Spangler J G, Bell R A, Knick S, Michielutte R, Dignan M B, Summerson J H
Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Ethn Dis. 1998 Winter;8(1):73-80.
Although minority populations suffer a disproportionately higher burden of tobacco-attributable morbidity and mortality, the church appears to be a promising avenue through which to pursue tobacco-cessation interventions in these communities. This report describes church-related correlates of tobacco use among the Lumbee Indians in North Carolina, a population with a high prevalence of tobacco use, strong ties to tobacco-related agriculture, and high levels of church participation.
A cross-sectional telephone survey of 400 adult Lumbee Indians was carried out in Pembroke, a town in Robeson County, NC. The questionnaire elicited information on tobacco use, demographic and social support information, knowledge and practices related to tobacco agriculture and traditional Native American tobacco use and church participation.
Sixty-three percent of participants were church members and 82% said the church is "very important" to the Lumbee community. In bivariate analysis, church attendance over the past year correlated with age, education, gender, number of close friends and relatives, marital status and current smoking status. Church attendance was not related to current smokeless tobacco use or participation in tobacco-related agriculture. Current smokers who had not attended church in the past year smoked significantly more cigarettes per day than current smokers attending church more often. In logistic regression, participants attending church weekly or more often were 73% less likely to be current smokers (adjusted odds ratio [AOR] = 0.27, 95% confidence interval [CI] = 0.11-0.68). Among ever-smokers, participants having attended church infrequently in the past year were 79% less likely to have quit (AOR = 0.21, 95% CI = 0.07-0.65). Having participated in tobacco agriculture as a child predicted current Christian views on tobacco use.
Tobacco use, common among Lumbee adults, correlates with a variety of demographic and social support variables. In addition, these data are the first to uncover a dose-response relationship between church attendance and number of cigarettes smoked per day by current smokers, and the relationship between childhood participation in tobacco agriculture and Christian views on tobacco use. Our results should be useful in designing a church-based tobacco-cessation intervention among Lumbee Indians.
尽管少数族裔群体承受着与烟草相关的发病率和死亡率方面不成比例的更高负担，但教会似乎是在这些社区开展戒烟干预措施的一个有前景的途径。本报告描述了北卡罗来纳州伦拜印第安人中与教会相关的烟草使用关联因素，该人群烟草使用率高，与烟草相关农业联系紧密，且教会参与度高。
在北卡罗来纳州罗伯逊县彭布罗克镇对400名成年伦拜印第安人进行了横断面电话调查。问卷收集了关于烟草使用、人口统计学和社会支持信息、与烟草农业及传统美洲原住民烟草使用相关的知识和行为以及教会参与情况的数据。
63%的参与者是教会成员，82%的人表示教会对伦拜社区“非常重要”。在双变量分析中，过去一年的教会出席情况与年龄、教育程度、性别、亲密朋友和亲属数量、婚姻状况及当前吸烟状况相关。教会出席情况与当前无烟烟草使用或参与烟草相关农业无关。过去一年未参加教会的当前吸烟者每天吸烟量明显多于更常参加教会的当前吸烟者。在逻辑回归分析中，每周或更频繁参加教会的参与者成为当前吸烟者的可能性降低73%（调整后的优势比[AOR]=0.27，95%置信区间[CI]=0.11 - 0.68）。在曾经吸烟者中，过去一年很少参加教会的参与者戒烟的可能性降低79%（AOR = 0.21，95% CI = 0.07 - 0.65）。童年时期参与烟草农业可预测当前基督徒对烟草使用的看法。
烟草使用在伦拜成年人中很常见，与多种人口统计学和社会支持变量相关。此外，这些数据首次揭示了教会出席情况与当前吸烟者每天吸烟量之间的剂量反应关系，以及童年参与烟草农业与基督徒对烟草使用看法之间的关系。我们的结果对于在伦拜印第安人中设计基于教会的戒烟干预措施应具有参考价值。
