title: Effect of financial incentives on ethnic disparities in smoking cessation interventions in primary care: cross-sectional study.
abstract: BACKGROUND
  Smoking cessation interventions are underprovided in primary care. Financial incentives may help address this. However, few studies in the UK have examined their impact on disparities in the delivery of smoking cessation interventions.
  
  
  METHODS
  Cross-sectional study using 2007 data from 29 general practices in Wandsworth, London, UK. We used logistic regression to examine associations between disease group [cardiovascular disease (CVD), respiratory disease, depression or none of these diseases], ethnicity and smoking outcomes following the introduction of the Quality and Outcomes Framework in 2004.
  
  
  RESULTS
  Significantly, more CVD patients had smoking status ascertained compared with those with respiratory disease (89 versus 72%), but both groups received similar levels of cessation advice (93 and 89%). Patients with depression or none of the diseases were less likely to have smoking status ascertained (60% for both groups) or to receive advice (80 and 75%). Smoking prevalence was high, especially for patients with depression (44%). White British patients had higher rates of smoking than most ethnic groups, but black Caribbean men with depression had the highest smoking prevalence (62%).
  
  
  CONCLUSIONS
  Smoking rates remain high, particularly for white British and black Caribbean patients. Extending financial incentives to include recording of ethnicity and rewarding quit rates may further improve smoking cessation outcomes in primary care.
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK. f.hamilton@imperial.ac.uk
authors: F L
authors: FL
authors: Hamilton
authors: A A
authors: AA
authors: Laverty
authors: E P
authors: EP
authors: Vamos
authors: A
authors: A
authors: Majeed
authors: C
authors: C
authors: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000208:ethnology; D005006:Ethnicity; D005260:Female; D006293:Health Promotion / Q000191:economics*; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008131:London / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000208:ethnology; D012907:Smoking / Q000208:ethnology*; D016540:Smoking Cessation / Q000191:economics* / Q000208:ethnology; D055815:Young Adult