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Latinos report less use of pharmaceutical aids when trying to quit smoking

  • Arnold H Levinson
    Correspondence
    Address correspondence and reprint requests to: Arnold H. Levinson, PhD, Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, and Center for Behavioral and Community Studies, AMC Cancer Research Center, 4200 East Ninth Avenue, Box B119, Denver CO 80262, USA.
    Affiliations
    Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine (Levinson, Byers), Denver, Colorado, USA

    Center for Behavioral and Community Studies, AMC Cancer Research Center (Levinson), Denver, Colorado, USA
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  • Eliseo J Pérez-Stable
    Affiliations
    Division of General Internal Medicine, Department of Medicine (Pérez-Stable), University of California at San Francisco, San Francisco, California, USA

    Medical Effectiveness Research Center for Diverse Populations (Pérez-Stable), University of California at San Francisco, San Francisco, California, USA
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  • Paula Espinoza
    Affiliations
    Latino/a Center for Research and Policy, University of Colorado at Denver (Espinoza, Flores), Denver, Colorado, USA
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  • Estevan T Flores
    Affiliations
    Latino/a Center for Research and Policy, University of Colorado at Denver (Espinoza, Flores), Denver, Colorado, USA
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  • Tim E Byers
    Affiliations
    Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine (Levinson, Byers), Denver, Colorado, USA
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      Abstract

      Background

      Latino smokers are more likely than white non-Latino smokers to attempt cessation, but less likely to receive cessation advice from physicians or to use nicotine replacement therapy (NRT). Proposed underlying causes have included lighter smoking, lower financial status, and less healthcare access. This study assessed these factors as possible explanations for disparate rates of smoking-cessation support.

      Methods

      Data were analyzed from a random, population-level telephone survey of Colorado adults that interviewed 10,945 white non-Latino respondents and 1004 Latino respondents. For the current analysis, main outcome measures were receipt of physician advice to quit smoking, use of NRT, and use of bupropion or other anti-depressant for smoking cessation.

      Results

      Latino smokers reported higher prevalence of quit attempts (71.5% v 61.6%, p <0.01) but less physician advice to quit smoking (46.4% v 56.2%, p <0.05) and less use of NRT or an anti-depressant for cessation (10.6% v 24.8%, p <0.0001). Adjusted for potentially confounding factors, the odds ratio (OR) for less Latino use of cessation medications was substantial and significant (full model OR=0.31; 95% confidence interval, 0.17 to 0.57). The adjusted OR for physician cessation advice was not significant.

      Conclusions

      Population-level differences in health status, smoking level, financial status, or healthcare access do not explain why Latino smokers less often use proven pharmaceutical aids to increase cessation. Further research is needed to understand these disparities, and greater effort is needed to deliver cessation support to Latino smokers seeking to quit.
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      References

      1. U.S. Department of Health and Human Services. Healthy people 2010. Conference edition, 2 vols. Washington DC: U.S. Department of Health and Human Services, October 2000

      2. Centers for Disease Control and Prevention. Investment in tobacco control: state highlights—2001. Atlanta GA: Centers for Disease Control and Prevention, Office on Smoking and Health, 2001

      3. Centers for Disease Control and Prevention. The health benefits of smoking cessation: a report of the Surgeon General. Atlanta GA: Centers for Disease Control and Prevention, Office on Smoking and Health, 1990

        • Lightwood J.M.
        • Glantz S.A.
        Short-term economic and health benefits of smoking cessation.
        Circulation. 1997; 96: 1089-1096
        • Samet J.M.
        The health benefits of smoking cessation.
        Med Clin North Am. 1992; 76: 399-414
        • Fiore M.C.
        • Novotny T.E.
        • Pierce J.P.
        • et al.
        Methods used to quit smoking in the United States.
        JAMA. 1990; 263: 2760-2765
        • Shu-Hong Z.
        • Melcer T.
        • Sun J.
        • Rosbrook B.
        • Pierce J.P.
        Smoking cessation with and without assistance.
        Am J Prev Med. 2000; 18: 305-311
        • Sutherland G.
        Current approaches to the management of smoking cessation.
        Drugs. 2002; 62: 53-61
        • West R.
        • McNeill A.
        • Raw M.
        Smoking cessation guidelines for health professionals.
        Thorax. 2000; 55: 987-999
        • Jorenby D.E.
        • Fiore M.C.
        The Agency for Health Care Policy and Research smoking cessation clinical practice guideline.
        Prim Care. 1999; 26: 513-528
      4. Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2003;1

      5. Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2003;1

        • Piper M.E.
        • Fox B.J.
        • Welsch S.K.
        • Fiore M.C.
        • Baker T.B.
        Gender and racial/ethnic differences in tobacco-dependence treatment.
        Nicotine Tob Res. 2001; 3: 291-297
      6. U.S. Department of Health and Human Services. Tobacco use among U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders and Hispanics: a report of the Surgeon General. Atlanta GA: Centers for Disease Control and Prevention, Office on Smoking and Health, 1998

      7. Silagy C, Stead LF. Physician advice for smoking cessation. Cochrane Database Syst Rev 2003;1

        • Centers for Disease Control and Prevention
        Smoking cessation during previous year among adults—United States, 1990 and 1991.
        MMWR Morb Mortal Wkly Rep. 1993; 42: 504-507
      8. Burns D, Pierce JP. Tobacco use in California, 1990–1991. Sacramento CA: California Department of Health Services, 1992

        • Tomar S.L.
        • Husten C.G.
        • Manley M.W.
        Do dentists and physicians advise tobacco users to quit?.
        J Am Dent Assoc. 1996; 127: 259-265
        • Winkleby M.A.
        • Schooler C.
        • Kraemer H.C.
        • Lin J.
        • Fortmann S.P.
        Hispanic versus white smoking patterns by sex and level of education.
        Am J Epidemiol. 1995; 142: 410-418
        • Kogan M.D.
        • Kotelchuck M.
        • Alexander G.R.
        • Johnson W.E.
        Racial disparities in reported prenatal care advice from health care providers.
        Am J Public Health. 1994; 84: 82-88
        • Cummings K.M.
        • Giovino G.
        • Sciandra R.
        • Koenigsberg M.
        • Emont S.L.
        Physician advice to quit smoking.
        Am J Prev Med. 1987; 3: 69-75
        • Pérez-Stable E.J.
        • Ramirez A.
        • Villareal R.
        • et al.
        Cigarette smoking behavior among U.S. Latino men and women from different countries of origin.
        Am J Public Health. 2001; 91: 1424-1430
        • Bolen J.C.
        • Rhodes L.
        • Powell-Griner E.E.
        • Bland S.D.
        • Holtzman D.
        State-specific prevalence of selected health behaviors, by race and ethnicity—Behavioral Risk Factor Surveillance System, 1997.
        MMWR Surveill Summ. 2000; 49: 1-60
        • Shetterly S.M.
        • Baxter J.
        • Mason L.D.
        • Hamman R.F.
        Self-rated health among Hispanics vs non-Hispanic white adults.
        Am J Public Health. 1996; 86: 1798-1801
        • Finch B.K.
        • Hummer R.A.
        • Reindl M.
        • Vega W.A.
        Validity of self-rated health among Latino(a)s.
        Am J Epidemiol. 2002; 155: 755-759
      9. Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System online prevalence data, 1995–2000. Available at: http://apps.nccd.cdc.gov/brfss/. Accessed August 16, 2002

      10. National Association of Attorneys General. Master Settlement Agreement and Amendments. Available at: www.naag.org/issues/tobacco/index.php?smod=919. Accessed February 20, 2003

      11. U.S. Census Bureau. March 2001 Current Population Survey. Data provided by Marketing Systems Group. Available at: www.cdc.gov/brfss/surveydata/2000/table3_00.htm. Accessed June 6, 2002

      12. Kish L. Survey sampling. New York: John Wiley & Sons, 1995 (reprint of 1965 edition)

        • Kish L.
        • Frankel M.R.
        Inference from complex samples.
        J R Stat Soc Bull. 1974; 36: 1-37
        • Cochran W.G.
        Sampling techniques.
        3rd ed. John Wiley & Sons, New York1977
      13. Lee ES, Forthofer RN, Lorimor RJ. Analyzing complex survey data. Sage University Paper Series on Quantitative Applications in the Social Sciences, 07-071. Newbury Park CA: Sage Publications, 1989

        • Kalton G.
        • Kasprzyk D.
        The treatment of missing survey data.
        Survey Methodol. 1986; 12: 1-16
      14. California Department of Health Services, Tobacco Control Section. California tobacco survey: 1999. Cancer Prevention and Control Unit, University of California, San Diego. La Jolla CA: Social Sciences Data Collection, Geisel Library, University of California, San Diego, 2002. Available at: http://ssdc.ucsd.edu/ssdc/cpc00006.html. Accessed February 20, 2003

      15. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey questionnaire. Atlanta GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2001

      16. U.S. Bureau of the Census. Current Population Survey, poverty 2001. Available at: www.census.gov/hhes/poverty/threshld/thresh01.html. Accessed September 9, 2002

      17. Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence: clinical practice guideline. Rockville MD: U.S. Department of Health and Human Services, Public Health Service, June 2000

        • Coreil J.
        • Ray L.A.
        • Markides K.S.
        Predictors of smoking among Mexican-Americans.
        Prev Med. 1991; 20: 508-517
        • Berman B.A.
        • Grosser S.C.
        • Gritz E.R.
        Recruitment to a school-based adult smoking-cessation program.
        J Cancer Educ. 1998; 13: 220-225
        • King T.K.
        • Borrelli B.
        • Black C.
        • Pinto B.M.
        • Marcus B.H.
        Minority women and tobacco.
        Ann Behav Med. 1997; 19: 301-313
        • Marin G.
        • Perez-Stable E.J.
        Effectiveness of disseminating culturally appropriate smoking-cessation information.
        J Natl Cancer Inst Monogr. 1995; 18: 155-163
        • Perez-Stable E.J.
        • Marin G.
        • Posner S.F.
        Ethnic comparison of attitudes and beliefs about cigarette smoking.
        J Gen Intern Med. 1998; 13: 167-174
        • Shiffman S.
        • Mason K.M.
        • Henningfield J.E.
        Tobacco dependence treatments.
        Ann Rev Pub Health. 1998; 19: 335-358
        • Miller C.
        • Kriven S.
        • Rowley D.
        • Abram L.
        Be wary of subsidising nicotine replacement therapy.
        Tob Control. 2002; 11: 380-381
        • Coultas D.B.
        • Howard C.A.
        • Peake G.T.
        • Skipper B.J.
        • Samet J.M.
        Discrepancies between self-reported and validated cigarette smoking in a community survey of New Mexico Hispanics.
        Am Rev Respir Dis. 1988; 137: 810-814
        • Navarro A.M.
        Smoking status by proxy and self report.
        Tob Control. 1999; 8: 182-185
        • Perez-Stable E.J.
        • Marin B.V.
        • Marin G.
        • Brody D.J.
        • Benowitz N.L.
        Apparent underreporting of cigarette consumption among Mexican American smokers.
        Am J Public Health. 1990; 80: 1057-1061
        • Ward J.
        • Sanson-Fisher R.
        Accuracy of patient recall of opportunistic smoking cessation advice in general practice.
        Tob Control. 1996; 5: 110-113