Trapl Erika S, VanFrank Brenna, Kava Christine M, Trinh Vinh, Land Stephanie R, Williams Rebecca S, Frost Elizabeth, Babb Stephen
Prevention Research Center for Healthy Neighborhoods, Dept. of Population and Quantitative Health Sciences, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-7069, USA.
Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy. NE, MS: S107-7, Atlanta, GA, 30341, USA.
Drug Alcohol Depend. 2021 Apr 1;221:108615. doi: 10.1016/j.drugalcdep.2021.108615. Epub 2021 Feb 15.
Federally funded health centers (HCs) provide care to the most vulnerable populations in the U.S., including populations with disproportionately higher smoking prevalence such as those with lower incomes.
This study compared characteristics of adult HC patients, by cigarette smoking status, and assessed smoking cessation-related behaviors using 2014 Health Center Patient Survey data; analysis was restricted to adults with data on cigarette smoking status (n = 5583). Chi-square and logistic regression analyses were conducted.
Overall, 28.1 % were current smokers and 19.2 % were former smokers. Current smokers were more likely to report fair/poor health (48.2 %) and a high burden of behavioral health conditions (e.g., severe psychological distress 23.9 %) versus former and never smokers. Most current smokers reported wanting to quit in the past 12 months (79.0 %) and receiving advice to quit from a healthcare professional (78.7 %). In a multivariable model, age <45, non-white race, COPD diagnosis, and past 3-month marijuana use were significantly associated with desire to quit. Few former smokers (15.2 %) reported using cessation treatment, though use was higher among those who quit within the previous year (30.6 %).
Although most current smokers reported a desire to quit, low uptake of evidence-based treatment may reduce the number who attempt to quit and succeed. Given the burden of tobacco use, future efforts could focus on identifying and overcoming unique personal, healthcare professional, or health system barriers to connecting them with cessation treatments. Increasing access to cessation treatments within HCs could reduce smoking-related disparities and improve population health.
联邦政府资助的健康中心（HCs）为美国最脆弱的人群提供医疗服务，包括吸烟率 disproportionately 较高的人群，如低收入人群。
本研究通过吸烟状况比较了成年HC患者的特征，并使用2014年健康中心患者调查数据评估了与戒烟相关的行为；分析仅限于有吸烟状况数据的成年人（n = 5583）。进行了卡方检验和逻辑回归分析。
总体而言，28.1%为当前吸烟者，19.2%为既往吸烟者。与既往吸烟者和从不吸烟者相比，当前吸烟者更有可能报告健康状况一般/较差（48.2%）以及行为健康状况负担较重（例如，严重心理困扰23.9%）。大多数当前吸烟者报告在过去12个月内想要戒烟（79.0%），并接受过医疗保健专业人员的戒烟建议（78.7%）。在多变量模型中，年龄<45岁、非白人种族、慢性阻塞性肺疾病（COPD）诊断以及过去3个月使用大麻与戒烟意愿显著相关。很少有既往吸烟者（15.2%）报告使用过戒烟治疗，不过在过去一年内戒烟的人群中使用率较高（30.6%）。
尽管大多数当前吸烟者表示有戒烟意愿，但循证治疗的低接受率可能会减少尝试戒烟并成功的人数。鉴于烟草使用的负担，未来的努力可以集中在识别和克服将他们与戒烟治疗联系起来的独特个人、医疗保健专业人员或卫生系统障碍上。增加在健康中心内获得戒烟治疗的机会可以减少与吸烟相关的差异并改善人群健康。
