Yi Zinan, Mayorga Maria E, Hassmiller Lich Kristen, Pearson Jennifer L
Operations Research Graduate Program, North Carolina State University, Raleigh, NC USA.
Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC USA.
Tob Induc Dis. 2017 Mar 14;15:17. doi: 10.1186/s12971-017-0121-3. eCollection 2017.
The tobacco epidemic in the U.S. has matured in the past decade. However, due to rapidly changing social policy and commercial environments, tailored prevention and interventions are needed to support further reduction in smoking.
Using Tobacco Use Supplement to the Current Population Survey (TUS-CPS) 2002-2003 and 2010-2011 longitudinal cohorts, five smoking states are defined including daily-heavy, daily-light, non-daily, former and non-smoker. We quantified the changes between smoking states for the two longitudinal cohorts, and used a series of multivariable logistic regression models to examine the association of socio-demographic attributes and initial smoking states on smoking initiation, cessation, and relapse between waves within each cohort.
The prevalence of adult heavy smoking decreased from 9.9% (95% CI: 9.6%, 10.2%) in 2002 to 7.1% (95% CI: 6.9%, 7.4%) in 2010. Non-daily smokers were less likely to quit in the 2010-2011 cohort than the 2002-2003 cohort (37.0% vs. 44.9%). Gender, age group, smoker type, race and marital status exhibit similar patterns in terms of their association to the odds of initiation, cessation and relapse between the two cohorts, while education groups showed some inconsistent results between the two cohorts regarding the odds of cessation.
Transitions between smoking states are complex and increasingly unstable, requiring a holistic, population-based perspective to understand the stocks and flows that ultimately dictate the public health impact of cigarette smoking behavior. This knowledge helps to identify groups in need of increased tobacco control prevention and intervention efforts.
美国的烟草流行在过去十年中已发展成熟。然而，由于社会政策和商业环境迅速变化，需要针对性的预防和干预措施来支持进一步减少吸烟。
利用2002 - 2003年和2010 - 2011年的当前人口调查烟草使用补充调查（TUS - CPS）纵向队列，定义了五个吸烟状态，包括每日重度、每日轻度、非每日、曾经吸烟和从不吸烟。我们对两个纵向队列的吸烟状态变化进行了量化，并使用一系列多变量逻辑回归模型来检验社会人口学属性和初始吸烟状态与每个队列中各波次之间的吸烟起始、戒烟和复吸的关联。
成年重度吸烟率从2002年的9.9%（95%置信区间：9.6%，10.2%）降至2010年的7.1%（95%置信区间：6.9%，7.4%）。在2010 - 2011年队列中，非每日吸烟者戒烟的可能性低于2002 - 2003年队列（37.0%对44.9%）。性别、年龄组、吸烟者类型、种族和婚姻状况在与两个队列之间起始、戒烟和复吸几率的关联方面表现出相似模式，而教育组在两个队列之间关于戒烟几率的结果存在一些不一致。
吸烟状态之间的转变复杂且日益不稳定，需要从整体的、基于人群视角来理解最终决定吸烟行为对公众健康影响的存量和流量。这一知识有助于确定需要加强烟草控制预防和干预努力的群体。
