Current tobacco use patterns associated with healthcare utilization among non-Hispanic Black and Hispanic men with chronic conditions

Abstract

IntroductionTobacco use disparities persist among U.S. adults who are male, racially/ethnically diverse, and have chronic conditions. This study assessed current tobacco use patterns associated with past year healthcare utilization among non-Hispanic Black and Hispanic men ≥40 years old with ≥1 chronic condition. MethodsData were collected from a sample of 1,904 non-Hispanic Black and Hispanic men from across the U.S. using an internet-delivered survey. Participants were categorized into four tobacco use groups: nontobacco users, exclusive cigarette smokers, dualtobacco users (cigarettes + one other tobacco product), and polytobacco users (cigarettes + ≥2 other tobacco products). Logistic regression analyses were conducted to assess current tobacco use patterns with past year primary care visits, emergency department (ED) visits, and overnight hospital stays. Adjusted models included participants’ age, race/ethnicity, education level, marital status, health insurance coverage, body mass index, and number of chronic conditions. ResultsRelative to nontobacco users, exclusive cigarette smokers were at decreased odds of having a past year primary care visit (adjusted odds ratio [AOR] = 0.68, 95% confidence interval [CI] = 0.47–0.99). Exclusive cigarette smokers (AOR = 1.66, 95%CI = 1.25–2.19), dualtobacco users (AOR = 1.75, 95%CI = 1.23–2.50), and polytobacco users (AOR = 4.10, 95%CI = 2.46–6.84) were at increased odds of having a past year ED visit compared to nontobacco users. Additionally, polytobacco users were at increased odds of having a past year overnight hospital stay (AOR = 2.72, 95%CI = 1.73–4.29) compared to nontobacco users. ConclusionsFindings suggest current tobacco use patterns are uniquely associated with past year healthcare utilization among non-Hispanic Black and Hispanic men, while taking into consideration important factors including complex disease profiles.