National Healthcare Quality and Disparities Report
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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 18 of 18 Research Studies DisplayedMcClure JB, Lapham G
Tobacco quitline engagement and outcomes among primary care patients reporting use of tobacco or dual tobacco and cannabis: an observational study.
Researchers examined dual users of tobacco and cannabis and how this use impacts individuals' interest in or ability to stop smoking. They found that, although dual use of tobacco and cannabis is common among smokers seen in primary care and those enrolling in quitline care, it may not undermine tobacco quitline engagement or smoking cessation. They concluded that tobacco quitline care was equally engaging and effective among tobacco users and dual users of tobacco and cannabis.
AHRQ-funded; HS026369.
Citation: McClure JB, Lapham G .
Tobacco quitline engagement and outcomes among primary care patients reporting use of tobacco or dual tobacco and cannabis: an observational study.
Subst Abus 2021;42(4):417-22. doi: 10.1080/08897077.2020.1846665..
Keywords: Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care
Fan T, Lee G
AHRQ Author: Fan T
Interventions for tobacco smoking cessation in adults, including pregnant persons.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on interventions for tobacco smoking cessation in adults, including pregnant persons. A case study is presented with questions on the best behavioral interventions, e-cigarette use, and pharmacotherapy for tobacco cessation in pregnant persons. References are also provided at the end of the answers.
AHRQ-authored.
Citation: Fan T, Lee G .
Interventions for tobacco smoking cessation in adults, including pregnant persons.
Am Fam Physician 2021 Jun 15;103(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Tobacco Use, Prevention, Case Study, Pregnancy, Women, Substance Abuse
Tabaac AR, Charlton BM, Tan ASL
Differences in tobacco product use by sexual orientation and violence factors among United States youth.
The goal of this study was to assess differences in the relationship between violence factor exposure and tobacco product pattern use (exclusive and poly). The investigators hypothesized that compared with heterosexuals, sexual minority youth would be more likely to report exclusive-tobacco and poly-tobacco use patterns and controlling for violence factors would attenuate these associations. The investigators concluded that sexual minority girls have greater exclusive- and poly-tobacco use compared with heterosexual girls.
AHRQ-funded; HS026120.
Citation: Tabaac AR, Charlton BM, Tan ASL .
Differences in tobacco product use by sexual orientation and violence factors among United States youth.
J Pediatr 2021 Jun;233:241-48. doi: 10.1016/j.jpeds.2021.02.011..
Keywords: Children/Adolescents, Tobacco Use, Domestic Violence, Vulnerable Populations
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Lewis JA, Senft N, Chen H
Evidence-based smoking cessation treatment: a comparison by healthcare system.
The authors surveyed general medicine providers and specialists in a large academic health center (AHC) and its affiliated Veterans Health Administration (VHA) in the Mid-South in 2017 to determine the cross-sectional association of healthcare system in which the provider practiced (AHC versus VHA) with self-reported provision of evidence-based smoking cessation treatment at least once in the past 12 months. They found that VHA healthcare providers were significantly more likely to provide evidence-based smoking cessation treatment compared to AHC healthcare providers.
AHRQ-funded; HS026122.
Citation: Lewis JA, Senft N, Chen H .
Evidence-based smoking cessation treatment: a comparison by healthcare system.
BMC Health Serv Res 2021 Jan 7;21(1):33. doi: 10.1186/s12913-020-06016-5..
Keywords: Health Systems, Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice, Substance Abuse
Chu KH, Matheny SJ, Escobar-Viera CG
Smartphone health apps for tobacco cessation: a systematic review.
The objective of this systematic review was to identify and evaluate the types of studies that use smartphone apps for interventions in tobacco cessation. Findings showed that the majority of studies identified that use tobacco cessation apps as an intervention delivery modality were mostly at the pilot/feasibility stage. The growing field has resulted in studies that varied in methodologies, study design, and inclusion criteria. Recommendations included more consistency in intervention components and larger randomized controlled trials for tobacco cessation smartphone apps.
AHRQ-funded; HS022989.
Citation: Chu KH, Matheny SJ, Escobar-Viera CG .
Smartphone health apps for tobacco cessation: a systematic review.
Addict Behav 2021 Jan;112:106616. doi: 10.1016/j.addbeh.2020.106616..
Keywords: Health Information Technology (HIT), Tobacco Use: Smoking Cessation, Tobacco Use, Evidence-Based Practice
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