Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke
Introduction: People who are covered by Medicaid have a higher smoking prevalence than the general population and are at an increased risk for tobacco-related disease, a major driver of Medicaid costs. California has the largest Medicaid program, called Medi-Cal, whose members also have higher tobac...
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Elsevier
2025-02-01
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| Series: | AJPM Focus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277306542400110X |
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| author | Nan Wang, PhD Melanie S. Dove, ScD Cindy V. Valencia, PhD Elisa K. Tong, MD |
| author_facet | Nan Wang, PhD Melanie S. Dove, ScD Cindy V. Valencia, PhD Elisa K. Tong, MD |
| author_sort | Nan Wang, PhD |
| collection | DOAJ |
| description | Introduction: People who are covered by Medicaid have a higher smoking prevalence than the general population and are at an increased risk for tobacco-related disease, a major driver of Medicaid costs. California has the largest Medicaid program, called Medi-Cal, whose members also have higher tobacco-use rates and tobacco-related disease. Quitting is beneficial at any age, and health professional advice and assistance are a key indicator of smoking cessation. As Medi-Cal transforms to improve population health and health equity, this study aimed to understand both the prevention and treatment of tobacco-related disease by comparing health professional advice and assistance among all Medi-Cal members with and without chronic disease who smoke. Methods: Using data from the California Health Interview Survey (2014, 2016–2018), the authors examined 3,517 Medi-Cal current smokers (age ≥18 years) who consulted a health professional and reported about having a chronic disease. The outcomes included receiving advice or assistance from a health professional to quit smoking. Adjusted logistic regression models were conducted to examine the association between chronic disease and the outcomes, including adjusting for frequency of office visits. Results: Among 1,227,154 Medi-Cal members who smoke, over half (51.9%) of whom had at least 1 chronic disease, approximately half received cessation advice, and less than one third received smoking cessation assistance. Smokers with chronic disease were more likely to receive health professional advice (63.9% vs 33.7%, p<0.001) and assistance (37.7% vs 20.5%, p<0.001) than those without chronic disease. In adjusted models, smokers with chronic disease were almost twice as likely to receive advice (OR=1.97, 95% CI=1.39, 2.78) and 1.5 times as likely to receive assistance (OR=1.50, 95% CI=0.94, 2.38) as those without chronic disease, but the latter was not statistically significant. Conclusions: Medi-Cal members who smoke have tobacco treatment disparities between those with or without chronic disease, even after adjusting for the number of office visits. Medi-Cal population health strategies for tobacco cessation treatment will need to improve prevention, not just treatment, of tobacco-related disease to reduce the long-term burden on the healthcare system and associated costs. |
| format | Article |
| id | doaj-art-8e92b135672143cdb9d3dbc505c5961e |
| institution | Kabale University |
| issn | 2773-0654 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj-art-8e92b135672143cdb9d3dbc505c5961e2025-01-08T04:53:52ZengElsevierAJPM Focus2773-06542025-02-0141100292Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who SmokeNan Wang, PhD0Melanie S. Dove, ScD1Cindy V. Valencia, PhD2Elisa K. Tong, MD3Department of Public Health Sciences, University of California, Davis, Davis, California; Center for Healthcare Policy Research, University of California, Davis, Sacramento, CaliforniaDepartment of Public Health Sciences, University of California, Davis, Davis, California; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, CaliforniaCenter for Healthcare Policy Research, University of California, Davis, Sacramento, California; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, CaliforniaCenter for Healthcare Policy Research, University of California, Davis, Sacramento, California; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, California; Department of Internal Medicine, University of California, Davis, Sacramento, California; Address correspondence to: Elisa K. Tong, MD, Department of Internal Medicine, University of California, Davis, 4150 V Street, Suite 2400, Sacramento CA 95817.Introduction: People who are covered by Medicaid have a higher smoking prevalence than the general population and are at an increased risk for tobacco-related disease, a major driver of Medicaid costs. California has the largest Medicaid program, called Medi-Cal, whose members also have higher tobacco-use rates and tobacco-related disease. Quitting is beneficial at any age, and health professional advice and assistance are a key indicator of smoking cessation. As Medi-Cal transforms to improve population health and health equity, this study aimed to understand both the prevention and treatment of tobacco-related disease by comparing health professional advice and assistance among all Medi-Cal members with and without chronic disease who smoke. Methods: Using data from the California Health Interview Survey (2014, 2016–2018), the authors examined 3,517 Medi-Cal current smokers (age ≥18 years) who consulted a health professional and reported about having a chronic disease. The outcomes included receiving advice or assistance from a health professional to quit smoking. Adjusted logistic regression models were conducted to examine the association between chronic disease and the outcomes, including adjusting for frequency of office visits. Results: Among 1,227,154 Medi-Cal members who smoke, over half (51.9%) of whom had at least 1 chronic disease, approximately half received cessation advice, and less than one third received smoking cessation assistance. Smokers with chronic disease were more likely to receive health professional advice (63.9% vs 33.7%, p<0.001) and assistance (37.7% vs 20.5%, p<0.001) than those without chronic disease. In adjusted models, smokers with chronic disease were almost twice as likely to receive advice (OR=1.97, 95% CI=1.39, 2.78) and 1.5 times as likely to receive assistance (OR=1.50, 95% CI=0.94, 2.38) as those without chronic disease, but the latter was not statistically significant. Conclusions: Medi-Cal members who smoke have tobacco treatment disparities between those with or without chronic disease, even after adjusting for the number of office visits. Medi-Cal population health strategies for tobacco cessation treatment will need to improve prevention, not just treatment, of tobacco-related disease to reduce the long-term burden on the healthcare system and associated costs.http://www.sciencedirect.com/science/article/pii/S277306542400110XSmoking cessationchronic diseaseMedicaidhealthcare disparitieshealth professionalspreventive care |
| spellingShingle | Nan Wang, PhD Melanie S. Dove, ScD Cindy V. Valencia, PhD Elisa K. Tong, MD Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke AJPM Focus Smoking cessation chronic disease Medicaid healthcare disparities health professionals preventive care |
| title | Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke |
| title_full | Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke |
| title_fullStr | Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke |
| title_full_unstemmed | Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke |
| title_short | Tobacco Treatment Disparities Among California Medicaid Members With and Without Chronic Disease Who Smoke |
| title_sort | tobacco treatment disparities among california medicaid members with and without chronic disease who smoke |
| topic | Smoking cessation chronic disease Medicaid healthcare disparities health professionals preventive care |
| url | http://www.sciencedirect.com/science/article/pii/S277306542400110X |
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