Department of Family and Community Medicine (Drs Cunningham, Solomon, and Cordova), Native American Research and Training Center (Drs Cunningham, Solomon, and Cordova), and Western Region Public Health Training Center (Dr Cunningham), The University of Arizona, Tucson, Arizona; and Tribal Epidemiology Center, Inter Tribal Council of Arizona, Phoenix, Arizona (Dr Ritchey).
J Public Health Manag Pract. 2019 Sep/Oct;25 Suppl 5, Tribal Epidemiology Centers: Advancing Public Health in Indian Country for Over 20 Years:S11-S19. doi: 10.1097/PHH.0000000000001026.
Cigarette use among the US general population is significantly lower in metropolitan areas than in rural areas.
To assess whether cigarette use among American Indians and Alaska Natives (AI/AN) is lower in metropolitan areas than in rural areas and tribal lands (which are predominantly rural).
Data came from the National Survey on Drug Use and Health (2012-2016). Regressions with adjustments for demographics were performed to assess whether cigarette use differed in association with type of place.
The AI/AN in tribal lands (n = 1569), nontribal large metropolitan (1+ million people) areas (n = 582), nontribal small metropolitan (<1 million) areas (n = 1035), and nontribal rural areas (n = 1043).
Cigarette abstinence, current smoking, daily use, number of cigarettes used, and days of use-all in the past month. Nicotine dependence was also examined.
Metropolitan (large or small) areas versus rural areas: no statistically significant differences in cigarette use were found. Metropolitan (large or small) areas versus tribal lands: days of cigarette use and daily use were significantly lower in tribal lands. Tribal lands were also lower than small metropolitan areas regarding number of cigarettes used and nicotine dependence. Rural areas versus tribal lands: cigarette measures were consistently lower in tribal lands. For example, the prevalence of current smokers, daily users and nicotine dependence, respectively, was 37.9%, 25.9%, and 16.3% in rural areas and 27.4%, 13.6%, and 8.9% in tribal lands.
Differences in cigarette use between AI/AN in nontribal rural and metropolitan areas were not indicated. Instead, the place differences found were lower cigarette use in tribal lands than in nontribal rural areas and, to some extent, metropolitan areas. These findings can help inform policy makers working to develop context-sensitive anticommercial tobacco efforts for AI/AN.
美国一般人群在大都市地区的吸烟率明显低于农村地区。
评估美国印第安人和阿拉斯加原住民（AI/AN）在大都市地区的吸烟率是否低于农村地区和部落土地（主要是农村地区）。
数据来自国家药物使用和健康调查（2012-2016 年）。进行回归分析，调整人口统计学因素，以评估吸烟情况是否因所处地点的不同而有所不同。
部落土地上的 AI/AN（n=1569）、非部落大型大都市（100 多万人）地区（n=582）、非部落小型大都市（<100 万人）地区（n=1035）和非部落农村地区（n=1043）。
过去一个月内的吸烟情况（包括戒烟、当前吸烟、每日吸烟、吸烟量和吸烟天数），以及尼古丁依赖情况。
大都市（大型或小型）地区与农村地区相比：吸烟情况无统计学显著差异。大都市（大型或小型）地区与部落土地相比：吸烟天数和每日吸烟量在部落土地上显著较低。部落土地上的吸烟量和尼古丁依赖程度也低于小型大都市地区。农村地区与部落土地相比：部落土地上的吸烟情况持续较低。例如，当前吸烟者、每日吸烟者和尼古丁依赖者的流行率分别为 37.9%、25.9%和 16.3%，而在部落土地上则分别为 27.4%、13.6%和 8.9%。
在非部落农村和大都市地区的 AI/AN 之间，吸烟情况的差异并不明显。相反，在部落土地上发现的差异是吸烟率低于非部落农村地区，在某种程度上也低于大都市地区。这些发现可以为制定针对 AI/AN 的基于背景的反商业烟草政策提供信息。
