Cokkinides Vilma E, Halpern Michael T, Barbeau Elizabeth M, Ward Elizabeth, Thun Michael J
Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30303-1002, USA.
Am J Prev Med. 2008 May;34(5):404-12. doi: 10.1016/j.amepre.2008.02.003.
Recent national surveys document racial and ethnic disparities in receipt of smoking-cessation advice. This study updates and expands prior analyses using survey data for 2005, and evaluates the association between smokers' race and ethnicity and three separate measures of healthcare-encounter-based tobacco interventions: screening, smoking-cessation advice, and use of smoking-cessation aids.
Analyses are based on 4756 smokers (aged 18 and older) reporting a healthcare encounter within the past year who participated in the 2005 National Health Interview Survey (NHIS). Multivariate-adjusted OR and 95% CI for receipt of tobacco interventions in non-Hispanic black and Hispanic smokers were compared to those of non-Hispanic white smokers, adjusted for smokers' characteristics (sociodemographics, health status, and healthcare-utilization factors, and smoking-related characteristics). Analyses were done in 2006.
Results show that compared to white smokers, black and Hispanic smokers had significantly lower odds of (1) being asked about tobacco use (AOR=0.70 and AOR=0.69, respectively); (2) being advised to quit (AOR=0.72 and AOR=0.64, respectively); or (3) having used tobacco-cessation aids during the past year in a quit attempt (AOR=0.60 and AOR=0.59, respectively). Compared to 2000 NHIS published data, the prevalence of receipt of advice to quit from a healthcare provider increased from 52.9% in 2000 to 61.2% in 2005, with increases across racial and ethnic groups.
Despite progress in smokers' being advised to quit during healthcare encounters in the past 5 years, black and Hispanic smokers continue to be less likely than whites to receive and use tobacco-cessation interventions, even after control for socioeconomic and healthcare factors. Further actions are needed to understand and eliminate this disparity.
近期的全国性调查记录了在接受戒烟建议方面存在的种族和民族差异。本研究利用2005年的调查数据更新并扩展了先前的分析，并评估吸烟者的种族和民族与基于医疗保健接触的三种不同烟草干预措施之间的关联：筛查、戒烟建议以及使用戒烟辅助工具。
分析基于4756名年龄在18岁及以上且报告在过去一年中有过医疗保健接触的吸烟者，这些吸烟者参与了2005年全国健康访谈调查（NHIS）。将非西班牙裔黑人和西班牙裔吸烟者接受烟草干预的多变量调整后的比值比（OR）及95%置信区间（CI）与非西班牙裔白人吸烟者进行比较，并根据吸烟者的特征（社会人口统计学、健康状况、医疗保健利用因素以及与吸烟相关的特征）进行调整。分析于2006年完成。
结果显示，与白人吸烟者相比，黑人和西班牙裔吸烟者在以下方面的几率显著更低：（1）被询问吸烟情况（调整后的比值比分别为0.70和0.69）；（2）被建议戒烟（调整后的比值比分别为0.72和0.64）；（3）在过去一年的戒烟尝试中使用过戒烟辅助工具（调整后的比值比分别为0.60和0.59）。与2000年NHIS公布的数据相比，从医疗保健提供者处获得戒烟建议的比例从2000年的52.9%增至2005年的61.2%，各种族和民族群体均有所增加。
尽管在过去5年中吸烟者在医疗保健接触期间被建议戒烟方面取得了进展，但即使在控制了社会经济和医疗保健因素之后，黑人和西班牙裔吸烟者接受和使用戒烟干预措施的可能性仍低于白人。需要采取进一步行动来理解并消除这种差异。
