The Impact of Tobacco-Specific Health Knowledge on Smoking Cessation Open Access

Berry, Joshua I (2015)

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Objectives: This study aims to understand the relationships between tobacco-specific health knowledge, evidence-based smoking cessation pharmacotherapy use, and self-reported smoking cessation status at the end of a smoking cessation program.

Methods: A prospective observational cohort study was conducted using data from the Courage to Quit (CTQ) program, a community health intervention based in Chicago, Illinois (n=1062). Logistic regression models were computed to determine which of three different tobacco knowledge measures (mean knowledge score before a brief education session, mean knowledge score after this education session, and the difference in these two scores) were associated with increased odds of smoking cessation as measured at the end of the program. These models were also examined to determine whether the use of cessation pharmacotherapy during the CTQ program was a mediator or confounder of the relationship between the tobacco knowledge measures and smoking cessation.

Results: A one-point increase out of seven points in the mean posttest knowledge score was most strongly correlated with successful smoking cessation, but this association is not statistically significant (OR = 1.13, CI = [0.99, 1.30]). Cessation medication use was significantly correlated with successful cessation in models evaluating two of the three knowledge measures (OR = 1.17, CI = [1.00, 2.92] in the knowledge pretest score model), but was not a confounder or mediator in any of these models.

Conclusions: There is insufficient evidence to conclude that tobacco-specific health knowledge is positively associated with successful smoking cessation, or that cessation pharmacotherapy use mediates or confounds this relationship. These findings stand somewhat in contrast to earlier research that suggests that higher health literacy is associated with increased odds of smoking cessation. Future research should use a comprehensive and better validated measure of tobacco knowledge to better evaluate the potential association between tobacco knowledge and smoking cessation.

Table of Contents

Background and Review of Literature. 1

Methods. 12

Results. 22

Discussion. 28

Future Directions. 33

References. 35

Tables. 41

Figures. 45

Appendix. 46

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