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Tobacco use assessments dropped during COVID-19 pandemic

A new study from the Oregon Health & Science University has revealed that routine tobacco use assessments dropped by 50% during the first wave of the COVID-19 pandemic and have yet to return to pre-pandemic levels. This decline could result in less information and access to resources to help quit tobacco products, including cigarettes and e-cigarettes, leading to increased health risks, including more severe illness from COVID-19. The study highlights the impact that the COVID-19 pandemic has had on primary care practices, including a rapid increase in telehealth visits and staffing shortages, which have affected routine patient care and the delivery of cancer prevention and control services.

Tobacco assessment monthly rates drop by 50% during the first wave of the COVID-19 pandemic

The study analyzed health record data from 217 primary care clinics from January 2019 through July 2021, including telehealth and in-person visits for 759,138 adult patients 18 and older. The research team found that between March and May 2020, tobacco assessment monthly rates plummeted by 50%, from 155.7 per 1,000 patients to 77.7 per 1,000 patients. Although there was an increase in tobacco assessment between June 2020 and May 2021, assessments remained 33.5% lower than pre-pandemic levels.

Impact of the COVID-19 pandemic on primary care practices

The COVID-19 pandemic has impacted primary care practices in a multitude of ways. Many primary care physicians were redeployed to urgent COVID areas, and there was a rapid increase in telehealth visits. Additionally, many practices experienced pandemic-related staffing shortages, which had the potential to affect routine patient care and the delivery of cancer preventive services and tobacco use assessments. The onset of the COVID-19 pandemic brought a substantial shift to telehealth visits, with telehealth visits increasing from less than 1% of visits to 70% of visits in just two months. This massive change in how primary care visits were conducted could have altered routine patient check-in processes, including tobacco use assessments.

Tobacco use can increase the severity of COVID-19 symptoms and is associated with many types of cancer

Tobacco use is associated with increased severity of COVID-19 symptoms and is a major cause of many types of cancer, including lung, throat, and mouth cancer. Tobacco use is also linked to a host of chronic diseases, including diabetes, heart disease, and lung disease. The study's lead author, Sue Flocke, Ph.D., warns that the decline in routine tobacco use assessments could mean people have less information about and access to resources to help quit tobacco products, leading to increased health risks.

Access to resources for quitting tobacco is critical

Although a large portion of people who use tobacco want to quit, the vast majority of them do not have access to or do not use available resources. Health care providers can provide access to a wide variety of resources, including referral for tobacco cessation counseling and prescriptions for FDA-approved tobacco cessation medications. A successful quit attempt typically requires many tries, which is why these discussions are so important.

Journal Information: Susan A. Flocke et al, Impact of COVID-19 Pandemic on Assessing Tobacco Status in Community Health Centers, The Annals of Family Medicine (2023). DOI: 10.1370/afm.2948
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