TY - JOUR T1 - Impact of cigarette smoking on utilization of nursing home services. JF - Nicotine Tob Res Y1 - 2013 A1 - Kenneth E. Warner A1 - Ryan J McCammon A1 - Brant E Fries A1 - Kenneth M. Langa KW - Age Factors KW - Aged KW - Aged, 80 and over KW - Black or African American KW - Cross-Sectional Studies KW - Female KW - Hispanic or Latino KW - Humans KW - Length of Stay KW - Logistic Models KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Nursing homes KW - Risk KW - Self Report KW - Smoking KW - Socioeconomic factors KW - United States KW - White People AB -

INTRODUCTION: Few studies have examined the effects of smoking on nursing home utilization, generally using poor data on smoking status. No previous study has distinguished utilization for recent from long-term quitters.

METHODS: Using the Health and Retirement Study, we assessed nursing home utilization by never-smokers, long-term quitters (quit >3 years), recent quitters (quit ≤3 years), and current smokers. We used logistic regression to evaluate the likelihood of a nursing home admission. For those with an admission, we used negative binomial regression on the number of nursing home nights. Finally, we employed zero-inflated negative binomial regression to estimate nights for the full sample.

RESULTS: Controlling for other variables, compared with never-smokers, long-term quitters have an odds ratio (OR) for nursing home admission of 1.18 (95% CI: 1.07-1.2), current smokers 1.39 (1.23-1.57), and recent quitters 1.55 (1.29-1.87). The probability of admission rises rapidly with age and is lower for African Americans and Hispanics, more affluent respondents, respondents with a spouse present in the home, and respondents with a living child. Given admission, smoking status is not associated with length of stay (LOS). LOS is longer for older respondents and women and shorter for more affluent respondents and those with spouses present.

CONCLUSIONS: Compared with otherwise identical never-smokers, former and current smokers have a significantly increased risk of nursing home admission. That recent quitters are at greatest risk of admission is consistent with evidence that many stop smoking because they are sick, often due to smoking.

VL - 15 UR - http://ntr.oxfordjournals.org/content/early/2013/06/18/ntr.ntt079.abstract IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23803394?dopt=Abstract ER -