title: Utilization of smoking-cessation pharmacotherapy among chronic obstructive pulmonary disease (COPD) and lung cancer patients.
abstract: OBJECTIVE
  Smoking is one of the major risk factors causing morbidity and mortality in chronic obstructive pulmonary disease (COPD) and lung cancer patients. Use of smoking cessation pharmacotherapy is an effective way to help quit smoking. The purpose of the study was to determine the prevalence of smoking and the proportion of patients using smoking cessation agents, and to identify the socio-demographic factors that affect the use of these agents among COPD and lung cancer patients.
  
  
  METHODS
  A retrospective study was done to identify smokers having COPD (ICD-9: 490-492) or lung cancer (ICD-9: 162), and those who use smoking cessation agents from 2006-2010, using Medical Expenditure Panel Survey (MEPS) data. A multiple logistic regression model was built to identify significant socio-demographic predictors associated with the use of smoking cessation agents.
  
  
  RESULTS
  Around 16.8% of COPD patients and 15.1% of lung cancer patients reported smoking after diagnosis. Out of the total smokers, 8.8% patients with COPD and 12.6% patients with lung cancer reported use of smoking cessation agents during the 5 year period. Logistic regression showed that odds for smoking cessation use in COPD patients were lower for Hispanics (OR = 0.107, 95% CI 0.023-0.502) and higher for patients having insurance coverage (OR = 3.453, 95% CI 1.240-9.617).
  
  
  CONCLUSIONS
  Results showed that a large number of patients continued to smoke even after the diagnosis of COPD and lung cancer; whereas only a few among them used smoking cessation agents. Ethnicity disparities and insurance status were associated with the use of smoking cessation agents. Differential use among population sub-groups suggests a requirement for need based smoking cessation programs and appropriate prescription drug coverage. Further research needs to be done to evaluate reasons for disparities in smoking cessation agents' use. The study had limitations common to research designs based on observational and self-reported datasets.
authors.affiliation: University of Toledo , Toledo, OH , USA.
authors.forename: Varun
authors.initials: V
authors.lastname: Vaidya
authors.forename: Meghan
authors.initials: M
authors.lastname: Hufstader-Gabriel
authors.forename: Nilesh
authors.initials: N
authors.lastname: Gangan
authors.forename: Surbhi
authors.initials: S
authors.lastname: Shah
authors.forename: Robert
authors.initials: R
authors.lastname: Bechtol
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012189:Retrospective Studies; D066252:Sociological Factors; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Chronic obstructive pulmonary disease; Disparities; Lung cancer; MEPS; Pharmacotherapy; Smoking cessation