TABLE 3—
Adjusted Odds Ratios of Smoking Cessation Assistance Type Versus No Assistance by Patient Characteristics Among Current Smokers: OCHIN Network, United States, 2014 to 2016
| Smoking Cessation Assistance Type (Ref = No Assistance) |
|||
| Characteristic | Counseling Only,a,b
OR (95% CI) |
Medication Ordered Only,a,c OR (95% CI) | Counseling and Medication Ordered,a,b,c OR (95% CI) |
| Gender | |||
| Male (Ref) | 1 | 1 | 1 |
| Female | 1.08 (1.04, 1.12) | 1.07 (1.02, 1.12) | 1.18 (1.13, 1.24) |
| Age,d y | |||
| 18–24 (Ref) | 1 | 1 | 1 |
| 25–34 | 0.93 (0.87, 0.99) | 1.50 (1.36, 1.65) | 1.39 (1.25, 1.55) |
| 35–44 | 0.92 (0.86, 0.99) | 1.92 (1.74, 2.12) | 1.77 (1.59, 1.97) |
| 45–54 | 0.92 (0.86, 0.98) | 2.20 (1.99, 2.43) | 1.94 (1.75, 2.16) |
| 55–64 | 0.98 (0.91, 1.06) | 2.13 (1.92, 2.37) | 1.92 (1.72, 2.15) |
| ≥ 65 | 0.96 (0.85, 1.08) | 1.39 (1.20, 1.62) | 1.24 (1.05, 1.46) |
| Race/ethnicity | |||
| Non-Hispanic White (Ref) | 1 | 1 | 1 |
| Hispanic | 1.00 (0.93, 1.07) | 0.61 (0.55, 0.67) | 0.65 (0.58, 0.71) |
| Non-Hispanic Black | 0.97 (0.91, 1.04) | 0.80 (0.73, 0.87) | 0.82 (0.75, 0.89) |
| Non-Hispanic other | 0.86 (0.78, 0.95) | 0.86 (0.77, 0.97) | 0.74 (0.65, 0.84) |
| Unknown | 1.02 (0.90, 1.16) | 0.78 (0.66, 0.93) | 0.98 (0.82, 1.17) |
| Federal poverty levele | |||
| ≤ 138% (Ref) | 1 | 1 | 1 |
| > 138% | 1.03 (0.98, 1.09) | 1.01 (0.95, 1.08) | 1.05 (0.98, 1.13) |
| Unknown | 0.99 (0.92, 1.06) | 0.94 (0.86, 1.04) | 0.96 (0.86, 1.07) |
| Location of primary clinic | |||
| Urban (Ref) | 1 | 1 | 1 |
| Rural | 1.05 (0.97, 1.14) | 0.96 (0.87, 1.06) | 0.98 (0.88, 1.10) |
| Unknown | 0.80 (0.66, 0.98) | 0.94 (0.75, 1.19) | 0.75 (0.58, 0.97) |
| Number of visits | |||
| 1 (Ref) | 1 | 1 | 1 |
| 2–5 | 1.69 (1.61, 1.76) | 1.90 (1.79, 2.01) | 3.15 (2.91, 3.40) |
| ≥ 6 | 2.71 (2.56, 2.87) | 3.60 (3.36, 3.87) | 9.17 (8.41, 10.00) |
| Insurance coverage at majority of visits | |||
| Commercial (Ref) | 1 | 1 | 1 |
| Medicaid | 0.96 (0.90, 1.02) | 1.33 (1.22, 1.44) | 1.17 (1.07, 1.28) |
| Medicare | 0.90 (0.83, 0.98) | 1.13 (1.02, 1.25) | 0.93 (0.84, 1.04) |
| Self-pay (uninsured) | 0.96 (0.88, 1.04) | 0.58 (0.51, 0.67) | 0.56 (0.48, 0.64) |
| Other | 0.92 (0.72, 1.18) | 0.58 (0.37, 0.92) | 0.25 (0.13, 0.49) |
| Readiness to quit smoking | |||
| Assessed and not ready to quit (Ref) | 1 | 1 | 1 |
| Assessed and ready to quit | 1.23 (1.17, 1.29) | 2.67 (2.44, 2.91) | 3.84 (3.62, 4.07) |
| Not assessed | 0.02 (0.016, 0.018) | 1.10 (1.02, 1.19) | 0.02 (0.02, 0.03) |
| Comorbiditiesf | |||
| Hypertension | 1.08 (1.03, 1.14) | 1.04 (0.98, 1.10) | 1.18 (1.11, 1.25) |
| Diabetes | 0.99 (0.93, 1.05) | 0.85 (0.79, 0.91) | 0.85 (0.79, 0.92) |
| Asthma or COPD | 1.07 (1.02, 1.12) | 1.60 (1.52, 1.69) | 1.70 (1.60, 1.80) |
| Coronary artery disease | 1.12 (0.99, 1.28) | 1.24 (1.08, 1.42) | 1.53 (1.32, 1.78) |
| Hyperlipidemia | 1.20 (1.14, 1.26) | 1.21 (1.14, 1.28) | 1.41 (1.32, 1.49) |
| Cancer | 0.96 (0.88, 1.04) | 1.16 (1.06, 1.26) | 1.07 (0.97, 1.18) |
| Psychiatric disorderg | 0.99 (0.95, 1.03) | 1.09 (1.04, 1.14) | 1.08 (1.03, 1.14) |
| Substance use disorderh | 1.04 (0.997, 1.08) | 1.31 (1.24, 1.37) | 1.24 (1.18, 1.31) |
Note. CI = confidence interval; COPD = chronic obstructive pulmonary disease; OR = odds ratio. n = 136 314. Adjusted odds ratios were estimated by using a multivariable multinomial logistic regression model with service areas and states included as fixed effects through a set of indicator variables.
Compared with no documented smoking cessation assistance during the study period.
Counseling included “counseling given” in the electronic health records vital sign checked, standard procedure codes for smoking counseling assistance, and OCHIN internal codes for referral for services.
Smoking cessation medication included bupropion, varenicline, and nicotine replacement products.
Age as of January 1, 2014.
Federal poverty level is estimated according to the US Department of Health and Human Services.
Reference for each comorbid condition is the absence of the condition.
Psychiatric disorders included anxiety disorders and posttraumatic stress disorder, schizophrenia and other psychosis disorders, depressive disorders, and bipolar disorder.
Substance use disorder excluded tobacco use disorder.