Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.
Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.
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阿巴拉契亚农村地区吸烟的持续差异：山地空气项目的证据。
DOI：
10.1186/s12889-021-10334-6
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发表时间：
2021-02-02
影响因子：
4.5
通讯作者：
Browning S
中科院分区：
文献类型：
--
作者：
Cardarelli K;Westneat S;Dunfee M;May B;Schoenberg N;Browning S
阿巴拉契亚中部的成人吸烟率是美国最高的，但很少有流行病学研究描述了这一人群的吸烟行为。使用基于社区的方法，山地空气项目（MAP）招募了来自阿巴拉契亚中部阿巴拉契亚的最大成人队列，使我们能够检查吸烟行为的流行率和模式。2015-2017年对972名21岁及以上的参与者进行了一项横断面流行病学研究，应答率为82%。计算整个队列的当前吸烟（与不吸烟者相比）的患病率和95%置信区间，然后按多个特征（包括呼吸健康）分层。还计算了当前吸烟与不吸烟的校正患病率。MAP参与者报告目前的吸烟率（33%）是全国成人吸烟率的两倍多。在被诊断为慢性阻塞性肺疾病和肺气肿的参与者中，目前吸烟的比例分别为51.5%和53.3%。与年龄在65岁及以上的参与者相比，年龄在45岁及以下的参与者报告的吸烟率是年龄在65岁及以上的参与者的两倍（PR：2.04，95% CI：1.51-2.74）。调整后的分析表明，年龄较小，受教育程度较低，未满足的经济需求和抑郁症与当前吸烟显著相关。尽管美国各地的吸烟率下降，但吸烟仍然是阿巴拉契亚中部地区的一个持续挑战，该地区继续面临教育资金和烟草控制政策的明显差异，这些政策使全国其他地区受益匪浅。与国家数据相比，我们的队列显示年轻人群的吸烟率较高，并报告了更高的吸烟强度。
Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior. A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015–2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed. MAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51–2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking. Despite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use.
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DOI：
10.15585/mmwr.mm6707a1
发表时间：
2018-02-23
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Croft JB;Wheaton AG;Liu Y;Xu F;Lu H;Matthews KA;Cunningham TJ;Wang Y;Holt JB
通讯作者：
Holt JB
影响因子：
1.8
作者：
Buettner-Schmidt, Kelly;Miller, Donald R.;Maack, Brody
通讯作者：
Maack, Brody
影响因子：
12.7
作者：
Breslau, N;Peterson, EL
通讯作者：
Peterson, EL
影响因子：
5
作者：
Caraballo, RS;Giovino, GA;Mowery, PD
通讯作者：
Mowery, PD
影响因子：
5.1
作者：
Doogan, N. J.;Roberts, M. E.;Higgins, S. T.
通讯作者：
Higgins, S. T.