The Influence of Increasing Levels of Provider-Patient Discussion on Quit Behavior: An Instrumental Variable Analysis of a National Survey

• Activity Number: 340 - SPEED: SPAAC SESSION III
• Type: Topic-Contributed
• Date/Time: Thursday, August 12, 2021 : 10:00 AM to 11:50 AM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Serena Zhan* and Bian Liu and Lihua Li and Madhu Mazumdar and Karen Wilson
• Companies: Icahn School of Medicine at Mount Sinai and Icahn School of Medicine at Mount Sinai and Icahn School of Medicine at Mount Sinai, New York and Icahn School of Medicine at Mount Sinai and Icahn School of Medicine at Mount Sinai
• Keywords: NHIS; survey data; instrumental variable; logistic regression; propensity score weighting; epidemiology

Abstract

We aimed to examine the effect of increasing level of discussion on quit behavior. We included 4133 adult current smokers from the 2015 National Health Interview Survey. The primary outcomes were quit intent and quit attempt, and the secondary outcomes were methods used for quitting. We used an instrumental variable analysis, as well as propensity score weighted and multivariable logistic regressions. Compared to no discussion, having both or only one discussion, respectively, increased quit intent (OR=1.65, 95% CI =1.63-1.66 and OR=1.02, 95% CI =0.99-1.05), quit attempt (OR=1.76, 95% CI =1.75-1.77 and OR=1.60, 95% CI =1.57-1.63). Among those who attempted to quit (n=1536), having both or only one discussion increased using pharmacologic (OR=1.99, 95% CI =1.97-2.02 and OR=1.56, 95% CI =1.49-1.63) or behavioral (OR=2.01, 95% CI =1.94-2.08 and OR=2.91, 95% CI =2.74-3.08) quit methods. Increasing levels of provider-patient discussion encourages quit behavior to reduce the health and economic burden of smoking. Strategies that promote the adherence and compliance of providers to communicate with patients may help increase the success of smoking cessation.