Low medical trust predicts delays in seeking care among U.S. individuals who smoke: Findings from the 2022 HINTS

Abstract

Objectives

Individuals who smoke face increased risk for chronic disease but often delay seeking care, hindering prevention efforts. Low medical trust is a barrier associated with care delays in the general population; less is known about this relationship among people who smoke.

We examined whether low medical trust predicted delays in seeking care among U.S. individuals who smoke (n = 431, weighted n = 20.8 million), using the 2022 Health Information National Trends Survey.

Methods

We conducted a pre-registered, multivariable logistic regression with medical trust predicting delayed care (within the prior 12 months) as the outcome. Covariates included race, sex, age, education, financial strain, chronic conditions, self-reported health, and insurance.

Results

Lower trust was associated significantly with a higher likelihood of delaying needed medical care (OR = 0.54, 95% CI [0.31, 0.93]). Participants who were Black/African American (vs. non-Hispanic White), aged 65–74 (vs. 18–34), and those who reported better general health were significantly less likely to delay care (all p < .05).

Conclusions

Lower trust predicted delayed care-seeking among people who smoke. Future research should explore whether anticipated stigma explains this relationship. Findings highlight the need to bolster trust in healthcare (e.g., communication interventions) to facilitate engagement in preventive care (e.g., smoking cessation, lung cancer screening).