Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States.
Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States.
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DOI：
10.1186/s12877-017-0438-z
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发表时间：
2017-02-08
期刊：
影响因子：
4.1
通讯作者：
Thielke SM
中科院分区：
文献类型：
--
作者：
Quiñones AR;Nagel CL;Newsom JT;Huguet N;Sheridan P;Thielke SM
来自代表性不足的种族和民族背景的中年和老年美国人比他们的白色同行有更大的慢性病发病率的风险。吸烟增加了慢性病的严重程度，损害了身体功能，并损害了症状的成功管理。因此，重要的是要了解吸烟行为是否在慢性疾病发作后发生变化。我们评估了美国中老年人慢性病发作后吸烟行为改变的种族/民族差异。我们使用健康与退休研究（HRS 1992-2010）的纵向数据来检查吸烟者在新的心脏病，糖尿病，癌症，中风或肺部疾病诊断后吸烟状态和吸烟量的变化。中老年吸烟者在新诊断后戒烟的比例因种族/民族和疾病而异：对于白色吸烟者，这一比例从糖尿病诊断后的14%到癌症诊断后的32%不等;对于黑人吸烟者，这一比例从肺部疾病诊断后的15%到心脏病诊断后的40%不等;拉丁裔吸烟者戒烟的比例只有在斯托克之后才有统计学意义，其中38%戒烟。在logistic模型中，黑色（OR = 0.43，95% CI：0.19-0.99）和拉丁裔（OR = 0.26，95% CI：0.11-0.65）老年人中风后相对于白色老年人继续吸烟的可能性较小，而拉丁美洲人在心脏病发作后相对于黑人老年人继续吸烟的可能性较大（OR = 2.69，95%CI [1.05-6.95]）。在评估新诊断后吸烟数量变化的模型中，黑人老年人在新诊断糖尿病，心脏病，中风或癌症后吸烟明显少于白人，拉丁美洲老年人在新诊断糖尿病和心脏病后吸烟明显少于白色老年人。相对于黑人老年人，拉丁美洲人在新诊断的糖尿病后吸烟明显减少。绝大多数中年和老年吸烟者在诊断患有重大慢性疾病后继续吸烟。黑人参与者在吸烟行为方面表现出最大的减少。这些发现对为老年人量身定制二级预防工作具有重要意义。本文的在线版本（doi：10.1186/s12877-017-0438-z）包含补充材料，可供授权用户使用。
Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US. We use longitudinal data from the Health and Retirement Study (HRS 1992–2010) to examine changes in smoking status and quantity of cigarettes smoked after a new heart disease, diabetes, cancer, stroke, or lung disease diagnosis among smokers. The percentage of middle-aged and older smokers who quit after a new diagnosis varied by racial/ethnic group and disease: for white smokers, the percentage ranged from 14% after diabetes diagnosis to 32% after cancer diagnosis; for black smokers, the percentage ranged from 15% after lung disease diagnosis to 40% after heart disease diagnosis; the percentage of Latino smokers who quit was only statistically significant after stoke, where 38% quit. In logistic models, black (OR = 0.43, 95% CI: 0.19–0.99) and Latino (OR = 0.26, 95% CI: 0.11–0.65) older adults were less likely to continue smoking relative to white older adults after a stroke, and Latinos were more likely to continue smoking relative to black older adults after heart disease onset (OR = 2.69, 95% CI [1.05–6.95]). In models evaluating changes in the number of cigarettes smoked after a new diagnosis, black older adults smoked significantly fewer cigarettes than whites after a new diagnosis of diabetes, heart disease, stroke or cancer, and Latino older adults smoked significantly fewer cigarettes compared to white older adults after newly diagnosed diabetes and heart disease. Relative to black older adults, Latinos smoked significantly fewer cigarettes after newly diagnosed diabetes. A large majority of middle-aged and older smokers continued to smoke after diagnosis with a major chronic disease. Black participants demonstrated the largest reductions in smoking behavior. These findings have important implications for tailoring secondary prevention efforts for older adults. The online version of this article (doi:10.1186/s12877-017-0438-z) contains supplementary material, which is available to authorized users.