Avila Jaqueline C, Flores Efren J, Su Yan-Jhu, Haas Jennifer S, Park Elyse R, Rigotti Nancy A
University of Massachusetts Boston, Manning College of Nursing and Health Sciences, Department of Gerontology, Boston, MA, USA; Tobacco Research and Treatment Center, Department of Medicine, and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Prev Med. 2025 Feb;191:108207. doi: 10.1016/j.ypmed.2024.108207. Epub 2024 Dec 16.
Lung cancer screening (LCS) offers a teachable moment for smoking cessation. This study assesses whether individual- or neighborhood-level SES is associated with tobacco abstinence and completion of a smoking cessation intervention in the LCS context.
Secondary analysis of a clinical trial (NCT03611881) that tested the effectiveness of smoking cessation treatment for smokers scheduled for LCS (N = 615) in eastern Massachusetts, USA from 2019 to 2024. Outcomes were self-reported 7-day smoking abstinence and study follow-up completion at 6-months. Independent variables were individual SES (high school or less [low SES] vs. post-high school education [high SES]); neighborhood SES (Area Deprivation Index [ADI], range: 0-100, categorized as: highest 15 % [low SES] vs. remaining 85 % scores [high SES]), and a combination of both measures. Logistic regression models tested the association between outcomes and SES measures, adjusted for covariates.
32 % of participants had low individual SES. The mean sample ADI was 19.9 (SD: 12.8). Smoking cessation was higher among those with high vs. low neighborhood SES (15.7 % vs. 7.4 %, p-value = 0.03). Study completion was marginally higher among those with high vs. low individual SES (84.5 % vs. 78.1 %, p = 0.05). In multivariable models, these associations were not significant, but individuals with high individual and low neighborhood SES were more likely to complete the study than those with both low individual and low neighborhood SES, (OR: 6.04, 95 %CI: 1.47-24.7).
Individual and neighborhood SES were not independently associated with the study outcomes in the multivariable analysis, but combinations of individual and neighborhood SES differentially affected treatment completion.
肺癌筛查（LCS）为戒烟提供了一个可用于开展教育的时机。本研究评估在肺癌筛查背景下，个人或社区层面的社会经济地位（SES）是否与戒烟及完成戒烟干预措施相关。
对一项临床试验（NCT03611881）进行二次分析，该试验于2019年至2024年在美国马萨诸塞州东部对计划进行肺癌筛查的吸烟者（N = 615）的戒烟治疗效果进行了测试。结局指标为自我报告的7天戒烟情况以及6个月时的研究随访完成情况。自变量为个人社会经济地位（高中及以下学历[低社会经济地位]与高中后教育程度[高社会经济地位]）；社区社会经济地位（地区贫困指数[ADI]，范围：0 - 100，分类为：最高的15%[低社会经济地位]与其余85%的分数[高社会经济地位]），以及这两种测量方法的组合。逻辑回归模型测试了结局指标与社会经济地位测量方法之间的关联，并对协变量进行了调整。
32%的参与者个人社会经济地位较低。样本的平均地区贫困指数为19.9（标准差：12.8）。社区社会经济地位高的人群戒烟率高于社区社会经济地位低的人群（15.7%对7.4%，p值 = 0.03）。个人社会经济地位高的人群的研究完成率略高于个人社会经济地位低的人群（84.5%对78.1%，p = 0.05）。在多变量模型中，这些关联并不显著，但个人社会经济地位高而社区社会经济地位低的个体比个人和社区社会经济地位都低的个体更有可能完成研究，（比值比：6.04，95%置信区间：1.47 - 24.7）。
在多变量分析中，个人和社区社会经济地位与研究结局并无独立关联，但个人和社区社会经济地位的组合对治疗完成情况有不同影响。
