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医疗服务提供者在提供戒烟援助方面的社会经济差异。

Socioeconomic disparity in provider-delivered assistance to quit smoking.

作者信息

Browning Kristine K, Ferketich Amy K, Salsberry Pamela J, Wewers Mary Ellen

机构信息

The Ohio State University College of Nursing, OH, USA.

出版信息

Nicotine Tob Res. 2008 Jan;10(1):55-61. doi: 10.1080/14622200701704905.

Abstract

The U.S. Public Health Service smoking cessation clinical practice guideline is the accepted gold standard for smoking cessation treatment. It offers evidence-based treatment recommendations for all clinicians to deliver to all patients at each visit. Despite the release of the guideline and the publication of Healthy People 2010, health care providers still may not appropriately counsel patients to quit smoking. Furthermore, disparities may exist among smokers who are assisted to quit smoking by their health care providers. The present study tested for an association between selected sociodemographic and tobacco-related factors and assistance to quit smoking. This 2001 National Health Interview Survey secondary analysis included a U.S. civilian, noninstitutionalized population. Participants were self-reported current smokers who visited a health care provider in the past 12 months and were at least 25 years old. The outcome measure was smokers' self-report of whether assistance to quit smoking was given by a health care provider. Of smokers who received advice (N = 3,046), only 38% received assistance to quit smoking. Smokers were less likely to report assistance to quit smoking if they were younger or Black, or if they had a high or middle level of socioeconomic disadvantage. In the final logistic regression model, being married, attempting to quit in the past 12 months, and consuming more tobacco were associated with receiving assistance to quit smoking. Increased age also was associated with receiving assistance, as was greater socioeconomic advantage (higher education, higher income, health insurance). The mechanisms responsible for the disparities in delivery of tobacco dependence treatment must be investigated further.

摘要

美国公共卫生服务戒烟临床实践指南是公认的戒烟治疗金标准。它为所有临床医生每次就诊时向所有患者提供基于证据的治疗建议。尽管该指南已发布且《2010年美国人健康目标》也已公布,但医疗保健提供者可能仍未适当地建议患者戒烟。此外,在由医疗保健提供者协助戒烟的吸烟者中可能存在差异。本研究测试了选定的社会人口统计学和烟草相关因素与戒烟协助之间的关联。这项对2001年国家健康访谈调查的二次分析纳入了美国非机构化平民人口。参与者为自我报告的当前吸烟者,他们在过去12个月内就诊过医疗保健提供者且年龄至少为25岁。结果指标是吸烟者关于医疗保健提供者是否提供戒烟协助的自我报告。在接受建议的吸烟者中(N = 3046),只有38%获得了戒烟协助。如果吸烟者较年轻或为黑人,或者具有高或中等程度的社会经济劣势,则他们报告获得戒烟协助的可能性较小。在最终的逻辑回归模型中,已婚、在过去12个月内尝试戒烟以及吸烟量更多与获得戒烟协助相关。年龄增长以及更大的社会经济优势(高等教育、高收入、医疗保险)也与获得协助相关。必须进一步调查导致烟草依赖治疗提供方面差异的机制。

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