Background And Aims: Smoking is a risk factor for multiple sclerosis (MS) development, symptom burden, decreased medication efficacy, and increased disease-related mortality. Veterans with MS (VwMS) smoke at critically high rates; however, treatment rates and possible disparities are unknown. To promote equitable treatment, we aim to investigate smoking cessation prescription practices for VwMS across social determinant factors.
Methods: We extracted data from the national Veterans Health Administration electronic health records between October 1, 2017, and September 30, 2018. To derive marginal estimates of the association of MS with receipt of smoking-cessation pharmacotherapy, we used propensity score matching through the extreme gradient boosting machine learning model. VwMS who smoke were matched with veterans without MS who smoke on factors including age, race, depression, and healthcare visits. To assess the marginal association of MS with different cessation treatments, we used logistic regression and conducted stratified analyses by sex, race, and ethnicity.
Results: The matched sample achieved a good balance across most covariates, compared to the pre-match sample. VwMS (n = 3320) had decreased odds of receiving prescriptions for nicotine patches ([Odds Ratio]OR = 0.86, p < .01), non-patch nicotine replacement therapy (NRT; OR = 0.81, p < .001), and standard practice dual NRT (OR = 0.77, p < .01), compared to matches without MS (n = 13,280). Men with MS had lower odds of receiving prescriptions for nicotine patches (OR = 0.88, p = .05), non-patch NRT (OR = 0.77, p < .001), and dual NRT (OR = 0.72, p < .001). Similarly, Black VwMS had lower odds of receiving prescriptions for patches (OR = 0.62, p < .001), non-patch NRT (OR = 0.75, p < .05), and dual NRT (OR = 0.52, p < .01). The odds of receiving prescriptions for bupropion or varenicline did not differ between VwMS and matches without MS.
Conclusion: VwMS received significantly less smoking cessation treatment, compared to matched controls without MS, showing a critical gap in health services as VwMS are not receiving dual NRT as the standard of care. Prescription rates were especially lower for male and Black VwMS, suggesting that under-represented demographic groups outside of the white female category, most often considered as the "traditional MS" group, could be under-treated regarding smoking cessation support. This foundational work will help inform future work to promote equitable treatment and implementation of cessation interventions for people living with MS.
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http://dx.doi.org/10.1002/brb3.3513 | DOI Listing |
Clin Med Insights Case Rep
January 2025
Pneumology Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
The respiratory impact of e-cigarette usage, also known as vaping, emerged as a significant healthcare issue in 2019. This concern arose due to the sharp rise in cases of e-cigarette or vaping-associated lung injury (EVALI) among adolescents and young adults. Now, systemic manifestations have been described.
View Article and Find Full Text PDFTob Induc Dis
January 2025
Faculty of Health Sciences, Valencian International University, Valencia, Spain.
Introduction: The aim was to establish EC use risk and protective factors, the reasons for use, associations with tobacco and other substance use, and use for smoking cessation.
Methods: A systematic review following PRISMA guidelines was registered in PROSPERO (CRD42024532771). Searches in Web of Science and PubMed/MEDLINE (March-April 2024) used terms like 'electronic cigarette' and 'adolescents' with a PICO framework.
JAMA Netw Open
January 2025
Department of Behavioural Science and Health, University College London, London, United Kingdom.
Importance: A wide range of medications, noncombustible nicotine products, behavioral support, and alternative treatments are available in England to help people stop smoking. Understanding their effectiveness outside of clinical trial settings can support informed decision-making.
Objectives: To provide up-to-date estimates of the prevalence of different smoking cessation aids and associations with quit success and to explore moderation by socioeconomic position.
Aust N Z J Obstet Gynaecol
January 2025
Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.
Background: While many pregnant women accept referrals for smoking cessation support, the uptake of telephone counselling appointments is unknown.
Aims: To determine the uptake rate of Quitline appointments among Australian pregnant women who smoke after being referred by a healthcare provider.
Materials And Methods: Data on attendance at telephone counselling appointments, number of appointments attended, gestational age at referral, referral source and smoking cessation upon completion of the program were requested from Quitline.
Schizophrenia (Heidelb)
January 2025
Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania.
The aim of this study was to assess mortality risk in people with schizophrenia in Lithuania from 2001 and 2020. Cause-specific and all-cause mortality risk among patients with schizophrenia was assessed using a retrospective cohort study design. The cohort identified all patients with schizophrenia diagnosis (ICD-10 code F20) who were admitted to the Vilnius Republican Psychiatric Hospital from 1 January, 2001 to December 31, 2020.
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