Disparities in Smoking Cessation Treatment Among Immigrants and Potential Barriers to Care

• DOI: 10.1007/s40615-025-02443-4
• Publication Date: 2025-04-22T15:06:54Z
• Authors: Raymond Hsu; Sebastian T. Tong

Abstract

Introduction Despite lower smoking prevalence than U.S.-born individuals, immigrants face disparities in smoking cessation treatment. Insurance status and limited English proficiency (LEP) impede their healthcare access, but their impact on tobacco cessation treatment remains unclear. This study examines smoking cessation treatment differences between immigrants and U.S.-born individuals and explores potential barriers to access for immigrants.

Methods Data from the 2018 and 2020 Medical Expenditure Panel Survey were analyzed. Variables regarding demographics, insurance status, time spent in the U.S., and English proficiency were examined. Chi-squared and binomial logistic regression were used to compare smoking cessation treatment between U.S.-born individuals and immigrants and to understand differences within the immigrant subsample.

Results Among 3727 daily smokers surveyed, 247 were immigrants (6.6%). Immigrants had lower odds than U.S.-born individuals of being asked about tobacco use by healthcare providers (OR = 0.66, 95% CI [0.47–0.93]). Within the immigrant subgroup, those without insurance had lower odds of being asked about tobacco use (OR = 0.26, 95% CI [0.11–0.62]) and had lower odds of being advised to quit smoking in the past year (OR = 0.29, 95% CI [0.12–0.69]). Immigrants who had LEP were less likely to have ever been asked about tobacco use (OR = 0.44, 95% CI [0.20–0.94]).

Conclusion These findings highlight that persistent disparities in healthcare, namely insurance status and language barriers, may hinder access to smoking cessation treatment services in immigrant populations. Future research should focus on developing interventions that address these barriers while promoting cultural competency and linguistically appropriate care.