Predictors of a Successful Outcome among Adult Smokers using Smoking Cessation Medication

Date

2013-08

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Abstract

Introduction: Our objectives were to assess the smoking cessation medication utilization patterns among adult smokers in 2011 and identify predictors of successful outcome among adult smokers using each type of smoking cessation medication. Methods: A retrospective cross-sectional study and a retrospective cohort study were conducted to achieve objective I and objective II of our study using GE healthcare clinical data. Descriptive statistics were used to provide estimates of the utilization rates of each smoking cessation medication (varenicline, bupropion, NRT) in 2011.Multivariate logistic regression models were conducted to identify predictors of successful outcome among adult smokers using each type of smoking cessation medication using Andersen’s health service utilization model as conceptual framework. SAS 9.3 was used in our study with a significance level of 0.05. Results: The final cohort for objective I consisted of 886,604 current adult smokers in 2011. Among these smokers, 5.66% have been prescribed a smoking cessation medication, which included vareniciline, bupropion or NRT. The use rate of varenicline in 2011 was 3.69%, followed by NRT (2.00%) and bupropion (0.18%). For objective II, we found age, gender, race, region, payment type, specialty group, baseline BMI, smoking cessation counseling, number of cigarettes smoking per day and comorbidities including hypertension, hyperlipidemia, lung cancer, diabetes and AMI were significant predictors of successful quitting for smokers who were prescribed varenicline. Age, race, baseline BMI, smoking cessation counseling, number of cigarettes smoking per day, and comorbidities including hyperlipidemia, stroke, COPD and depression were significant predictors of successful quitting for smokers who were prescribed bupropion. Age, gender, race, region, payment type, specialty group, baseline BMI, smoking cessation counseling, number of cigarettes smoking per day, and comorbidities including lung cancer, stroke, COPD and AMI were significant predictors of successful quitting among smokers who were prescribed NRT. Conclusions: Each different type of smoking cessation medication may be particularly beneficial to certain smoking subpopulations in real life world. NRT was more effective among patients with COPD comparedto those without COPD. Bupropion could be more beneficial to smokers with depression compared to those without depression. NRT could be more beneficial to male smokers vs female smokes. Varenicline might be more beneficial to female smokers in a real world setting.

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Keywords

Smoking, Smoking cessation, Medication, Predictors

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