title: Employment, gender, and smoking cessation outcomes in low-income smokers using nicotine replacement therapy.
abstract: BACKGROUND
  This study examines the presence and correlates of gender disparities in smoking cessation among lower income smokers prescribed nicotine replacement medication.
  
  
  METHODS
  We examined quit rates (7-day abstinence point prevalence) among a cohort of smokers who filled prescriptions for nicotine replacement (N = 1,782), using Minnesota Health Care Programs' (e.g., Medicaid) pharmacy claims databases (2005-2006) and mixed-mode survey protocols. A cohort of smokers who recently filled a prescription for nicotine replacement was stratified by race, and then subjects were selected by simple random sample from each race, oversampling the nonWhite groups (N = 1,782). The primary outcome was point prevalence of 7-day abstinence, and outcomes were assessed about 8 months after the nicotine replacement therapy (NRT) index prescription fill date using a mixed-mode survey protocol. Final interaction models were constructed using backward elimination.
  
  
  RESULTS
  Abstinence rates were 11.4% among women and 19.2% among men (p = .02) and remained marginally significant after controlling for demographics, mental and physical health, period of cigarette abstinence, social environment, religious attendance, perceived stress, and NRT prescription type (p = .08). There was a significant Gender x Employment interaction (p = .02). Among men, quit rates were higher among the employed (26%) compared with the unemployed (16%); among women, quit rates were lower among those who were employed (8%) compared with those who were unemployed (14%).
  
  
  CONCLUSIONS
  Results suggest the need for research on factors specific to women's work roles or workplaces that inhibit cessation as well as cessation programs tailored to low-income, employed female smokers. On-site workplace interventions and flexible counseling programs may be especially beneficial.
authors.affiliation: Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN 55417, USA. diana.burgess@va.gov
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Burgess
authors.forename: Steven S
authors.initials: SS
authors.lastname: Fu
authors.forename: Siamak
authors.initials: S
authors.lastname: Noorbaloochi
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Clothier
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ricards
authors.forename: Rachel
authors.initials: R
authors.lastname: Widome
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003376:Counseling / Q000458:organization & administration; D004651:Employment / Q000458:organization & administration* / Q000523:psychology; D005260:Female; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D011203:Poverty / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D012931:Social Environment; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D016387:Women's Health; D017132:Workplace / Q000458:organization & administration; D055815:Young Adult
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine