date: 2006-09-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8704773 Medline TA: Am J Prev Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 405-12 Citation Subset: IM |
Affiliation:
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University of Medicine and Dentistry of New Jersey, Division of General Internal Medicine, New Brunswick, 08903, USA. michael.steinberg@umdnj.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Distribution Aged Female Humans Insurance, Health Male Middle Aged Physician-Patient Relations* Prevalence Sex Distribution Smoking / epidemiology Smoking Cessation / economics, statistics & numerical data* United States / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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