Associations between comorbid health conditions and quit outcomes among smokers enrolled in a state quitline, arizona, 2011-2016

Uma S. Nair, Melanie L Bell, Nicole P Yuan, Betsy C. Wertheim, Cynthia Thomson

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 ¼ 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 þ 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 þ MHC. Compared with other groups, the CHC þ MHC group had the lowest odds of quitting (adjusted odds ratio ¼ 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.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalPublic Health Reports
Volume133
Issue number2
DOIs
StatePublished - Jan 1 2018

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Mental Health
Health
Tobacco Use Cessation
Tobacco Use Disorder
Smoking Cessation
Telephone
Substance-Related Disorders
Tobacco
Comorbidity
Counseling
Cardiovascular Diseases
Anxiety
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Neoplasms

Keywords

  • Health promotion
  • Health services
  • Smoking
  • Tobacco cessation

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Associations between comorbid health conditions and quit outcomes among smokers enrolled in a state quitline, arizona, 2011-2016. / Nair, Uma S.; Bell, Melanie L; Yuan, Nicole P; Wertheim, Betsy C.; Thomson, Cynthia.

In: Public Health Reports, Vol. 133, No. 2, 01.01.2018, p. 200-206.

Research output: Contribution to journalArticle

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title = "Associations between comorbid health conditions and quit outcomes among smokers enrolled in a state quitline, arizona, 2011-2016",
abstract = "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 ¼ 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 {\th} 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 {\th} MHC. Compared with other groups, the CHC {\th} MHC group had the lowest odds of quitting (adjusted odds ratio ¼ 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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AU - Wertheim, Betsy C.

AU - Thomson, Cynthia

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N2 - 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 ¼ 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 þ 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 þ MHC. Compared with other groups, the CHC þ MHC group had the lowest odds of quitting (adjusted odds ratio ¼ 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.

AB - 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 ¼ 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 þ 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 þ MHC. Compared with other groups, the CHC þ MHC group had the lowest odds of quitting (adjusted odds ratio ¼ 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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KW - Health services

KW - Smoking

KW - Tobacco cessation

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