Disparities in hospital smoking cessation treatment by immigrant status

Jenny Chen, Ellie Grossman, Alissa Link, Binhuan Wang, Scott Sherman

Research output: Contribution to journalArticle

Abstract

Despite the efficacy of nicotine replacement therapy (NRT) in promoting smoking cessation, no studies have been done to evaluate NRT prescribing rates among immigrants, a vulnerable minority population in the United States. The aim of this study is to explore for differences in NRT prescribing behavior by immigrant status. Participants were enrolled in a smoking cessation trial for hospitalized patients between July 2011 and April 2014 at two NYC hospitals. For this analysis, we used baseline data from patient surveys and electronic medical-record reviews to examine associations between immigrant status and prescription of NRT in-hospital and on discharge, as well as acceptance of NRT in-hospital. We included age, gender, education, health literacy, race, ethnicity, English language ability, inpatient service, and site insurance in the models as potential confounders. Our study population included 1,608 participants, of whom 21% were not born in the United States. Bivariate analysis found that nonimmigrants were more likely than immigrants to be prescribed NRT in the hospital (46.1% vs. 35.7%, p =.0006) and similarly on discharge (19.4% vs. 15.3%, p =.09). Both groups were equally likely to accept NRT in-hospital when prescribed. On multivariable analysis, being an immigrant (OR 0.65), Black race (OR 0.52), and Hispanic ethnicity (OR 0.63) were associated with lower likelihood of being prescribed NRT in-hospital. Multivariable analysis for provision of NRT prescription at discharge showed no significant difference between immigrants and nonimmigrants. These findings show differences in in-hospital smoking cessation treatment between immigrants and nonimmigrants.

Original languageEnglish (US)
Pages (from-to)44-57
Number of pages14
JournalJournal of Ethnicity in Substance Abuse
Volume19
Issue number1
DOIs
StatePublished - Jan 2 2020

Keywords

  • Hospitals
  • immigrants
  • nicotine replacement therapy
  • pharmacotherapy
  • smoking cessation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)

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