Health-Care Provider Intervention And Utilization Of Cessation Assistance In Low- And Middle-Income Countries

Background The psychological and physiological addictive nature of tobacco smoking makes it difficult for some smokers to quit without assistance. Tobacco cessation and utilization of cessation assistance rates are low in low-and-middle income countries (LMICs). It is not clear if health care provider tobacco screening and quit advice promote utilization of assistance to quit tobacco.This study examined the relationship between health care provider intervention and utilization of cessation assistance in 12 LMICs. Methods Data from 13967 participants of the Global Adults Tobacco Survey (GATS) in 12 LMICs were analyzed. Outcome variables were utilization of counseling/cessation clinic, prescription medication, quit line and any cessation assistance. Health care provider intervention ('no intervention', 'tobacco screening', 'quit advice') was the independent variable. Four multiple logistic regression models were fit to evaluate the relationship between the independent variable and each outcome, adjusting for covariates. All analyses were conducted using SAS version 9.4. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results Approximately 52%, 8%, and 40% of participants received no intervention, tobacco screening, and advice to quit, respectively. Overall, 0.4%, 1.9%, 3.0% and 4.5% used quit line, counseling/cessation clinic, prescription medication, and any cessation assistance, respectively. Compared to no intervention, quit advice was associated with increased utilization of counseling/cessation clinic (OR=4.41, 95% CI=3.2-6.1), prescription medication (OR=1.67, 95% CI=1.2-2.3) and any assistance (OR=2.80, 95% CI=2.2-3.6). Conclusions A comprehensive tobacco control program, with frequent tobacco screening and quit advice by health care providers may improve utilization of cessation assistance in LMICs.