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Smoking cessation therapy varies by race in primary care

Compared with white patients, African-American patients were significantly more likely to receive smoking cessation counselling, but were significantly less likely to receive a prescription for a smoking cessation medication in primary care, according to findings published in Family Practice.

“Existing studies of race disparities in smoking cessation treatment using medical record data are inconsistent,” Denise R. Hooks-Anderson, MD, from the department of family and community medicine at Saint Louis University School of Medicine, and colleagues wrote. “No existing studies have determined if race disparities exist in the type of smoking cessation support provided to white vs. African-American patients in primary care as measured from electronic medical record (EMR) data generated during real world medical encounters.”

Researchers examined medical recorded data from 3,510 white and 2,707 African-American patients between 2008 and 2015 to determine whether smoking cessation treatment varied by race in primary care. They examined data on smoking status, cessation treatments and covariates. Using logistic regression models before and after adjusting for covariates, the investigators measured the link between race and type of smoking cessation treatment (counselling or medication) offered in primary care.

In total, only 23.1% of patients received some type of smoking cessation treatment. Before and after adjusting for covariates, white patients were significantly less likely to receive smoking cessation counselling compared with African-American patients (unadjusted OR = 0.82 [95% CI, 0.65–0.99]; adjusted OR = 0.81 [95% CI, 0.65–0.99]). Patients with high health care utilization, depression and obesity were more likely to receive smoking cessation counselling, but those with vascular disease were less likely to receive counselling. In contrast, white patients had a 40% increased chance of receiving a prescription for smoking cessation compared to African-American patients (OR = 1.40; 95% CI, 1.21–1.62). Patients with high neighborhood socioeconomic status, high clinic utilization, depression, anxiety, substance use disorder, obesity and hyperlipidemia were more likely to receive smoking cessation medication.

“After adjusting for covariates, white patients compared to African-American patients were significantly less likely to receive counselling and significantly more likely to receive medication for smoking cessation,” Hooks-Anderson and colleagues wrote. “Education is warranted for patients who fear dependence on smoking cessation medications or do not believe they are effective. Furthermore, regular provider and staff training regarding best practices to engage more smokers in cessation discussion is also warranted.” – by Savannah Demko

Disclosures: Hooks-Anderson reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.