UC Davis

Tobacco use is a significant public health issue in the United States. This dissertation focuses on tobacco use behaviors from different populations, including young adults, smokers with California Medicaid, and patients in cancer centers.

Chapter one used data from the American College Health Association-National College Health Assessment (ACHA-NCHA) to examine the association between tobacco and/or cannabis use and serious psychological distress (SPD) among college students. Logistic regression was used to examine the association between single/dual/multiple use of tobacco as well as cannabis and SPD.

Chapter two used the California Health Interview Survey (CHIS) to explore the association between individuals with/without chronic diseases and providers smoking cessation advice and assistance among smokers with California Medicaid. Two logistic regression models were estimated to examine the associations between having at least one chronic disease and receipt of advice and assistance.

Chapter three used Electronic Health Records from UC Davis Comprehensive Cancer Center to evaluate the effectiveness of a tobacco treatment program to increase access to smoking cessation treatment for cancer patients at UC Davis Comprehensive Cancer Center, comparing patients with and without internal PCPs from January 2017 to December 2022. To examine whether the association between PCPs and assistance differs over time, a logistic regression model with an interaction term between PCPs and study year on assistance was estimated using generalized estimating equations (GEE) to account for within-patient correlation. By exploring tobacco behaviors across diverse populations, this dissertation seeks to inform targeted interventions, policies, and healthcare delivery models to reduce smoking-related disparities, promote cessation, and ultimately improve population health outcomes.