Smoking cessation strategies and outcomes

Smoking Cessation

Studies of six diverse communities in Chicago, poor women under welfare reform and Medicaid recipients as well as a focus group of seniors concerning smoking cessation showed that 1) populations do vary in their smoking behavior and ability to stop smoking and 2) programs must be developed to target specific demographics.

Although prior studies showed that poorer individuals have worse health, comparatively less research has been conducted specifically on a subgroup of this population -- single mothers receiving welfare. Kaplan et. al. (2005) hypothesized that the health of these women is not only at risk, but that the Personal Responsibility and Work Opportunity Reconciliation Act in 1996, made this problematic situation even worse. The researchers thus compared the health of single mothers from Michigan who were impacted by welfare reform with a nationally representative sample of women.

Results indicated that current smoking rates were higher and smoking cessation rates lower among the women welfare recipients than the national sample. In addition, women welfare recipients had poorer health, including higher rates of elevated glycosylated hemoglobin and hypertension as well as lower peak expiratory flow and less physical functioning. The authors concluded: "The absence of well-designed studies of the physical health status of poor women and their families as they weather one of the most sweeping social policy changes ... represents an important missed opportunity" (Kaplan n.p.). Studies are needed on how specific policy changes affect a population's health and make empirical data on health part of evaluating the impact of such changes.

A 2005 study by Dell et. al. likewise indicated disparities among populations in Chicago. Recognizing that smoking behavior may not be similar for all communities, the authors analyzed smoking data to research variations. A health survey of six racially and ethnically diverse communities included questions about present smoking, smoking history, and cessation attempts. The authors found smoking prevalence varied from 18% in the wealthiest or predominately White community to 39% in the poorest or mostly Black community. Further, 46 to 58% of smokers reported they tried to quit during the past year and 49 to 75% of current smokers were still trying to stop.

'However, less than 4% of the Master Tobacco Settlement Agreement funds are being spent on smoking prevention, or even on health in general, in Illinois ... Understanding community-level smoking rates could improve the allocation of resources and assist the shaping of culturally meaningful prevention efforts" (Dell n.p.)

Murphy et. al. (2005) researched a Medicaid population to determine the success of the smoking cessation pharmacotherapy program. The objectives were to (1) assess awareness of this benefit among Medicaid smokers and (2) compare pharmacotherapy use among Medicaid smokers to those in a general Western New York population. The researchers found Medicaid smokers were much less likely than the general population to report using pharmacotherapies. Highlighting availability of smoking cessation benefits of pharmacotherapy to Medicaid participants may enhance quit attempts (Murphy n.p.)

Lastly, the Center for Social Gerontology initiated focus groups of current and recent former smokers aged 60+ to obtain information on motivations, opinions and behaviors about smoking and smoking cessation. Information such as this is expected to help healthcare providers design programs that better target this population. The three studies and focus groups indicate that in order to change smoking behavior across the United States, it is necessary to recognize and target variations in population groups to be most effective.

References Cited

Center for Social Gerontology. "Summary of Focus Group Research on Current and Recent Former Older Smokers." 22 August 2005.

Dell, Jade L. "Smoking in 6 Diverse Chicago Communities -- A Population Study."

American Journal of Public Health. 95.6 (2005): 1036-1043. [electronic version]

Kaplan, George A. et. al. "The Health of Poor Women Under Welfare Reform." American Journal of Public Health. 95.7 (2005): 1252-1259.

Murphy, Jill M. "Disparity in the Use of Smoking Cessation Pharmacotherapy Among Medicaid and General Population Smokers." Journal of Public Health Management and Practice. 11.4 (2005): 341-346. [electronic version]

Outline

I. Introduction with thesis statement: Studies noted in this report indicated that

1) populations do vary in their smoking behavior and ability to stop smoking and 2) programs must be developed to target specific demographics to be most effective.

II. Study by Kaplan et. al. (2005) showed that the health of women welfare program recipients is not only at risk, but that the Personal Responsibility and Work Opportunity Reconciliation Act in 1996 made their situation worse.

A. Welfare women in Michigan have higher current smoking rates and lower smoking cessation rates than the national sample of women.

B. Welfare women have higher rates of certain health ailments such as hypertension.