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May 20, 2026American Journal of Respiratory and Critical Care Medicine

Female gender and Hispanic ethnicity linked to ~23% lower odds of complete tobacco pack-year documentation.

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Why the study?

Lung cancer screening is underutilized and requires a comprehensive smoking history to identify eligible patients, but completeness of tobacco pack-year documentation across demographic factors was unclear.

Population

10,154 current and former smokers aged 50 to 80 years across 12 primary care clinics

Comparison

Tobacco pack-year documentation across patient demographic factors

Design

Retrospective cross-sectional analysis

Key result

Female gender (OR 0.77; 95% CI 0.70-0.85) and Hispanic ethnicity (OR 0.76; 95% CI 0.66-0.87) were associated with decreased odds of complete tobacco pack-year documentation among eligible smokers.

Authors

AMA MartinezMHM HudsonGSG Su

Discussion

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Overview

Disparities in pack-year documentation by sex warrant clinical attention; this cross-sectional finding leaves open causal mechanisms and equity-focused interventions.

Key Points

  • This study evaluates the completeness of tobacco pack-year documentation and examines differences based on demographic factors.
  • Retrospective cross-sectional analysis of EHR data from 12 primary care clinics.
  • Included patients aged 50 to 80 years who were current or former smokers.
  • Assessed associations between pack-year documentation and demographic characteristics using multivariable logistical regression.
  • 40.1% of smokers had any tobacco pack-year documentation.
  • Female patients had 23% decreased odds of documentation (OR 0.77, 95%CI 0.70, 0.85).
  • Hispanic patients had 24% decreased odds of documentation (OR 0.76, 95%CI 0.66, 0.87).

Study Design

Type

Cross-Sectional (n=10,154)

Multicenter

Yes

Structured PICO

P
Population
10,154 current and former tobacco smokers aged 50 to 80 years old with at least one clinical primary care encounter within a 12-month period across 12 primary care clinics in the San Francisco Health Network.
O
Outcome
Completeness of tobacco pack-year (PY) documentation in structured EHR fields

Main Result

Effect estimate: OR 0.77 (95% CI 0.70-0.85)

Significant disparities exist in tobacco pack-year documentation by gender and ethnicity, potentially limiting equitable access to lung cancer screening.

Cite This Study

Martinez et al. (2026) conducted a cross-sectional in Lung cancer screening eligibility (n=10,154). Demographic factors (gender, ethnicity) was evaluated on Complete tobacco pack-year (PY) documentation (OR 0.77, 95% CI 0.70-0.85). Female gender (OR 0.77; 95% CI 0.70-0.85) and Hispanic ethnicity (OR 0.76; 95% CI 0.66-0.87) were associated with decreased odds of complete tobacco pack-year documentation among eligible smokers.

synapsesocial.com/papers/6a0d4f62f03e14405aa9ab64https://doi.org/10.1093/ajrccm/aamag162.993
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