Kaiser Permanente Northern California, Division of Research, Oakland, California.
University of California, San Francisco, San Francisco, California.
Cancer Epidemiol Biomarkers Prev. 2024 May 1;33(5):694-702. doi: 10.1158/1055-9965.EPI-23-0386.
We evaluated smoking differences across nativity and race/ethnicity among women diagnosed with breast cancer.
In our Northern Californian pooled population of 5,653 [670 Asian, 690 Hispanic, and 4,300 non-Hispanic White (White)] women diagnosed with breast cancer, we evaluated smoking differences across nativity, race/ethnicity, and acculturation and effect modification of nativity by race/ethnicity and education.
Foreign-born women currently smoked less than US-born women [odds ratio (OR) = 0.46, 95% confidence limit (CL): 0.29-0.72]. Hispanic (OR = 0.50; 95% CL: 0.32-0.78) women currently smoked less than White women. Among those who ever smoked (n = 2,557), foreign-born women smoked 5.23 fewer pack-years (PY) than US-born women (95% CL: -2.75 to -7.70). Furthermore, Asian (-4.60, 95% CL: -0.81 to -8.39) and Hispanic (-6.79, 95% CL: -4.14 to -9.43) women smoked fewer PY than White women. Associations were generally suggestive of greater smoking with greater acculturation (immigration age, US years, survey language). Finally, associations for nativity differed by education but not race/ethnicity, with a higher likelihood of smoking in US-born women only among those with less than a bachelor's degree (OR = 2.84, 95% CL: 2.15-3.77; current smoking: P = 0.01, PY: P = 0.05).
Asian and Hispanic (vs. White) and foreign-born (vs. US-born) breast cancer survivors reported fewer smoking behaviors. Smoking differences across nativity and education were driven by higher rates of smoking in US-born women with lower educational attainment.
Smoking behavioral patterns were similar among breast cancer survivors and the general population, informing potential smoking interventions.
我们评估了在诊断患有乳腺癌的女性中，种族和民族与吸烟之间的差异。
在我们北加州的 5653 名女性（670 名亚洲人，690 名西班牙裔，4300 名非西班牙裔白人（白人））中，我们评估了种族和民族、文化适应和种族/民族和教育对出生地的影响修饰对吸烟的影响。
外国出生的女性当前吸烟少于美国出生的女性（优势比（OR）= 0.46，95%置信区间（CL）：0.29-0.72）。西班牙裔（OR = 0.50；95% CL：0.32-0.78）女性当前吸烟少于白人女性。在曾经吸烟的人（n = 2557）中，外国出生的女性比美国出生的女性吸烟少 5.23 包年（PY）（95% CL：-2.75 至-7.70）。此外，亚洲人（-4.60，95% CL：-0.81 至-8.39）和西班牙裔（-6.79，95% CL：-4.14 至-9.43）女性吸烟的 PY 比白人女性少。这些关联通常表明，随着文化适应程度的提高（移民年龄、在美国的年限、调查语言），吸烟量会增加。最后，与出生地有关的关联因教育程度而异，但与种族/民族无关，仅在美国出生的女性中，具有低于学士学位的女性更有可能吸烟（OR = 2.84，95% CL：2.15-3.77；当前吸烟：P = 0.01，PY：P = 0.05）。
亚洲和西班牙裔（与白人相比）以及外国出生的（与美国出生的相比）乳腺癌幸存者报告的吸烟行为较少。出生地和教育程度之间的吸烟差异是由受教育程度较低的美国出生女性更高的吸烟率所驱动的。
乳腺癌幸存者的吸烟行为模式与一般人群相似，为潜在的吸烟干预提供了信息。
