TY - JOUR
T1 - Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status
AU - Stewart, Diana W.
AU - Cano, Miguel Ángel
AU - Correa-Fernández, Virmarie
AU - Spears, Claire Adams
AU - Li, Yisheng
AU - Waters, Andrew J.
AU - Wetter, David W.
AU - Vidrine, Jennifer Irvin
N1 - Funding Information:
This research is supported in part by grants from the Centers for Disease Control and Prevention (K01CD000193), the National Cancer Institute (R25T CA57730), and the University of Texas MD Anderson's Cancer Center Support Grant CA016672, and the Latinos Contra el Cancer Community Networks Program Center Grant U54CA153505. This work was also supported in part by a faculty fellowship from the University of Texas MD Anderson Cancer Center’s Duncan Family Institute for Cancer Prevention and Risk Assessment.
PY - 2014/7/14
Y1 - 2014/7/14
N2 - Background: Nearly half of U.S. adults have difficulties with health literacy (HL), which is defined as the ability to adequately obtain, process, and understand basic health information. Lower HL is associated with negative health behaviors and poor health outcomes. Racial/ethnic minorities and those with low socioeconomic status (SES) are disproportionately affected by poor HL. They also have higher smoking prevalence and more difficulty quitting smoking. Thus, lower HL may be uniquely associated with poorer cessation outcomes in this population. Methods. This study investigated the association between HL and smoking cessation outcomes among 200, low-SES, racially/ethnically diverse smokers enrolled in smoking cessation treatment. Logistic regression analyses adjusted for demographics (i.e., age, gender, race/ethnicity, relationship status), SES-related characteristics (i.e., education, income), and nicotine dependence were conducted to investigate associations between HL and smoking relapse at the end of treatment (3 weeks post quit day). Results: Results indicated that smokers with lower HL (score of < 64.5 on the Rapid Estimate of Adult Literacy in Medicine [REALM]) were significantly more likely than those with higher HL (score of ≥ 64.5 on the REALM) to relapse by the end of treatment, even after controlling for established predictors of cessation including demographics, SES, and nicotine dependence (OR = 3.26; 95% CI = 1.14, 9.26). Conclusions: Findings suggest that lower HL may serve as an independent risk factor for smoking relapse among low-SES, racially/ethnically diverse smokers enrolled in treatment. Future research is needed to investigate longitudinal relations between HL and cessation outcomes and potential mechanisms of this relationship.
AB - Background: Nearly half of U.S. adults have difficulties with health literacy (HL), which is defined as the ability to adequately obtain, process, and understand basic health information. Lower HL is associated with negative health behaviors and poor health outcomes. Racial/ethnic minorities and those with low socioeconomic status (SES) are disproportionately affected by poor HL. They also have higher smoking prevalence and more difficulty quitting smoking. Thus, lower HL may be uniquely associated with poorer cessation outcomes in this population. Methods. This study investigated the association between HL and smoking cessation outcomes among 200, low-SES, racially/ethnically diverse smokers enrolled in smoking cessation treatment. Logistic regression analyses adjusted for demographics (i.e., age, gender, race/ethnicity, relationship status), SES-related characteristics (i.e., education, income), and nicotine dependence were conducted to investigate associations between HL and smoking relapse at the end of treatment (3 weeks post quit day). Results: Results indicated that smokers with lower HL (score of < 64.5 on the Rapid Estimate of Adult Literacy in Medicine [REALM]) were significantly more likely than those with higher HL (score of ≥ 64.5 on the REALM) to relapse by the end of treatment, even after controlling for established predictors of cessation including demographics, SES, and nicotine dependence (OR = 3.26; 95% CI = 1.14, 9.26). Conclusions: Findings suggest that lower HL may serve as an independent risk factor for smoking relapse among low-SES, racially/ethnically diverse smokers enrolled in treatment. Future research is needed to investigate longitudinal relations between HL and cessation outcomes and potential mechanisms of this relationship.
KW - Health disparities
KW - Health literacy
KW - Smoking cessation
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U2 - 10.1186/1471-2458-14-716
DO - 10.1186/1471-2458-14-716
M3 - Article
C2 - 25018151
AN - SCOPUS:84905172441
SN - 1471-2458
VL - 14
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 716
ER -