title: Socioeconomic disparities in community-based treatment of tobacco dependence.
abstract: OBJECTIVE
  We examined socioeconomic disparities in a community-based tobacco dependence treatment program.
  
  
  METHODS
  We provided cognitive-behavioral treatment and nicotine patches to 2739 smokers. We examined treatment use, clinical and environmental, and treatment outcome differences by socioeconomic status (SES). We used logistic regressions to model end-of-treatment and 3- and 6-month treatment outcomes.
  
  
  RESULTS
  The probability of abstinence 3 months after treatment was 55% greater for the highest-SES than for the lowest-SES (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.03, 2.33) smokers and increased to 2.5 times greater for the highest-SES than for the lowest-SES smokers 6 months after treatment (AOR = 2.47; 95% CI = 1.62, 3.77). Lower-SES participants received less treatment content and had fewer resources and environmental supports to manage a greater number of clinical and environmental challenges to abstinence.
  
  
  CONCLUSIONS
  Targets for enhancing therapeutic approaches for lower socioeconomic groups should include efforts to ensure that lower-SES groups receive more treatment content, strategies to address specific clinical and environmental challenges associated with treatment outcomes for lower-SES smokers (i.e., higher dependence and stress levels and exposure to other smokers), and strategies to provide longer-term support.
authors.affiliation: Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. csheffer@med.cuny.edu
authors.forename: Christine E
authors.initials: CE
authors.lastname: Sheffer
authors.forename: Maxine
authors.initials: M
authors.lastname: Stitzer
authors.forename: Reid
authors.initials: R
authors.lastname: Landes
authors.forename: S Laney
authors.initials: SL
authors.lastname: Brackman
authors.forename: Tiffany
authors.initials: T
authors.lastname: Munn
authors.forename: Page
authors.initials: P
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001131:Arkansas; D015928:Cognitive Behavioral Therapy; D019058:Community Networks; D016001:Confidence Intervals; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D012923:Social Class; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D055815:Young Adult