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J Gen Intern Med. 2019 Feb 19. doi: 10.1007/s11606-019-04857-3. [Epub ahead of print]

Cigarette Smoking and Quitting-Related Factors Among US Adult Health Center Patients with Serious Mental Illness.

Author information

1
Tobacco Research and Treatment Center, General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. skalkhoran@mgh.harvard.edu.
2
Harvard Medical School, Boston, MA, USA. skalkhoran@mgh.harvard.edu.
3
Tobacco Research and Treatment Center, General Medicine Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
4
Harvard Medical School, Boston, MA, USA.
5
Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
6
Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, Boston, MA, USA.

Abstract

INTRODUCTION:

US adults with serious mental illness (SMI), compared to those without SMI, have a higher prevalence of smoking, which contributes to a shorter life expectancy. This study compared current smoking and quitting-related characteristics of low-income US adults with and without SMI who received healthcare at federally funded health centers.

METHODS:

Using cross-sectional data from adults ≥ 18 years old in the nationally representative 2014 Health Center Patient Survey (n = 5592), we compared the prevalence of ever and current smoking among adults with and without SMI and calculated quit ratios as the percentage of ever smokers who have quit smoking. We examined the association between SMI and receiving advice to quit, making quit attempts, and having plans to quit in the next 30 days using multivariable logistic regression.

RESULTS:

A total of 1376 (23%) of participants had SMI. Ever smoking prevalence was 68% in adults with SMI and 41% in adults without SMI, and current smoking prevalence was 48% and 22%, respectively. The quit ratio was 30% and 46% among participants with and without SMI, respectively. Compared to smokers without SMI, more smokers with SMI reported receiving advice to quit in the past 12 months (aOR 2.47, 95% CI 1.20-5.07). Smokers with and without SMI did not differ significantly in their odds of having made a past-12-month quit attempt or plans to quit.

CONCLUSIONS:

Smokers with SMI seen in federally funded health centers were just as likely to have made a quit attempt and to have plans to quit as smokers without SMI. Despite a higher likelihood of receiving clinician advice to quit, the lower quit ratio in this population suggests that advice alone is unlikely to be sufficient. These results underscore the need for augmented strategies to promote smoking cessation and reduce the excess burden of tobacco-related disease in patients with SMI.

KEYWORDS:

mental health; smoking cessation; vulnerable populations

PMID:
30783880
DOI:
10.1007/s11606-019-04857-3

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