Predictors of Smoking Cessation Medication Use among Nonobese and Obese Smokers

Abstract

The objective of this study was to identify and compare the predictors of smoking cessation medication use among obese and nonobese adult smokers. A retrospective cross-sectional study was conducted using the Medical Expenditure Panel Survey (MEPS) data (2008–2009). The study participants included smokers aged 18 years and older who self-reported their smoking status as smoker. The outcome variable was utilization of any Food and Drug Administration approved smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy). Multivariable logistic regression analyses were conducted. A total of 82.20 million (weighted sample size for two years) adult smokers were included; of which nearly 30% were obese-smokers. The use of smoking cessation medication was 2.66% and 5.17% among nonobese and obese smokers, respectively. Multivariable logistic regression results showed that race/ethnicity, health insurance coverage, prescription insurance coverage, usual source of health care, urban residence, region, Charlson comorbidity index, and instrumental activities of daily living (IADL), were significant predictors of using smoking cessation medications. The overall smoking cessation medication use rate was low implying limited compliance to guideline. Predictors identified in this study should be taken into consideration in health promotion programs that are designed to optimize the utilization of these smoking cessation medications.

Keywords :

• obesity
• smoking cessation
• medication use
• medical expenditure panel survey (MEPS) data
• risk factors

THE AUTHORS

Mo Yang, PhD, is a principal outcome research associate working in Allergan Inc. Her research interest includes the prevention and intervention of tobacco use and obesity. Her current area of interest is mainly focused on prophylactic treatment for chronic migraine patient.

Hemalkumar B. Mehta, MS, is pursuing PhD in Pharmacy Administration at University of Houston, College of Pharmacy. His research interest includes comparative effectiveness research, risk adjustment and causal inference.

Debajyoti Bhowmik, PhD, is an outcomes researcher working in McKesson Specialty Health/US Oncology Network. His current area of research involves evaluation of health outcomes in community-based cancer patients using integrated electronic health record (EHR), medical chart review, and claims data. He is particularly engaged in assessment of treatment utilization, overall survival, disease progression, medication toxicity, healthcare resource use and expenditure in community-based cancer patients. His research interest also includes assessment of drug utilization, safety, and effectiveness of psychotropic medications in the treatment of pediatric bipolar depression.

Ekere James Essien, MD, DrPH, is a professor in the Department of Pharmaceutical Health Outcomes and Policy at the University of Houston. His research interests include the prevention of tobacco use and HIV/AIDS.

Susan M Abughosh, PhD, is an assistant professor of Pharmacy administration at the University of Houston, in the Department of Pharmaceutical Health Outcomes and Policy. Her research interests include smoking cessation, waterpipe smoking, and adherence to long-term therapies.

GLOSSARY

• Obesity: Adults were considered obese of they had Body Mass Index (BMI) ≥30 kg/m².

• Smoking cessation: Smoking cessation, also known as quitting smoking, is the act of discontinuing tobacco smoking. Smoking cessation medications (bupropion, varenicline, or nicotine replacement therapies) have been proved as an effective intervention to quit smoking.

Notes

1 This is the most updated version of the guidance available.