Covey Lirio S, Botello-Harbaum Maria, Glassman Alexander H, Masmela Jenny, LoDuca Catherine, Salzman Victoria, Fried Jane
New York State Psychiatric Institute, New York City, New York, USA.
Ethn Dis. 2008 Winter;18(1):59-64.
Evidence on how to tailor nicotine dependence treatment to specific race/ethnic groups is limited. The present study investigated responses to established smoking cessation treatments among African American, Hispanic, and White adults.
Participants were 559 smokers (126 African American, 73 Hispanic, and 360 White). All received treatment for eight weeks with open-label bupropion, the nicotine patch, and individual counseling. The dependent variable was tobacco abstinence during the last four weeks of treatment. The independent variables were race/ethnicity and other known predictors of abstinence, including sex, age, smoking history (nicotine dependence level, number of cigarettes smoked daily, serum cotinine level and expired carbon monoxide, number of past quit attempts, and age when daily smoking began), confidence in ability to stop smoking, body mass index, psychological status, and psychiatric history (past major depression and alcohol dependence).
The total proportion of abstainers in the sample was 53%, with proportional differences by race/ethnicity (Whites 60%, African Americans 38%, Hispanics 41%). Compared to Whites, the odds ratios (OR) for quitting, adjusted for moderators of race/ ethnicity and other predictors of abstinence, were significantly lower among African Americans (OR .44, 95% confidence interval 195% CI] .27-.72) and Hispanics (OR .46, 95% CI .26-.81).
Disparity in smoking cessation treatment outcome among African American and Hispanic smokers compared to Whites implies that the burden of tobacco-related illness will continue to fall disproportionately among minority racial/ethnic groups. Gaining knowledge on the effectiveness of nicotine dependence treatments and on the factors that facilitate or impede a successful response by minority smokers is a public health priority.
关于如何针对特定种族/族裔群体调整尼古丁依赖治疗的证据有限。本研究调查了非裔美国人、西班牙裔和白人成年人对既定戒烟治疗的反应。
参与者为559名吸烟者（126名非裔美国人、73名西班牙裔和360名白人）。所有人均接受了为期八周的开放标签安非他酮、尼古丁贴片和个体咨询治疗。因变量是治疗最后四周的烟草戒断情况。自变量是种族/族裔以及其他已知的戒断预测因素，包括性别、年龄、吸烟史（尼古丁依赖水平、每日吸烟量、血清可替宁水平和呼出一氧化碳水平、过去的戒烟尝试次数以及开始每日吸烟的年龄）、戒烟能力信心、体重指数、心理状态和精神病史（过去的重度抑郁症和酒精依赖）。
样本中戒烟者的总比例为53%，按种族/族裔存在比例差异（白人60%，非裔美国人38%，西班牙裔41%）。与白人相比，并对种族/族裔调节因素和其他戒断预测因素进行调整后，非裔美国人（优势比[OR].44，95%置信区间[CI].27-.72）和西班牙裔（OR.46，95%CI.26-.81）的戒烟优势比显著更低。
与白人相比，非裔美国人和西班牙裔吸烟者在戒烟治疗结果上的差异意味着烟草相关疾病负担将继续在少数种族/族裔群体中不成比例地加重。了解尼古丁依赖治疗的有效性以及促进或阻碍少数族裔吸烟者成功反应的因素是公共卫生优先事项
