Analysis Exposes Disparities in Invitations for Tobacco Treatment


UW-CTRI Researcher Dr. Kristin Berg is the lead author on the paper, Identifying Differences in Rates of Invitation to Participate in Tobacco Treatment in Primary Care, recently published in the Wisconsin Medical Journal. This secondary analysis assessed the differences of tobacco treatment invitation rates based on patient characteristics from 11 primary care clinics from two health systems in Wisconsin from 2010-2013.

The study found a significant difference in smoking cessation invitation rates among groups, despite efforts to invite all smokers. The average invitation rate between the two health systems was 67 percent. With a 92-percent average tobacco-use screening rate, it was clear there was a disconnect.

“If we don’t invite people to quit smoking, how are we going to get people into treatment options?” said Berg.

Studies going back to 1997 have concluded that certain individuals are less likely to receive cessation advice and treatment from their health-care providers. Yet, Berg expected to see a higher invitation rate because this study implemented use of the electronic health record to help rooming staff assess all individuals for tobacco use and invite all smokers to receive cost-free treatment.

The disparities remained in younger individuals, those who identify as non-white/non-black, and those with high-risk diagnoses. The health system which did not utilize visual cues to prompt invitation also had a lower invitation rate.

Berg acknowledges the importance of smokers receiving treatment invitations from health-care providers. “Even if they’re not ready to quit, it still shows that the health provider cares and demonstrates the importance of quitting smoking,” stated Berg.

Nearly two-hundred billion dollars vanish each year due to lost productivity and medical care for tobacco use in the United States. Wisconsin mimics other states in contributing to this cost.

“We need to get more creative in what we’re doing,” Berg suggests. In addition, Berg proposes to have more trained tobacco specialists in clinic.

Berg and her co-authors agree that more research on tobacco interventions is needed in order to improve screening and treatment disparities in primary care clinics and health systems.