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Current smoking and quit-attempts among US adults following Medicaid expansion.

Publication ,  Journal Article
Valvi, N; Vin-Raviv, N; Akinyemiju, T
Published in: Prev Med Rep
September 2019

The objective of this study was to estimate the influence of the Affordable Care Act (ACA) Medicaid Expansion on current smoking and quit attempts in expanded and non-expanded states. We analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2003 through 2015 to evaluate changes in current smoking and quit attempts using multivariable logistic regression and generalized estimating equations (GEE), adjusting for socioeconomic factors. Time periods evaluated were: 2003-2009 (pre-expansion) and 2011-2015 (post-expansion), and in supplemental analysis, also 2011-2017. Overall, smoking prevalence among adults in expanded and non-expanded states were 16% and 17% (p < 0.001), respectively, and quit attempt prevalence for expanded and non-expanded states were 56% and 57% (p = 0.05), respectively. In adjusted models comparing post- versus pre- expansion periods, current smoking declined by 6% in both expanded (RR: 0.94, 95% CI: 0.93-0.94) and non-expanded (RR: 0.94, 95% CI: 0.94-0.95) states. Quit attempts increased by 4% (RR: 1.04, 95% CI: 1.04-1.05) in expanded states, and by 3% (RR: 1.03, 95% CI: 1.02-1.03) in non-expanded states. States that imposed barriers to utilization of smoking cessation services e.g. prior authorization, saw only a 3% increase in quit attempts regardless of expansion status, while expanded states that did not impose barriers experienced a 6% (RR: 1.06, 95% CI: 1.05-1.06) increase in quit attempts. Reducing administrative barriers to smoking cessation programs may enhance further declines in smoking rates among US adults.

Duke Scholars

Published In

Prev Med Rep

DOI

ISSN

2211-3355

Publication Date

September 2019

Volume

15

Start / End Page

100923

Location

United States

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 4202 Epidemiology
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
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Valvi, N., Vin-Raviv, N., & Akinyemiju, T. (2019). Current smoking and quit-attempts among US adults following Medicaid expansion. Prev Med Rep, 15, 100923. https://doi.org/10.1016/j.pmedr.2019.100923
Valvi, Nimish, Neomi Vin-Raviv, and Tomi Akinyemiju. “Current smoking and quit-attempts among US adults following Medicaid expansion.Prev Med Rep 15 (September 2019): 100923. https://doi.org/10.1016/j.pmedr.2019.100923.
Valvi N, Vin-Raviv N, Akinyemiju T. Current smoking and quit-attempts among US adults following Medicaid expansion. Prev Med Rep. 2019 Sep;15:100923.
Valvi, Nimish, et al. “Current smoking and quit-attempts among US adults following Medicaid expansion.Prev Med Rep, vol. 15, Sept. 2019, p. 100923. Pubmed, doi:10.1016/j.pmedr.2019.100923.
Valvi N, Vin-Raviv N, Akinyemiju T. Current smoking and quit-attempts among US adults following Medicaid expansion. Prev Med Rep. 2019 Sep;15:100923.
Journal cover image

Published In

Prev Med Rep

DOI

ISSN

2211-3355

Publication Date

September 2019

Volume

15

Start / End Page

100923

Location

United States

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 4202 Epidemiology
  • 1117 Public Health and Health Services