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

## TL;DR

People who smoke and have low trust in healthcare are more likely to delay seeking medical care, according to a U.S. survey.

## Contribution

This study identifies low medical trust as a novel predictor of delayed care-seeking among U.S. smokers.

## Key findings

- Lower medical trust was significantly associated with a higher likelihood of delaying needed care (OR = 0.54).
- Black/African American participants were less likely to delay care compared to non-Hispanic White participants.
- Better self-reported health was linked to a lower likelihood of delaying care.

## Abstract

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.

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.

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).

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).