Rurality, tobacco use, and COPD: an analysis of two national datasets

农村、烟草使用和慢性阻塞性肺病：对两个国家数据集的分析

• 批准号: 10366172
• 负责人: LAURA Marie PAULIN
• 金额: $ 25.22万
• 依托单位: DARTMOUTH-HITCHCOCK CLINIC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10366172
• 关键词: Address; American; Behavior; Belief; Benefits and Risks; Chronic Obstructive Airway Disease; Cigarette; Data; Data Set; Disease Outcome; Electronic cigarette; Epidemiology; Exposure to; Future; Generations; Geographic Locations; Geography; Goals; Health; Incidence; Individual; Intervention; Location; Mission; Motivation; National Health Interview Survey; Outcome; Pattern; Perception; Population; Population Assessment of Tobacco and Health; Prevalence; Public Health; Research; Respiratory Signs and Symptoms; Risk; Risk Factors; Rural; Rural Population; Testing; Tobacco use; United States; United States National Institutes of Health; Urban Population; Vulnerable Populations; airway obstruction; base; cigarette smoking; disorder risk; experience; geographic difference; health disparity; improved outcome; insight; regional difference; risk perception; rural area; rural residence; rurality; smoking cessation; social; tailored messaging; therapy design; tobacco exposure; tobacco products; trend

Project Abstract Individuals with chronic obstructive pulmonary disease (COPD) who live in rural areas of the United States have worse health outcomes compared with their non-rural counterparts. Although it is known that rural areas have higher rates of cigarette smoking, and that cigarette smoking is associated with worse outcomes in COPD, less is known about geographic variations in the motivations and beliefs that influence tobacco product appeal and use, especially among newer tobacco products including e-cigarettes. Further, it is largely unknown how much variability in tobacco use accounts for the geographic differences seen in COPD outcomes. Our long-term goal is to identify potentially modifiable determinants of tobacco product use that contribute to worse COPD in rural US, leading to future geographically tailored interventions designed to improve outcomes. Our overall objective for this application, which is the next step toward attainment of our long-term goal, is to quantify the perceptions of risk and benefit on the pattern of tobacco use in rural and urban populations in the United States, and to determine the impact of such patterns on COPD outcomes. Our central hypothesis is that perceptions of risk and benefit of tobacco products differ by geographic location in the US, and that tobacco exposure contributes significantly to the increased COPD risks associated with rural location. The rationale for this project is that identifying factors that influence tobacco product appeal and use will provide detailed insight into potentially modifiable contributors to geographic disparities in health outcomes and inform regulatory strategy. Using existing datasets, we will test our hypothesis in two specific aims: 1) To quantify and compare patterns of tobacco product use by geographic location, and to determine how perceptions of risk and benefit of tobacco products differ by geographic location; 2) To determine the relationship between geographic location and COPD prevalence, incidence, and respiratory symptoms, and to quantify the contribution of tobacco product exposure to these relationships. To address our aims, will use data from the Population Assessment of Tobacco and Health (PATH) Study and the National Health Interview Survey (NHIS).The PATH Study is a longitudinal, nationally representative study that includes detailed questions on the motivations, beliefs, and perceptions influencing tobacco product use, allowing us to analyze the longitudinal association of these trends with COPD risk and respiratory symptoms within a broad definition of urbanicity. In a separate, focused analysis, we will determine the cross-sectional association between tobacco products and COPD prevalence across urban/rural continuum using nationally representative data from the NHIS study. Our research team has extensive experience working with these datasets, each providing complimentary longitudinal and cross sectional perspectives to allow for comprehensive assessment of the contribution of tobacco use to observed disparities in COPD outcomes in rural populations.

项目摘要 生活在美国农村地区的慢性阻塞性肺疾病（COPD）患者 与非农村地区相比，他们的健康状况更差。尽管众所周知，农村地区 吸烟率更高，吸烟与更糟糕的结果有关， COPD，对影响烟草产品的动机和信念的地理差异知之甚少 吸引力和使用，特别是包括电子烟在内的新型烟草产品。此外，它在很大程度上 目前尚不清楚烟草使用的变异性在多大程度上解释了COPD的地理差异 结果。我们的长期目标是确定烟草制品使用的潜在可改变的决定因素， 导致美国农村地区COPD恶化，导致未来针对不同地区的干预措施， 改善成果。我们的总体目标，这是实现我们的下一步应用程序， 长期目标是量化农村和农村地区烟草使用模式的风险和效益， 美国城市人群，并确定这种模式对COPD结局的影响。 我们的中心假设是，对烟草产品的风险和益处的看法因地理位置而异 在美国，烟草暴露显著增加了与吸烟相关的COPD风险。 农村位置。该项目的基本原理是，确定影响烟草产品吸引力的因素 和使用将提供详细的见解，潜在的可修改的贡献者在健康的地理差异 结果并为监管战略提供信息。使用现有的数据集，我们将在两个特定的环境中测试我们的假设 目的：1）量化和比较按地理位置划分的烟草制品使用模式，并确定 对烟草产品的风险和益处的看法如何因地理位置而异; 2）确定 地理位置与COPD患病率、发病率和呼吸道症状之间的关系，以及 量化烟草产品暴露对这些关系的贡献。为了实现我们的目标，将使用 烟草与健康人口评估（PATH）研究和国家健康访谈的数据 PATH研究是一项具有全国代表性的纵向研究， 关于影响烟草制品使用的动机、信念和看法的问题，使我们能够分析 这些趋势与COPD风险和呼吸道症状在广义上的纵向关联 城市化。在一个单独的，集中的分析中，我们将确定以下因素之间的横截面关联： 使用全国代表性数据分析烟草制品与城市/农村COPD患病率的关系 来自NHIS的研究。我们的研究团队在处理这些数据集方面拥有丰富的经验， 提供互补的纵向和横截面透视图， 评估烟草使用对观察到的农村人群COPD结局差异的贡献。