Socioeconomic disparities in telephone-based treatment of tobacco dependence

M. Varghese, C. Sheffer, M. Stitzer, Maurice Landes, S.L. Brackman and T. Munn

American Journal of Public Health, 2014, vol. 104, issue 8, e76-e84

Abstract: Objectives. We examined socioeconomic disparities in tobacco dependence treatment outcomes from a free, proactive telephone counseling quitline. Methods. We delivered cognitive-behavioral treatment and nicotine patches to 6626 smokers and examined socioeconomic differences in demographic, clinical, environmental, and treatment use factors. We used logistic regressions and generalized estimating equations (GEE) 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 tobaccorelated socioeconomic health disparities. Strategies to improve treatment outcomes for lower SES smokers might include novel methods to address multiple factors associated with socioeconomic disparities.

Keywords: nicotine gum, adolescent; adult; aged; article; cognitive therapy; directive counseling; economics; female; health care disparity; health disparity; human; male; methodology; middle aged; smoking; smoking cessation; socioeconomics; statistical model; statistics; telephone; treatment outcome; United States; very elderly; young adult, Adolescent; Adult; Aged; Aged, 80 and over; Arkansas; Cognitive Therapy; Directive Counseling; Female; Health Status Disparities; Healthcare Disparities; Humans; Logistic Models; Male; Middle Aged; Smoking; Smoking Cessation; Socioeconomic Factors; Telephone; Tobacco Use Cessation Products; Treatment Outcome; Young Adult (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.301951_9

DOI: 10.2105/AJPH.2014.301951

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