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 居住在美国农村地区的慢性阻塞性肺疾病（COPD）的人 与非农村同行相比，健康结果较差。尽管众所周知农村地区 吸烟的速度更高，吸烟与较差的结果有关 COPD，对影响烟草产品的动机和信念的地理变化知之甚少 吸引和使用，尤其是在包括电子烟​​在内的新烟草产品中。此外，这主要是 未知烟草使用帐户中有多少可变性的COPD中的地理差异 结果。我们的长期目标是确定烟草产品使用的潜在可修改的决定因素 在美国农村造成更糟的COPD，导致未来的地理量身定制干预措施 改善结果。我们对此应用的总体目标，这是实现我们的下一步 长期目标是量化对农村烟草使用方式的风险和利益的看法 美国的城市人口，并确定此类模式对COPD结果的影响。 我们的中心假设是，烟草产品对风险和利益的看法因地理位置而异 在美国，烟草的暴露对与COPD风险的增加相关的贡献很大 农村地点。该项目的理由是确定影响烟草产品上诉的因素 使用将提供详细的洞察 结果并为监管策略提供信息。使用现有的数据集，我们将在两个特定的两个特定方面测试我们的假设 目的：1）量化和比较地理位置的烟草产品使用模式，并确定 烟草产品对风险和利益的看法因地理位置而有所不同； 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 量化烟草产品对这些关系的贡献。为了解决我们的目标，将使用 来自烟草与健康（PATH）研究和国家健康访谈的人口评估的数据 调查（NHIS）。路径研究是一项纵向，全国代表性的研究，包括详细的研究 关于影响烟草产品使用的动机，信念和看法的问题，使我们能够分析 这些趋势与COPD风险和呼吸道症状的纵向关联 城市性。在一个单独的集中分析中，我们将确定 使用全国代表性数据 来自NHIS研究。我们的研究团队在这些数据集中有丰富的经验 提供免费的纵向和横截面观点，以允许全面 评估烟草使用对农村人群中COPD结果差异的贡献的评估。