Factors Associated With Accepting Assistance for Smoking Cessation Among Military Veterans.
Cigarette smoking remains a significant health risk for Veterans. Increased understanding of factors that influence the tobacco cessation referral process within Veterans Affairs medical facilities is useful for enhancing utilization of smoking cessation treatment. The present study examined the association of demographic and health variables with whether smokers accepted referral for medication and/or tobacco cessation clinic.



Electronic medical record data (2011-2013) were obtained for a sample of US military Veterans who accepted cessation assistance from their health care provider. Demographic and diagnostic variables were examined to identify predictors of the types of assistance accepted (medication only, clinic referral only, or both).



The sample includes 2941 Veterans, 10.3% female, 19.9% African American, 10.7% Hispanic, and 57.9% non-Hispanic white. Veterans averaged of 50.69 years of age (SD = 14.01), 31.5% had a substance use disorder diagnosis and 54.1% had a psychiatric diagnosis. Demographic and diagnostic information was compared across types of assistance accepted. Significant differences were found between those who accepted medications only and those who accepted either clinic referral or both medication and clinic referral. Veterans in the latter two categories were younger and more likely to have a psychiatric diagnosis than those accepting medication only. Women Veterans were significantly more likely than men to accept clinic referral plus medication. However, in contrast to men, almost none of the variables examined were associated with the type of assistance accepted by women.



These findings indicate significant gender differences in influences on accepting assistance for smoking cessation among Veterans.



Existing research identifies factors associated with unassisted quitting. However, little is known regarding the referral process, which is critical in connecting smokers with treatment. The present work is unique in employing electronic medical record data to examine factors associated with accepting different types of smoking cessation treatment referrals. This study represents an initial effort to elucidate the smoking cessation treatment referral process. These findings highlight the need to examine sex specific influences on smoking cessation treatment utilization and the importance of focusing on smokers with psychiatric disorders.
Department of Mental Health Service, Veterans Affairs San Diego Healthcare System, San Diego, CA; mgmyers@ucsd.edu.|Department of Psychiatry, University of California, San Diego, La Jolla, CA.
Mark G
MG
Myers
Department of Mental Health Service, Veterans Affairs San Diego Healthcare System, San Diego, CA.|Department of Psychiatry, University of California, San Diego, La Jolla, CA.
Timothy
T
Chen
Department of Mental Health Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA.|Department of Medicine, University of California, Los Angeles, Los Angeles, CA.
C Amanda
CA
Schweizer
D000328:Adult; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000523:psychology*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration; D014728:Veterans / Q000523:psychology*