Ethnic disparities in the use of nicotine replacement therapy for smoking cessation in an equal access health care system

Purpose. To examine ethnic variations in the use of nicotine replacement therapy (NRT) in an equal access health care system. Design. Cross-sectional survey. Setting. Eighteen Veterans Affairs medical and ambulatory care, centers. Measures. Use of NRT (nicotine patch or nicotine gum), ethnicity, sociodemographics, health status, smoking-related history, and facility prescribing policy. Results. Overall, only 34% of African-American and 26% of Hispanic smokers have ever used. NRT as a cessation aid compared with 50% of white smokers. In the past year African-American smokers were most likely to have attempted quilling During a serious past-year quit attempt, however Affican-American and Hispanic smokers reported, lower rates of NRT use than while smokers (20% vs. 22% vs. 34%, respectively, p =. 001). In mulivariate analyses, ethnicity was independently associated with NRT use during a past-year quit attempt. Compared with white smokers, Affican-American (adjusted odds ratio, .53; 95% confidence interval, .34-83) and Hispanic (adjusted odds ratio, .55; 95% confidence interval,.28-1.08) smokers were less likely to use NRT Conclusions. Assessment of variations in use of NRT demonstrates that African-American and Hispanic smokers tire less likely to use NRT during quit attempts. Future research is needed on the relative contributions of patient, physician, and system features to gaps in guideline implementation to Provide treatment for ethnic minority smokers.