Smokers with Access to Care are More Likely to Attempt Quitting Smoking

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Objective: The Affordable Care Act (ACA) increased healthcare access and smoking cessation services. We examined the association between access to care and quit attempts after the ACA. Methods: We analyzed 2015-2018 Behavioral Risk Factor Surveillance System data (N = 209,213). Using logistic regression, independent variables included having a personal healthcare provider and time since last healthcare provider visit. The dependent variable included smoking cessation attempt in the past 12 months (yes or no). Interactions were examined for demographic variables. Results: Smokers with one (OR = 1.27, 95% CI=1.21, 1.33) or more (OR = 1.28, 95% CI=1.28, 1.48) providers were more likely to have a quit attempt versus no provider. Smokers with a recent check-up were more likely to have a quit attempt versus those who never had/had a check-up greater than 5 years ago (OR2-5 years = 1.19, 95% CI = 1.10, 1.29, OR1-2 years = 1.34, 95% CI = 1.25, 1.44, OR1 year = 1.50, 95% CI = 1.42, 1.58). Age and education modified these associations. Conclusions: Instead of disincentive measures, policies should promote healthcare system interactions to support cessation.