Vanderbilt University Medical Center, Nashville, Tennessee.
Meharry Medical College, Nashville, Tennessee.
Cancer Epidemiol Biomarkers Prev. 2019 Aug;28(8):1345-1352. doi: 10.1158/1055-9965.EPI-19-0179. Epub 2019 Jun 3.
Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease.
We surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. Seven items assessed attitudes toward aspects of precision smoking treatment, from undergoing tests to acting on results. Items were dichotomized as favorable (5 = strongly agree/4 = agree) versus less favorable (1 = strongly disagree/2 = disagree/3 = neutral); a summary score reflecting generalized attitudes was also computed. Multivariable logistic regression tested independent associations of motivation (precontemplation, contemplation, and preparation) and confidence in quitting (low, medium, and high) with generalized attitudes, controlling for sociodemographic factors and nicotine dependence.
More than 70% of respondents endorsed favorable generalized attitudes toward precision medicine, with individual item favorability ranging from 64% to 83%. Smokers holding favorable generalized attitudes reported higher income and education ( < 0.05). Predicted probabilities of favorable generalized attitudes ranged from 63% to 75% across motivation levels [contemplation vs. precontemplation: adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI), 1.36-3.25, = 0.001; preparation vs. precontemplation: AOR = 1.83, 95% CI, 1.20-2.78, = 0.005; contemplation vs. preparation: AOR = 1.15, 95% CI, 0.75-1.77, = 0.52] and from 59% to 78% across confidence (medium vs. low: AOR = 1.91, 95% CI, 1.19-3.07, = 0.007; high vs. low: AOR = 2.62, 95% CI, 1.68-4.10, < 0.001; medium vs. high: AOR = 0.73, 95% CI, 0.48-1.11, = 0.14).
Among disproportionately burdened community smokers, most hold favorable attitudes toward precision smoking treatment. Individuals with lower motivation and confidence to quit may benefit from additional intervention to engage with precision smoking treatment.
Predominantly favorable attitudes toward precision smoking treatment suggest promise for future research testing their effectiveness and implementation.
使用生物数据进行精准干预可能会增强戒烟治疗效果，但在那些受吸烟相关疾病影响不成比例的吸烟者中，这种干预方法的研究还很不足。
我们调查了美国国家癌症研究所（NCI）赞助的南方社区队列研究中的吸烟者，该研究主要由非裔美国人和低收入成年人组成。有 7 个项目评估了对精准戒烟治疗各个方面的态度，从接受测试到根据结果采取行动。项目被分为有利（5 = 非常同意/4 = 同意）和不利（1 = 非常不同意/2 = 不同意/3 = 中立）；还计算了反映普遍态度的综合评分。多变量逻辑回归测试了动机（未考虑、考虑和准备）和戒烟信心（低、中、高）与普遍态度的独立关联，控制了社会人口因素和尼古丁依赖。
超过 70%的受访者对精准医学的普遍态度表示赞成，个别项目的赞成率在 64%到 83%之间。持有赞成普遍态度的吸烟者报告了更高的收入和教育水平（<0.05）。在动机水平上，有利的普遍态度的预测概率在 63%到 75%之间[考虑与未考虑：调整后的优势比（AOR）=2.10，95%置信区间（CI）为 1.36-3.25， = 0.001；准备与未考虑：AOR = 1.83，95% CI，1.20-2.78， = 0.005；考虑与准备：AOR = 1.15，95% CI，0.75-1.77， = 0.52]，在信心水平上的预测概率在 59%到 78%之间（中等与低：AOR = 1.91，95% CI，1.19-3.07， = 0.007；高与低：AOR = 2.62，95% CI，1.68-4.10， < 0.001；中与高：AOR = 0.73，95% CI，0.48-1.11， = 0.14）。
在受疾病影响不成比例的社区吸烟者中，大多数人对精准戒烟治疗持赞成态度。那些戒烟动机和信心较低的人可能受益于额外的干预措施，以参与精准戒烟治疗。
对精准戒烟治疗的普遍赞成态度表明，未来研究测试其效果和实施的前景广阔。
