Messer Karen, Pierce John P, Chen Jiayu, Luo Man, Stone Matthew D, Leas Eric C, Shi Yuyan, Strong David R, Trinidad Dennis R, McMenamin Sara B
Moores Cancer Center, Univeristy of California, San Diego, California, USA.
Moores Cancer Center, Univeristy of California, San Diego, California, USA
Tob Control. 2024 Jul 9. doi: 10.1136/tc-2023-058483.
To investigate the association of state-level cigarette price and tobacco control expenditure with the large 2000-2019 decline in cigarette smoking among US 18-24 year-olds.
Smoking behaviour was assessed in the 24 most populous US states using the 1992-2019 Tobacco Use Supplements to the Current Population Survey; association with price and expenditure was tested using adjusted logistic regression. States were ranked by inflation-adjusted average price and tobacco control expenditure and grouped into tertiles. State-specific time trends were estimated, with slope changes in 2001/2002 and 2010/2011.
Between 2000 and 2010, the odds of smoking among US young adults decreased by a third (adjusted OR, AOR 0.68, 95% CI 0.56 to 0.84). By 2019, these odds were one-quarter of their 2000 level (AOR 0.24, 95% CI 0.19 to 0.31). Among states in the lowest tertile of price/expenditure tobacco control activity, initially higher young adult smoking decreased by 13 percentage points from 2010 to 2018-2019, to a prevalence of 5.6% (95% CI 4.5% to 6.8%), equal to that in the highest tobacco-control tertile of states (6.5%, 95% CI 5.2% to 7.8%). Neither state tobacco control spending (AOR 1.0, 95% CI 0.999 to 1.002) nor cigarette price (AOR 0.96, 95% CI: 0.92 to 1.01) were associated with young adult smoking in statistical models. In 2019, seven states had prevalence over 3 SDs higher than the 24-state mean.
National programmes may have filled a gap in state-level interventions, helping drive down the social acceptability of cigarette smoking among young adults across all states. Additional interventions are needed to assist high-prevalence states to further reduce smoking.
研究美国州级香烟价格和烟草控制支出与2000 - 2019年美国18 - 24岁人群吸烟率大幅下降之间的关联。
利用1992 - 2019年《当前人口调查》的烟草使用补充调查，对美国人口最多的24个州的吸烟行为进行评估；使用调整后的逻辑回归检验与价格和支出的关联。根据通货膨胀调整后的平均价格和烟草控制支出对各州进行排名，并分为三分位数组。估计各州特定的时间趋势，观察2001/2002年和2010/2011年的斜率变化。
2000年至2010年期间，美国年轻成年人吸烟的几率下降了三分之一（调整后的比值比，AOR 0.68，95%置信区间0.56至0.84）。到2019年，这些几率仅为2000年水平的四分之一（AOR 0.24，95%置信区间0.19至0.31）。在烟草控制活动价格/支出最低三分位数的州中，最初较高的年轻成年人吸烟率从2010年到2018 - 2019年下降了13个百分点，降至5.6%（95%置信区间4.5%至6.8%），与烟草控制最高三分位数州的患病率（6.5%，95%置信区间5.2%至7.8%）相当。在统计模型中，州烟草控制支出（AOR 1.0，95%置信区间0.999至1.002）和香烟价格（AOR 0.96，95%置信区间：0.92至1.01）均与年轻成年人吸烟无关。2019年，有七个州的患病率比24个州的平均水平高出3个标准差以上。
国家项目可能填补了州级干预措施的空白，有助于降低所有州年轻成年人吸烟的社会接受度。需要采取额外的干预措施来帮助高患病率州进一步降低吸烟率。
