Objectives: In Appalachia, tobacco smoking rates are significantly higher than the United States average, and many of the comorbidities that exist with tobacco are prominent. The researchers investigated the impact of tobacco smoking on patients for one year of health outcomes at our resident primary care clinic.
Methods: The present study examined outpatient clinic charts and hospital records for a calendar year to determine patient self-reported tobacco rates. Patient medical comorbidities were tracked as well as rates of hospital utilization during the calendar year, and those figures were compared for a group of 90 patients who currently smoke and another group of 90 patients who have never smoked.
Results: Tobacco smokers in the present study were more likely to have a history of several medical comorbidities including COPD, musculoskeletal problems, psychiatric treatment, and substance abuse issues. Additionally, tobacco smokers were more likely to have visited the emergency department and to have been admitted to the hospital during the year.
Conclusions: The problem of tobacco smoking is complex and primary care clinics provide a wealth of information to investigate numerous comorbid concerns. Consistent with prior research, tobacco users in this study were at greater risk for many medical problems.
Abstract Word Count: 198
Conflict(s) of Interest
References with DOI
1. Centers for Disease Control and Prevention. 2014 Behavioral Risk Factor Surveillance System. [cited 2016 May 5]. Available from: http://www.cdc.gov/brfss/.
2. Centers for Disease Control and Prevention. Weekly report on smoking death rates. MMWR Morb Mortal Wkly Rep. 2013;62:15-18.
3. Vineis P, Alvanja M, Buffler P, et al. Tobacco and cancer: recent epidemiological evidence. J Natl Cancer Inst. 2004;21;96(2):99-106. http://dx.doi.org/10.1093/jnci/djh014
4. Willi C, Bodenmann P, Ghali WA, et al. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007;298:2654. http://dx.doi.org/10.1001/jama.298.22.2654
5. Kanis J, Johnell O, Oden A, et al. Smoking and fracture risk: a meta-analysis. Osteoporos Int. 2004; 16(2):155- 162. http://dx.doi.org/10.1007/s00198-004-1640-3
6. Haapanen-Niemi N, Milunpalo S, Vuori I, et al. The impact of smoking: alcohol consumption, and physical activity on use of hospital services. Am J Public Health. 1999;89(5):691-698. http://dx.doi.org/10.2105/ajph.89.5.691
7. Chew R, Bryson C, Au D, et al. Are smoking and alcohol misuse associated with subsequent hospitalizations for ambulatory care sensitive conditions? J Behav Health Serv Res. 2011;38(1):3-15. http://dx.doi.org/10.1007/s11414-010-9215-x
8. Fiore M, Jaen C, Baker T, et al. Treating Tobacco Use and Dependence: 2008 Update, Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services, 2008. http://dx.doi.org/10.1037/e481882008-001
9. Bornemann P, Eissa A. Strayer S. Smoking cessation: what should you recommend? J Fam Pract. 2016;65(1):22-29B
10. Abate M, Vanni D, Pantalone A, et al. Cigarette smoking and musculoskeletal disorders. Muscles Ligaments Tendons J. 2013;3(2):63–69. http://dx.doi.org/10.11138/mltj/2013.3.2.063
11. Richard P, Gilles H, Alavi Z, et al. Screening for chronic obstructive pulmonary disease in smoking cessation clinic in France. Addiction and Health. 2016;8(1):1-8.
12. Schroeder S, Morris C. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health. 2010;31:297-314. http://dx.doi.org/10.1146/annurev.publhealth.012809.103701
13. Kalman D, Morissette S, George T. Co-Morbidity of smoking in patients with psychiatric and substance use disorders. Am J Addiction. 2005;14(2):106-123. http://dx.doi.org/10.1080/10550490590924728
14. Clark M. Weight concerns in tobacco treatment. In: Mayo Clinic Nicotine Dependence Seminar: Counselor Training and Program Development Manual. Rochester, MN: Mayo Foundation, 2002.
15. Chiolero A, Faeh D, Paccaud D, et al. Consequences of smoking for body weight, body fat distribution, and insulin resistance. Am J Clin Nutr. 2008;87(4):801-809.
16. Ondler C, Hegde G, Carlson J. Resource utilization and health care charges associated with the most frequent ED users. Am J Emerg Med. 2014;32(10):1215-1219. http://dx.doi.org/10.1016/j.ajem.2014.07.013
Fields, PhD, Scott A.; Chitturi, MD, Satyakant; Kumar, MD, Anoop; Rose, DO, Jennifer; and Tanner, DO, Andy
"The Impact of Tobacco Smoking on One Year Patient Outcomes at a Family Medicine Residency Clinic,"
Marshall Journal of Medicine:
3, Article 12.
Available at: http://mds.marshall.edu/mjm/vol2/iss3/12