Burns Emily K, Levinson Arnold H, Lezotte Dennis, Prochazka Allan V
Department of Preventive Medicine and Biometrics, University of Colorado at Denver & Health Sciences Center, Denver, CO, USA.
Nicotine Tob Res. 2007 Jul;9(7):731-7. doi: 10.1080/14622200701397882.
A smoker's risk of disease and death from cigarettes is related directly to the duration of smoking. The present study compared duration of smoking between a state-level population of Anglo versus highly acculturated Latino ever-smokers (N = 6,100). Kapla-Meier analysis was used to obtain weighted median smoking duration. Weighted Cox proportional hazard models were used to evaluate the relative likelihood of continued smoking, adjusted for demographics, smoking history, home and workplace smoking restrictions, and socioeconomic covariates (education, health insurance status, and poverty level). On average, Latinos continued smoking longer than Anglos (M = 30 years vs. 27 years; weighted Cox HR = 0.73; 95% CI = 0.60-0.89). The disparity remained significant when adjusted for demographic, smoking history, and smoking-rule covariates but was not significant when adjusted for socioeconomic status (HR = 0.89, 95% CI = 0.73-1.09). Education alone accounted for the majority of the disparity, more so than poverty or health insurance status. We conclude that highly acculturated Latino smokers may be at greater risk of cigarette disease and death related to longer duration of smoking associated with lower socioeconomic status.
吸烟者因吸烟而患病和死亡的风险与吸烟时长直接相关。本研究比较了一个州级层面的英裔与高度同化的拉丁裔既往吸烟者群体（N = 6100）的吸烟时长。采用Kaplan-Meier分析来获取加权中位数吸烟时长。使用加权Cox比例风险模型来评估持续吸烟的相对可能性，并对人口统计学特征、吸烟史、家庭和工作场所吸烟限制以及社会经济协变量（教育程度、医疗保险状况和贫困水平）进行了调整。平均而言，拉丁裔持续吸烟的时间比英裔更长（M = 30年对27年；加权Cox风险比 = 0.73；95%置信区间 = 0.60 - 0.89）。在对人口统计学特征、吸烟史和吸烟规定协变量进行调整后，这种差异仍然显著，但在对社会经济地位进行调整后则不显著（风险比 = 0.89，95%置信区间 = 0.73 - 1.09）。仅教育程度就占了这种差异的大部分，比贫困或医疗保险状况的影响更大。我们得出结论，高度同化的拉丁裔吸烟者可能因吸烟时长更长且社会经济地位较低而面临更高的吸烟相关疾病和死亡风险。
