Smoking and the Asian American workforce in the National Latino and Asian American Study

Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression

INTRODUCTION

Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic.

METHODS

We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms.

RESULTS

We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts.

CONCLUSIONS

The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use.

DIAGNOSTIC PATTERNS OF AGE-RELATED MACULAR DEGENERATION

PURPOSE

To characterize prevalence estimates by race, age, sex, and comorbidity (diabetes and hypertension) within the Medicare beneficiary demographic.

METHODS

In this US population-based retrospective cohort analysis, the Vision and Eye Health Surveillance System was analyzed for a 100% sample of Medicare Fee-For-Service beneficiary populations of Asians and non-Hispanic Whites between 2014 and 2018. Exclusionary criteria included beneficiaries younger than 40 years. Prevalence rate ratios, defined as prevalence rate for Asians divided by prevalence rate for non-Hispanic Whites, were calculated using multivariate negative binomial regression or Pearson-scaled Poisson regression, stratified by age, sex, and comorbidity.

RESULTS

A total of 21,892,200 Medicare beneficiaries fulfilled the inclusionary criteria in 2018. Of the entire cohort, 3.2% of the beneficiaries (N = 714,500) were Asian. For beneficiaries aged 40 to 64 years, Asian male (prevalence rate ratios 1.73, 95% confidence interval 1.64-1.83, P < 0.0001) and female (prevalence rate ratios 1.34, 95% confidence interval 1.28-1.41, P < 0.0001) beneficiaries had an increased prevalence rate of all age-related macular degeneration relative to non-Hispanic Whites. Significant time-wise increases in prevalence rate ratios were observed within several age groups, sexes, and comorbidities (race-time interaction coefficients P < 0.05 ).

CONCLUSION

This analysis highlights increased age-related macular degeneration prevalence estimates within the Asian American demographic relative to non-Hispanic Whites. Furthermore, specific Asian subpopulations are experiencing accelerated prevalence rates over time.

How is smoking distributed in relation to socioeconomic status? Evidence from Brazil in the years 2013 and 2019

The present study aimed to analyze income-related inequality in tobacco consumption in Brazil using data from the National Health Survey at two points in time (2013 and 2019). This study contributes to the growing literature analyzing socioeconomic inequalities in tobacco use by investigating income-related inequalities in the consumption of different tobacco products in Brazil. The inequality measure is the concentration index with an Erreygers correction (EI), and the analysis of its decomposition allows the identification of the factors that determine such inequality. There is inequality in smoking concentrated in the poorest persons, and this pattern also occurs for manufactured cigarettes and roll-your-own cigarettes (RYO), while inequality in smoking cessation is concentrated among the wealthiest. Smoking inequalities were greater in men, older age groups, and RYO. In terms of evolution, the overall results indicated a small decline in smoking inequality. For the decomposition analysis, the results show that the main factors that affect tobacco inequality in terms of concentration in the poorest are education, income, and having private health insurance. The region variable, by contrast, has a positive contribution, since the wealthiest regions have individuals who are more likely to smoke. These results have important implications that serve as a basis for formulating public health policies. For example, greater inequalities for men and older individuals can be targeted by public policies with a special focus on these cases.

The Impact of Lifetime Work and Non-work Physical Activity on Physical Fitness Among White – and Blue – Collar Retirees: A Cross-Sectional Study

Objective: The literature offers significant amount of data on the effects of occupational activity on health, with a distinct link between retirement and health among the most frequently tackled topics. Studies on the relationship between past occupational activity and physical fitness among older retirees remain scarce. The aim of the study was to assess the effects of physical activity on physical fitness in white- and blue-collar retirees.

Methods: A total of 200 participants (aged ≥60) were included in the study. Lifetime physical activity was assessed using the Lifetime Physical Activity Questionnaire. Mean MET/week/year values of total Physical Activity and for each domain separately (occupational, sports, household) were calculated. Participants were stratified to blue- or white- collar group. Physical performance, hand-grip strength (HGS) and pulmonary function were assessed.

Results: Mean total MET/week/year values for the blue- and the white-collar workers were 140.48 ± 55.13 and 100.75 ± 35.98, respectively. No statistically significant differences in physical performance scores were found between the white- and blue- collar groups. Adjustment for age, sex weight and height revealed a statistically significant association between work-related PA FEV*1 in the blue-collar group. White – collar workers presented higher odds ratio for membership in highest quartile in regard to short physical performance battery test score.

Conclusion: Only minimal association of type of occupation on physical fitness were found despite statistically significant differences between mean intensity and duration of sports- and work-related lifetime physical activity. These findings may indicate that the type of past work is not an independent factor influencing the state of a person in old age. Large-scale investigations with physically fit and unfit participants, are necessary.

Cultural Perspectives on Tobacco Use and Cessation Among Chinese American Immigrants: A Community-Engaged Qualitative Study

INTRODUCTION

Tobacco use is a preventable cause of death among ethnic minorities. Chinese Americans have high smoking rates and underutilize evidence-based cessation therapies. Community members' perspectives on tobacco use and cessation may help bridge treatment gaps and ensure that cessation approaches are aligned with cultural values.

METHODS

Focus group methods were used to explore cultural factors influencing tobacco use and cessation among 50 Chinese immigrants. Emerging themes were identified using thematic analysis.

RESULTS

The three emerging themes are (a) tobacco use is influenced by Chinese American immigrants' socioecological environment, (b) self-discipline determines the ability to quit, and (c) complex family dynamics influence quitting.

DISCUSSION

Cessation approaches framed within cultural perspectives may help bridge treatment gaps. Innovations such as leveraging soft technologies that are widely used in the community may extend the reach of health promotion campaigns and treatments.

A literature review on prevalence of gender differences and intersections with other vulnerabilities to tobacco use in the United States, 2004-2014

This report describes results from a systematic literature review examining gender differences in U.S. prevalence rates of current use of tobacco and nicotine delivery products and how they intersect with other vulnerabilities to tobacco use. We searched PubMed on gender differences in tobacco use across the years 2004-2014. For inclusion, reports had to be in English, in a peer-reviewed journal or federal government report, report prevalence rates for current use of a tobacco product in males and females, and use a U.S. nationally representative sample. Prevalence rates were generally higher in males than in females across all products. This pattern remained stable despite changes over time in overall prevalence rates. Gender differences generally were robust when intersecting with other vulnerabilities, although decreases in the magnitude of gender differences were noted among younger and older users, and among educational levels and race/ethnic groups associated with the highest or lowest prevalence rates. Overall, these results document a pervasive association of gender with vulnerability to tobacco use that acts additively with other vulnerabilities. These vulnerabilities should be considered whenever formulating tobacco control and regulatory policies.

The Associations Between Smoking and Occupational Categories

The implementation of smoke-free policies for workplaces and their impacts have been far from satisfactory. We investigated smoking prevalence in various occupations using data (n = 9283) from the Korea National Health and Nutrition Examination Survey collected from 2008 to 2010. Young adults who were working in the occupation categories of “service and sales,” “skilled agricultural, fishery, and forest workers,” and “crafts and machine operation” for men and “service and sales” for women showed 1.8 to 7.1 and 3.7 times higher ( P < .05) smoking prevalence compared with the reference (managers and professionals), respectively, and the highest prevalence among the 7 occupational categories that were studied. Drinking and stress level were positively associated with being current smokers. We provide quantitative evidence supporting clinicians and policy makers wishing to establish smoking-cessation programs in workplaces for young adults in South Korea, and evidence supporting the improvement of prevention by the concomitant reduction of risk factors.

Occupational gradients in smoking behavior and exposure to workplace environmental tobacco smoke: the multi-ethnic study of atherosclerosis

OBJECTIVE

This study examines associations of occupation with smoking status, amount smoked among current and former smokers (number of cigarettes per day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education.

METHODS

This is a cross-sectional analysis of data from a community sample (n = 6355, age range: 45-84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables.

RESULTS

Male blue-collar and sales/office workers had higher odds of having consumed more than 20 pack-years of cigarettes than managers/professionals. For both male and female current or former smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years.

CONCLUSIONS

Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual and workplace levels especially in blue-collar workplaces.

Tabagismo, situação no mercado de trabalho e gênero: análise da PNAD 2008

O presente estudo teve como objetivo verificar se o tabagismo atual está associado à inserção no mercado de trabalho, após ajuste por escolaridade, renda e saúde em homens e mulheres; objetivou, também, discutir hipóteses explicativas. Foram estudados indivíduos de 15 a 64 anos, residentes em regiões metropolitanas brasileiras, pertencentes à população economicamente ativa, incluídos na Pesquisa Nacional por Amostra de Domicílios (2008). Razão de prevalência (RP) e intervalo de 95% de confiança (IC95%) foram obtidos pela regressão de Poisson. Após ajustes, o tabagismo foi estatisticamente maior em indivíduos inseridos no trabalho sem proteção social (homens, RP = 1,31, IC95%: 1,24-1,38; mulheres, RP = 1,22, IC95%: 1,12-1,31) e desempregados (homens, RP = 1,31, IC95%: 1,18-1,44; mulheres, RP = 1,16, IC95%: 1,03-1,32). Prevalências mais altas de tabagismo foram observadas nos homens inseridos no trabalho sem proteção social. Nossos resultados confirmam que a situação no mercado de trabalho é uma dimensão independente das desigualdades sociais no tabagismo. O gradiente social observado foi mais acentuado nos homens, mas a associação entre inserção no trabalho e tabagismo está presente nos dois gêneros.

Surveillance of occupational health disparities: challenges and opportunities

Increasingly, the occupational health community is turning its attention to the effects of work on previously underserved populations, and researchers have identified many examples of disparities in occupational health outcomes. However, the occupational health status of some underserved worker populations is not described due to limitations in existing surveillance systems. As such, the occupational health community has identified the need to enhance and improve occupational health surveillance to describe the nature and extent of disparities in occupational illnesses and injuries (including fatalities), identify priorities for research and intervention, and evaluate trends. This report summarizes the data sources and methods discussed at an April 2008 workshop organized by NIOSH on the topic of improving surveillance for occupational health disparities. We discuss the capability of existing occupational health surveillance systems to document occupational health disparities and to provide surveillance data on minority and other underserved communities. Use of administrative data, secondary data analysis, and the development of targeted surveillance systems for occupational health surveillance are also discussed. Identifying and reducing occupational health disparities is one of NIOSH's priority areas under the National Occupational Research Agenda (NORA).