Kegler Michelle C, Zhang Angela, Haardörfer Regine, Pouncy Ja'Shondra, Owens Crystal, Berg Carla J
Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, United States.
Community Health Care Systems, Tennille, United States.
Tob Prev Cessat. 2024 Dec 10;10. doi: 10.18332/tpc/195832. eCollection 2024.
The COVID-19 pandemic caused major stress, as well as changes to home and work environments, with the potential to alter smoking-related behaviors. This study examined determinants of smoking-related behaviors among patients of federally qualified health centers (FQHCs) in Georgia.
We analyzed survey data from 353 patients (mean age=50 years, 62.9% women, 54.4% Black/African American, 27.8% <high school education, 56.5% ≤$25000 annual income) enrolled in a smoking cessation trial, from 3 FQHCs in rural Georgia (November 2020 to December 2022). Multivariable multinomial regression examined home smoking environments (i.e. household members who smoke, household smoking rules) and changes in stress in relation to: 1) smoking increases/decreases in general and in the home, and 2) quit attempts since pre-pandemic.
Most study participants (85.6%) smoked daily, and 41.6% had smoke-free homes. Compared to pre-pandemic, 36.3% reported increased stress, 28.8% increased smoking, 18.8% increased in-home smoking, and 55.4% quit attempts. Regression models showed more household members who smoke (AOR=1.56; 95% CI: 1.02-2.39) and greater stress (AOR=5.52; 95% CI: 2.74-11.12) were associated with increased smoking (vs no change) since the pandemic began. Non-daily (vs daily) smoking (OR=4.79; 95% CI: 1.71-13.46) was associated with decreased smoking (vs no change). Allowing smoking in the home and greater stress were associated with both increased and decreased in-home smoking (vs no change). We found no associations with quit attempts.
Home environments, specifically home smoking restrictions, as well as stress, may be important intervention targets during societal stressors.
新冠疫情造成了巨大压力，同时改变了家庭和工作环境，有可能改变与吸烟相关的行为。本研究调查了佐治亚州联邦合格医疗中心（FQHC）患者中与吸烟相关行为的决定因素。
我们分析了来自佐治亚州农村地区3家FQHC的353名参加戒烟试验的患者的调查数据（平均年龄 = 50岁，62.9%为女性，54.4%为黑人/非裔美国人，27.8%高中以下学历，56.5%年收入≤25000美元）（2020年11月至2022年12月）。多变量多项回归分析了家庭吸烟环境（即吸烟的家庭成员、家庭吸烟规则）以及压力变化与以下方面的关系：1）总体和在家中吸烟的增加/减少，以及2）自疫情前以来的戒烟尝试。
大多数研究参与者（85.6%）每天吸烟，41.6%的家庭无烟。与疫情前相比，36.3%的人报告压力增加，28.8%的人吸烟增加，18.8%的人在家吸烟增加，55.4%的人尝试戒烟。回归模型显示，自疫情开始以来，更多吸烟的家庭成员（调整后比值比[AOR]=1.56；95%置信区间[CI]：1.02 - 2.39）和更大的压力（AOR = 5.52；95% CI：2.74 - 11.12）与吸烟增加（与无变化相比）相关。非每日（与每日相比）吸烟（OR = 4.79；95% CI：1.71 - 13.46）与吸烟减少（与无变化相比）相关。允许在家中吸烟和更大的压力与在家吸烟的增加和减少（与无变化相比）均相关。我们未发现与戒烟尝试有关联。
家庭环境，特别是家庭吸烟限制以及压力，可能是社会压力源期间重要的干预目标。
