Fu Steven S, Burgess Diana J, Hatsukami Dorothy K, Noorbaloochi Siamak, Clothier Barbara A, Nugent Sean, van Ryn Michelle
Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA.
Am J Prev Med. 2008 Dec;35(6 Suppl):S442-8. doi: 10.1016/j.amepre.2008.09.009.
Prior research suggests that racial/ethnic minority smokers experience more difficulty with cessation than white smokers and access formal treatment less often. Minority smokers may respond differently to treatment interventions than white smokers. This prospective, observational cohort study compared long-term cessation outcomes among four racial/ethnic groups after an aided quit attempt using nicotine replacement therapy (NRT).
A random cohort of smokers (N=1782) who recently filled a prescription for NRT was selected, stratified by race, using Minnesota Health Care Programs (e.g., Medicaid) pharmacy claims databases between July 2005 and September 2006. The primary outcome was 7-day point prevalence abstinence, which was assessed about 8 months after the NRT index prescription fill date using a mixed-mode survey protocol.
The overall survey response was 58.2%. Overall, abstinence outcomes did not significantly vary by race. Unadjusted comparisons show that among survey respondents, at 8 months, 7-day point prevalence abstinence was 13.8% among whites, 13.6% among blacks, 14.1% among American Indians/Alaska Natives, and 20.7% among Asians (p=0.42). Similarly, the 30-day duration abstinence was 10.0% among whites, 11.5% among blacks, 8.9% among American Indians/Alaska Natives, and 18.3% among Asians (p=0.14). In multivariate analysis using propensity adjustment for potential confounding and response bias, there was no evidence that the effectiveness of NRT was lower for racial/ethnic minority smokers compared to white smokers.
These findings indicate that racial/ethnic minorities are as likely to quit smoking at a level similar to whites when using cessation treatment that includes NRT. Given documented disparities in the use of evidence-based cessation treatments such as NRT, interventions are sorely needed to improve access and utilization of these treatments in racial/ethnic minority groups.
先前的研究表明，与白人吸烟者相比，少数族裔吸烟者戒烟难度更大，且较少接受正规治疗。少数族裔吸烟者对治疗干预的反应可能与白人吸烟者不同。这项前瞻性观察队列研究比较了使用尼古丁替代疗法（NRT）辅助戒烟尝试后四个种族/族裔群体的长期戒烟结果。
从2005年7月至2006年9月期间使用明尼苏达医疗保健计划（如医疗补助）药房索赔数据库，选取最近开具NRT处方的吸烟者随机队列（N = 1782），按种族分层。主要结局是7天点患病率戒断，在NRT索引处方填写日期约8个月后使用混合模式调查方案进行评估。
总体调查回复率为58.2%。总体而言，戒断结果在种族间无显著差异。未经调整的比较显示，在调查受访者中，8个月时，白人的7天点患病率戒断率为13.8%，黑人为13.6%，美国印第安人/阿拉斯加原住民为14.1%，亚洲人为20.7%（p = 0.42）。同样，白人的30天持续戒断率为10.0%，黑人为11.5%，美国印第安人/阿拉斯加原住民为8.9%，亚洲人为18.3%（p = 0.14）。在使用倾向调整以处理潜在混杂因素和反应偏倚的多变量分析中，没有证据表明与白人吸烟者相比，少数族裔吸烟者使用NRT的效果更低。
这些发现表明，少数族裔在使用包括NRT的戒烟治疗时，戒烟可能性与白人相似。鉴于在使用NRT等循证戒烟治疗方面存在已记录的差异，迫切需要采取干预措施来改善少数族裔群体对这些治疗的可及性和利用率。
