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

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  • Bian Liu

    (Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
    Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
    Tisch Cancer Institute, New York, NY 10029-6574, USA)

  • Serena Zhan

    (Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
    Tisch Cancer Institute, New York, NY 10029-6574, USA
    Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA)

  • Karen M. Wilson

    (Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA)

  • Madhu Mazumdar

    (Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
    Tisch Cancer Institute, New York, NY 10029-6574, USA
    Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA)

  • Lihua Li

    (Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA
    Tisch Cancer Institute, New York, NY 10029-6574, USA
    Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, USA)

Abstract

Objective: We aimed to examine the influence of increasing levels of discussion (both asked and advised, either asked or advised but not both, and neither asked nor advised) on quit behavior. Methods: 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. Results: 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 the use of 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. Conclusions: Increasing levels of provider–patient discussion encourages quit behavior, and should be an integral part of reducing 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.

Suggested Citation

  • Bian Liu & Serena Zhan & Karen M. Wilson & Madhu Mazumdar & Lihua Li, 2021. "The Influence of Increasing Levels of Provider-Patient Discussion on Quit Behavior: An Instrumental Variable Analysis of a National Survey," IJERPH, MDPI, vol. 18(9), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:9:p:4593-:d:543879
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    References listed on IDEAS

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    1. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    2. Geraci Andrea & Fabbri Daniele & Monfardini Chiara, 2018. "Testing Exogeneity of Multinomial Regressors in Count Data Models: Does Two-stage Residual Inclusion Work?," Journal of Econometric Methods, De Gruyter, vol. 7(1), pages 1-19, January.
    3. Lopez-Quintero, C. & Crum, R.M. & Neumark, Y.D., 2006. "Racial/ethnic disparities in report of physician-provided smoking cessation advice: Analysis of the 2000 National Health Interview Survey," American Journal of Public Health, American Public Health Association, vol. 96(12), pages 2235-2239.
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