title: Ethnic disparities in the use of nicotine replacement therapy for smoking cessation in an equal access health care system.
abstract: OBJECTIVE
  To examine ethnic variations in the use of nicotine replacement therapy (NRT) in an equal access health care system.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Eighteen Veterans Affairs medical and ambulatory care centers.
  
  
  METHODS
  A cohort of male current smokers (n = 1606).
  
  
  METHODS
  Use of NRT (nicotine patch or nicotine gum), ethnicity, sociodemographics, health status, smoking-related history, and facility prescribing policy.
  
  
  RESULTS
  Overall, only 34% of African-American and 26% of Hispanic smokers have ever used NRT as a cessation aid compared with 50% of white smokers. In the past year, African-American smokers were most likely to have attempted quitting. During a serious past-year quit attempt, however African-American and Hispanic smokers reported lower rates of NRT use than white smokers (20% vs. 22% vs. 34%, respectively, p = .001). In multivariate analyses, ethnicity was independently associated with NRT use during a past-year quit attempt. Compared with white smokers, African-American (adjusted odds ratio, .53; 95% confidence interval, .34-.83) and Hispanic (adjusted odds ratio, .55; 95% confidence interval, .28-1.08) smokers were less likely to use NRT.
  
  
  CONCLUSIONS
  Assessment of variations in use of NRT demonstrates that African-American and Hispanic smokers are less likely to use NRT during quit attempts. Future research is needed on the relative contributions of patient, physician, and system features to gaps in guideline implementation to provide treatment for ethnic minority smokers.
authors.affiliation: Section of General Internal Medicine, Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA. Steven.Fu@med.va.gov
authors.forename: Steven S
authors.initials: SS
authors.lastname: Fu
authors.forename: Scott E
authors.initials: SE
authors.lastname: Sherman
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
authors.forename: Andy B
authors.initials: AB
authors.lastname: Lanto
authors.forename: Anne M
authors.initials: AM
authors.lastname: Joseph
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000628:therapy*