Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA.
Information Management Services, Inc., Calverton, Maryland, USA.
Am J Ind Med. 2022 Jan;65(1):72-77. doi: 10.1002/ajim.23311. Epub 2021 Nov 12.
Previous studies indicate tobacco use was more prevalent among firefighters and law enforcement personnel than in the US adult population. Trends of smoking and smokeless tobacco (SLT) use among these first responders are unknown. We examined trends in current smoking and SLT use among US firefighters and law enforcement personnel and compared smoking and SLT use prevalence in firefighters and law enforcement personnel to US adults in non-first-responder occupations.
Trends of smoking and SLT use prevalence among firefighters, law enforcement personnel, and adults in other occupations were assessed by fitting joinpoint regression models using the 1992-2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). We used multivariable logistic regression models adjusted for demographics to examine associations between occupation and smoking and SLT use status using the 2018-2019 TUS-CPS data. Analyses were conducted in 2021.
From 1992 to 2019, the smoking prevalence declined overall (all p's < 0.01). Though SLT use prevalence among adults in non-first-responder occupations declined (annual percentage change [APC] = -1.2%; 95% confidence interval [CI] = -1.7% to -0.7%), no changes were shown among firefighters and law enforcement personnel which suggests SLT use may be increasing among firefighters over time. In 2018-2019, firefighters (adjusted odds ratio [AOR] = 3.4; 95% CI = 1.7 to 6.8) and law enforcement personnel (AOR = 3.2; 95% CI = 2.1 to 4.7) were more likely than adults in non-first-responder occupations to use SLT.
While smoking prevalence declined overall, SLT use is higher among firefighters and law enforcement personnel and may be increasing over time among firefighters. Research should examine reasons for SLT use by first responders. Comprehensive tobacco policies and SLT-specific cessation programs are needed for first responders.
先前的研究表明，消防员和执法人员的吸烟率高于美国成年人。目前尚不清楚这些急救人员的吸烟和无烟烟草（SLT）使用趋势。我们检查了美国消防员和执法人员当前吸烟和 SLT 使用的趋势，并将消防员和执法人员的吸烟和 SLT 使用流行率与非急救人员职业的美国成年人进行了比较。
使用 1992-2019 年烟草使用补充当前人口调查（TUS-CPS）的连接点回归模型评估消防员、执法人员和其他职业成年人的吸烟和 SLT 使用流行率趋势。我们使用多变量逻辑回归模型调整人口统计学因素，使用 2018-2019 年 TUS-CPS 数据检查职业与吸烟和 SLT 使用状况之间的关联。分析于 2021 年进行。
从 1992 年到 2019 年，总体吸烟率下降（均 p<0.01）。虽然非急救人员成年人的 SLT 使用流行率下降（年百分比变化[APC]=-1.2%；95%置信区间[CI]=-1.7%至-0.7%），但消防员和执法人员没有变化，这表明随着时间的推移，消防员的 SLT 使用可能会增加。2018-2019 年，消防员（调整后的优势比[AOR]=3.4；95%CI=1.7 至 6.8）和执法人员（AOR=3.2；95%CI=2.1 至 4.7）比非急救人员职业的成年人更有可能使用 SLT。
尽管总体吸烟率下降，但消防员和执法人员的 SLT 使用率较高，并且随着时间的推移，消防员的 SLT 使用率可能会增加。研究应检查急救人员使用 SLT 的原因。急救人员需要全面的烟草政策和 SLT 特定的戒烟计划。
