258379 More smokers receive smoking cessation service in low disposable income regions in Taiwan

Tuesday, October 30, 2012

Chih-Kuan Lai , Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
Shi-Tzu Tsai , Center for Preventive Services, Buddhist Tzu Chi General Hospital, Hwalien, TN, Taiwan
Background: Cigarettes smoking is the leading cause to poverty and health inequality. To establish cessation service is urgent and must be prioritized. However, some arguments concern the inappropriate distribution of service may worsen the existing disparity of health. Taiwan has implemented nation-wide project Taiwan Cessation Service (TCS) since Sep 2002. This research intends to understand whether the coverage of TCS is impartial without jeopardizing health equality. Methods: A total of 305,654 participants were retrieved from the TCS registration dataset between 2007 and 2009. The service coverage rates were calculated for each of 17 regions in Taiwan. The quartile levels of disposable income and physician capacity were produced for each region. GEE model was employed to compare the coverage rates of different income regions, adjusted by the levels of physician capacity, in 3 successive years. Results: TCS coverage rates of 17 regions ranged from 1.48% to 6.03%, 1.30% to 3.41%, 1.12% to 4.29% for 2007, 2008 and 2009 respectively. After adjustment of physician capacity, the increase of coverage rate was statistically significant (OR=1.51, 1.18-1.93, p=0.0009*) in the lowest income regions (fourth quartile) as compared to the highest income regions (first quartile). For the regions in the third and second quartiles, the OR (vs. first quartile regions) were 1.22 (0.98-1.52, p=0.08) and 1.30 (1.04-1.62, p=0.02*). Conclusion: After adjustment for physician capacity, our analysis clearly demonstrated that more smokers utilized TCS in the lower disposable income regions. Thus, the distribution of TCS seemed to curtail the health inequality.

Learning Areas:
Public health administration or related administration
Public health or related public policy

Learning Objectives:
Demonstrate, Evaluate

Keywords: Health Service, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal of governemnt funded grants to provide cessation treatment service in Taiwan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.