title: Smoking among veterans with multiple sclerosis: prevalence correlates, quit attempts, and unmet need for services.
abstract: OBJECTIVE
  To describe the prevalence and correlates of smoking as well as quit attempts and unmet need for smoking cessation services in a national sample of veterans with multiple sclerosis (MS).
  
  
  METHODS
  Cross-sectional cohort study linking computerized medical record information to mailed survey data from 1999.
  
  
  METHODS
  Veterans Health Administration (VHA).
  
  
  METHODS
  Sixty-four percent (2994/4685) of veterans with MS who received services in VHA and also returned survey questionnaires, as well as a 20% random subsample (n=569) who completed a more extensive assessment of smoking.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Items assessing smoking, quit attempts, and unmet need for smoking services.
  
  
  RESULTS
  Among all survey respondents with MS, 28.5% (95% confidence interval [CI], 26.9-30.2) endorsed current smoking. Of extended survey respondents, 54.5% (95% CI, 46.6-62.1) reported a quit attempt in the past year, and 59.0% (95% CI, 51.1-66.4) reported not getting needed services for smoking in the past year. In fully adjusted logistic regression, smoking was associated with younger age, lower levels of education, being unmarried, higher levels of physical pain, and poorer mental health. A quit attempt was associated with higher levels of education and greater pain intensity.
  
  
  CONCLUSIONS
  Smoking among veterans with MS is common, with rates similar to those for other veterans. There is substantial need for cessation services. Cessation interventions should address correlates of smoking including pain, poorer mental health, and social isolation.
authors.affiliation: VA Puget Sound Health Care System, Seattle, WA, USA.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.forename: Lewis E
authors.initials: LE
authors.lastname: Kazis
authors.forename: Jodie K
authors.initials: JK
authors.lastname: Haselkorn
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000706:statistics & numerical data; D004185:Disability Evaluation; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000534:rehabilitation; D015999:Multivariate Analysis; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*