Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Division of General Medicine and Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Am J Prev Med. 2018 Jul;55(1):80-88. doi: 10.1016/j.amepre.2018.01.036. Epub 2018 Apr 5.
Cigarette smoking is substantially more prevalent and rates of smoking cessation are lower in low-SES adults. Financial strain may be one explanation for this. This study assessed the association between financial strain, quit attempts, and successful smoking cessation among adult smokers in the U.S.
Longitudinal data on adult current smokers (aged ≥18 years) from Waves 1 and 2 of the nationally representative Population Assessment of Tobacco and Health Study (2013-2015) were analyzed in 2017. Negative binomial regression and logistic regression models assessed the association between financial strain and (1) quit attempts and (2) cigarette abstinence, adjusting for important confounders.
Smokers with financial strain made more quit attempts than smokers without financial strain (adjusted incidence-rate ratio=1.34, 95% CI=1.07, 1.68), but financial strain was not associated with smoking abstinence at follow-up (AOR=0.86, 95% CI=0.70, 1.05). Low income was associated with less smoking abstinence at follow-up (AOR=0.66, 95% CI=0.50, 0.87, for <100% federal poverty level; AOR=0.64, 95% CI=0.48, 0.85, for 100%-199% of federal poverty level). Smokers with baseline financial strain who quit at follow-up had lower odds of financial strain at follow-up (AOR=0.57, 95% CI=0.36, 0.89).
Financially strained smokers made slightly more quit attempts than non-strained smokers but were no more likely to successfully quit. Low-income (less than 200% of the federal poverty level) smokers were less likely to quit than higher-income smokers, suggesting that financial strain alone may not explain the low quit rates in this population. Further efforts are needed to increase the success of quit attempts in low-income and financially strained smokers.
在社会经济地位较低的成年人中，吸烟更为普遍，戒烟率也较低。经济压力可能是造成这种情况的一个原因。本研究评估了美国成年吸烟者的经济压力与戒烟尝试和成功戒烟之间的关系。
2017 年，对全国代表性的烟草与健康人口评估研究（2013-2015 年）第 1 波和第 2 波的成年当前吸烟者（年龄≥18 岁）的纵向数据进行了分析。使用负二项回归和逻辑回归模型，调整了重要混杂因素后，评估了经济压力与（1）戒烟尝试和（2）香烟戒断之间的关系。
与没有经济压力的吸烟者相比，有经济压力的吸烟者进行了更多的戒烟尝试（调整后的发病率比=1.34，95%置信区间=1.07，1.68），但经济压力与随访时的吸烟戒断无关（调整后的比值比=0.86，95%置信区间=0.70，1.05）。低收入者在随访时的吸烟戒断率较低（收入低于联邦贫困水平的 100%时，调整后的比值比=0.66，95%置信区间=0.50，0.87；收入为联邦贫困水平的 100%-199%时，调整后的比值比=0.64，95%置信区间=0.48，0.85）。在随访时戒烟且有基线经济压力的吸烟者，在随访时经济压力的可能性较低（调整后的比值比=0.57，95%置信区间=0.36，0.89）。
有经济压力的吸烟者比没有经济压力的吸烟者稍微更倾向于戒烟尝试，但成功戒烟的可能性并没有更高。收入较低（低于联邦贫困水平的 200%）的吸烟者比收入较高的吸烟者更不可能戒烟，这表明经济压力本身可能无法解释该人群中较低的戒烟率。需要进一步努力提高低收入和经济紧张的吸烟者戒烟尝试的成功率。
