Trends and Factors Related to Smokeless Tobacco Use in the United States
Trends and Factors Related to Smokeless Tobacco Use in the United States
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DOI：
10.1093/ntr/ntw090
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发表时间：
2016-08-01
影响因子：
4.7
通讯作者：
Meza, Rafael
中科院分区：
文献类型：
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作者：
Chang, Joanne T.;Levy, David T.;Meza, Rafael
虽然美国吸烟流行率的下降已经有了很好的记录，但无烟烟草(SLT)使用的趋势并不明显。这项研究更新了之前对美国SLT使用情况的分析，以更好地了解与SLT使用相关的趋势和因素。我们使用当前人口调查中的烟草使用补充资料(TUS-CPS)，使用连接点和Logistic回归模型来检验与SLT使用相关的趋势和因素。1985年至2011年的SLT消费量来自2011年联邦贸易委员会无烟烟草报告。进行了敏感性分析，以评估SLT使用的不同频率定义的影响。从1992年到2003年，观察到吸烟和SLT患病率总体上的下降趋势，而不考虑使用定义。从1992年到2003年，SLT在成年总人口中的患病率以每年4.5%的年百分比变化显著下降，但此后几乎保持不变。在成年男性(APC=-4.4%)和年轻男性(APC=-9.5%)中也发现了类似的模式。人均SLT消费量从1991年到1999年大幅下降(APC=-2.2%)，但此后仅以每年0.35%的速度下降(1999-2011年)。研究发现，SLT的使用与前吸烟者身份、年龄较小、白人、生活在农村地区、在南方居住、较低的教育和失业率以及调整其他因素有关。在美国，SLT的使用有所下降，这表明烟草控制产生了积极的影响，但自2003年以来，这些影响已经放缓。有必要针对高危人群制定控烟政策，以进一步减少SLT在美国的使用。这项研究证实，SLT使用率的下降在不同人口群体中于2003年停止，这与SLT消费的趋势一致。此外，与以前的研究相比，较长的分析周期允许使用连接点回归来定量描述SLT的使用趋势。这项研究还显示了不同的SLT使用定义在确定烟草产品使用流行率和趋势方面的影响。
While declines in smoking prevalence in the United States have been well documented, trends in smokeless tobacco (SLT) use are less clear. This study updates previous analyses of US SLT use prevalence to better understand trends and factors related to SLT use.We used the Tobacco Use Supplement of the Current Population Survey (TUS-CPS) to examine trends and factors related to SLT use using joinpoint and logistic regression models. SLT consumption from 1985 to 2011 was obtained from the 2011 Federal Trade Commission Smokeless Tobacco Report. Sensitivity analyses were conducted for assessing the impact of varying frequency definitions of SLT use.Decreasing trends in smoking and SLT prevalence overall were observed from 1992 to 2003 independently of use definition. SLT prevalence in the total adult population significantly decreased at an annual percent change (APC) of 4.5% per year from 1992 to 2003, but has been approximately constant ever since. Similar patterns were also found in adult males (APC = -4.4%) and young males (APC = -9.5%). SLT per capita consumption decreased significantly from 1991 to 1999 (APC = -2.2%), but has since decreased at only 0.35% per year (1999-2011). SLT use was found to be associated with former smoker status, younger age, white race, living in rural areas, residence in the South, lower education and unemployment, adjusting for other factors.Declines in SLT use were found in the United States, suggesting tobacco control has had positive impacts, but these have slowed since 2003. Targeting tobacco control policies to at-risk demographic groups is needed to further reduce SLT use in the United States.This study confirms that the declines in SLT use prevalence stopped in 2003 across different demographic groups, consistent with trends in SLT consumption. In addition, the longer period of analysis in comparison with earlier studies allows for quantitative characterization of SLT use trends using joinpoint regression. The study also shows the impact of different SLT use definitions in determining tobacco product use prevalence and trends.