National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Adverse Events (1)
- Alcohol Use (1)
- Anxiety (1)
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- Cancer (1)
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- Case Study (1)
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- Human Immunodeficiency Virus (HIV) (1)
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- Low-Income (1)
- Medicaid (2)
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- Prevention (4)
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- Primary Care: Models of Care (1)
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- (-) Tobacco Use (21)
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- Vulnerable Populations (1)
- Young Adults (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedProchaska JJ, Brown-Johnson C, Baiocchi M
Treating tobacco dependence to aid re-employment among job-seekers: a randomized controlled trial.
This study evaluated whether a cessation intervention for job-seekers would result in significantly fewer cigarettes per day and a greater likelihood of tobacco abstinence and re-employment compared to a control group at 6-months follow-up. A cohort of unemployed job-seekers who smoked daily were recruited from five employment development departments in the San Francisco Bay Area from October 2015 to February 2018. The 360 participants were 70% men, 43% African American, 27% non-Hispanic Caucasian and 19% unhoused. They averaged 12 cigarettes per day, 67% smoked within 30 minutes of wakening, and 27% were in preparation stage to quit. Study participants were randomized to a brief motivationally-tailored, computer-assisted counseling intervention or referred to a toll-free quitline. Participants were more likely to make a quit attempt and reported a significantly greater reduction in cigarettes/day than control participants but bioconfirmed abstinence and re-employment did not differ by treatment group.
AHRQ-funded; HS022192.
Citation: Prochaska JJ, Brown-Johnson C, Baiocchi M .
Treating tobacco dependence to aid re-employment among job-seekers: a randomized controlled trial.
Prev Med 2020 Dec;141:106259. doi: 10.1016/j.ypmed.2020.106259..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation
Oates GR, Baker E, Rowe SM
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
This longitudinal study evaluates the effects of tobacco smoke exposure and socioeconomic factors on pulmonary decline in pediatric cystic fibrosis (CF). Data from the CF Foundation Patient Registration was obtained for patients who were 6-18 years old at the end of 2016. Lung function measures (ppFEV(1)) for 10,895 individuals was calculated at each attained age. At age 6, lung function was 4.7% lower among smoke-exposed children than among unexposed with this deficit continuing through age 18. Smoke exposure and socioeconomic factors had independent, additive associations with lung function. Factors that declined ppFEV(1) include smoke exposure (2.4%), lower paternal education (4.9%), public insurance (0.3%), and increased 0.2% with each $10,000 annual household income.
AHRQ-funded; HS023009.
Citation: Oates GR, Baker E, Rowe SM .
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
J Cyst Fibros 2020 Sep;19(5):783-90. doi: 10.1016/j.jcf.2020.02.004..
Keywords: Children/Adolescents, Respiratory Conditions, Tobacco Use, Social Determinants of Health, Risk
Oates GR, Harris WT, Gutierrez HH
Tobacco smoke exposure in pediatric cystic fibrosis: a qualitative study of clinician and caregiver perspectives on smoking cessation.
This qualitative study identified barriers and facilitators of smoking cessation in caregivers to children with cystic fibrosis (CF) and outlined potential interventional approaches. Researchers conducted semi-structured interviews with CF familial caregivers who were current or former smokers, and with members of the CF care team, asking about experiences, practices, and prerequisites for a successful program. Findings revealed intrapersonal, interpersonal, and structural barriers to eliminating tobacco smoke exposure in children with CF, outlined opportunities to address these barriers, and made recommendations for a comprehensive tobacco cessation strategy.
AHRQ-funded; HS023009.
Citation: Oates GR, Harris WT, Gutierrez HH .
Tobacco smoke exposure in pediatric cystic fibrosis: a qualitative study of clinician and caregiver perspectives on smoking cessation.
Pediatr Pulmonol 2020 Sep;55(9):2330-40. doi: 10.1002/ppul.24879..
Keywords: Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Caregiving, Respiratory Conditions
Fan T, Smith HJ
AHRQ Author: Fan T
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
In this case study, three questions are posed concerning a 13-year-old girl presenting for a routine well-child visit who reports that she has never used tobacco products in any form.
AHRQ-authored.
Citation: Fan T, Smith HJ .
Primary care interventions for prevention and cessation of tobacco use in children and adolescents.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Case Study, Children/Adolescents, Tobacco Use: Smoking Cessation, Tobacco Use, Primary Care, Prevention, Substance Abuse
Friedman AS, Xu S
Associations of flavored e-cigarette uptake with subsequent smoking initiation and cessation.
Researchers evaluated whether new uptake of flavored e-cigarettes is more strongly associated with subsequent smoking initiation and cessation than uptake of unflavored e-cigarettes for youths, emerging adults, and prime-age adults. The cohort study conducted secondary data analyses of survey data from the Population Assessment of Tobacco and Health Study. The researchers found that vaping uptake was positively associated with smoking initiation in youth and in emerging adults, while vaping uptake was associated with cessation in adults. Additionally, vaping nontobacco flavors was no more associated with youth smoking initiation than vaping tobacco-flavors but was associated with increased adult smoking cessation. They recommended more research to establish the relationship between e-cigarette flavors and smoking and to guide related policy.
AHRQ-funded; HS017589.
Citation: Friedman AS, Xu S .
Associations of flavored e-cigarette uptake with subsequent smoking initiation and cessation.
JAMA Netw Open 2020 Jun;3(6):e203826. doi: 10.1001/jamanetworkopen.2020.3826..
Keywords: Children/Adolescents, Young Adults, Tobacco Use: Smoking Cessation, Tobacco Use, Substance Abuse
Bailey SR, Marino M, Ezekiel-Herrera D
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
This study examined whether states that expanded Medicaid eligibility under the ACA had increased smoking quit rates, tobacco cessation medication orders, and greater health care utilization compared to patients in non-expansion states. The researchers used electronic health record (EHR) data from 219 community health centers (CHCs) in 10 states that expanded Medicaid as of January 2014. They identified patients aged 19-64 with tobacco use status in their records within six months prior to ACA Medicaid expansion and 1 or more visits. They found that patients in expansion states had increased adjusted odds of quitting, having a medication ordered and having follow-up visits compared to patients in non-expansion states.
AHRQ-funded; HS024270.
Citation: Bailey SR, Marino M, Ezekiel-Herrera D .
Tobacco cessation in Affordable Care Act Medicaid expansion states versus non-expansion states.
Nicotine Tob Res 2020 Jun;22(6):1016-22. doi: 10.1093/ntr/ntz087..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Substance Abuse, Medication, Medicaid, Policy, Healthcare Utilization, Access to Care, Health Insurance
Selph S, Patnode C, Bailey SR
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury. The objective of this study was to update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Selph S, Patnode C, Bailey SR .
Primary care-relevant interventions for tobacco and nicotine use prevention and cessation in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Apr 28;323(16):1599-608. doi: 10.1001/jama.2020.3332..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Prevention, Primary Care, Evidence-Based Practice, Guidelines
Yuce TK, Khorfan R, Soper NJ
Post-operative complications and readmissions associated with smoking following bariatric surgery.
The link between smoking and poor postoperative outcomes is well established. Despite this, current smokers are still offered bariatric surgery. In this study, the investigators describe the risk of postoperative 30-day complications and readmission following laparoscopic sleeve gastrectomy and laparoscopic Roux-En-Y gastric bypass in smokers. The investigators concluded that smokers undergoing bariatric surgery experienced significantly worse 30-day outcomes when compared with non-smokers.
AHRQ-funded; HS000078.
Citation: Yuce TK, Khorfan R, Soper NJ .
Post-operative complications and readmissions associated with smoking following bariatric surgery.
J Gastrointest Surg 2020 Mar;24(3):525-30. doi: 10.1007/s11605-019-04488-3..
Keywords: Surgery, Tobacco Use, Adverse Events, Hospital Readmissions, Obesity: Weight Management, Obesity, Risk, Outcomes
Parekh TM, Bhatia S, Cherrington A
Factors influencing decline in quality of life in smokers without airflow obstruction: the COPDGene study.
This study looked at factors influencing decline in quality of life (QoL) in smokers without airflow obstruction using participants from the COPDGene study, a multicenter, longitudinal US study designed to determine genetic determinants of chronic obstructive pulmonary disease (COPD). The authors hypothesized that exacerbations and changes in exacerbation status would predict QoL decline among normal spirometry and Preserved Ratio Impaired Spirometry (PRISm) populations. They enrolled study subjects from Phase 1 of COPDGene and performed multivariable logistic regression models to determine independent predictors of decline in quality of life. Independent predictors of QoL deterioration included current smoking, higher exacerbation frequency, and a change from infrequent to frequent exacerbation status in both groups.
AHRQ-funded; HS023009.
Citation: Parekh TM, Bhatia S, Cherrington A .
Factors influencing decline in quality of life in smokers without airflow obstruction: the COPDGene study.
Respir Med 2020 Jan;161:105820. doi: 10.1016/j.rmed.2019.105820..
Keywords: Respiratory Conditions, Chronic Conditions, Tobacco Use, Quality of Life
Elkhadragy N, Corelli RL, Russ AL
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Researchers conducted a long-term, qualitative follow-up study of faculty participants in the Rx for Change: Clinician-Assisted Tobacco Cessation workshop. All study participants reported implementing components of Rx for Change at their institution. The researchers’ analysis yielded eight major themes pertaining to faculty perceptions and experiences with implementation. They found that participation in the train-the-trainer workshop increased self-reported confidence for teaching tobacco cessation, and faculty valued access to useful, updated tools for teaching. Furthermore, the newly-acquired counseling skills were deemed helpful for treating patients' tobacco use and dependence in clinical practice.
AHRQ- funded; HS022119.
Citation: Elkhadragy N, Corelli RL, Russ AL .
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Res Social Adm Pharm 2019 Dec;15(12):1436-45. doi: 10.1016/j.sapharm.2019.01.005..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Education: Continuing Medical Education
Maclean JC, Pesko MF, Hill SC
AHRQ Author: Hill SC
Public insurance expansions and smoking cessation medications.
The authors examined public insurance expansion on use of smoking cessation medications. The Affordable Care Act expanded coverage of these medications with financing with Medicaid. Data was analyzed from retail and online pharmacies from 2011 to 2017, and the expansion increased smoking cessation prescriptions by 24% in new medication use.
AHRQ-authored.
Citation: Maclean JC, Pesko MF, Hill SC .
Public insurance expansions and smoking cessation medications.
Econ Inq 2019 Oct;57(4):1798-820. doi: 10.1111/ecin.12794..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Health Insurance, Medication, Substance Abuse, Medicaid
Senft N, Sanderson M, Selove R
Attitudes toward precision treatment of smoking in the Southern Community Cohort Study.
Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease. In this study, the investigators surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. The researchers concluded that among disproportionately burdened community smokers, most held favorable attitudes toward precision smoking treatment.
AHRQ-funded; HS026122.
Citation: Senft N, Sanderson M, Selove R .
Attitudes toward precision treatment of smoking in the Southern Community Cohort Study.
Cancer Epidemiol Biomarkers Prev 2019 Aug;28(8):1345-52. doi: 10.1158/1055-9965.Epi-19-0179..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Substance Abuse, Social Determinants of Health, Cancer: Lung Cancer, Cancer
Chu KH, Colditz J, Malik M
Identifying key target audiences for public health campaigns: leveraging machine learning in the case of hookah tobacco smoking.
Current social media platforms provide researchers with opportunities to better identify and target specific audiences and even individuals. However, the investigators were not aware of systematic research attempting to identify audiences with mixed or ambivalent views toward hookah tobacco smoking (HTS). The objective of their study was to (1) confirm previous research showing positively skewed HTS sentiment on Twitter using a larger dataset by leveraging machine learning techniques and (2) systematically identify individuals who exhibit mixed opinions about HTS via the Twitter platform and therefore represent key audiences for intervention.
AHRQ-funded; HS022989.
Citation: Chu KH, Colditz J, Malik M .
Identifying key target audiences for public health campaigns: leveraging machine learning in the case of hookah tobacco smoking.
J Med Internet Res 2019 Jul 8;21(7):e12443. doi: 10.2196/12443..
Keywords: Health Promotion, Public Health, Social Media, Tobacco Use, Tobacco Use: Smoking Cessation
Kalkhoran S, Thorndike AN, Rigotti NA
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
This study compared current smoking and quitting-related characteristics of low-income US adults with and without serious mental illness (SMI) who received healthcare at federally funded health centers. Using data from the Health Center Patient Survey, researchers concluded that the lower quit ratio in the SMI population suggests that advice alone is unlikely to be sufficient. They recommend augmented strategies to promote smoking cessation and to reduce the excess burden of tobacco-related disease in patients with SMI.
AHRQ-funded; HS025378.
Citation: Kalkhoran S, Thorndike AN, Rigotti NA .
Cigarette smoking and quitting-related factors among us adult health center patients with serious mental illness.
J Gen Intern Med 2019 Jun;34(6):986-91. doi: 10.1007/s11606-019-04857-3..
Keywords: Behavioral Health, Lifestyle Changes, Low-Income, Tobacco Use, Vulnerable Populations
Schnall R, Carcamo J, Porras T
Use of the phase-based model of smoking treatment to guide intervention development for persons living with HIV who self-identify as African American tobacco smokers.
To address the issue of developing effective tobacco cessation interventions for persons with HIV, this study conducted six focus group sessions with 45 African American smokers who are living with HIV in order to understand barriers to smoking cessation and strategies to help overcome these barriers. The participants articulated key components for incorporation into tobacco cessation intervention: personalized plans for quitting, reminders about the plan, and a support system. Participants also described barriers to use of pharmacotherapy, such as adverse side effects of nicotine gum and patch, and expressed concerns about negative health effects of some oral medications. The authors conclude that their findings provide information on the components of a tobacco cessation intervention for persons living with HIV.
AHRQ-funded; HS025071.
Citation: Schnall R, Carcamo J, Porras T .
Use of the phase-based model of smoking treatment to guide intervention development for persons living with HIV who self-identify as African American tobacco smokers.
Int J Environ Res Public Health 2019 May 15;16(10). doi: 10.3390/ijerph16101703..
Keywords: Human Immunodeficiency Virus (HIV), Primary Care: Models of Care, Racial and Ethnic Minorities, Tobacco Use, Tobacco Use: Smoking Cessation
Gianfrancesco MA, Trupin L, Shiboski S
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
Prior studies around the relationship between smoking and rheumatoid arthritis (RA) disease activity have reported inconsistent findings, which may be ascribed to heterogeneous study designs or biases in statistical analyses. In this study, the investigators examined the association between smoking and RA outcomes using statistical methods that account for time-varying confounding and loss to followup. They found that smoking was associated with higher levels of disease activity in RA.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Trupin L, Shiboski S .
Smoking is associated with higher disease activity in rheumatoid arthritis: a longitudinal study controlling for time-varying covariates.
J Rheumatol 2019 Apr;46(4):370-75. doi: 10.3899/jrheum.180262..
Keywords: Arthritis, Tobacco Use
Iyer AS, Holm KE, Bhatt SP
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
This study compared the frequency of anxiety/depressive symptoms of current and former smokers with and without COPD and their use of anxiolytic-hypnotics/antidepressants. A cohort of 5331 current/former smokers were surveyed. About 25% of smokers with and without COPD had anxiety/depressive symptoms. Unmedicated smokers tended to be African American, male, have no health insurance, have severe-very severe COPD and higher respiratory symptoms/exacerbation history.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Holm KE, Bhatt SP .
Symptoms of anxiety and depression and use of anxiolytic-hypnotics and antidepressants in current and former smokers with and without COPD - a cross sectional analysis of the COPDGene cohort.
J Psychosom Res 2019 Mar;118:18-26. doi: 10.1016/j.jpsychores.2019.01.002..
Keywords: Anxiety, Medication, Respiratory Conditions, Depression, Behavioral Health, Anxiety, Tobacco Use
Shafer PR, Borsky A, Ngo-Metzger Q
AHRQ Author: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
The authors of this study estimated screening and counseling rates for tobacco and alcohol use, and obesity by using a nationally representative sample of adults aged 35 years and older. Receipt of the recommended level of services ranged from nearly two-thirds for obesity and tobacco use to less than half for alcohol misuse. The authors conclude that care delivery shows significant room for improvement, but primary care practices may need additional resources to raise their screening and counseling rates.
AHRQ-authored.
Citation: Shafer PR, Borsky A, Ngo-Metzger Q .
The practice gap: national estimates of screening and counseling for alcohol, tobacco, and obesity.
Ann Fam Med 2019 Mar;17(2):161-63. doi: 10.1370/afm.2363..
Keywords: Alcohol Use, Lifestyle Changes, Obesity, Prevention, Primary Care, Screening, Substance Abuse, Tobacco Use
Chu KH, Escobar-Viera CG, Matheny SJ
Tobacco cessation mobile app intervention (Just Kwit! study): protocol for a pilot randomized controlled pragmatic trial.
The aims of this pilot study were to assess the impact on tobacco cessation of using a smartphone app compared with usual care and to generate feasibility data to inform a future fully powered clinical trial. The authors suggest that data generated by this study can be used for larger fully powered trials such as comparative effectiveness studies against apps developed by academics or health scientists based on behavioral theories, or cost-effectiveness analyses of mobile interventions.
AHRQ-funded; HS022989.
Citation: Chu KH, Escobar-Viera CG, Matheny SJ .
Tobacco cessation mobile app intervention (Just Kwit! study): protocol for a pilot randomized controlled pragmatic trial.
Trials 2019 Feb 26;20(1):147. doi: 10.1186/s13063-019-3246-2..
Keywords: Health Information Technology (HIT), Patient-Centered Outcomes Research, Tobacco Use, Young Adults
Forster M, Amy GL, Areba E
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
The authors investigated whether internal assets (IAs), factors that promote healthy youth development, can mitigate the adverse effects of psychosocial risks on tobacco use. Their results indicated that every additional psychosocial risk factor was associated with an increase in the odds of using tobacco and in the estimated number of products used. IAs were inversely associated with tobacco use and attenuated the association between cumulative psychosocial risks and use. They concluded that bolstering resilience by facilitating students' IAs represents a promising direction for youth-focused prevention efforts.
AHRQ-funded; HS022236.
Citation: Forster M, Amy GL, Areba E .
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
Addict Behav 2019 Feb;89:240-47. doi: 10.1016/j.addbeh.2018.10.014..
Keywords: Tobacco Use, Children/Adolescents, Risk, Education
Livingston CJ, Freeman RJ, Costales VC
AHRQ Author: Niebuhr DW
Electronic nicotine delivery systems or e-cigarettes: American College of Preventive Medicine's practice statement.
E-cigarettes or or electronic nicotine delivery systems (ENDS) have rapidly gained popularity in the U.S. Controversy exists about the safety and efficacy of ENDS. This paper describes the American College of Preventive Medicine's Prevention Practice Committee’s consensus-based evidence review process to develop a practice statement for the American College of Preventive Medicine.
AHRQ-authored
Citation: Livingston CJ, Freeman RJ, Costales VC .
Electronic nicotine delivery systems or e-cigarettes: American College of Preventive Medicine's practice statement.
Am J Prev Med 2019 Jan;56(1):167-78. doi: 10.1016/j.amepre.2018.09.010.
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Keywords: Guidelines, Prevention, Substance Abuse, Tobacco Use