Comparison of Smoking History Patterns Among African American and White Cohorts in the United States Born 1890 to 1990
Comparison of Smoking History Patterns Among African American and White Cohorts in the United States Born 1890 to 1990
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DOI：
10.1093/ntr/ntv274
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发表时间：
2016-04-01
影响因子：
4.7
通讯作者：
Meza, Rafael
中科院分区：
文献类型：
--
作者：
Holford, Theodore R.;Levy, David T.;Meza, Rafael
描述吸烟史模式总结了出生队列的生命过程暴露，这对于评估烟草控制对健康的影响至关重要。对非裔美国人的模式关注有限，从1890年出生队列开始，对非裔美国人和白人的生命历程吸烟史进行了估计。吸烟开始和停止的概率，和强度的估计可以用作研究吸烟干预策略，目标吸烟暴露的基线。从1965年到2012年进行的美国国家健康访谈调查产生了关于非洲裔美国人和白人目前吸烟行为的横截面信息。在一些调查中提供了吸烟者的其他详细信息，包括开始吸烟时的年龄、戒烟时的年龄和吸烟强度，这些信息用于构建参与者截至接受采访时的吸烟史。采用约束自然样条的双期队列模型提供了从1890年开始的队列中当前、既往和从未吸烟者的患病率估计值。与白人相比，非裔美国人开始吸烟的概率往往较低，戒烟的概率也普遍较低。较高的开始导致白人在年轻时吸烟率较高，但较低的戒烟率导致黑人在老年时吸烟率较高，当吸烟对健康的不良影响变得最明显时。这些估计提供了一个总结，可以用来更好地理解1964年卫生部长报告发表后吸烟行为变化的影响。应用于国家健康访谈调查的数据，该调查提供了1964年卫生局局长报告发表后该人群吸烟史的广泛总结。研究结果表明，吸烟相关疾病的一些现有差异可能是由于与白人相比，非洲裔美国人的戒烟率较低。然而，非裔美国人吸烟的数量也较低。需要进一步的工作来确定吸烟持续时间和强度可以解释吸烟相关疾病的种族差异的机制。
Characterizing smoking history patterns summarizes life course exposure for birth cohorts, essential for evaluating the impact of tobacco control on health. Limited attention has been given to patterns among African Americans.Life course smoking histories of African Americans and whites were estimated beginning with the 1890 birth cohort. Estimates of smoking initiation and cessation probabilities, and intensity can be used as a baseline for studying smoking intervention strategies that target smoking exposure. US National Health Interview Surveys conducted from 1965 to 2012 yielded cross-sectional information on current smoking behavior among African Americans and whites. Additional detail for smokers including age at initiation, age at cessation and smoking intensity were available in some surveys and these were used to construct smoking histories for participants up to the date that they were interviewed. Age-period-cohort models with constrained natural splines provided estimates of current, former and never-smoker prevalence in cohorts beginning in 1890.This approach yielded yearly estimates of initiation, cessation and smoking intensity by age for each birth cohort. Smoking initiation probabilities tend to be lower among African Americans compared to whites, and cessation probabilities also were generally lower. Higher initiation leads to higher smoking prevalence among whites in younger ages, but lower cessation leads to higher prevalence at older ages in blacks, when adverse health effects of smoking become most apparent.These estimates provide a summary that can be used to better understand the effects of changes in smoking behavior following publication of the Surgeon General's Report in 1964.A novel method of estimating smoking histories was applied to data from the National Health Interview Surveys, which provided an extensive summary of the smoking history in this population following publication of the Surgeon General's Report in 1964. The results suggest that some of the existing disparities in smoking-related disease may be due to the lower cessation rates in African Americans compared to whites. However, the number of cigarettes smoked is also lower among African Americans. Further work is needed to determine mechanisms by which smoking duration and intensity can account for racial disparities in smoking-related diseases.