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Socioeconomic disparities in community-based treatment of tobacco dependence

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  • Sheffer, C.E.
  • Stitzer, M.
  • Landes, R.
  • Brackman, S.L.
  • Munn, T.
  • Moore, P.

Abstract

Objectives: We examined socioeconomic disparities in a community-based tobacco dependence treatment program. Methods: We provided cognitive-behavioral treatment and nicotine patches to 2739 smokers. We examined treatment use, clinical and environmental, and treatment outcome differences by socioeconomic status (SES). We used logistic regressions to model end-of-treatment and 3- and 6-month treatment outcomes. Results: The probability of abstinence 3 months after treatment was 55% greater for the highest-SES than for the lowest-SES (adjusted odds ratio [AOR]=1.55; 95% confidence interval [CI]=1.03, 2.33) smokers and increased to 2.5 times greater for the highest-SES than for the lowest-SES smokers 6 months after treatment (AOR=2.47; 95% CI=1.62, 3.77). Lower-SES participants received less treatment content and had fewer resources and environmental supports to manage a greater number of clinical and environmental challenges to abstinence. Conclusions: Targets for enhancing therapeutic approaches for lower socioeconomic groups should include efforts to ensure that lower-SES groups receive more treatment content, strategies to address specific clinical and environmental challenges associated with treatment outcomes for lower-SES smokers (i.e., higher dependence and stress levels and exposure to other smokers), and strategies to provide longer-term support.

Suggested Citation

  • Sheffer, C.E. & Stitzer, M. & Landes, R. & Brackman, S.L. & Munn, T. & Moore, P., 2012. "Socioeconomic disparities in community-based treatment of tobacco dependence," American Journal of Public Health, American Public Health Association, vol. 102(3), pages 8-16.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300519_8
    DOI: 10.2105/AJPH.2011.300519
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    Cited by:

    1. Stephen J. Lepore & Bradley N. Collins & Donna L. Coffman & Jonathan P. Winickoff & Uma S. Nair & Beth Moughan & Tyra Bryant-Stephens & Daniel Taylor & David Fleece & Melissa Godfrey, 2018. "Kids Safe and Smokefree (KiSS) Multilevel Intervention to Reduce Child Tobacco Smoke Exposure: Long-Term Results of a Randomized Controlled Trial," IJERPH, MDPI, vol. 15(6), pages 1-16, June.
    2. Monica Webb Hooper, 2019. "Racial/Ethnic Differences in Physiological Stress and Relapse among Treatment Seeking Tobacco Smokers," IJERPH, MDPI, vol. 16(17), pages 1-12, August.
    3. Christine E. Sheffer & Jeffrey S. Stein & Cara Petrucci & Martin C. Mahoney & Shirley Johnson & Pamela Giesie & Ellen Carl & Laurie Krupski & Allison N. Tegge & Mary E. Reid & Warren K. Bickel & Andre, 2020. "Tobacco Dependence Treatment in Oncology: Initial Patient Clinical Characteristics and Outcomes from Roswell Park Comprehensive Cancer Center," IJERPH, MDPI, vol. 17(11), pages 1-15, May.

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