Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
Am J Prev Med. 2023 Apr;64(4 Suppl 1):S42-S52. doi: 10.1016/j.amepre.2022.08.018. Epub 2023 Jan 16.
Smoking rates across U.S. states have declined at different rates over time because some states have progressive tobacco control policies, whereas others have yet to adopt them. Therefore, each state has its own unique historical experience of smoking initiation, cessation, and prevalence. This study characterizes smoking histories for each U.S. state by birth cohort.
Using 1965-2018 National Health Interview Survey and 1992-2019 Tobacco Use Supplement to the Current Population Survey data, statistical methods applied an age‒period‒cohort modeling framework to reconstruct population-level smoking histories for each state. Smoking initiation, cessation, and intensity by age, gender, and cohort were estimated for each state. These were used to construct state-specific trends in the prevalence of current, former, and never smoking as well as the mean smoking duration and pack years. Analysis was conducted from 2017 to 2022.
California and Kentucky, respectively, are exemplar states of more and less aggressive tobacco control. Initiation probabilities were consistently lower in California than in Kentucky, and cessation probabilities were higher. Hence, the smoking prevalence derived from these parameters is higher in Kentucky. The intensity of cigarette smoking was higher in Kentucky than in California, yielding considerably higher estimated pack years when used with the other parameters. Summaries of smoking trends are given for all states.
Smoking initiation, cessation, and intensity trends vary substantially across states, resulting in major differences in estimated smoking prevalence, duration, and pack years. Some states show improvements in smoking metrics over time with more recent birth cohorts, but others have shown very little.
美国各州的吸烟率随时间呈现出不同的下降趋势，这是因为一些州采取了积极的烟草控制政策，而其他州尚未采取这些政策。因此，每个州都有其独特的吸烟起始、戒烟和流行历史。本研究通过出生队列来描述美国各州的吸烟史。
利用 1965-2018 年全国健康访谈调查和 1992-2019 年当前人口调查的烟草使用补充调查数据，应用年龄-时期-队列建模框架，对每个州的人口吸烟史进行了统计分析。估计了每个州的吸烟起始年龄、戒烟年龄、吸烟强度、性别和队列。这些数据用于构建各州当前、曾经和从不吸烟的流行率以及平均吸烟持续时间和吸烟包年数的趋势。分析于 2017 年至 2022 年进行。
加利福尼亚州和肯塔基州分别是烟草控制较为积极和不那么积极的范例州。加利福尼亚州的吸烟起始率始终低于肯塔基州，而戒烟率则更高。因此，从这些参数中得出的吸烟率在肯塔基州更高。肯塔基州的香烟吸烟强度高于加利福尼亚州，当与其他参数一起使用时，估计的吸烟包年数要高得多。给出了所有州的吸烟趋势摘要。
吸烟起始、戒烟和强度趋势在各州之间存在很大差异，导致吸烟流行率、持续时间和吸烟包年数的估计值存在很大差异。随着最近出生队列的出现，一些州的吸烟指标在一段时间内有所改善，但其他州则改善甚微。
