Disparities in Cessation Behaviors Between Hispanic and Non-Hispanic White Adult Cigarette Smokers in the United States, 2000–2015

Stephen Babb, MPH; Ann Malarcher, PhD; Kat Asman, MSPH; Michelle Johns, MA, MPH; Ralph Caraballo, PhD, MPH; Brenna VanFrank, MD, MSPH; Bridgette Garrett, PhD

Disclosures

Prev Chronic Dis. 2020;17(1):e10 

In This Article

Abstract and Introduction

Abstract

Introduction: Hispanic adults make up a growing share of US adult smokers, and smoking is a major preventable cause of disease and death among Hispanic adults. No previous study has compared trends in smoking cessation behaviors among Hispanic adults and non-Hispanic white adults over time. We examined trends in cessation behaviors among Hispanic and non-Hispanic white adult cigarette smokers during 2000–2015.

Methods: Using self-reported data from the National Health Interview Survey, we compared trends in quit attempts, receipt of advice to quit from a health professional, and use of cessation treatment (counseling and/or medication) among Hispanic and non-Hispanic white adult smokers. We also assessed these behaviors among 4 Hispanic subgroups. We conducted analyses in 2018–2019.

Results: Past-year quit attempts increased during 2000–2015 among both non-Hispanic white and Hispanic smokers, with no significant differences between these groups. Receiving advice to quit increased significantly among non-Hispanic white adults but did not increase significantly among Hispanic adults. Cessation treatment use increased among both non-Hispanic white and Hispanic adults. Throughout 2000–2015, the prevalence of receiving advice to quit and using cessation treatments was lower among Hispanic adults than non-Hispanic white adults. In 2015, a higher proportion of Hispanic than non-Hispanic white smokers visited a health care provider without receiving advice to quit.

Conclusion: Hispanic adult smokers are less likely to receive advice to quit and to use proven cessation treatments than non-Hispanic white smokers, and this pattern persisted over time. Culturally competent educational initiatives directed at both providers and Hispanic communities could help eliminate this marked and persistent disparity.

Introduction

In 2018, more than 3.9 million Hispanic adults in the United States reported current cigarette smoking, comprising about 11% of the 34.2 million US adult smokers, up from about 8% in 2000.[1] In 2018, Hispanic adults had a lower smoking prevalence (9.8%) than non-Hispanic white adults (15.0%) and US adults overall (13.7%);[2] however, smoking prevalence varies among Hispanic subgroups.[3] Cigarette smoking is a major preventable cause of disease and death among Hispanic adults in the United States.[4]

Smokers who receive advice to quit from a health professional and use individual, group, and telephone cessation counseling and 7 US Food and Drug Administration (FDA)-approved cessation medications are more likely to quit than those who do not receive advice or use counseling or medications.[5,6] Clinical cessation guidelines recommend that health care providers consistently advise patients who use tobacco to quit and offer them cessation treatments.[5,6] Disparities in receiving advice to quit and using proven cessation treatments can contribute to disparities in smoking cessation.[5,7]

Several studies reported that Hispanic smokers are less likely than non-Hispanic white smokers to be screened for tobacco use, receive advice to quit, and use cessation treatments.[7–17] Previous studies examined prevalence and trends in receiving advice to quit and using cessation treatments among the overall population of US adult smokers.[7,14,18,19] However, no previous study explored how these trends compare among Hispanic and non-Hispanic white adults.

The primary goal of this study was to examine trends during 2000–2015 in the prevalence of quit attempts, receiving advice to quit, and using cessation treatments among Hispanic and non-Hispanic white adult cigarette smokers, as well as among Hispanic subgroups, to determine whether comparable progress in these cessation behaviors occurred across these groups during this period. In addition, for 2015, we examined 1) demographic correlates of current cigarette smoking among Hispanic adults overall, Hispanic subgroups, and non-Hispanic white adults, 2) the association of receiving advice to quit with making a past-year quit attempt and treatment use, and 3) demographic correlates of making a past-year quit attempt, receiving advice to quit, and treatment use. Our findings can inform efforts to address disparities in smoking cessation behaviors among Hispanic adults.

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