Smoking and cessation behaviors in patients at federally funded health centers – United States, 2014

Trapl, Erika S.; VanFrank, Brenna; Kava, Christine M.; Trinh, Vinh; Land, Stephanie R.; Williams, Rebecca S.; Frost, Elizabeth; Babb, Stephen

doi:10.1016/j.drugalcdep.2021.108615

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Research has found that patients at federally funded community health centers, which provide care to patients with lower income, smoke at higher rates than the overall U.S. population and that a higher proportion of patients at these centers receive advice to quit compared to the overall U.S. population. 24,25 For nearly all knowledge indicators measured in this study, results demonstrated that opportunities exist to educate healthcare providers about clinical practice guidelines, treatment efficacy, and treatment modalities. Although efforts have been made to integrate this content into medical education, more work could be done at both the undergraduate and graduate level and through continuing medical education.…”

Section: Discussionmentioning

confidence: 78%

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Healthcare Providers’ Knowledge of Evidence-Based Treatment for Tobacco Dependence, DocStyles 2020

Golden,

Courtney-Long,

VanFrank

2023

Am J Health Promot

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Purpose Although smoking cessation reduces the risk of all-cause mortality, evidence-based cessation treatments are underused. This study examined healthcare provider knowledge of evidence-based cessation treatments and associations between knowledge and clinical practice characteristics. Design Cross-sectional survey. Setting 2020 DocStyles. Subjects 1480 U.S. healthcare providers. Measures Provider knowledge of availability of tobacco use disorder diagnostic criteria, clinical practice guideline availability, treatment efficacy, evidence-based counseling modalities, and medications approved by the U.S. Food and Drug Administration (FDA). Analysis Adjusted odds ratios (aORs), adjusted for personal and clinical practice characteristics. Results Less than half of respondents demonstrated high knowledge of availability of diagnostic criteria (36.8%), cessation treatment efficacy (33.2%), evidence-based counseling modalities (5.6%), and FDA-approved medications (40.1%). Significant differences were found between specialties: compared to internists, family physicians were less likely to have low knowledge of medications (aOR = .69, 95% CI = .53, .90) and obstetricians/gynecologists were more likely to have low knowledge of medications (aOR = 2.62, 95% CI = 1.82, 3.76). Overall, few associations between knowledge and clinical practice characteristics were identified. Conclusion Most providers had low knowledge of the topics of interest, with little variation across clinical practice characteristics, indicating room for improvement. Efforts to improve provider knowledge of evidence-based treatments are an important component of a comprehensive approach to improving delivery and use of cessation interventions and increasing tobacco cessation.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Healthcare Providers’ Knowledge of Evidence-Based Treatment for Tobacco Dependence, DocStyles 2020

Golden,

Courtney-Long,

VanFrank

2023

Am J Health Promot

Self Cite

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“…Pharmacotherapy and counseling remain the gold standard for smoking cessation, 49 which are unfortunately underutilized in practice. 50 Efforts to increase uptake of these existing strategies should supplement public policy efforts, as outlined by the WHO FCTC. Opportunities are available to increase offers of support by training health professionals in smoking cessation, as outlined in our own original research studies.…”

Section: Discussionmentioning

confidence: 99%

“…Increasing the uptake of existing evidence‐based smoking cessation support should be a focus of investment for global tobacco control. Pharmacotherapy and counseling remain the gold standard for smoking cessation, 49 which are unfortunately underutilized in practice 50 . Efforts to increase uptake of these existing strategies should supplement public policy efforts, as outlined by the WHO FCTC.…”

Section: Discussionmentioning

confidence: 99%

Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990–2019

et al. 2022

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Background Cancers are leading causes of mortality and morbidity, with smoking being recognized as a significant risk factor for many types of cancer. We aimed to report the cancer burden attributable to tobacco smoking by sex, age, socio‐demographic index (SDI), and cancer type in 204 countries and territories from 1990 to 2019. Methods The burden of cancers attributable to smoking was reported between 1990 and 2019, based upon the Comparative Risk Assessment approach used in the Global Burden of Disease (GBD) study 2019. Results Globally, in 2019 there were an estimated 2.5 million cancer‐related deaths (95% UI: 2.3 to 2.7) and 56.4 million DALYs (51.3 to 61.7) attributable to smoking. The global age‐standardized death and DALY rates of cancers attributable to smoking per 100,000 decreased by 23.0% (−29.5 to −15.8) and 28.6% (−35.1 to −21.5), respectively, over the period 1990–2019. Central Europe (50.4 [44.4 to 57.6]) and Western Sub‐Saharan Africa (6.7 [5.7 to 8.0]) had the highest and lowest age‐standardized death rates, respectively, for cancers attributable to smoking. In 2019, the age‐standardized DALY rate of cancers attributable to smoking was highest in Greenland (2224.0 [1804.5 to 2678.8]) and lowest in Ethiopia (72.2 [51.2 to 98.0]). Also in 2019, the global number of DALYs was highest in the 65–69 age group and there was a positive association between SDI and the age‐standardized DALY rate. Conclusions The results of this study clearly illustrate that renewed efforts are required to increase utilization of evidence‐based smoking cessation support in order to reduce the burden of smoking‐related diseases.

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“…1 Community health centers (CHCs) are the primary source of health care for this population, and they can play a pivotal role in addressing this disparity. 2 Yet, CHCs often lack resources and staff to deliver robust smoking cessation programs. Even where such programs exist, these programs provide little systematic attention to social and behavioral barriers to smoking cessation.…”

Section: Introductionmentioning

confidence: 99%

Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers

Potter,

Tsoh,

Lugtu

et al. 2024

J Am Board Fam Med

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Background: Cigarette smoking rates remain disproportionately high among low income populations with unmet social and behavioral health needs. To address this problem, we sought to develop and evaluate the feasibility, acceptability, and preliminary effectiveness of a novel smoking cessation program for community health centers that serve these populations.Methods: We implemented a randomized pilot trial of two smoking cessation programs in three county operated community health center (CHC) sites: (1) a systematic assessment of smoking habits and standard tools to assist with smoking cessation counseling ("Enhanced Standard Program" or ESP), and (2) another that added a structured assessment of social and behavioral barriers to smoking cessation, ("Connection to Health for Smokers" or CTHS). Clinical outcomes were evaluated between 10 to 16 weeks, supplemented with interviews of patient participants and health care team members.Results: 141 adults were randomized and 123 completed the intervention (61 in ESP, 62 in CTHS). At follow-up, over half of participants reported ≥1 quit attempts (59.7% ESP and 56.5% CTHS; adjusted p = .66) while more in ESP (24.6% vs. 12.9%) were documented as not smoking in the last 7 days (adjusted p = 0.03). In addition to being in ESP, predictors of smoking cessation included higher baseline confidence in ability to quit (p = 0.02) and more quit attempts during the study (p = 0.04). Health care teams, however, generally preferred the more comprehensive approach of CTHS.Conclusion: Lessons learned from this pilot study may inform the development of effective smoking cessation programs for CHCs that combine elements of both interventions.

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Smoking and cessation behaviors in patients at federally funded health centers – United States, 2014

Cited by 6 publications

References 20 publications

Healthcare Providers’ Knowledge of Evidence-Based Treatment for Tobacco Dependence, DocStyles 2020

Healthcare Providers’ Knowledge of Evidence-Based Treatment for Tobacco Dependence, DocStyles 2020

Global, regional, and national burden of cancers attributable to tobacco smoking in 204 countries and territories, 1990–2019

Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers

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