Socioeconomic disparities in community-based treatment of tobacco dependence

Am J Public Health. 2012 Mar;102(3):e8-16. doi: 10.2105/AJPH.2011.300519. Epub 2012 Jan 19.


Objectives: We examined socioeconomic disparities in a community-based tobacco dependence treatment program.

Methods: We provided cognitive-behavioral treatment and nicotine patches to 2739 smokers. We examined treatment use, clinical and environmental, and treatment outcome differences by socioeconomic status (SES). We used logistic regressions to model end-of-treatment and 3- and 6-month treatment outcomes.

Results: The probability of abstinence 3 months after treatment was 55% greater for the highest-SES than for the lowest-SES (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.03, 2.33) smokers and increased to 2.5 times greater for the highest-SES than for the lowest-SES smokers 6 months after treatment (AOR = 2.47; 95% CI = 1.62, 3.77). Lower-SES participants received less treatment content and had fewer resources and environmental supports to manage a greater number of clinical and environmental challenges to abstinence.

Conclusions: Targets for enhancing therapeutic approaches for lower socioeconomic groups should include efforts to ensure that lower-SES groups receive more treatment content, strategies to address specific clinical and environmental challenges associated with treatment outcomes for lower-SES smokers (i.e., higher dependence and stress levels and exposure to other smokers), and strategies to provide longer-term support.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arkansas
  • Cognitive Behavioral Therapy
  • Community Networks*
  • Confidence Intervals
  • Female
  • Healthcare Disparities*
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Outcome Assessment, Health Care
  • Social Class*
  • Tobacco Use Disorder / drug therapy*
  • Young Adult