{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:05:00Z","timestamp":1787666700025,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["VA IK2HX002398"],"award-info":[{"award-number":["VA IK2HX002398"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Smoking is a risk factor for multiple sclerosis (MS) development, symptom burden, decreased medication efficacy, and increased disease\u2010related mortality. Veterans with MS (VwMS) smoke at critically high rates; however, treatment rates and possible disparities are unknown. To promote equitable treatment, we aim to investigate smoking cessation prescription practices for VwMS across social determinant factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted data from the national Veterans Health Administration electronic health records between October 1, 2017, and September 30, 2018. To derive marginal estimates of the association of MS with receipt of smoking\u2010cessation pharmacotherapy, we used propensity score matching through the extreme gradient boosting machine learning model. VwMS who smoke were matched with veterans without MS who smoke on factors including age, race, depression, and healthcare visits. To assess the marginal association of MS with different cessation treatments, we used logistic regression and conducted stratified analyses by sex, race, and ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The matched sample achieved a good balance across most covariates, compared to the pre\u2010match sample. VwMS (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a03320) had decreased odds of receiving prescriptions for nicotine patches ([Odds Ratio]\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), non\u2010patch nicotine replacement therapy (NRT;\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), and standard practice dual NRT (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01), compared to matches without MS (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a013,280). Men with MS had lower odds of receiving prescriptions for nicotine patches (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.05), non\u2010patch NRT (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), and dual NRT (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). Similarly, Black VwMS had lower odds of receiving prescriptions for patches (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), non\u2010patch NRT (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.05), and dual NRT (\n                      <jats:italic>OR<\/jats:italic>\n                      \u00a0=\u00a00.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.01). The odds of receiving prescriptions for bupropion or varenicline did not differ between VwMS and matches without MS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VwMS received significantly less smoking cessation treatment, compared to matched controls without MS, showing a critical gap in health services as VwMS are not receiving dual NRT as the standard of care. Prescription rates were especially lower for male and Black VwMS, suggesting that under\u2010represented demographic groups outside of the white female category, most often considered as the \u201ctraditional MS\u201d group, could be under\u2010treated regarding smoking cessation support. This foundational work will help inform future work to promote equitable treatment and implementation of cessation interventions for people living with MS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3513","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T01:14:12Z","timestamp":1714698852000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Investigating disparities in smoking cessation treatment for veterans with multiple sclerosis: A national analysis"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0555-5190","authenticated-orcid":false,"given":"Carri S.","family":"Polick","sequence":"first","affiliation":[{"name":"Durham VA Health Care System  Durham North Carolina USA"},{"name":"School of Nursing, Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dennis","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick S.","family":"Calhoun","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany J.","family":"Braley","sequence":"additional","affiliation":[{"name":"Department of Neurology Michigan Medicine  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Lee","sequence":"additional","affiliation":[{"name":"Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wilson","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Psychiatry and Behavioral Sciences Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.3416"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0162752"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-5890.2000.tb00031.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516685169"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.01.045"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1191\/1352458504ms1086oa"},{"key":"e_1_2_10_8_1","volume-title":"gboost: Extreme gradient boosting","author":"Chen T.","year":"2015"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0054"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103289"},{"key":"e_1_2_10_11_1","first-page":"7","article-title":"Smoking cessation policy in the VA health care system: Where have we been and where are we going?","author":"Hamlett\u2010Berry K.","year":"2004","journal-title":"Building on Success in Smoking Cessation"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458513515086"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181b59c40"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.103085"},{"issue":"2","key":"e_1_2_10_15_1","first-page":"77","article-title":"National trends in the provision of smoking cessation aids within the Veterans Health Administration","volume":"11","author":"Jonk Y. 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