title: Risk of smoking and receipt of cessation services among veterans with mental disorders.
abstract: OBJECTIVE
  The purpose of this study was to determine rates of smoking and receipt of provider recommendations to quit smoking among patients with mental disorders treated in U.S. Department of Veterans Affairs (VA) treatment settings.
  
  
  METHODS
  The authors conducted a secondary analysis of the yearly, cross-sectional 2007 Veterans Health Administration Outpatient Survey of Healthcare Experiences of Patients (N=224,193). Logistic regression was used to determine the independent association of mental health diagnosis and the dependent variables of smoking and receipt of provider recommendations to quit smoking.
  
  
  RESULTS
  Patients with mental disorders had greater odds of smoking, compared with those without mental disorders (p<.05). Those with various mental disorders reported similar rates of receiving services (more than 60% to 80% reported receiving selected services), compared with those without these disorders, except that those with schizophrenia had more than 30% lower odds of receiving advice to quit smoking from their physicians (p<.05). Moreover, those who had co-occurring posttraumatic stress disorder or substance use disorders had significantly greater odds of reporting that they received advice to quit, recommendations for medications, and physician discussions of quitting methods, compared with those without these disorders (p<.05). Older patients, male patients, members of ethnic minority groups, those who were unmarried, those who were disabled or unemployed, and those living in rural areas had lower odds of receiving selected services (p<.05).
  
  
  CONCLUSIONS
  The majority of patients with mental disorders served by the VA reported receiving cessation services, yet their smoking rates remained high, and selected groups were at risk for receiving fewer cessation services, suggesting the continued need to disseminate cessation services.
authors.affiliation: Serious Mental Illness Treatment Resource and Evaluation Center, US Department of Veterans Affairs Ann Arbor Center for Clinical Management Research, 2215 Fuller Rd., Ann Arbor, MI 48105, USA.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Karen L
authors.initials: KL
authors.lastname: Austin
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Dalack
authors.forename: Emily M
authors.initials: EM
authors.lastname: Woltmann
authors.forename: Jeanette
authors.initials: J
authors.lastname: Waxmonsky
authors.forename: Devon
authors.initials: D
authors.lastname: Noonan
mesh_terms: D004812:Epidemiologic Methods; D005260:Female; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*