Fu Steven S, Kodl Molly M, Joseph Anne M, Hatsukami Dorothy K, Johnson Eric O, Breslau Naomi, Wu Baolin, Bierut Laura
Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center (152/2E), Minneapolis, MN 55417, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Jul;17(7):1640-7. doi: 10.1158/1055-9965.EPI-07-2726. Epub 2008 Jun 26.
We examined racial/ethnic variations in the use of nicotine replacement therapy (NRT) and quit ratios among Caucasian, African American, Asian, and Latino lifetime smokers ages 25 to 44 years. We conducted cross-sectional analyses using data from individuals (n = 27,031) screened for enrollment in the Collaborative Study of the Genetics of Nicotine Dependence. Participants were randomly sampled from three Midwestern metropolitan areas using Health Maintenance Organization membership lists in Detroit, MI and Minneapolis, MN and a driver's license registry in St. Louis, MO from March 2003 to August 2005. A telephone survey collected information on smoking history, previous quit attempts, and sociodemographic characteristics. Among lifetime smokers (n = 9,216), univariate analysis indicated that African Americans (22%) and Latinos (22%) were significantly less likely to report having ever used NRT for smoking cessation than Caucasians (31%). Asians (22%) also reported lower rates of using NRT than Caucasians, but this difference was marginally significant (P = 0.06). These disparities persisted in multivariate analysis for African Americans [adjusted odds ratio (OR), 0.76; 95% confidence interval (95% CI), 0.63-0.91; P < 0.01] but not for Latinos (adjusted OR, 0.76; 95% CI, 0.54-1.06; P = 0.11) or Asians (adjusted OR, 0.98; 95% CI, 0.60-1.60; P = 0.95). As measured by the quit ratio, African Americans (35%) were less likely to have quit smoking than Caucasians (52%). This disparity persisted in multivariate logistic regression (adjusted OR, 0.66; 95% CI, 0.56-0.78; P < 0.001). Asian and Latino smokers were as likely as Caucasians to report smoking cessation. Future prospective studies are needed to assess whether lower utilization of cessation treatments such as NRT contribute to the observed disparity in quit ratios for African Americans.
我们研究了25至44岁的白人、非裔美国人、亚裔和拉丁裔终身吸烟者在使用尼古丁替代疗法(NRT)及戒烟率方面的种族/族裔差异。我们利用参与尼古丁依赖遗传学合作研究筛选的个体(n = 27,031)数据进行了横断面分析。参与者于2003年3月至2005年8月期间,从底特律、明尼阿波利斯和圣路易斯这三个中西部大都市地区,通过密歇根州底特律市和明尼苏达州明尼阿波利斯市的健康维护组织会员名单以及密苏里州圣路易斯市的驾照登记处随机抽取。通过电话调查收集了吸烟史、既往戒烟尝试以及社会人口学特征等信息。在终身吸烟者(n = 9,216)中,单因素分析表明,非裔美国人(22%)和拉丁裔(22%)报告曾使用NRT戒烟的可能性显著低于白人(31%)。亚裔(22%)报告使用NRT的比例也低于白人,但这种差异边缘显著(P = 0.06)。在多因素分析中,非裔美国人的这些差异仍然存在[调整后的优势比(OR)为0.76;95%置信区间(95%CI)为0.63 - 0.91;P < 0.01],但拉丁裔(调整后的OR为0.76;95%CI为0.54 - 1.06;P = 0.11)和亚裔(调整后的OR为0.98;95%CI为0.60 - 1.60;P = 0.95)不存在差异。以戒烟率衡量,非裔美国人(35%)戒烟的可能性低于白人(52%)。这种差异在多因素逻辑回归中仍然存在(调整后的OR为0.66;95%CI为0.56 - 0.78;P < 0.001)。亚裔和拉丁裔吸烟者报告戒烟的可能性与白人相当。未来需要进行前瞻性研究,以评估诸如NRT等戒烟治疗的较低利用率是否导致了观察到的非裔美国人戒烟率差异。