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1.
Prev Chronic Dis ; 17: E10, 2020 01 30.
Artículo en Inglés | MEDLINE | ID: mdl-31999539

RESUMEN

INTRODUCTION: Hispanic adults make up a growing share of US adult smokers, and smoking is a major preventable cause of disease and death among Hispanic adults. No previous study has compared trends in smoking cessation behaviors among Hispanic adults and non-Hispanic white adults over time. We examined trends in cessation behaviors among Hispanic and non-Hispanic white adult cigarette smokers during 2000-2015. METHODS: Using self-reported data from the National Health Interview Survey, we compared trends in quit attempts, receipt of advice to quit from a health professional, and use of cessation treatment (counseling and/or medication) among Hispanic and non-Hispanic white adult smokers. We also assessed these behaviors among 4 Hispanic subgroups. We conducted analyses in 2018-2019. RESULTS: Past-year quit attempts increased during 2000-2015 among both non-Hispanic white and Hispanic smokers, with no significant differences between these groups. Receiving advice to quit increased significantly among non-Hispanic white adults but did not increase significantly among Hispanic adults. Cessation treatment use increased among both non-Hispanic white and Hispanic adults. Throughout 2000-2015, the prevalence of receiving advice to quit and using cessation treatments was lower among Hispanic adults than non-Hispanic white adults. In 2015, a higher proportion of Hispanic than non-Hispanic white smokers visited a health care provider without receiving advice to quit. CONCLUSION: Hispanic adult smokers are less likely to receive advice to quit and to use proven cessation treatments than non-Hispanic white smokers, and this pattern persisted over time. Culturally competent educational initiatives directed at both providers and Hispanic communities could help eliminate this marked and persistent disparity.

2.
Am J Prev Med ; 57(4): 478-486, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31447242

RESUMEN

INTRODUCTION: Variations exist in insurance coverage of smoking-cessation treatments and cigarette smokers' use of these treatments. Recent trends in cessation behaviors by health insurance status have not been reported. This study examines trends in quit attempts, provider advice to quit, and use of cessation counseling and/or medications among adult cigarette smokers by insurance status. Demographic correlates of these cessation behaviors are also identified. METHODS: Data from the 2000-2015 National Health Interview Surveys were used to estimate the prevalence of and trends in past-year quit attempts, receipt of health professional advice to quit, and use of counseling and/or medication among cigarette smokers aged 18-64 years by insurance status (private, Medicaid, or uninsured). Multivariable logistic regression models were used to identify demographic correlates. The analysis was conducted in 2017. RESULTS: Past-year quit attempts increased linearly among all insurance groups (p<0.05), whereas provider advice to quit remained unchanged. Use of cessation treatment increased linearly among smokers with Medicaid (18.1% [95% CI=13.4%, 22.8%] in 2000 to 34.9% [95% CI=28.5%, 40.5%] in 2015, p<0.05), whereas nonlinear increases were observed among those with private insurance (26.2% [95% CI=24.0%, 28.4%] in 2000 to 32.3% [95% CI=29.0%, 35.6%] in 2015; quadratic trend, p<0.05) and uninsured smokers (13.9% [95% CI=11.0%, 16.8%] in 2000 to 21.8% [95% CI=17.1%, 26.5%] in 2015; quadratic trend, p<0.05). Regardless of insurance status, adults aged 18-24 years had lower odds than older adults of receiving advice to quit and using cessation treatments. CONCLUSIONS: Despite increased use of cessation treatments among Medicaid enrollees, disparities by insurance status persist in adult cessation behaviors. Opportunities exist to increase cessation by making comprehensive, barrier-free cessation coverage available to all smokers.

3.
Am J Prev Med ; 55(4): 480-487, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30241616

RESUMEN

INTRODUCTION: Cigarette smoking is a major preventable cause of disease and death among U.S. Hispanics. Tobacco-cessation quitlines have been shown to increase quitting among Hispanics. However, the use of quitlines by this population remains low, especially among Spanish-speaking Hispanics. This study evaluates the promotion of 1-855-DÉJELO-YA (a quitline portal that routes callers to state-specific Spanish-language services) implemented as part of the Centers for Disease Control and Prevention's national Tips From Former Smokers® (Tips®) campaign. Additionally, this study examines how media content impacted calls to 1-855-DÉJELO-YA. METHODS: Using National Cancer Institute data on calls to 1-855-DÉJELO-YA from February 2013 to December 2014, multivariate linear regressions were conducted of weekly area code-level call volume as a function of media market-level Gross Rating Points for Tips Spanish-language TV ads tagged with 1-855-DÉJELO-YA. The models were adjusted for covariates, including market-level population characteristics and state fixed effects. The data were analyzed from October 2017 through April 2018. RESULTS: Greater exposure to Tips Spanish-language ads was associated with increased calls to 1-855-DÉJELO-YA (p<0.001). On average, each additional 100 Tips Gross Rating Points per media market increased calls by 0.56 (95% CI=0.45, 0.67) calls/week/area code, representing ≅ 974 additional calls beyond the baseline. Media messages highlighting health consequences of smoking had a greater effect size than messages highlighting health effects of secondhand smoke. CONCLUSIONS: A national Spanish-language quitline number could be a useful cessation resource for Spanish-speaking cigarette smokers. Opportunities exist to increase use of this number through a national Spanish-language media campaign, particularly by focusing campaign messages on the health consequences of smoking.


Asunto(s)
Publicidad , Hispanoamericanos/estadística & datos numéricos , Líneas Directas/estadística & datos numéricos , Lenguaje , Cese del Hábito de Fumar , Fumar Tabaco/efectos adversos , Centers for Disease Control and Prevention, U.S. , Femenino , Promoción de la Salud , Humanos , Masculino , Estados Unidos
4.
Public Health Rep ; 133(2): 191-199, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29471727

RESUMEN

OBJECTIVES: Information on the impact of health insurance on smoking and quit attempts at the state level is limited. We examined the state-specific prevalence of cigarette smoking and past-year quit attempts among adults aged 18-64 by health insurance and other individual- and state-level factors. METHODS: We used data from 41 states, the District of Columbia, and Puerto Rico, the jurisdictions that administered the Health Care Access module of the 2014 Behavioral Risk Factor Surveillance System. Data on quit attempts included current smokers with a past-year quit attempt and former smokers who quit during the past year. RESULTS: Overall, smoking prevalence ranged from 14.6% among those with private insurance to 34.7% among Medicaid enrollees, and past-year quit-attempt prevalence ranged from 66.4% among the uninsured to 71.5% among Medicaid enrollees. By insurance group, differences in the prevalence of state-specific past-year quit attempts ranged from 15 to 26 percentage points. Regardless of insurance type, people who were non-Hispanic white and had lower education levels were less likely to attempt quitting than were Hispanic people, non-Hispanic black people, and adults with more than a high school education. CONCLUSIONS: We found disparities in smoking and quit attempts by insurance status and state. Opportunities exist to increase access to cessation treatments through comprehensive state tobacco control programs and improved cessation insurance coverage, coupled with promotion of covered cessation treatments.


Asunto(s)
Grupos Étnicos/psicología , Grupos Étnicos/estadística & datos numéricos , Conductas Relacionadas con la Salud , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Fumar/psicología , Adolescente , Adulto , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Sistema de Vigilancia de Factor de Riesgo Conductual , District of Columbia/epidemiología , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Humanos , Cobertura del Seguro/estadística & datos numéricos , Masculino , Medicaid/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Puerto Rico/epidemiología , Estados Unidos/epidemiología , Adulto Joven
5.
Nicotine Tob Res ; 19(12): 1473-1481, 2017 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-29121347

RESUMEN

Introduction: State quitlines provide free telephone-based cessation services and are available in all states. However, quitlines presently reach 1% of US cigarette smokers. We assessed variations in quitline reach by race/ethnicity across 45 US states included in the National Quitline Data Warehouse, a repository on non-identifiable data reported by state quitlines. Methods: During 2011 to 2013, we analyzed 1 220 171 records from the National Quitline Data Warehouse. Annual quitline reach was defined as the proportion of cigarette smokers and smokeless tobacco users who utilized quitline services during each year, and was calculated by dividing the number of state-specific quitline registrants in each year by the number of adult cigarette smokers and smokeless tobacco users in the state. Results: Average annual reach ranged from: 0.08% (Tennessee) to 3.42% (Hawaii) among non-Hispanic whites; 0.17% (Tennessee) to 3.85% (Delaware) among non-Hispanic blacks; 0.27% (Nevada) to 9.98% (Delaware) among non-Hispanic American Indians/Alaska Native; 0.03% (Alabama) to 2.43% (Hawaii) among non-Hispanic Asian/Pacific Islanders; and from 0.08% (Tennessee) to 3.18% (Maine) among Hispanics. Average annual reach was highest among non-Hispanic American Indians/Alaska Native in 27 states, non-Hispanic blacks in 14 states, and non-Hispanic whites in four states. Conclusions: Quitlines appear to be reaching minority populations; however, overall reach remains low and variations in quitline reach exist by race/ethnicity. Opportunities exist to increase the utilization of quitlines and other effective cessation treatments among racial/ethnic minority populations. Implications: Some studies have assessed quitline reach across demographic groups in individual states; however, no studies have provided multistate data about quitline reach across race/ethnic groups. Ongoing monitoring of the use of state quitlines can help guide targeted outreach to particular race/ethnic groups with the goal of increasing the overall proportion and number of tobacco users that use quitlines. These efforts should be complemented by comprehensive tobacco control initiatives that increase cessation including mass media campaigns, smoke-free policies, increased tobacco prices, expansion of health insurance coverage, and health systems change.


Asunto(s)
Programas de Gobierno/estadística & datos numéricos , Líneas Directas/estadística & datos numéricos , Cese del Hábito de Fumar/etnología , Uso de Tabaco/etnología , Uso de Tabaco/terapia , Adolescente , Adulto , Anciano , Femenino , Programas de Gobierno/tendencias , Conductas Relacionadas con la Salud , Líneas Directas/tendencias , Humanos , Masculino , Persona de Mediana Edad , Política para Fumadores/tendencias , Cese del Hábito de Fumar/psicología , Productos de Tabaco/efectos adversos , Uso de Tabaco/psicología , Estados Unidos/etnología , Adulto Joven
6.
J Smok Cessat ; 12(1): 15-21, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28243318

RESUMEN

INTRODUCTION: The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. AIMS: This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. METHODS: A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. RESULTS/FINDINGS: The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. CONCLUSIONS: This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.

7.
PLoS One ; 12(2): e0170381, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28207744

RESUMEN

OBJECTIVE: To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. METHODS: We used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. RESULTS: In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. CONCLUSIONS: Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.


Asunto(s)
Planes de Aranceles por Servicios/economía , Cobertura del Seguro/estadística & datos numéricos , Medicaid/estadística & datos numéricos , Cese del Hábito de Fumar/economía , Cese del Uso de Tabaco/métodos , Tabaquismo/tratamiento farmacológico , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Patient Protection and Affordable Care Act , Estados Unidos , Adulto Joven
8.
MMWR Morb Mortal Wkly Rep ; 65(52): 1457-1464, 2017 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-28056007

RESUMEN

Quitting cigarette smoking benefits smokers at any age (1). Individual, group, and telephone counseling and seven Food and Drug Administration-approved medications increase quit rates (1-3). To assess progress toward the Healthy People 2020 objectives of increasing the proportion of U.S. adults who attempt to quit smoking cigarettes to ≥80.0% (TU-4.1), and increasing recent smoking cessation success to ≥8.0% (TU-5.1),* CDC assessed national estimates of cessation behaviors among adults aged ≥18 years using data from the 2000, 2005, 2010, and 2015 National Health Interview Surveys (NHIS). During 2015, 68.0% of adult smokers wanted to stop smoking, 55.4% made a past-year quit attempt, 7.4% recently quit smoking, 57.2% had been advised by a health professional to quit, and 31.2% used cessation counseling and/or medication when trying to quit. During 2000-2015, increases occurred in the proportion of smokers who reported a past-year quit attempt, recently quit smoking, were advised to quit by a health professional, and used cessation counseling and/or medication (p<0.05). Throughout this period, fewer than one third of persons used evidence-based cessation methods when trying to quit smoking. As of 2015, 59.1% of adults who had ever smoked had quit. To further increase cessation, health care providers can consistently identify smokers, advise them to quit, and offer them cessation treatments (2-4). In addition, health insurers can increase cessation by covering and promoting evidence-based cessation treatments and removing barriers to treatment access (2,4-6).


Asunto(s)
Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Prevención del Hábito de Fumar , Fumar/psicología , Adolescente , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto Joven
9.
Am J Health Promot ; 30(5): 374-81, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-27404646

RESUMEN

PURPOSE: The ads from the first federally funded national tobacco education campaign, Tips From Former Smokers (Tips), considerably increased quitline calls nationwide. This study evaluates the effect of Tips on state-specific quitline calls. DESIGN: Precampaign, during-campaign, and postcampaign comparison; regression modeling. SETTING: All fifty states as well as the District of Columbia. SUBJECTS: Calls to state quitlines. INTERVENTION: Tips. MEASURES: Tips campaign exposure was measured by gross rating points (GRPs). Calls to quitline's 1-800-QUIT-NOW were assigned to markets in each state based on their area codes. ANALYSIS: Multivariate regression was used to assess the relationship between calls to state quitlines and media market-level Tips GRPs, while controlling for market and area code characteristics. RESULTS: Nationally, every 100 Tips GRPs per week at the market level was associated with an average of 45 additional quitline calls in each area code (ß = 44.65, p < .001). Tips GRPs were associated with significant increases in quitline calls in 46 states and the District of Columbia, of which 11 experienced effects significantly larger than the national average and 5 experienced significantly smaller effects. We were unable to detect statistically significant effects of GRPs on call volumes for four states. Graphically, call volumes in those states followed Tips GRPs. CONCLUSION: The Tips campaign significantly increased calls to quitlines for almost all the states. These findings underscore the effectiveness of national tobacco media campaigns for reaching state audiences.


Asunto(s)
Promoción de la Salud/métodos , Líneas Directas/estadística & datos numéricos , Cese del Hábito de Fumar/estadística & datos numéricos , Prevención del Hábito de Fumar/métodos , Humanos , Cese del Hábito de Fumar/psicología , Estados Unidos
10.
Prev Chronic Dis ; 13: E70, 2016 05 26.
Artículo en Inglés | MEDLINE | ID: mdl-27236381

RESUMEN

INTRODUCTION: Five key health-related behaviors for chronic disease prevention are never smoking, getting regular physical activity, consuming no alcohol or only moderate amounts, maintaining a normal body weight, and obtaining daily sufficient sleep. The objective of this study was to estimate the clustering of these 5 health-related behaviors among adults aged 21 years or older in each state and the District of Columbia and to assess geographic variation in clustering. METHODS: We used data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) to assess the clustering of the 5 behaviors among 395,343 BRFSS respondents aged 21 years or older. The 5 behaviors were defined as currently not smoking cigarettes, meeting the aerobic physical activity recommendation, consuming no alcohol or only moderate amounts, maintaining a normal body mass index (BMI), and sleeping at least 7 hours per 24-hour period. Prevalence of having 4 or 5 of these behaviors, by state, was also examined. RESULTS: Among US adults, 81.6% were current nonsmokers, 63.9% obtained 7 hours or more sleep per day, 63.1% reported moderate or no alcohol consumption, 50.4% met physical activity recommendations, and 32.5% had a normal BMI. Only 1.4% of respondents engaged in none of the 5 behaviors; 8.4%, 1 behavior; 24.3%, 2 behaviors; 35.4%, 3 behaviors; and 24.3%, 4 behaviors; only 6.3% reported engaging in all 5 behaviors. The highest prevalence of engaging in 4 or 5 behaviors was clustered in the Pacific and Rocky Mountain states. Lowest prevalence was in the southern states and along the Ohio River. CONCLUSION: Additional efforts are needed to increase the proportion of the population that engages in all 5 health-related behaviors and to eliminate geographic variation. Collaborative efforts in health care systems, communities, work sites, and schools can promote all 5 behaviors and produce population-wide changes, especially among the socioeconomically disadvantaged.


Asunto(s)
Índice de Masa Corporal , Enfermedad Crónica/prevención & control , Ejercicio Físico , Conductas Relacionadas con la Salud , Estilo de Vida , Fumar/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Sistema de Vigilancia de Factor de Riesgo Conductual , Análisis por Conglomerados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Sueño , Estados Unidos/epidemiología , Adulto Joven
11.
Nicotine Tob Res ; 18(8): 1780-5, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27073208

RESUMEN

INTRODUCTION: Previous research has shown that the first federally funded national tobacco education campaign (Tips) increased calls to the national quitline portal (1-800-QUIT-NOW). Quitlines in 13 states have alternate state-specific telephone numbers. This study examined quitline calls to 1-800-QUIT-NOW in states with and without alternate numbers during the Tips campaign. METHODS: We used data on calls to 1-800-QUIT-NOW from all US states and the District of Columbia from 2 weeks before to 2 weeks after the 2012 Tips campaign. Similar data were obtained for California's alternate number, 1-800-NO-BUTTS. Multivariate linear models examined whether an interaction existed between Tips exposure, as measured by gross rating points, and presence of an alternate quitline number as well as the effect of Tips on calls to California's 1-800-NO-BUTTS. RESULTS: Having an alternate quitline number did not affect the rate of increase in calls to 1-800-QUIT-NOW, but it was associated with lower absolute numbers of calls to 1-800-QUIT-NOW. On average, states with alternate numbers had 98 fewer calls to 1-800-QUIT-NOW per week in a given area code than those without an alternate number (P < .001). In California, Tips gross rating points were positively correlated with calls to 1-800-QUIT-NOW (b = 38.5, P < .001) and to 1-800-NO-BUTTS (b = 14.1, P < .05). CONCLUSIONS: The Tips campaign had the same effect in increasing calls to 1-800-QUIT-NOW in states with and without alternate quitline numbers and had a modest spillover effect on calls to California's alternate number. States may consider the advantages and disadvantages of having alternate quitline numbers given continued national promotions of 1-800-QUIT-NOW. IMPLICATIONS: This is the first study that assesses whether the impact of a national tobacco education campaign promoting the national quitline portal number was influenced by the presence of state-specific quitline numbers and whether there was any spillover effect on calls to states' alternate quitline numbers. This study provides important information for states to consider the advantages and disadvantages of maintaining state-specific quitline numbers.


Asunto(s)
Promoción de la Salud , Líneas Directas/estadística & datos numéricos , Cese del Hábito de Fumar/estadística & datos numéricos , Prevención del Hábito de Fumar , Publicidad , Humanos , Evaluación de Resultado en la Atención de Salud , Estados Unidos
12.
Prev Chronic Dis ; 13: E17, 2016 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-26851336

RESUMEN

INTRODUCTION: Telephone-based tobacco quitlines are an evidence-based intervention, but little is known about how callers hear about quitlines and whether variations exist by demographics or state. This study assessed trends in "how-heard-abouts" (HHAs) in 38 states. METHODS: Data came from the Centers for Disease Control and Prevention's (CDC's) National Quitline Data Warehouse, which stores nonidentifiable data collected from individual callers at quitline registration and reported quarterly by states. Callers were asked how they heard about the quitline; responses were grouped into the following categories: media, health professional, family or friends, and "other." We examined trends from 2010 through 2013 (N = 1,564,437) using multivariable models that controlled for seasonality and the impact of CDC's national tobacco education campaign, Tips From Former Smokers (Tips). Using data from 2013 only, we assessed HHAs variation by demographics (sex, age, race/ethnicity, education) and state in a 38-state sample (n = 378,935 callers). RESULTS: From 2010 through 2013, the proportion of HHAs through media increased; however, this increase was not significant when we controlled for calendar quarters in which Tips aired. The proportion of HHAs through health professionals increased, whereas those through family or friends decreased. In 2013, HHAs occurred as follows: media, 45.1%; health professionals, 27.5%, family or friends, 17.0%, and other, 10.4%. Media was the predominant HHA among quitline callers of all demographic groups, followed by health professionals (except among people aged 18-24 years). Large variations in source of HHAs were observed by state. CONCLUSION: Most quitline callers in the 38-state sample heard about quitlines through the media or health care professionals. Variations in source of HHAs exist across states; implementation of best-practice quitline promotional strategies is critical to maximize reach.


Asunto(s)
Promoción de la Salud/métodos , Autoinforme , Cese del Hábito de Fumar/métodos , Tabaquismo/prevención & control , Adolescente , Adulto , Anciano , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto Joven
13.
Prev Med ; 91S: S28-S34, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-26824891

RESUMEN

OBJECTIVE: We examined the change over time in tobacco advertising, promotion and sponsorship exposure and the concurrent changes in cigarette smoking behavior among students age 13 to 15years in two African countries with different anti-tobacco advertising, promotion and sponsorship policies. In South Africa, anti-tobacco advertising, promotion and sponsorship policies became more comprehensive over time and were more strictly enforced, whereas the partial anti-tobacco advertising, promotion and sponsorship policies adopted in Botswana were weakly enforced. METHOD: We analyzed two rounds of Global Youth Tobacco Survey data from South Africa (1999, n=2342; 2011, n=3713) and in Botswana (2001, n=1073; 2008, n=1605). We assessed several indicators of tobacco advertising, promotion and sponsorship exposure along with prevalence of current cigarette smoking and smoking susceptibility for each data round. Logistic regression was used to examine changes over time in tobacco advertising, promotion and sponsorship exposure and smoking behavior in both countries. RESULTS: Between 1999 and 2011, South African students' exposure to tobacco advertising and sponsorship decreased significantly by 16% (p value, <0.0001) and 14% (p value, <0.0001), respectively. Exposure to tobacco promotion was lower and did not decrease significantly. Botswanan students' tobacco advertising, promotion and sponsorship exposure did not change significantly between 2001 and 2008. South African students' prevalence of cigarette smoking decreased over time (OR, 0.68) as did susceptibility to smoking (OR, 0.75), but declines did not remain significant after adjusting for parents' and friends' smoking. In Botswana, students' prevalence of cigarette smoking increased significantly over time (OR, 1.84), as did susceptibility to smoking (OR, 2.71). CONCLUSION: Enforcement of strong anti-tobacco advertising, promotion and sponsorship policies is a vital component of effective tobacco control programs in Africa. Such regulations, if effectively implemented, can reduce tobacco advertising, promotion and sponsorship exposure among adolescents and may influence cigarette smoking behavior.


Asunto(s)
Conducta del Adolescente , Publicidad , Fumar/epidemiología , Adolescente , Botswana/epidemiología , Femenino , Promoción de la Salud/métodos , Humanos , Masculino , Políticas , Prevalencia , Cese del Hábito de Fumar/métodos , Prevención del Hábito de Fumar , Sudáfrica/epidemiología , Estudiantes , Encuestas y Cuestionarios
14.
Chest ; 149(3): 676-84, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26291388

RESUMEN

BACKGROUND: Cigarette smoking is the predominant cause of COPD. Quitting can prevent development of and complications from COPD. The gold standard in clinician delivery of smoking cessation treatments is the 5As (ask, advise, assess, assist, arrange). This study assessed prevalence and correlates of self-reported receipt of the 5A strategies among adult smokers with and without COPD. METHODS: Data were analyzed from 20,021 adult past-year cigarette smokers in the 2009-2010 National Adult Tobacco Survey, a nationally representative telephone survey of US adults 18 years of age and older. Past-year receipt of the 5As was self-reported by participants who saw a clinician in the past year. Logistic regression was used to estimate the likelihood of receipt of each of the 5As by COPD status, adjusted for sociodemographic and smoking characteristics. RESULTS: Among smokers, those with COPD were more likely than those without COPD to report being asked about tobacco use (95.4% vs 85.8%), advised to quit (87.5% vs 59.4%), assessed for readiness to quit (63.8% vs 37.9%), offered any assistance to quit (58.6% vs 34.0%), and offered follow-up (14.9% vs 5.2%). In adjusted logistic regression models, those with COPD were significantly more likely than those without COPD to receive each of the 5As. CONCLUSIONS: Health professionals should continue to prioritize tobacco cessation counseling and treatment to smokers with COPD. Increased system-level changes and insurance coverage for cessation treatments could be used to improve the delivery of brief tobacco cessation counseling to all smokers, regardless of COPD status.


Asunto(s)
Personal de Salud , Tamizaje Masivo/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Adolescente , Adulto , Anciano , Consejo/estadística & datos numéricos , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Fumar/terapia , Encuestas y Cuestionarios , Adulto Joven
15.
Nicotine Tob Res ; 18(1): 41-7, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25744953

RESUMEN

INTRODUCTION: It is unclear how use of other tobacco products impacts cigarette-smoking cessation. We assessed differences in past year cigarette smoking quit attempts and use of counseling and medication among current cigarette-only users, cigarette and cigar users, and cigarette and smokeless tobacco (SLT) users. METHODS: Data came from 24 448 current cigarette-only, 1064 cigarette and cigar only, and 508 cigarette and SLT only users who responded to the 2010-2011 Tobacco Use Supplement to the Current Population Survey. Demographic, smoking, and cessation characteristics were computed by group. Bivariate and multivariable logistic regression models assessed the relationship of tobacco use group to making a past year quit attempt, and use of counseling or medication during the last quit attempt. RESULTS: Dual users of cigarettes and cigars or SLT had similar interest in quitting and prevalence of reported past year quit attempts compared to cigarette-only users. In unadjusted analyses, cigarette and SLT users had higher odds of trying to quit in the past year compared to cigarette-only users (odds ratio [OR] = 1.31, 95% confidence interval [CI] = 1.05, 1.64); no differences were found for cigarette and cigar users. However, adjusting for demographic and cigarette smoking variables, both groups of dual users had similar odds as cigarette-only users for having made a past year cigarette smoking quit attempt, and to have used counseling or medication during the last quit attempt. CONCLUSION: Dual tobacco use was not associated with decreased attempts to quit smoking cigarettes; however, use of evidence-based treatment was sub-optimal among cigarette-only and dual users, and should be increased.


Asunto(s)
Consejo , Cese del Hábito de Fumar/métodos , Prevención del Hábito de Fumar , Fumar/psicología , Tabaquismo/prevención & control , Tabaquismo/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Prevalencia , Tabaco , Productos de Tabaco , Tabaco sin Humo , Adulto Joven
16.
Nicotine Tob Res ; 18(6): 1539-44, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26588937

RESUMEN

INTRODUCTION: To understand changes occurring in nondaily smoking, we assessed differences in demographics and trends in nondaily smoking, by smoking frequency and amount. METHODS: Participants were 13 966 adult nondaily cigarette smokers (NDS) age 18 years and older responding to the 2000-2012 US National Health Interview Survey, an annual, nationally-representative, cross-sectional, household interview survey. We created a nine-level smoking frequency-amount variable using tertile cut points from the number of days smoked in the past 30 (1-7, 8-14, 15-29 days) and number of cigarettes smoked per day (cpd; 1-2, 3-5, ≥6). We computed weighted frequencies by low-, moderate-, high-frequency use, by low-, moderate-, high-cpd amount, and by demographics. We estimated temporal trends using weighted least squares regression, and the association between groups and past-year quit attempts using logistic regression. RESULTS: Overall prevalence of nondaily smoking among adults remained stable between 2000 to 2012 (P = .62). The most prevalent nondaily smoking frequency-amount groups were: smoking 15-29 days (in the past 30), 3-5 cpd (20.2%); 1-7 days, 1-2 cpd (19.7%); 15-29 days, 1-2 cpd (14.9%); and 15-29 days, ≥6 cpd (12.1%). From 2000 to 2012, low-cpd NDS (1-2 cpd) across moderate (8-14 days) and high (15-29 days) frequency groups increased (P < .01), while moderate frequency-moderate cpd (8-14 days, 3-5 cpd; P < .05) and high frequency-high cpd (15-29 days, ≥6 cpd; P < .01) NDS declined. Adjusting for demographics and year, the lowest frequency-amount groups had the lowest odds of past-year quit attempts. CONCLUSION: Changes occurred in NDS frequency and amount from 2000 to 2012, suggesting that more granular classifications may be important for monitoring NDS patterns. IMPLICATIONS: From 2000 to 2012, low-cpd NDS (1-2 cpd) across moderate- (8-14 days) and high-frequency (15-29 days) groups increased in the United States, while moderate frequency-moderate cpd (8-14 days, 3-5 cpd) and high frequency-high cpd (15-29 days, ≥6 cpd) NDS declined. Demographic differences were found across NDS frequency-amount groups. Adjusting for demographics and year, the lowest frequency-amount groups had the lowest odds of past-year quit attempts. These data can be used to further understand evolving patterns of NDS behavior, and to provide possible targeted groups-both by demographics and smoking frequency/amount-for future research and intervention.


Asunto(s)
Cese del Hábito de Fumar/estadística & datos numéricos , Fumar , Tabaquismo , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumar/epidemiología , Fumar/terapia , Tabaquismo/epidemiología , Tabaquismo/terapia , Adulto Joven
17.
Prev Chronic Dis ; 12: E191, 2015 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-26542143

RESUMEN

INTRODUCTION: We estimated changes in call volume in the United States in response to increases in advertising doses of the Tips From Former Smokers (Tips) campaign, the first federal national tobacco education campaign, which aired for 12 weeks from March 19 to June 10, 2012. We also measured the effectiveness of ad taglines that promoted calls directly with a quitline number (1-800-QUIT-NOW) and indirectly with a cessation help website (Smokefree.gov). METHODS: Multivariate regressions estimated the weekly number of calls to 1-800-QUIT-NOW by area code as a function of weekly market-level gross rating points (GRPs) from CDC's Tips campaign in 2012. The number of quitline calls attributable solely to Tips was predicted. RESULTS: For quitline-tagged ads, an additional 100 television GRPs per week was associated with an increase of 89 calls per week in a typical area code in the United States (P < .001). The same unit increase in advertising GRPs for ads tagged with Smokefree.gov was associated with an increase of 29 calls per week in any given area code (P < .001). We estimated that the Tips campaign was responsible for more than 170,000 additional calls to 1-800-QUIT-NOW during the campaign and that it would have generated approximately 140,000 additional calls if all ads were tagged with 1-800-QUIT-NOW. CONCLUSION: For campaign planners, these results make it possible to estimate 1) the likely impact of tobacco prevention media buys and 2) the additional quitline capacity needed at the national level should future campaigns of similar scale use 1-800-QUIT-NOW taglines exclusively.


Asunto(s)
Publicidad/estadística & datos numéricos , Promoción de la Salud/métodos , Líneas Directas/estadística & datos numéricos , Cese del Hábito de Fumar , Prevención del Hábito de Fumar , Centers for Disease Control and Prevention, U.S. , Internet , Análisis Multivariante , Análisis de Regresión , Televisión , Estados Unidos
18.
Prev Med Rep ; 2: 686-688, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26457245

RESUMEN

The Affordable Care Act (ACA) requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians-gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians-gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians-gynecologists (n = 252) regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05) were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%-96.8%; P = 0.02). One-third (36.1%) of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians-gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.

19.
MMWR Morb Mortal Wkly Rep ; 64(40): 1129-35, 2015 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-26468619

RESUMEN

What is already known on this topic? Quitting smoking is beneficial to health at any age, and cigarette smokers who quit before age 35 years have mortality rates similar to those of persons who never smoked. What is added by this report?During 2001­2010, the proportion of adult cigarette smokers who had made a quit attempt in the past year increased significantly in 29 states and the U.S. Virgin Islands. During 2011­2013, the proportion who had made a quit attempt increased in Hawaii and Puerto Rico and decreased in New Mexico. In 2013, the proportion who had made a quit attempt ranged from 56.2% (Kentucky) to 76.4% (Puerto Rico and Guam) with a median of 65.9%, and was generally lower in older age groups. What are the implications for public health practice? Continued implementation of effective evidence-based public health interventions can reduce the health and costs impacts of smoking-related disease and death and accelerate progress toward meeting the Healthy People 2020 target to increase to ≥80% the proportion of U.S. adult cigarette smokers who made a quit attempt in the past year. These interventions include increasing the price of tobacco products, implementing comprehensive smoke-free laws, conducting educational mass media campaigns, and providing insurance coverage for all effective cessation treatments as well as access to quitlines.


Asunto(s)
Cese del Hábito de Fumar/psicología , Prevención del Hábito de Fumar , Fumar/psicología , Adolescente , Adulto , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Humanos , Persona de Mediana Edad , Fumar/epidemiología , Cese del Hábito de Fumar/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
20.
Am J Prev Med ; 49(6): 939-44, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26362404

RESUMEN

INTRODUCTION: Quitting smoking at any age confers health benefits. However, studies have suggested that quitting by age 35 years leads to mortality rates similar to never smokers. This study assessed whether the mean and median ages of past-year quitting and prevalence of past-year quit attempts and successful quitting by age group changed over time. METHODS: Data came from 113,599 adult cigarette smokers participating in the 1997-2012 National Health Interview Survey, an annual, cross-sectional household survey of U.S. adults aged ≥18 years. Mean and median ages of past-year successful abstinence (quit 6-12 months) were computed. Orthogonal polynomial logistic regression models tested for trends in quit attempts and successful quitting. Data were analyzed in 2014. RESULTS: The average age of quitting (40.0 years in 1997-1998, 39.5 years in 2011-2012, p=0.80) and median age of quitting (35.9 years in 1997-1998, 36.9 years in 2011-2012, p=0.62) did not change over time. During 1997-2012, the percentage of smokers making a past-year quit attempt increased among those aged 25-34, 35-44, and 45-64 years; the percentage of smokers who reported quitting successfully increased among those aged 25-34 and 35-44 years (p<0.001). CONCLUSIONS: Although the average age of quitting did not change over time, increases in past-year quit attempts and successful quitting occurred among adults aged 25-44 years. Proven population-level interventions--including price increases, mass media campaigns, comprehensive smoke-free policies, and health systems interventions--should be continued to further increase cessation, particularly among younger adults.


Asunto(s)
Cese del Hábito de Fumar , Adolescente , Adulto , Factores de Edad , Anciano , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Cese del Hábito de Fumar/estadística & datos numéricos , Estados Unidos , Adulto Joven
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