Potter Lindsey N, Jones Dusti R, Braudt David B, Nahum-Shani Inbal, Lam Cho Y, Fagundes Christopher, Wetter David W
Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, USA; Department of Population Health Sciences, University of Utah, USA.
Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute, University of Utah, USA; Department of Population Health Sciences, University of Utah, USA.
Drug Alcohol Depend. 2025 Jan 1;266:112499. doi: 10.1016/j.drugalcdep.2024.112499. Epub 2024 Nov 17.
African Americans who smoke are disproportionately affected by the health consequences of smoking. Nicotine replacement therapy (NRT) is effective for helping people successfully quit, yet there are well-documented issues with nicotine patch adherence. This study aimed to examine the real-time associations of risk factors for patch non-adherence [lapse, motivation, self-efficacy, urge, cigarette availability] with patch adherence in a sample of African Americans who smoke and are attempting to quit.
Participants were 239 African American adults, 50 % female, and ages 18-74. Ecological momentary assessment was used to assess patch use and risk factors. Multilevel modeling for binary outcomes was used to test concurrent and lagged associations between risk factors and patch use.
Lapse at a previous assessment (OR=0.61, 95 % CI: 0.42, 0.88), and urge (OR=0.77, 95 % CI: 0.66, 0.89) and cigarette availability (OR=0.84, 95 % CI: 0.71, 0.99) at concurrent assessments were associated with lower likelihood of patch use. Concurrent motivation (OR=1.28, 95 % CI: 1.05, 1.55) and self-efficacy (OR=1.31, 95 % CI: 1.06, 1.62) were associated with greater likelihood of patch use. There were no significant lagged associations between motivation, self-efficacy, urge, or cigarette availability with patch use.
It is critical to examine correlates of non-adherence among African Americans who smoke because they are less likely to quit and are disproportionately impacted by the health consequences of tobacco use. The results suggest that interventions might focus on promoting patch adherence at certain times (e.g., when cigarettes are available) and/or leveraging the benefits of protective factors (e.g., motivation and self-efficacy).
吸烟的非裔美国人受吸烟健康后果的影响尤为严重。尼古丁替代疗法（NRT）有助于人们成功戒烟，然而，尼古丁贴片的依从性存在诸多有据可查的问题。本研究旨在调查吸烟且试图戒烟的非裔美国人样本中，贴片不依从的风险因素（复吸、动机、自我效能感、冲动、香烟可得性）与贴片依从性之间的实时关联。
参与者为239名非裔美国成年人，50%为女性，年龄在18 - 74岁之间。采用生态瞬时评估法评估贴片使用情况和风险因素。使用二元结局的多水平模型来检验风险因素与贴片使用之间的同步关联和滞后关联。
前一次评估时的复吸（比值比[OR]=0.61，95%置信区间[CI]：0.42，0.88），以及同步评估时的冲动（OR=0.77，95% CI：0.66，0.89）和香烟可得性（OR=0.84，95% CI：0.71，0.99）与较低的贴片使用可能性相关。同步的动机（OR=1.28，95% CI：1.05，1.55）和自我效能感（OR=1.31，95% CI：1.06，1.62）与较高的贴片使用可能性相关。动机、自我效能感、冲动或香烟可得性与贴片使用之间不存在显著的滞后关联。
研究吸烟的非裔美国人中不依从的相关因素至关重要，因为他们戒烟的可能性较小，且受烟草使用健康后果的影响尤为严重。结果表明，干预措施可能应侧重于在特定时间（例如，有香烟可得时）促进贴片依从性，和/或利用保护因素（例如，动机和自我效能感）的益处。
