Assessing trends in tobacco cessation in diverse patient populations
Menée à partir des données de six registres médicaux numériques portant sur 34 393 fumeurs ayant consulté au moins une fois en médecine générale entre 2007 et 2011, cette étude américaine analyse les tendances en matière de sevrage tabagique, puis identifie les facteurs démographiques et médicaux associés au sevrage tabagique de longue durée
Introduction : This study examined change in tobacco use over four years among the general population of patients in six diverse health care organizations using electronic medical record data. Methods : The study cohort (N = 34,393) included all patients age 18 years or older who were identified as smokers in 2007, and who then had at least one primary care visit in each of the following four years. Results : In the four years following 2007, this patient cohort had a median of 13 primary care visits, and 38.6% of the patients quit smoking at least once. At the end of the fourth follow-up year, 15.4% had stopped smoking for one year or more. Smokers were more likely to become long-term quitters if they were 65 or older (OR=1.32, 95% CI= [1.16, 1.49]), or had a diagnoses of cancer (1.26 [1.12, 1.41]), cardiovascular disease (1.22 [1.09, 1.37]), asthma (1.15 [1.06, 1.25]) or diabetes (1.17 [1.09, 1.27]). Characteristics associated with lower likelihood of becoming a long-term quitter were female gender (0.90 [0.84, 0.95]), African-American race (0.84 [0.75, 0.94]) and those identified as non-Hispanic (0.50 [0.43, 0.59]). Conclusions : Among smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. This study shows the practicality of using electronic medical records for monitoring patient smoking status over time. Similar methods could be used to assess tobacco use in any health care organization to evaluate the impact of environmental and organizational programs.