, 2006; Buntin, Colla, Deb, Sood, & Escarce, 2010). In our study, as in the prior study using similar instrumental variables, the ����marginal patients���� are those who were counseled on smoking cessation because their providers BI 6727 counseled them on exercise and carried the pattern to smoking cessation. Additional studies are needed to determine whether these findings also apply to those individuals who are ��nonmarginal�� (Bao et al., 2006). The generalizability of our findings to all smokers with ADM disorders is also limited by the study sample. Our analyses were restricted to those individuals who visited a general medical provider in the year prior to the HCC2 interview and individuals needed to be dwelling in the community with a telephone to be in the survey sampling frame.
As a result, our findings may not extend to the full spectrum of smokers with ADM disorders, particularly those who do not access primary care, nor to those who are institutionally housed or homeless. Additional studies are needed to explore the effectiveness of primary care smoking cessation interventions among smokers with ADM disorders those who do not routinely use primary care and among those who are institutionally housed or homeless. The predicted probability of successful quitting in this analysis is higher than what might be expected from smoking cessation counseling alone since most studies suggest a baseline 4%�C7% annual quit rate without assistance (Fiore et al., 2008), and physician counseling alone in studies is only 1.3 times as likely to result in smoking cessation as no advice to quit or 10.
2% versus 7.9% (Fiore et al., 2008). However, we are not able to identify whether individuals used other smoking cessation aids as a result of physician counseling, such as nicotine replacement therapy or bupropion. Use of these aids would increase the likelihood of smoking cessation; the combination of counseling (not just brief physician counseling) and medication is 1.7 times as likely to result in smoking cessation as counseling alone or 22.1% versus 14.6% (Fiore et al., 2008). In addition, the time interval between the CTS2 and HCC2 surveys, essentially 2 years, may also result in higher predicted probabilities of smoking cessation than what would be seen with a 1-year interval due to repeated quit attempts. Further studies using shorter time intervals are needed to confirm the relationship between smoking cessation counseling and subsequent quitting among individuals with ADM disorders. As our data are from a survey of individuals from 2000 to 2001, it is possible that this relationship between smoking cessation counseling and quitting AV-951 behavior may have changed over time.
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