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Smoking-Cessation Efforts by US Adult Smokers with Medical Comorbidities

  • Sara Kalkhoran
    Correspondence
    Requests for reprints should be addressed to Sara Kalkhoran, MD, MAS, Division of General Internal Medicine, Massachusetts General Hospital, 50 Staniford St, Room 913, Boston, MA 02114.
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston

    Harvard Medical School, Boston, Mass
    Search for articles by this author
  • Gina R. Kruse
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston

    Harvard Medical School, Boston, Mass
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  • Yuchiao Chang
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston

    Harvard Medical School, Boston, Mass
    Search for articles by this author
  • Nancy A. Rigotti
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston

    Harvard Medical School, Boston, Mass
    Search for articles by this author
Published:October 09, 2017DOI:https://doi.org/10.1016/j.amjmed.2017.09.025

      Abstract

      Background

      Continued cigarette smoking by individuals with chronic medical diseases can adversely affect their symptoms, disease progression, and mortality. We assessed the association between medical comorbidities and smoking-cessation efforts among US adult smokers.

      Methods

      We analyzed cross-sectional data from 12,494 past-year cigarette smokers aged ≥18 years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health study. We assessed the association between self-reported medical comorbidities and past-year quit attempts, use of evidence-based smoking-cessation treatment or electronic cigarettes, and successful smoking cessation using logistic regression, adjusting for sociodemographics, insurance status, geographic region, and having a past-year doctor visit.

      Results

      In the study sample, 39% were aged 18 to 34 years, 45% were female, 70% were non-Hispanic white, and 48% reported ≥1 comorbidity. Smokers with any comorbidity, compared with those without comorbidities, had higher odds of trying to quit (adjusted odds ratio, 1.19; 95% confidence interval, 1.08-1.30), but no higher likelihood of quitting success. Having more medical comorbidities was associated with increased odds of trying to quit. Smokers with a comorbidity used evidence-based treatment more often than smokers without comorbidities (43% vs 26%); use of e-cigarettes to quit was similar between smokers with and without comorbidities (27% vs 28%).

      Conclusions

      Adult smokers with chronic medical diseases try to quit and use evidence-based tobacco-cessation treatment more often than smokers without comorbidities, but they are no more likely to quit, suggesting that their quit attempts are less likely to succeed. Smokers with medical comorbidities may require more intensive, prolonged, and repeated treatment to stop smoking.

      Keywords

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