142nd APHA Annual Meeting and Exposition

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Quality Improvement Opportunities for Smoking Cessation Intervention in Adults with COPD: An Analysis by Race/Ethnicity

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Melissa Zullo, PhD, MPH, MA , Department of Epidemiology and Biostatistics, Kent State University College of Public Health, Kent, OH
Dana Mowls, MPH , Department of Biostatistics and Epidemiology, College of Public Health University of Oklahoma Health Sciences Center, Oklahoma City, OK
Vinay K. Cheruvu, PhD, MS, MSc, PGD-MISCA , Department of Epidemiology and Biostatistics, College of Public Health, Kent State University, Kent, OH
Chronic obstructive pulmonary disease (COPD) will be the 3rd and 5th leading cause of death and disability by 2020. The most important intervention to preventing COPD progression is smoking cessation. Adults with COPD have high healthcare utilization that can act as opportunities to deliver smoking cessation intervention. This research examined comorbid and healthcare factors associated with being a former smoker in whites, blacks, and Hispanics with COPD.

Data from the 2011-2012 BRFSS (n=18,288) were used in race-stratified, weighted logistic regression models to examine comorbid and  healthcare factors associated with former vs. current smoking in adults with COPD.

Overall, 52% reported former smoking, 88% were white, and 8% were black. The majority in each race had insurance and a personal doctor. Whites were more likely to be former smokers if they had asthma (OR=1.2, CI: 1.1-1.4), had a personal doctor (OR=1.7, CI: 1.2-2.3), had seen a doctor about shortness of breath (OR=1.3, CI: 1.1-1.5) or been hospitalized (OR=1.4, CI: 1.1-1.7) in the past 12 months, or if they had insurance (OR=1.9, CI: 1.5-2.5) when controlling for individual factors. Blacks were less likely to be former smokers if they had heart disease (OR=0.51, CI: 0.29-0.88) but more likely if they had a personal doctor (OR=3.7, CI: 1.4-9.7). Hispanics were more likely to be former smokers if they had asthma (OR=3.5, CI: 1.4-8.9). Healthcare factors were not associated with being a former smoker in Hispanics.

Comorbid and healthcare factors that may act as opportunities for quality improvement related to cessation interventions vary by race/ethnicity in adults with COPD. Understanding why these factors have different impact in blacks and Hispanics compared to whites may be important to assisting with cessation in adults with COPD.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Describe the association of comorbidity and healthcare utilization factors on likelihood of being a former smoker in adults with chronic obstructive pulmonary disease who are of varying race/ethnicity.

Keyword(s): Health Disparities/Inequities, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead investigator on multiple research projects examining management and outcomes in Chronic Obstructive Pulmonary Disease. Further, my expertise is in utilization of large databases and administrative/clinical data and I have practical experiences working with older adults with respiratory diseases.
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.

Back to: 4085.0: Chronic Disease Epidemiology Poster Session 4