Merilyn Varghese and Christine Sheffer are with the Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, City College of New York, New York, NY. Maxine Stitzer is with Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Reid Landes is with the Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock. S. Laney Brackman and Tiffany Munn are with the Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences.
Am J Public Health. 2014 Aug;104(8):e76-84. doi: 10.2105/AJPH.2014.301951. Epub 2014 Jun 12.
We examined socioeconomic disparities in tobacco dependence treatment outcomes from a free, proactive telephone counseling quitline.
We delivered cognitive-behavioral treatment and nicotine patches to 6626 smokers and examined socioeconomic differences in demographic, clinical, environmental, and treatment use factors. We used logistic regressions and generalized estimating equations (GEE) to model abstinence and account for socioeconomic differences in the models.
The odds of achieving long-term abstinence differed by socioeconomic status (SES). In the GEE model, the odds of abstinence for the highest SES participants were 1.75 times those of the lowest SES participants. Logistic regression models revealed no treatment outcome disparity at the end of treatment, but significant disparities 3 and 6 months after treatment.
Although quitlines often increase access to treatment for some lower SES smokers, significant socioeconomic disparities in treatment outcomes raise questions about whether current approaches are contributing to tobacco-related socioeconomic health disparities. Strategies to improve treatment outcomes for lower SES smokers might include novel methods to address multiple factors associated with socioeconomic disparities.
我们考察了免费主动电话咨询戒烟热线在烟草依赖治疗结果方面的社会经济差异。
我们为 6626 名吸烟者提供了认知行为治疗和尼古丁贴片，并考察了人口统计学、临床、环境和治疗使用因素方面的社会经济差异。我们使用逻辑回归和广义估计方程（GEE）来建立模型，以分析 abstinence，并在模型中考虑社会经济差异。
社会经济地位（SES）对实现长期戒烟的可能性有影响。在 GEE 模型中，最高 SES 参与者的戒烟几率是最低 SES 参与者的 1.75 倍。逻辑回归模型显示，在治疗结束时没有治疗结果的差异，但在治疗结束后 3 个月和 6 个月时存在显著差异。
尽管戒烟热线通常为一些社会经济地位较低的吸烟者增加了治疗的机会，但治疗结果方面存在显著的社会经济差异，这引发了对当前方法是否有助于减少与烟草相关的社会经济健康差异的质疑。为了提高社会经济地位较低的吸烟者的治疗效果，可能需要采用新的方法来解决与社会经济差异相关的多个因素。
