Mowery Paul D, Dube Shanta R, Thorne Stacy L, Garrett Bridgette E, Homa David M, Nez Henderson Patricia
Biostatistics, Inc., Sarasota, Florida.
Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, Georgia.
Am J Prev Med. 2015 Nov;49(5):738-744. doi: 10.1016/j.amepre.2015.05.002. Epub 2015 Jul 7.
Smoking-related disparities continue to be a public health problem among American Indian/Alaska Native (AI/AN) population groups and data documenting the health burden of smoking in this population are sparse. The purpose of this study was to assess mortality attributable to cigarette smoking among AI/AN adults relative to non-Hispanic white adults (whites) by calculating and comparing smoking-attributable fractions and mortality.
Smoking-attributable fractions and mortality among AI/ANs (n=1.63 million AI/ANs) and whites were calculated for people living in 637 Indian Health Service Contract Health Service Delivery Area counties in the U.S., from mortality data collected during 2001-2009. Differences in smoking-attributable mortality between AI/ANs and whites for five major causes of smoking-related deaths were examined. All data analyses were carried out in 2013-2014.
Overall, from 2001 to 2009, age-adjusted death rates, smoking-attributable fractions, and smoking-attributable mortality for all-cause mortality were higher among AI/ANs than among whites for adult men and women aged ≥35 years. Smoking caused 21% of ischemic heart disease, 15% of other heart disease, and 17% of stroke deaths in AI/AN men, compared with 15%, 10%, and 9%, respectively, for white men. Among AI/AN women, smoking caused 18% of ischemic heart disease deaths, 13% of other heart diseases deaths, and 20% of stroke deaths, compared with 9%, 7%, and 10%, respectively, among white women.
These findings underscore the need for comprehensive tobacco control and prevention efforts that can effectively reach and impact the AI/AN population to prevent and reduce smoking.
与吸烟相关的差异在美国印第安人/阿拉斯加原住民（AI/AN）人群中仍然是一个公共卫生问题，而记录该人群吸烟对健康造成负担的数据却很稀少。本研究的目的是通过计算和比较吸烟归因分数及死亡率，评估AI/AN成年人相对于非西班牙裔白人成年人（白人）因吸烟导致的死亡率。
利用2001 - 2009年收集的死亡率数据，计算了居住在美国637个印第安卫生服务合同健康服务提供地区县的AI/AN人群（n = 163万AI/AN人）和白人的吸烟归因分数及死亡率。研究了AI/AN人群和白人在与吸烟相关的五种主要死亡原因的吸烟归因死亡率方面的差异。所有数据分析均在2013 - 2014年进行。
总体而言，2001年至2009年期间，年龄调整后的死亡率、吸烟归因分数以及全因死亡率的吸烟归因死亡率在年龄≥35岁的AI/AN成年男性和女性中均高于白人。吸烟导致AI/AN男性中21%的缺血性心脏病死亡、15%的其他心脏病死亡以及17%的中风死亡，而白人男性分别为15%、10%和9%。在AI/AN女性中，吸烟导致18%的缺血性心脏病死亡、13%的其他心脏病死亡以及20%的中风死亡，而白人女性分别为9%、7%和10%。
这些发现强调了开展全面烟草控制和预防工作的必要性，这些工作要能有效覆盖并影响AI/AN人群，以预防和减少吸烟。
