Department of Medicine, Hennepin Healthcare, Hennepin County Medical Center, 701 Park Ave, S2.309, Minneapolis, MN, 55415, USA.
Hennepin Healthcare Research Institute, 701 Park Ave, Suite PP7.700, Minneapolis, MN, 55415, USA.
Addict Sci Clin Pract. 2019 Jan 11;14(1):2. doi: 10.1186/s13722-019-0131-y.
Tobacco use remains the leading cause of preventable disease and death in the United States and is concentrated among disadvantaged populations, including individuals with a history of criminal justice involvement. However, tobacco use among individuals with a history of criminal justice involvement has been understudied in the United States, and data are needed to inform policy and practice.
We used data from the 2008-2016 National Survey on Drug Use and Health (unweighted N = 330,130) to examine trends in tobacco use, categories of tobacco use, characteristics of cigarette use, and health care utilization and tobacco use screening among individuals (aged 18-64) with and without a history of criminal justice involvement in the past year. We used multiple logistic and Poisson regression models with predictive margins to provide adjusted prevalence estimates.
The weighted sample in each year was, on average, representative of 8,693,171 individuals with a history of criminal justice involvement in the past year and 182,817,228 individuals with no history of criminal justice involvement in the past year. Tobacco use was significantly more common among individuals with a history of criminal justice involvement compared with individuals with no criminal justice involvement, and disparities increased over time (Difference in adjusted relative differences: - 10.2% [95% CI - 17.7 to - 2.7]). In 2016, tobacco use prevalence was more than two times higher among individuals with a history of criminal justice involvement (62.9% [95% CI 59.9-66.0] vs. 27.6% [95% CI 26.9-28.3]). Individuals with a history of criminal justice involvement who smoked reported a significantly earlier age of cigarette initiation, more cigarettes used per day, and higher levels of nicotine dependence and chronic obstructive pulmonary disease. Individuals with a history of criminal justice involvement were less likely to report an outpatient medical visit in the past year and, among those reporting an outpatient medical visit, were less likely to be asked about tobacco use, but paradoxically, more likely to report being advised to quit.
Novel programs and tobacco control policies are needed to address persistently high rates of tobacco use and reduce cardiovascular morbidity and mortality among individuals with a history of criminal justice involvement.
在美国，吸烟仍然是可预防疾病和死亡的主要原因，而且主要集中在弱势群体中，包括有犯罪司法史的个人。然而，在美国，有犯罪司法史的个人的吸烟行为研究不足，需要数据来为政策和实践提供信息。
我们使用了 2008-2016 年全国毒品使用和健康调查（未加权 N=330130）的数据，来研究过去一年有和没有犯罪司法史的个人（年龄在 18-64 岁之间）的吸烟趋势、吸烟类别、香烟使用特点、医疗保健利用和烟草使用筛查情况。我们使用具有预测边缘的多逻辑和泊松回归模型来提供调整后的流行率估计。
每年的加权样本平均代表过去一年有 8693171 名有犯罪司法史的个人和过去一年没有犯罪司法史的 182817228 名个人。与没有犯罪司法史的个人相比，有犯罪司法史的个人吸烟的情况明显更为常见，而且这种差距随着时间的推移而增加（调整后的相对差异差异：-10.2% [95%CI -17.7 至 -2.7]）。2016 年，有犯罪司法史的个人的吸烟流行率高出两倍多（62.9% [95%CI 59.9-66.0] vs. 27.6% [95%CI 26.9-28.3]）。有犯罪司法史的吸烟者报告说，他们开始吸烟的年龄更早，每天吸烟的数量更多，尼古丁依赖和慢性阻塞性肺疾病的程度更高。有犯罪司法史的个人更不可能在过去一年中报告门诊医疗就诊，而且在报告门诊医疗就诊的个人中，他们更不可能被问到吸烟问题，但矛盾的是，他们更有可能被建议戒烟。
需要新的项目和烟草控制政策来解决有犯罪司法史的个人持续高吸烟率问题，并降低心血管发病率和死亡率。
