Summary
As Medi-Cal transforms to improve population health and health equity, this study aimed to understand both the prevention and treatment of tobacco-related disease by comparing health professional advice and assistance among all Medi-Cal members with and without chronic disease who smoke.
Using data from the 2014 and 2016–2018 California Health Interview Surveys, the authors examined 3,517 Medi-Cal current smokers (age ≥18 years) who consulted a health professional and reported about having a chronic disease. The outcomes included receiving advice or assistance from a health professional to quit smoking.
Findings: Among 1,227,154 Medi-Cal members who smoke, over half (51.9%) of whom had at least one chronic disease, approximately half received cessation advice, and less than one third received smoking cessation assistance. Smokers with chronic disease were more likely to receive health professional advice and assistance than those without chronic disease. In adjusted models, smokers with chronic disease were almost twice as likely to receive advice and 1.5 times as likely to receive assistance as those without chronic disease, but the latter was not statistically significant.
Medi-Cal members who smoke have tobacco treatment disparities between those with or without chronic disease, even after adjusting for the number of office visits. Medi-Cal population health strategies for tobacco cessation treatment will need to improve prevention, not just treatment, of tobacco-related disease to reduce the long-term burden on the health care system and associated costs.
