Impact of Medicaid expansion on smoking prevalence and quit attempts among those newly eligible, 2011–2019

Introduction: Low-income populations have higher rates of smoking and are disproportionately affected by smoking-related illnesses. This study assessed the long-term impact of increased coverage for tobacco cessation through Medicaid expansion on past-year quit attempts and prevalence of cigarette smoking. Methods: Using data from CDC's annual Behavioral Risk Factor Surveillance System 2011-2019, we conducted difference-in-difference regression analyses to compare changes in smoking prevalence and past-year quit attempts in expansion states versus non-expansion states. Our sample included non-pregnant adults (18-64 years old) without dependent children with incomes at or below 100% of the Federal Poverty Level (FPL). Results: Regression analyses indicate that Medicaid expansion was associated with reduced smoking prevalence in the first two years post-expansion (β=-0.019, p=0.04), but that this effect was not maintained at longer follow-up periods (β=-0.006, p=0.49). Results of regression analyses also suggest that Medicaid expansion does not significantly impact quit attempts in the short-term (β=-0.013, p=0.52) or at longer term follow-up (β=-0.026, p=0.08). Conclusions: Expanded coverage for tobacco cessation services through Medicaid alone may not be enough to increase quit-attempts or sustain a reduction in overall prevalence of smoking in newly eligible populations over time. Medicaid programs should consider additional strategies, such as public education campaigns and removal of barriers, to support cessation among enrollees

Exile Vol. XVIII

POETRY The Man And His Table by Al Werder 3 Ours by Debra Tucker 6 Running through rows and pile of leaves by Molly O\u27neill 12 Looking Glass by Alice Colthart 13 16 Years Old by Peter Porteous 14-15 a feather by Judy Meloy 28 I kicked summer\u27s shed garments by Bruce P. Andre 29 Tuesday Afternoon by Juliet Lockwood 30 snuggled deep inside by Judi Hasel 31 Star Spangled Pterdactyl by Peter Porteous 44 Billy\u27s by Suzi Harriss 45 Hong Kong by Peter Porteous 46 Ennui by Debra Tucker 47 pathetic collapse by Bruce P. Andre 48 In place of alphabet by Suzi Harriss 51 Encore by Richard Glaser 58 reflections disrupt by Judi Hasel 60 FICTION Eyes by Clark Blaise 7-11 Characters From New Mexico Life by Ardyth Hilts 16-27 Hospital Scene by Dennis Trudell 34-35 A Late Morning by Peter Porteous 36-42 Accident by Richard Glaser 52-57 ART Cover by Gail Lutsch by Jane Demos 5 by Tom Coulter 10 by Maria Ramoki 13 by Vicki Haskell 11, 15 by Alex Hutton 20 by Pat Menster 31, 59 by Scott Kenan 43 by Ann Merrill 46 by James Lautz PHOTOGRAPHY by Kathy Kerschner 1, 2, 62, 36, 64 by Bruce P. Andre 7, 28, 49 by Bruce Marshall 32, 36, 42, 61 to Paul Bennett, founder of Exile, teacher, 25 years. 2 The following previous graduates of Denison University contributed pieces of fiction to this issue of Exile: Clark Blaise \u2761 (Eyes 7-11) and Dennis Trudell \u2760 (Hospital Scene 34-35

Origin and Evolution of Prebiotic Organic Matter as Inferred from the Tagish Lake Meteorite

The complex suite of organic materials in carbonaceous chondrite meteorites probably originally formed in the interstellar medium and/or the solar protoplanetary disk, but was subsequently modified in the meteorites' asteroidal parent bodies. The mechanisms of formation and modification are still very poorly understood. We carried out a systematic study of variations in the mineralogy, petrology, and soluble and insoluble organic matter in distinct fragments of the Tagish Lake meteorite. The variations correlate with indicators of parent body aqueous alteration and at least some molecules of pre-biotic importance formed during the alteration

Reporting bias in medical research - a narrative review

Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting. We explore whether these types of bias have been shown in areas beyond the well-known cases noted above, in order to gain an impression of how widespread the problem is. For this purpose, we screened relevant articles on reporting bias that had previously been obtained by the German Institute for Quality and Efficiency in Health Care in the context of its health technology assessment reports and other research work, together with the reference lists of these articles

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)