Unbound MEDLINE

Socioeconomic disparities in community-based treatment of tobacco dependence.

Abstract

OBJECTIVES
We examined socioeconomic disparities in a community-based tobacco dependence treatment program.
METHODS
We provided cognitive-behavioral treatment and nicotine patches to 2739 smokers. We examined treatment use, clinical and environmental, and treatment outcome differences by socioeconomic status (SES). We used logistic regressions to model end-of-treatment and 3- and 6-month treatment outcomes.
RESULTS
The probability of abstinence 3 months after treatment was 55% greater for the highest-SES than for the lowest-SES (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.03, 2.33) smokers and increased to 2.5 times greater for the highest-SES than for the lowest-SES smokers 6 months after treatment (AOR = 2.47; 95% CI = 1.62, 3.77). Lower-SES participants received less treatment content and had fewer resources and environmental supports to manage a greater number of clinical and environmental challenges to abstinence.
CONCLUSIONS
Targets for enhancing therapeutic approaches for lower socioeconomic groups should include efforts to ensure that lower-SES groups receive more treatment content, strategies to address specific clinical and environmental challenges associated with treatment outcomes for lower-SES smokers (i.e., higher dependence and stress levels and exposure to other smokers), and strategies to provide longer-term support.

Links

  • Publisher Full Text
  • Authors

    Sheffer CE, Stitzer M, Landes R, Brackman SL, Munn T, Moore P

    Institution

    Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. csheffer@med.cuny.edu

    Source

    American journal of public health 102:3 2012 Mar pg e8-16

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Arkansas
    Cognitive Therapy
    Community Networks
    Confidence Intervals
    Female
    Healthcare Disparities
    Humans
    Interviews as Topic
    Logistic Models
    Male
    Middle Aged
    Odds Ratio
    Outcome Assessment (Health Care)
    Social Class
    Tobacco Use Disorder
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22390525