Undertreatment of tobacco use relative to other chronic conditions

Abstract

Objectives: We compared the likelihood that a tobacco user would receive treatment with the likelihood that an adult with another common chronic condition would receive treatment for that condition at an office visit.

Methods: We analyzed data from the 2005-2007 National Ambulatory Medical Care Survey to compare the proportion of US office visits at which tobacco users and individuals with hypertension, hyperlipidemia, diabetes, asthma, or depression received condition-specific treatment. We calculated the odds that a visit for a comparison condition would result in treatment relative to a visit for tobacco dependence.

Results: From 2005 to 2007, 38, 004 patient visits involved at least 1 study condition. Tobacco users received medication at fewer visits (4.4%) than individuals with hypertension (57.4%), diabetes (46.2%), hyperlipidemia (47.1%), asthma (42.6%), and depression (53.3%). In multivariate analyses, the odds for pharmacological treatment of these disorders relative to tobacco use were, for hypertension, 32.8; diabetes, 20.9; hyperlipidemia, 16.5; asthma, 22.1; and depression, 24.0 (all Ps < .001). Patients with hypertension, diabetes, or hyperlipidemia were also more likely to receive behavioral counseling.

Conclusions: Alternate models of engagement may be needed to enhance use of effective treatments for tobacco use.