Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston; Harvard Medical School, Boston, Mass.
Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston; Harvard Medical School, Boston, Mass.
Am J Med. 2018 Mar;131(3):318.e1-318.e8. doi: 10.1016/j.amjmed.2017.09.025. Epub 2017 Oct 9.
Continued cigarette smoking by individuals with chronic medical diseases can adversely affect their symptoms, disease progression, and mortality. We assessed the association between medical comorbidities and smoking-cessation efforts among US adult smokers.
We analyzed cross-sectional data from 12,494 past-year cigarette smokers aged ≥18 years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health study. We assessed the association between self-reported medical comorbidities and past-year quit attempts, use of evidence-based smoking-cessation treatment or electronic cigarettes, and successful smoking cessation using logistic regression, adjusting for sociodemographics, insurance status, geographic region, and having a past-year doctor visit.
In the study sample, 39% were aged 18 to 34 years, 45% were female, 70% were non-Hispanic white, and 48% reported ≥1 comorbidity. Smokers with any comorbidity, compared with those without comorbidities, had higher odds of trying to quit (adjusted odds ratio, 1.19; 95% confidence interval, 1.08-1.30), but no higher likelihood of quitting success. Having more medical comorbidities was associated with increased odds of trying to quit. Smokers with a comorbidity used evidence-based treatment more often than smokers without comorbidities (43% vs 26%); use of e-cigarettes to quit was similar between smokers with and without comorbidities (27% vs 28%).
Adult smokers with chronic medical diseases try to quit and use evidence-based tobacco-cessation treatment more often than smokers without comorbidities, but they are no more likely to quit, suggesting that their quit attempts are less likely to succeed. Smokers with medical comorbidities may require more intensive, prolonged, and repeated treatment to stop smoking.
患有慢性疾病的个体继续吸烟可能会对其症状、疾病进展和死亡率产生不利影响。我们评估了美国成年吸烟者的医学合并症与戒烟努力之间的关联。
我们分析了来自全国代表性的烟草与健康人群评估研究第 1 波（2013-2014 年）的 12494 名过去一年吸烟的成年人的数据。我们使用逻辑回归评估了自我报告的医学合并症与过去一年的戒烟尝试、使用基于证据的戒烟治疗或电子烟以及成功戒烟之间的关联，调整了社会人口统计学、保险状况、地理位置和过去一年的医生就诊情况。
在研究样本中，39%的人年龄在 18 至 34 岁之间，45%为女性，70%为非西班牙裔白人，48%报告有≥1 种合并症。与无合并症的吸烟者相比，有任何合并症的吸烟者尝试戒烟的可能性更高（调整后的优势比，1.19；95%置信区间，1.08-1.30），但戒烟成功的可能性没有更高。有更多医学合并症与尝试戒烟的几率增加相关。有合并症的吸烟者比没有合并症的吸烟者更有可能使用基于证据的治疗方法（43%对 26%）；有合并症的吸烟者和没有合并症的吸烟者使用电子烟戒烟的比例相似（27%对 28%）。
患有慢性疾病的成年吸烟者比没有合并症的吸烟者更频繁地尝试戒烟并使用基于证据的戒烟治疗方法，但他们戒烟成功的可能性没有更高，这表明他们的戒烟尝试不太可能成功。有医学合并症的吸烟者可能需要更密集、更持久和更反复的治疗来戒烟。
