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BioSocial Health J. Inpress.
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Original Article

Exploring the Relationship Between Urgent Healthcare Visits on Daily Smoking Intensity: A Cross-Sectional Study Using Zero-Inflated Models

Shafeel Umam ORCID logo, Rubaiya Binte Razzak* ORCID logo
*Corresponding Author: Email: r.binterazzak@gmail.com

Abstract

Background

Cigarette smoking is a significant public health concern, leading to increased illness and higher healthcare costs. This research aims to investigate how frequencies of visits to urgent care facilities impact the daily cigarette consumption of smokers. Understanding these relationships is crucial for developing public health policies and interventions to reduce smoking rates and lessen the strain on healthcare systems.

Methods

This study draws on data from the 2023 National Health Interview Survey (NHIS) to investigate the relationship between daily cigarette consumption and urgent healthcare visits. A sample of 28,122 adult respondents was analyzed using Zero-Inflated Poisson (ZIP) and Zero-Inflated Negative Binomial (ZINB) models to account for overdispersion and the count nature of the data. Covariates included age, sex, cardiovascular disease (CVD), education level, and health insurance coverage.

Results

Among 28,122 adults, 8% were smokers. In zero-inflated models, urgent care visit frequency showed only weak associations with smoking, while very frequent users (≥5 visits/year) were less likely to be non-smokers. Males smoked significantly more cigarettes daily compared to females, and higher education levels correlated with increased smoking intensity. The ZINB model was a better fit than the ZIP model, indicated by lower AIC values.

Conclusion

Urgent care settings present can be a crucial opportunity for implementing smoking cessation interventions, particularly for high-risk groups such as men and older adults. Integrating brief smoking cessation counseling during visits can reduce daily smoking intensity. Tailored public health interventions addressing sociodemographic disparities are crucial.

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Submitted: 03 Jan 2026
Accepted: 17 Jan 2026
ePublished: 19 May 2026
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