J Prev Med Public Health.  2018 Sep;51(5):257-262. 10.3961/jpmph.18.119.

National Trends in Smoking Cessation Medication Prescriptions for Smokers With Chronic Obstructive Pulmonary Disease in the United States, 2007-2012

Affiliations
  • 1Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA. dr.min.ji.kwak@gmail.com
  • 2Department of Management Policy and Community Health, University of Texas School of Public Health, Houston, TX, USA.
  • 3Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
  • 4Department of Internal Medicine, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
  • 5Healthcare Transformation Initiatives, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Abstract


OBJECTIVES
Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein.
METHODS
We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions.
RESULTS
The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion.
CONCLUSIONS
The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

Keyword

Chronic obstructive pulmonary disease; Smoking cessation; Varenicline; Bupropion; Tobacco use cessation products; Nicotine

MeSH Terms

Bupropion
Comorbidity
Continental Population Groups
Depression
Drug Therapy
Health Care Surveys
Hispanic Americans
Humans
Insurance
Logistic Models
Mortality
Nicotine
Prescriptions*
Pulmonary Disease, Chronic Obstructive*
Retrospective Studies
Smoke*
Smoking Cessation*
Smoking*
Tobacco Use Cessation Products
United States*
Varenicline
Bupropion
Nicotine
Smoke
Varenicline
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