Maskarinec Gertraud, Dhakal Sanjaya, Pagano Ian, Carlin Linda, Goodman Marc T, Le Marchand Loic, Nomura Abraham, Wilkens Lynne R, Kolonel Laurence N
Cancer Research Center of Hawaii, Honolulu, Hawaii 96813, USA.
Ethn Dis. 2005 Spring;15(2):316-23.
The prevalence of smoking continues to be higher in some ethnic groups than in others, despite the overall decrease of smoking during the last 30 years. The goal of this project was to investigate the trends and predictors of cigarette smoking among a population of Caucasians, Japanese, Chinese, Filipino, and Native Hawaiians.
We combined data from 19 earlier studies conducted in Hawaii between 1975 and 2001. After excluding 1,885 individuals without smoking data, 158,629 subjects (40.0% Japanese, 30.3% Caucasian, 14.3% Hawaiian, 8.1% Filipino, 3.0% Chinese) were included in the analysis. The prevalence of current smoking and past smoking was estimated for 5-year periods by sex and ethnicity and age-adjusted to the state's population. We calculated odds ratios and 95% confidence intervals by using polytomous logistic regression to explore determinants of smoking, while controlling for clustering by study.
Men were more likely to smoke than women throughout the study period, but they experienced a greater decline in smoking until 1994. We observed a small increase in smoking prevalence thereafter. Native Hawaiians reported the highest smoking prevalence, Japanese the lowest, and Caucasians intermediate levels. Graduate level education had the strongest inverse association with current and past smoking. Older age at interview, being married, and a higher body weight were related to lower smoking prevalence.
Our data suggest a modest reversal in the declining smoking prevalence during the late 1990s. The persistent ethnic differences require new approaches that reach those groups who remain at high risk for adverse health effects from smoking.
尽管过去30年吸烟率总体呈下降趋势，但某些种族群体的吸烟率仍高于其他群体。本项目的目标是调查白种人、日本人、中国人、菲律宾人和夏威夷原住民人群中吸烟的趋势及预测因素。
我们合并了1975年至2001年间在夏威夷进行的19项早期研究的数据。在排除1885名无吸烟数据的个体后，158629名受试者（40.0%为日本人，30.3%为白种人，14.3%为夏威夷人，8.1%为菲律宾人，3.0%为中国人）纳入分析。按性别、种族和年龄对该州人口进行调整后，估计了5年期间当前吸烟和既往吸烟的患病率。我们使用多分类逻辑回归计算比值比和95%置信区间，以探索吸烟的决定因素，同时控制研究中的聚类情况。
在整个研究期间，男性比女性更易吸烟，但到1994年男性吸烟率下降幅度更大。此后我们观察到吸烟率略有上升。夏威夷原住民报告的吸烟率最高，日本人最低，白种人处于中间水平。研究生教育程度与当前和既往吸烟的负相关最强。访谈时年龄较大、已婚以及体重较高与较低的吸烟率相关。
我们的数据表明，20世纪90年代后期吸烟率下降趋势出现适度逆转。持续存在的种族差异需要采取新方法，以覆盖那些因吸烟仍面临健康不良影响高风险的群体。
