Changes in Veteran Tobacco Use Identified in Electronic Medical Records

Paul G. Barnett, Adam Chow, Nicole E. Flores, Scott E. Sherman, Sonia A. Duffy

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Electronic medical records represent a new source of longitudinal data on tobacco use. Methods Electronic medical records of the U.S. Department of Veterans Affairs were extracted to find patients’ tobacco use status in 2009 and at another assessment 12–24 months later. Records from the year prior to the first assessment were used to determine patient demographics and comorbidities. These data were analyzed in 2015. Results An annual quit rate of 12.0% was observed in 754,504 current tobacco users. Adjusted tobacco use prevalence at follow-up was 3.2% greater with alcohol use disorders at baseline, 1.9% greater with drug use disorders, 3.3% greater with schizophrenia, and lower in patients with cancer, heart disease, and other medical conditions (all differences statistically significant with p<0.05). Annual relapse rates in 412,979 former tobacco users were 29.6% in those who had quit for <1 year, 9.7% in those who had quit for 1–7 years, and 1.9% of those who had quit for >7 years. Among those who had quit for <1 year, adjusted relapse rates were 4.3% greater with alcohol use disorders and 7.2% greater with drug use disorders (statistically significant with p<0.05). Conclusions High annual cessation rates may reflect the older age and greater comorbidities of the cohort or the intensive cessation efforts of the U.S. Department of Veterans Affairs. The lower cessation and higher relapse rates in psychiatric and substance use disorders suggest that these groups will need intensive and sustained cessation efforts.

Original languageEnglish (US)
Pages (from-to)e9-e18
JournalAmerican journal of preventive medicine
Volume53
Issue number1
DOIs
StatePublished - Jul 2017

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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