Kumar Pallavi, Gareen Ilana F, Lathan Christopher, Sicks JoRean D, Perez Giselle K, Hyland Kelly A, Park Elyse R
Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island, USA and Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
Oncologist. 2016 Jan;21(1):40-9. doi: 10.1634/theoncologist.2015-0325. Epub 2015 Dec 28.
Black smokers have demonstrated greater lung cancer disease burden and poorer smoking cessation outcomes compared with whites. Lung cancer screening represents a unique opportunity to promote cessation among smokers; however, little is known about the differential impact of screening on smoking behaviors among black and white smokers. Using data from the National Lung Screening Trial (NLST), we examined the racial differences in smoking behaviors after screening.
We examined racial differences in smoking behavior and cessation activity among 6,316 white and 497 black (median age, 60 and 59 years, respectively) NLST participants who were current smokers at screening using a follow-up survey on 24-hour and 7-day quit attempts, 6-month continuous abstinence, and the use of smoking cessation programs and aids at 12 months after screening. Using multiple regression analyses, we examined the predictors of 24-hour and 7-day quit attempts and 6-month continuous abstinence.
At 12 months after screening, blacks were more likely to report a 24-hour (52.7% vs. 41.2%, p < .0001) or 7-day (33.6% vs. 27.2%, p = .002) quit attempt. However, no significant racial differences were found in 6-month continuous abstinence (5.6% blacks vs. 7.2% whites). In multiple regression, black race was predictive of a higher likelihood of a 24-hour (odds ratio [OR], 1.6, 95% confidence interval [CI], 1.2-2.0) and 7-day (OR, 1.5, 95% CI, 1.1-1.8) quit attempt; however, race was not associated with 6-month continuous abstinence. Only a positive screening result for lung cancer was significantly predictive of successful 6-month continuous abstinence (OR, 2.3, 95% CI, 1.8-2.9).
Although blacks were more likely than whites to have 24-hour and 7-day quit attempts, the rates of 6-month continuous abstinence did not differ. Targeted interventions are needed at the time of lung cancer screening to promote abstinence among all smokers.
Among smokers undergoing screening for lung cancer, blacks were more likely than whites to have 24-hour and 7-day quit attempts; however, these attempts did not translate to increased rates of 6-month continuous abstinence among black smokers. Targeted interventions are needed at the time of lung cancer screening to convert quit attempts to sustained smoking cessation among all smokers.
与白人相比，黑人吸烟者表现出更大的肺癌疾病负担和更差的戒烟效果。肺癌筛查是促进吸烟者戒烟的一个独特机会；然而，关于筛查对黑人和白人吸烟者吸烟行为的不同影响知之甚少。利用国家肺癌筛查试验（NLST）的数据，我们研究了筛查后吸烟行为的种族差异。
我们通过一项关于24小时和7天戒烟尝试、6个月持续戒烟以及筛查后12个月使用戒烟计划和辅助手段的随访调查，研究了NLST中6316名白人参与者和497名黑人参与者（中位年龄分别为60岁和59岁）在筛查时为当前吸烟者的吸烟行为和戒烟活动的种族差异。我们使用多元回归分析来研究24小时和7天戒烟尝试以及6个月持续戒烟的预测因素。
在筛查后12个月，黑人更有可能报告24小时（52.7%对41.2%，p <.0001）或7天（33.6%对27.2%，p =.002）的戒烟尝试。然而，在6个月持续戒烟方面未发现显著的种族差异（黑人5.6%，白人7.2%）。在多元回归中，黑人种族预示着24小时（优势比[OR]，1.6，95%置信区间[CI]，1.2 - 2.0）和7天（OR，1.5，95% CI，1.1 - 1.8）戒烟尝试的可能性更高；然而，种族与6个月持续戒烟无关。只有肺癌筛查结果为阳性显著预示着6个月持续戒烟成功（OR，2.3，95% CI，1.8 - 2.9）。
尽管黑人比白人更有可能进行24小时和7天的戒烟尝试，但6个月持续戒烟率并无差异。在肺癌筛查时需要有针对性的干预措施，以促进所有吸烟者戒烟。
在接受肺癌筛查的吸烟者中，黑人比白人更有可能进行24小时和7天的戒烟尝试；然而，这些尝试并未转化为黑人吸烟者6个月持续戒烟率的提高。在肺癌筛查时需要有针对性的干预措施，以将戒烟尝试转化为所有吸烟者的持续戒烟。
