{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:22:28Z","timestamp":1778221348680,"version":"3.51.4"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T00:00:00Z","timestamp":1644019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100008746","name":"National Cancer Center","doi-asserted-by":"publisher","award":["3P30CA016086-43S1"],"award-info":[{"award-number":["3P30CA016086-43S1"]}],"id":[{"id":"10.13039\/100008746","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>While strong associations exist between social determinants of health (SDOH), socioeconomic status, and smoking, these factors are not routinely assessed in tobacco treatment programs (TTP). This study addresses this gap by evaluating a composite metric of SDOH and a measure of access to care to determine program reach before and after the implementation of telehealth tobacco treatment delivery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims and Methods<\/jats:title>\n                  <jats:p>We examined inpatient data from a large TTP during two comparable time periods from April 1, 2019 to September 30, 2019 (pre-telehealth) and from April 1, 2020 to September 30, 2020 (telehealth). The populations were compared using point-of-care data, including 5-digit zip codes mapped to the CDC\u2019s Social Vulnerability Index (SVI) and driving distance (in 60-min increments) to the study hospital. Chi-square tests for homogeneity were performed for SVI and driving distance comparisons.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>While distance distributions were significantly different between the pre-telehealth and telehealth populations (\u03c7\u200a2 = 13.5 (df = 3, N = 3234), p = .004, no significant differences existed in the proportion of SVI categories between the two populations (\u03c7\u200a2 = 5.8 (df = 3, N = 3234), p = .12). In the telehealth population, patients with the highest SVI vulnerability had the greatest proportions living &amp;gt;1 h from the hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study offers a novel evaluation of tobacco treatment in relation to an SDOH metric (SVI) and care access (distance to the hospital) for inpatient populations. Patient reach, including to those with high vulnerabilities, remained consistent in a transition to telehealth. These methods can inform future reach and engagement of patients who use tobacco products, including patients with high vulnerability or who reside at greater distances from treatment programs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study provides the first analysis of inpatient tobacco use treatment (TUT) transition to telehealth delivery of care during the COVID-19 pandemic using the CDC\u2019s SVI metric and patient distance to the hospital. The transition resulted in consistent reach to patients at the highest vulnerability. These findings can inform efforts to evaluate SDOH measures and improve reach, engagement, and research on telehealth delivery of inpatient TUT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntac016","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T20:12:23Z","timestamp":1642104743000},"page":"904-908","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating a Tobacco Treatment Program\u2019s Transition to Telehealth Using a Social Determinants of Health Lens"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-638X","authenticated-orcid":false,"given":"Kimberly A","family":"Shoenbill","sequence":"first","affiliation":[{"name":"Department of Family Medicine, University of North Carolina , Chapel Hill, NC , USA"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H","family":"Baca-Atlas","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb A","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Medicine, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie B","family":"Wilhoit-Reeves","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8915-6751","authenticated-orcid":false,"given":"Stefani N","family":"Baca-Atlas","sequence":"additional","affiliation":[{"name":"School of Social Work, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam O","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of North Carolina , Chapel Hill, NC , USA"},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill, NC , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,2,5]]},"reference":[{"key":"2022071109062643800_CIT0001","author":"Centers for Disease Control and Prevention (CDC)"},{"issue":"45","key":"2022071109062643800_CIT0002","first-page":"1013","article-title":"Tobacco product use and cessation indicators among adults\u2014United States, 2018","volume":"68","author":"Creamer","year":"2019","journal-title":"MMWR."},{"issue":"8","key":"2022071109062643800_CIT0003","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1093\/ntr\/ntu266","article-title":"Addressing the social determinants of health to reduce tobacco-related disparities","volume":"17","author":"Garrett","year":"2015","journal-title":"Nicotine Tob Res."},{"key":"2022071109062643800_CIT0004","doi-asserted-by":"crossref","first-page":"E74","DOI":"10.5888\/pcd16.180553","article-title":"Socioeconomic differences in cigarette smoking among sociodemographic groups","volume":"16","author":"Garrett","year":"2019","journal-title":"Prev Chronic Dis."},{"key":"2022071109062643800_CIT0005","doi-asserted-by":"crossref","first-page":"E107","DOI":"10.5888\/pcd17.200090","article-title":"How much progress have we made? Trends in disparities in tobacco use","volume":"17","author":"Kingsbury","year":"2020","journal-title":"Prev Chronic Dis."},{"issue":"4","key":"2022071109062643800_CIT0006","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/MLR.0000000000000884","article-title":"Effect of an evidence-based inpatient tobacco dependence treatment service on 30-, 90-, and 180-day hospital readmission rates","volume":"56","author":"Cartmell","year":"2018","journal-title":"Med Care."},{"key":"2022071109062643800_CIT0007","author":"U.S. Department of Health and Human Services","year":"2020"},{"key":"2022071109062643800_CIT0008","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"2022071109062643800_CIT0009","author":"Behavioral Risk Factor Surveillance System"},{"issue":"9","key":"2022071109062643800_CIT0010","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1093\/ntr\/ntaa082","article-title":"Smoking is associated with COVID-19 progression: a meta-analysis","volume":"22","author":"Patanavanich","year":"2020","journal-title":"Nicotine Tob Res."},{"issue":"15","key":"2022071109062643800_CIT0011","doi-asserted-by":"crossref","first-page":"5368","DOI":"10.3390\/ijerph17155368","article-title":"Tobacco quit intentions and behaviors among cigar smokers in the United States in response to COVID-19","volume":"17","author":"Kowitt","year":"2020","journal-title":"Int J Environ Res Public Health."},{"issue":"1","key":"2022071109062643800_CIT0012","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s40615-020-00923-3","article-title":"COVID-19, social determinants past, present, and future, and African Americans\u2019 health","volume":"8","author":"Snowden","year":"2021","journal-title":"J Racial Ethn Health Disparities."},{"key":"2022071109062643800_CIT0013","first-page":"ntab233","article-title":"An analysis of inpatient tobacco use treatment transition to telehealth","author":"Shoenbill","year":"2021","journal-title":"Nicotine Tob Res."},{"key":"2022071109062643800_CIT0014","author":"Centers for Disease Control and Prevention\/Agency for Toxic Substances and Disease Registry\/Geospatial Research A, and Services Program"},{"issue":"1","key":"2022071109062643800_CIT0015","doi-asserted-by":"crossref","first-page":"e2036462","DOI":"10.1001\/jamanetworkopen.2020.36462","article-title":"Association of social and demographic factors with COVID-19 incidence and death rates in the US","volume":"4","author":"Karmakar","year":"2021","journal-title":"JAMA Netw Open."},{"issue":"1","key":"2022071109062643800_CIT0016","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/MLR.0b013e31822944d1","article-title":"Estimating proximity to care: are straight line and zipcode centroid distances acceptable proxy measures?","volume":"50","author":"Bliss","year":"2012","journal-title":"Med Care."},{"issue":"3","key":"2022071109062643800_CIT0017","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.amepre.2021.01.030","article-title":"Who is (and is not) receiving telemedicine care during the COVID-19 pandemic","volume":"61","author":"Cantor","year":"2021","journal-title":"Am J Prev Med."},{"key":"2022071109062643800_CIT0018","article-title":"Advancing Tobacco Prevention and Control in Rural America","author":"Talbot","year":"2019"},{"issue":"11","key":"2022071109062643800_CIT0019","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1377\/hlthaff.2020.00980","article-title":"The impact of the COVID-19 pandemic on hospital admissions in the United States","volume":"39","author":"Birkmeyer","year":"2020","journal-title":"Health Aff (Millwood)."},{"issue":"Jan","key":"2022071109062643800_CIT0020","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.addbeh.2015.10.013","article-title":"Connecting low-income smokers to tobacco treatment services","volume":"52","author":"Slater","year":"2016","journal-title":"Addict Behav."},{"issue":"5","key":"2022071109062643800_CIT0021","first-page":"e113","article-title":"Comparative and cost effectiveness of telemedicine versus telephone counseling for smoking cessation","volume":"17","author":"Richter","year":"2015","journal-title":"JMIR."},{"issue":"1","key":"2022071109062643800_CIT0022","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1089\/tmj.2020.0194","article-title":"Rapid scaling up of telehealth treatment for tobacco-dependent cancer patients during the COVID-19 outbreak in New York City","volume":"27","author":"Kotsen","year":"2021","journal-title":"Telemed J E Health."},{"key":"2022071109062643800_CIT0023","author":"Federal Communications Commission"},{"key":"2022071109062643800_CIT0024","doi-asserted-by":"crossref","first-page":"E152","DOI":"10.5888\/pcd16.190186","article-title":"Using geospatial analyses of linked electronic health records and tobacco outlet data to address the social determinants of smoking","volume":"16","author":"Siegel","year":"2019","journal-title":"Prev Chronic Dis."}],"container-title":["Nicotine &amp; Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntac016\/42436608\/ntac016.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/24\/6\/904\/44817186\/ntac016.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/24\/6\/904\/44817186\/ntac016.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T09:07:16Z","timestamp":1657530436000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/24\/6\/904\/6510078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,5]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,2,5]]},"published-print":{"date-parts":[[2022,4,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntac016","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6,1]]},"published":{"date-parts":[[2022,2,5]]}}}