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Disparities in Rates & Impact of Tobacco and Marijuana Use in UCLA Primary Care

Institution: University of California, Los Angeles
Investigator(s): Lillian Gelberg,
Award Cycle: 2019 (Cycle 29) Grant #: T29IR0277 Award: $932,434
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: High Impact Research Project Award

Initial Award Abstract
With the recent legalization of marijuana use in California, rates of marijuana use and frequent tobacco use and co-use are expected to increase. Little is known about how tobacco and marijuana use and co-use may affect health and use of emergency health services such as emergency room visits or hospitalizations. This project builds a group of primary care patients across the UCLA Health primary care system to assess rates of tobacco and marijuana use over an 18-month period of time to understand how they affect health conditions and emergency care, especially among vulnerable populations. The timeliness of this work is critical. UCLA Health is large, covering 2,500 square miles and serving 703,056 unique patients/year, thereby facilitating evaluation of the effect that tobacco and marijuana use and co-use have upon vulnerable populations including patients from minority race/ethnicity, poverty, sexual orientation backgrounds and by neighborhood. Primary care providers (PCP) will be given provider and patient support tools in the electronic medical record for patients who screen positive for tobacco use or marijuana use disorders, including patient education on reducing tobacco and harmful marijuana use and referral to treatment if indicated to clinic/community referral resources. A novel component will allow us to identify geographic areas in Los Angeles with elevated rates of tobacco and marijuana use in UCLA patients and the geographic characteristics to understand how vulnerable populations might be adversely affected by tobacco and cannabis. We have assembled a team comprised of patients, physicians, addiction experts, nurses, information technology experts, epidemiologists, healthcare leaders, and researchers across the UCLA system who have indicated willingness to collaborate on this project. This work will serve as a springboard to developing brief screening intervention for all UCLA Health primary care patients who admit tobacco and marijuana use, and to building UCLA-community coalitions to develop interventions to assist neighborhoods and vulnerable patient populations in Los Angeles that have elevated rates of tobacco and marijuana use and poor health outcomes related to their use.