A growing geographic disparity: Rural and urban cigarette smoking trends in the United States
A growing geographic disparity: Rural and urban cigarette smoking trends in the United States
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DOI：
10.1016/j.ypmed.2017.03.011
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发表时间：
2017-11-01
影响因子：
5.1
通讯作者：
Higgins, S. T.
中科院分区：
文献类型：
--
作者：
Doogan, N. J.;Roberts, M. E.;Higgins, S. T.
美国农村地区的吸烟率高于城市地区。然而，最近的研究没有严格审查这种差异随着时间的推移的潜在变化，或者这种差异是否可以通过与吸烟相关的人口统计学或心理社会特征来解释。本研究使用了2007年至2014年全国药物使用和健康调查的年度横断面数据，以研究美国农村与城市地区的吸烟趋势。分析样本包括303，311名受访者。建立了两个回归模型，以检查（a）未调整的农村和城市目前吸烟流行率的趋势和（B）调整人口统计学和心理社会特征后是否仍存在差异。未经调整的模型的结果显示，在8年的时间内，不同的和不同的香烟使用趋势。调整后的模型也显示出不同的趋势，最初没有差异或差异很小，在8年期间变得更加明显。我们的结论是，在早期的研究中报告的差异可能是由农村与城市的人口和心理社会风险因素的差异，而最近和越来越大的差距似乎与其他因素有关。这些新出现的差异可能归因于政策层面的烟草控制和监管因素，这些因素不成比例地使城市地区受益，例如围绕烟草产品的销售和营销以及治疗可用性的法规的执行。强有力的联邦政策和有针对性或量身定制的干预措施可能对扩大烟草控制和监管对包括美国农村在内的弱势群体的好处很重要。(C)2017爱思唯尔公司All rights reserved.
Rural areas of the United States have a higher smoking prevalence than urban areas. However, no recent studies have rigorously examined potential changes in this disparity over time or whether the disparity can be explained by demographic or psychosocial characteristics associated with smoking. The present study used yearly cross sectional data from the National Survey on Drug Use and Health from 2007 through 2014 to examine cigarette smoking trends in rural versus urban areas of the United States. The analytic sample included 303,311 respondents. Two regression models were built to examine (a) unadjusted rural and urban trends in prevalence of current smoking and (b) whether differences remained after adjusting for demographic and psychosocial characteristics. Results of the unadjusted model showed disparate and diverging cigarette use trends during the 8-year time period. The adjusted model also showed diverging trends, initially with no or small differences that became more pronounced across the 8-year period. We conclude that differences reported in earlier studies may be explained by differences in rural versus urban demographic and psychosocial risk factors, while more recent and growing disparities appear to be related to other factors. These emergent differences may be attributable to policy-level tobacco control and regulatory factors that disproportionately benefit urban areas such as enforcement of regulations around the sale and marketing of tobacco products and treatment availability. Strong federal policies and targeted or tailored interventions may be important to expanding tobacco control and regulatory benefits to vulnerable populations including rural Americans. (C) 2017 Elsevier Inc. All rights reserved.