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Gudina AT, Kamen C, Hardy SJ, Kehoe L, Culakova E, Cupertino AP. Revisiting the lung cancer screening eligibility criteria to promote equity for Black individuals. Lung Cancer 2024; 191:107539. [PMID: 38552545 DOI: 10.1016/j.lungcan.2024.107539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Early detection using low-dose computed tomography reduces lung-cancer-specific mortality by 20% among high-risk individuals. Blacks are less likely than Whites to meet lung cancer screening (LCS) criteria under both the former and the updated United States Preventive Services Task Force (USPSTF) guidelines. The purpose of this study was to assess racial disparities in LCS eligibility and to propose tailored eligibility criteria for Blacks to enable equitable screening rate between Whites and Blacks. METHODS Data for this study were obtained from the Behavioral Risk Factor Surveillance System (2017-2021). 101,552 subjects were included in the final analysis. By employing a systematic approach, we sought cut-off points at which Blacks were equally likely as Whites to be eligible for LCS. We evaluated the minimum age and smoking pack-years for Blacks while we retained the 2021 USPSTF criteria for Whites. The final decision was based on the minimum Wald's Chi-square statistics. RESULTS The model we employed identified cut-off points at which Blacks were equally likely as Whites to be eligible for LCS. Retaining the 2021 USPSTF criteria for Whites, the model discovered a new pair of points for Blacks by reducing the minimum age to 43 years and decreasing the cumulative number of cigarettes smoked to 15 pack-years. Based on these cut-off points, we created tailored criteria for Blacks. Under the tailored criteria, Blacks (OR: 1.00; 95 %CI: 0.88-1.14) had the same odds of eligibility for LCS as Whites. The odds of eligibility for LCS by sex under the tailored criteria did not differ significantly for Black men (OR: 1.02; 95 %CI: 0.85-1.24) and Black women (OR: 0.95; 95 %CI: 0.81-1.12) compared to their respective White counterparts. CONCLUSIONS These tailored criteria for Blacks eliminate the disparities between Blacks and Whites in LCS eligibility. Future studies should test the sensitivity and specificity of these tailored criteria.
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Affiliation(s)
- Abdi T Gudina
- Department of Public Health Sciences at the University of Rochester, School of Medicine and Dentistry, NY, United States.
| | - Charles Kamen
- Division of Supportive Care in Cancer in the Department of Surgery at the University of Rochester, School of Medicine and Dentistry and the James P. Wilmot Cancer Institute at the University of Rochester, School of Medicine and Dentistry, NY, United States
| | - Sara J Hardy
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States; Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Lee Kehoe
- Division of Supportive Care in Cancer in the Department of Surgery at the University of Rochester, School of Medicine and Dentistry and the James P. Wilmot Cancer Institute at the University of Rochester, School of Medicine and Dentistry, NY, United States
| | - Eva Culakova
- Division of Supportive Care in Cancer in the Department of Surgery at the University of Rochester, School of Medicine and Dentistry and the James P. Wilmot Cancer Institute at the University of Rochester, School of Medicine and Dentistry, NY, United States
| | - Ana-Paula Cupertino
- Surgical Health Outcomes and Reaching for Equity (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States
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2
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Mayorga NA, Redmond BY, Salwa A, Shepherd JM, Garey L, Asfar T, Zvolensky MJ. Evaluating the role of smoking abstinence expectancies in the relation between perceived ethnic discrimination and cigarette dependence among Latinx individuals who smoke. Addict Behav 2024; 148:107864. [PMID: 37778236 PMCID: PMC11200200 DOI: 10.1016/j.addbeh.2023.107864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
The experience of perceived ethnic discrimination is prevalent and has harmful effects across various behavioral health processes among Latinx persons. Yet, there is limited work on the association between perceived ethnic discrimination and smoking among this health disparities group. Building from initial work that has demonstrated a relationship between perceived ethnic discrimination and smoking abstinence expectancies, the present study sought to explore mechanisms by which perceived ethnic discrimination may be related to cigarette dependence. Specifically, we tested the indirect effect of perceived ethnic discrimination on cigarette dependence through smoking abstinence expectancies (i.e., negative mood, somatic symptoms, harmful consequences, and positive consequences) among Latinx persons who smoke (N = 338; Mage = 35.53 years; SD = 8.65; age range 18-61; 37.3% female). Results indicated that abstinence expectancies related to harmful consequences was a statistically significant underlying factor between the experience of perceived discrimination and cigarette dependence (b = 0.39, SE = 0.16, CI95% = 0.08, 0.71, CSE = 0.14). Overall, the present study suggests that smoking abstinence expectancies pertaining to harmful consequences may be a point of intervention for Latinx persons seeking to reduce or quit smoking. Future research is needed to extend the generalizability of these findings by corroborating the mediational role of abstinence expectancies related to harmful consequences across Latinx persons of varying cigarette use severity levels over time.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, United States
| | | | - Aniqua Salwa
- Department of Psychology, University of Houston, United States
| | | | - Lorra Garey
- Department of Psychology, University of Houston, United States; HEALTH Institute, University of Houston, United States
| | - Taghrid Asfar
- Department of Public Health Science, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, United States; HEALTH Institute, University of Houston, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, United States.
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3
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Rivera MP, Gudina AT, Cartujano-Barrera F, Cupertino P. Disparities Across the Continuum of Lung Cancer Care. Clin Chest Med 2023; 44:531-542. [PMID: 37517833 DOI: 10.1016/j.ccm.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Despite the overall decline in lung cancer incidence and mortality, minority populations continue to bear a higher disease burden. Lung cancer remains the leading cause of cancer-related death in the United States and disproportionately impacts minority populations. Social determinants of health-including low-socioeconomic status, lack of health insurance, and access to health care- disproportionately impact racial, ethnic, and rural populations resulting in direct consequences on lung cancer disparities.
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Affiliation(s)
- M Patricia Rivera
- University of Rochester Medical Center, 601 Elmwood Avenue, Box 692, Rochester, NY 14642, USA.
| | - Abdi T Gudina
- University of Rochester Medical Center, 265 Crittenden Boulevard, Rm 2-223, Rochester, NY 14642, USA
| | | | - Paula Cupertino
- University of Rochester Medical Center, 601 Elmwood Avenue, Box SURG, Rochester, NY 14642, USA
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4
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Maguire FB, Movsisyan AS, Morris CR, Parikh-Patel A, Keegan THM, Tong EK. Evaluation of Cancer Deaths Attributable to Tobacco in California, 2014-2019. JAMA Netw Open 2022; 5:e2246651. [PMID: 36515948 PMCID: PMC9856507 DOI: 10.1001/jamanetworkopen.2022.46651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE California's tobacco control efforts have been associated with a decrease in cancer mortality, but these estimates are based on smoking prevalence of the general population. Patient-level tobacco use information allows for more precise estimates of the proportion of cancer deaths attributable to smoking. OBJECTIVE To calculate the proportion (smoking-attributable fraction) and number (smoking-attributable cancer mortality) of cancer deaths attributable to tobacco use using patient-level data. DESIGN, SETTING, AND PARTICIPANTS The smoking-attributable fraction and smoking-attributable cancer mortality were calculated for a retrospective cohort of patients whose cancer was diagnosed from 2014 to 2019 with at least 1 year of follow-up using relative risks from large US prospective studies and patient-level smoking information. Follow-up continued through April 2022. A population-based cohort was identified from the California Cancer Registry. Participants included adults aged 20 years and older with a diagnosis of 1 of the 12 tobacco-related cancers (oral cavity or pharynx, larynx, esophagus, lung, liver, stomach, pancreas, kidney, bladder, colon or rectum, cervix, and acute myeloid leukemia). EXPOSURES Tobacco use defined as current, former, or never. MAIN OUTCOMES AND MEASURES The primary outcomes were the smoking-attributable fraction and smoking-attributable cancer mortality for each of the 12 tobacco-related cancers over 2 time periods (2014-2016 vs 2017-2019) and by sex. RESULTS Among 395 459 patients with a tobacco-related cancer, most (285 768 patients [72.3%]) were older than 60 years, the majority (228 054 patients [57.7%]) were non-Hispanic White, 229 188 patients were men (58.0%), and nearly one-half (184 415 patients [46.6%]) had lung or colorectal cancers. Nearly one-half of the deaths (93 764 patients [45.8%]) in the cohort were attributable to tobacco. More than one-half (227 660 patients [57.6%]) of patients had ever used tobacco, and 69 103 patients (17.5%) were current tobacco users, which was higher than the proportion in the general population (11.7%). The overall smoking-attributable fraction of cancer deaths decreased significantly from 47.7% (95% CI, 47.3%-48.0%) in 2014 to 2016 to 44.8% (95% CI, 44.5%-45.1%) in 2017 to 2019, and this decrease was seen for both men and women. The overall smoking-attributable cancer mortality decreased by 10.2%. CONCLUSIONS AND RELEVANCE California still has a substantial burden of tobacco use and associated cancer. The proportion of cancer deaths associated with tobacco use was almost double what was previously estimated. There was a modest but significant decline in this proportion for overall tobacco-associated cancers, especially for women.
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Affiliation(s)
- Frances B. Maguire
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento
| | - Ani S. Movsisyan
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento
| | - Cyllene R. Morris
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento
| | - Arti Parikh-Patel
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento
| | - Theresa H. M. Keegan
- California Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, Sacramento
- Center for Oncology Hematology Outcomes Research and Training, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento
| | - Elisa K. Tong
- Department of Internal Medicine, University of California Davis, Sacramento
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5
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Sakuma KLK, Pierce JP, Fagan P, Nguyen-Grozavu FT, Leas EC, Messer K, White MM, Tieu AS, Trinidad DR. Racial/Ethnic Disparities Across Indicators of Cigarette Smoking in the Era of Increased Tobacco Control, 1992-2019. Nicotine Tob Res 2021; 23:909-919. [PMID: 33196799 PMCID: PMC8522466 DOI: 10.1093/ntr/ntaa231] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 11/11/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study compared tobacco use and cessation for African Americans (AA), Asians/Pacific Islanders (API), Hispanics/Latinos (H/L), American Indian/Alaskan Natives (AI/AN), and non-Hispanic Whites (NHW) in the United States to California (CA), the state with the longest continually funded tobacco control program. The purpose of this study was to identify tobacco use disparities across racial/ethnic groups across time. METHODS Cigarette use prevalence (uptake and current use), consumption (mean number of cigarettes smoked per day [CPD]), and quit ratios were calculated across survey years, and trends were examined within each race/ethnic group and comparing between CA and the United States, utilizing the 1992-2019 Tobacco Use Supplements to the Current Population Survey. RESULTS Prevalence decreased for all race/ethnic groups. Current use among CA NHW showed significant decline compared with US counterparts, whereas US H/L showed greater decline than CA counterparts. CPD decreased by approximately 30% across race/ethnic groups, with CA groups having lower numbers. The greatest decrease occurred among AA in CA (average 10.3 CPD [95% confidence interval (CI): 10.3, 12.6] in 1992/1993 to 3 CPD [95% CI: 2.4, 3.7] in 2018/2019). Quit ratios increased from 1992/1993 to 2018/2019 for CA H/L 52.4% (95% CI: 49.8, 53.0) to 59.3 (95% CI: 55.8, 62.5) and CA NHWs 61.5% (95% CI: 60.7, 61.9) to 63.8% (95% CI: 63.9, 66.9). CONCLUSIONS Although overall prevalence decreased over time for each racial/ethnic group, declines in CA outpaced the United States only for NHWs. Reductions in CPD were encouraging but the quit ratio points to the need to increase tobacco control efforts toward cessation. IMPLICATIONS The successes in reduced cigarette use uptake and prevalence across time for both California and the rest of the United States were observed largely among non-Hispanic White populations. Although reductions in the number of cigarettes smoked per day are a notable success, particularly among the Californian African Americans, efforts to support quitting across racial/ethnic groups, especially marginalized groups, need to be prioritized.
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Affiliation(s)
- Kari-Lyn K Sakuma
- Health Promotion and Health Behavior Program, School of Social and
Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State
University, Corvallis, OR
| | - John P Pierce
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Pebbles Fagan
- Fay W. Boozman College of Public Health, University of Arkansas for
Medical Sciences, Little Rock, AR
| | - France T Nguyen-Grozavu
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Eric C Leas
- Division of Health Policy, Department of Family Medicine and Public
Health, University of California San Diego, La Jolla,
CA
| | - Karen Messer
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Martha M White
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Amanda S Tieu
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, Moores Cancer
Center, University of California San Diego, La Jolla,
CA
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6
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Potter LN, Lam CY, Cinciripini PM, Wetter DW. Intersectionality and Smoking Cessation: Exploring Various Approaches for Understanding Health Inequities. Nicotine Tob Res 2021; 23:115-123. [PMID: 32208484 PMCID: PMC7789945 DOI: 10.1093/ntr/ntaa052] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/20/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Many marginalized groups smoke at higher rates and have greater difficulty quitting than less marginalized groups. Most research on smoking cessation inequities has focused on a single sociodemographic attribute (eg, race or socioeconomic status), yet individuals possess multiple attributes that may increase risk. The current study used an intersectionality framework to examine how the interplay between multiple marginalized attributes may impact smoking cessation outcomes. METHODS A diverse sample of 344 adults enrolled in a smoking cessation program and reported on sociodemographic attributes (eg, race/ethnicity, gender, income) and continuous smoking abstinence on their quit date and at 1, 2, and 4 weeks postquit date. A Cox proportional hazard regression model was used to estimate whether intersectional links among race/ethnicity, gender, and income were related to smoking cessation outcomes. RESULTS Lower household income may be related to higher risk of smoking cessation failure. There were no significant interactions among race/ethnicity, gender, and income in predicting relapse. Pairwise intersectional group differences suggested some groups may be at higher risk of relapse. Number of marginalized sociodemographic attributes did not predict relapse. CONCLUSIONS Intersectionality may be a promising framework for addressing health inequities, and may help elucidate how to best design and target intervention efforts for individuals characterized by sociodemographic intersections that concur particularly high risk for poor tobacco cessation outcomes. IMPLICATIONS Despite an overall decline in smoking rates, socioeconomic inequities in smoking prevalence and cancer mortality are widening. Efforts targeting tobacco cessation should incorporate new theory to capture the complex set of factors that may account for tobacco cessation inequities (eg, multiple aspects of identity that may influence access to tobacco cessation treatment and exposure to certain stressors that impede cessation efforts). Intersectionality may be a promising framework for addressing health inequities in tobacco use and cessation and may help elucidate how to best design and target intervention efforts for individuals that concur particularly high risk for poor tobacco cessation outcomes.
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Affiliation(s)
- Lindsey N Potter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Cho Y Lam
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
| | - Paul M Cinciripini
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center, Houston, TX
| | - David W Wetter
- Center for Health Outcomes and Population Equity (HOPE), Huntsman Cancer Institute and Department of Population Health Sciences, University of Utah, Salt Lake City, UT
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7
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Levy D, Zavala-Arciniega L, Reynales-Shigematsu LM, Fleischer NL, Yuan Z, Li Y, Romero LMS, Lau YK, Meza R, Thrasher JF. Measuring Smoking Prevalence in a Middle Income Nation: An Examination of the 100 Cigarettes Lifetime Screen. GLOBAL EPIDEMIOLOGY 2019; 1. [PMID: 33907731 DOI: 10.1016/j.gloepi.2019.100016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Introduction Public health surveillance of smoking prevalence is essential in gauging the magnitude of the problem, identifying groups most affected, and evaluating polices. However, little attention has focused on how prevalence is measured, particularly in low-and middle-income countries, where smoking patterns may not mirror those in high-income countries and where the burden of tobacco use is rapidly growing. Mexico provides a unique opportunity to gauge how the questions used to define established smokers can affect prevalence estimates. This study assesses how using the 100-cigarette lifetime question to define smoking status affects estimates of smoking prevalence. Methods We consider data from four nationally representative surveys in Mexico, from 2002 to 2016. These surveys ask about current smoking even for adults who do not indicate having smoked 100 cigarettes in their lifetime. We compare estimates of daily and nondaily smoking prevalence by age and gender with and without the 100-cigarette screen. Results The relative difference in prevalence estimates with and without the screen was greater for nondaily than daily smoking and for females than males. The difference was especially pronounced for nondaily smokers aged 15-24, where there was a 50%-75% relative difference in estimates, albeit smaller discrepancies (20-49% relative difference) were also found among older smokers. In recent years, the relative difference was greatest at lower levels of educational attainment. Conclusions With the growth in nondaily smoking, using the 100-cigarettes screen to define smoking status can have important implications regarding size of smoking population. Further research is warranted in other countries.
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Affiliation(s)
- David Levy
- Lombardi Comprehensive Cancer Center Georgetown University
| | - Luis Zavala-Arciniega
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center Georgetown University
| | - Yameng Li
- Lombardi Comprehensive Cancer Center Georgetown University
| | | | - Yan Kwan Lau
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico.,Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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8
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Barrington-Trimis JL, Bello MS, Liu F, Leventhal AM, Kong G, Mayer M, Cruz TB, Krishnan-Sarin S, McConnell R. Ethnic Differences in Patterns of Cigarette and E-Cigarette Use Over Time Among Adolescents. J Adolesc Health 2019; 65:359-365. [PMID: 31248804 PMCID: PMC6708763 DOI: 10.1016/j.jadohealth.2019.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE Little is known about whether adolescent cigarette and e-cigarette use patterns over time differ by ethnicity. METHODS Data were pooled from three prospective cohort studies of adolescents in California and Connecticut (baseline: 2013-2014; 12-month follow-up: 2014-2015; N = 6,258). Adjusted polytomous regression models evaluated the association of baseline exclusive ever e-cigarette use, exclusive ever cigarette use, ever use of both e-cigarettes and cigarettes (dual use) with past 30-day use at follow-up (exclusively e-cigarettes, exclusively cigarettes, dual use; no use at baseline/follow-up were the referent groups). Interaction analyses evaluated differences by race/ethnicity (Hispanic white [HW], non-Hispanic white [NHW], Other). RESULTS A significant global interaction was observed for the association of baseline with follow-up tobacco use by ethnicity (p = .009). Among NHW participants, ever e-cigarette or cigarette users at baseline (vs. never users) had significantly higher odds of every past 30-day use tobacco use pattern at follow-up. Among HW participants, compared with never users, exclusive e-cigarette users at baseline had increased odds of continued e-cigarette use (ORexclusive e-cigarettes = 5.22; 95% confidence interval [CI]: 3.50, 7.79; ORdual use = 3.64; 95% CI: 1.62, 8.18) but not of transition to exclusive cigarette use at follow-up (ORexclusive cigarettes = 1.27; 95% CI: .47, 3.46), and HW exclusive cigarette users at baseline had greater odds of continued cigarette use (ORexclusive e-cigarettes = 12.3; 95% CI: 5.87, 25.8; ORdual use = 3.82; 95% CI: 1.06, 13.7) but not of transition to exclusive e-cigarette use at follow-up (ORexclusive cigarettes = 1.61; 95% CI: .62, 4.18). CONCLUSIONS Findings that NHW youth report more transitional use patterns and HW youth report more stable use patterns suggest a potential for differential impacts of e-cigarettes, by ethnicity, in increasing subsequent transition to or cessation from cigarette smoking.
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Affiliation(s)
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, California
| | - Fei Liu
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, California; Department of Psychology, University of Southern California, Los Angeles, California
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Margaret Mayer
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Tess Boley Cruz
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | | | - Rob McConnell
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
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9
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St Helen G, Benowitz NL, Ahluwalia JS, Tyndale RF, Addo N, Gregorich SE, Pérez-Stable EJ, Cox LS. Black Light Smokers: How Nicotine Intake and Carcinogen Exposure Differ Across Various Biobehavioral Factors. J Natl Med Assoc 2019; 111:509-520. [PMID: 31084916 DOI: 10.1016/j.jnma.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/07/2019] [Accepted: 04/11/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The study objective was to identify biobehavioral variables associated with greater intake of nicotine and a tobacco carcinogen among Black light smokers who smoke 1 to 10 cigarettes per day (CPD). METHODS We analyzed baseline data collected from 426 Black light smokers enrolled in Kick It at Swope III (KIS III), a smoking cessation trial for Black smokers. We examined differences in concentrations of tobacco biomarkers, including urinary total nicotine equivalents (TNE) and total 4-(methylnitrosamino)-1-(3)pyridyl-1-butanonol (NNAL; a human carcinogen), across gender, age, plasma nicotine metabolite ratio (NMR), CPD, and measures of tobacco dependence, including time to first cigarette (TFC), using ANOVA. RESULTS Tobacco biomarker levels were significantly higher among those who smoked more CPD (6-10 vs 1-5 CPD) and those with greater reported physical dependence on tobacco. Concurrently, those who smoked 1-5 CPD smoked each cigarette more intensely than those who smoked 6-10 CPD. While we found no gender differences overall, among those who smoked 1-5 CPD, women had higher NNAL levels compared to men. The rate of nicotine metabolism, measured by the nicotine metabolite ratio, was not significantly related to TNE or NNAL levels. CONCLUSION Among Black Light smokers, higher cigarette consumption and greater physical dependence-but not rate of nicotine metabolism, menthol use, or socioeconomic status-were associated with greater toxicant exposure and thus a likely increased risk of tobacco-related diseases. The lack of data on light smokers, and specifically on Blacks, make this observation important given the disproportionate burden of lung cancer in this population.
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Affiliation(s)
- Gideon St Helen
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA; Center for Tobacco Control Research and Education (CTCRE), University of California, San Francisco, CA, USA.
| | - Neal L Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA; Center for Tobacco Control Research and Education (CTCRE), University of California, San Francisco, CA, USA; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Jasjit S Ahluwalia
- Departments of Behavioral and Social Sciences and Medicine, Brown University School of Public Health and Alpert School of Medicine, Providence, RI, USA
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute and Addictions Division, Centre for Addiction and Mental Health (CAMH), Department of Pharmacology and Toxicology, Department of Psychiatry, University of Toronto, ON, Canada
| | - Newton Addo
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute and Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, MD, USA
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
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10
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Swayampakala K, Thrasher JF, Hardin JW, Titus AR, Liu J, Fong GT, Fleischer NL. Factors associated with changing cigarette consumption patterns among low-intensity smokers: Longitudinal findings across four waves (2008-2012) of ITC Mexico Survey. Addict Behav Rep 2018; 8:154-163. [PMID: 30364679 PMCID: PMC6197769 DOI: 10.1016/j.abrep.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background Light and intermittent smoking has become increasingly prevalent as smokers shift to lower consumption in response to tobacco control policies. We examined changes in cigarette consumption patterns over a four-year period and determined which factors were associated with smoking transitions. Methods We used data from a cohort of smokers from the 2008–2012 ITC Mexico Survey administrations to investigate transitions from non-daily (ND; n = 669), daily light (DL; ≤5 cigarettes per day (cpd); n = 643), and daily heavy (DH; >5 cpd; n = 761) smoking patterns. To identify which factors (i.e., sociodemographic measures, perceived addiction, quit behavior, social norms) were associated with smoking transitions, we stratified on smoking status at time t (ND, DL, DH) and used multinomial (ND, DL) and binomial (DH) logistic regression to examine transitions (quitting/reducing or increasing versus same level for ND and DL, quitting/reducing versus same level for DH). Results ND smokers were more likely to quit at follow-up than DL or DH smokers. DH smokers who reduced their consumption to ND were more likely to quit eventually compared to those who continued as DH. Smokers who perceived themselves as addicted had lower odds of quitting/reducing smoking consumption at follow-up compared to smokers who did not, regardless of smoking status at the prior survey. Quit attempts and quit intentions were also associated with quitting/reducing consumption. Conclusions Reducing consumption may eventually lead to cessation, even for heavier smokers. The findings that perceived addiction and quit behavior were important predictors of changing consumption for all groups may offer insights into potential interventions. Smoking transitions were evaluated in a cohort of Mexican smokers. The cohort consisted mostly of understudied light and intermittent smokers (LITS). Reductions in smoking intensity were found to facilitate smoking cessation. Greater perceived addiction inhibited cessation for smokers at all levels of intensity. LITS patterns warrant attention as number of low-intensity smokers worldwide grows.
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Affiliation(s)
- Kamala Swayampakala
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Andrea R. Titus
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Nancy L. Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Corresponding author at: Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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11
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Liautaud MM, Leventhal AM, Pang RD. Happiness as a Buffer of the Association Between Dependence and Acute Tobacco Abstinence Effects in African American Smokers. Nicotine Tob Res 2018; 20:1215-1222. [PMID: 29059368 PMCID: PMC6121915 DOI: 10.1093/ntr/ntx216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/25/2017] [Indexed: 11/14/2022]
Abstract
Introduction African American (AA) smokers are at disproportionate risk of tobacco dependence, utilizing smoking to regulate stress, and poor cessation outcomes. Positive emotional traits may function as coping factors that buffer the extent to which dependence increases vulnerability to adverse responses to acute tobacco abstinence (ie, tobacco withdrawal). This laboratory study examined subjective happiness (SH; dispositional orientation towards frequent and intense positive affect [PA] and life satisfaction) as a moderator of the relation between tobacco dependence and subjective and behavioral abstinence effects among AA smokers. Methods AA smokers (N = 420, 39.0% female) completed self-report measures of tobacco dependence and SH followed by two counterbalanced experimental sessions (nonabstinent vs. 16-hour abstinent) involving self-report measures of composite withdrawal, urge to smoke, and mood, and a behavioral smoking task in which participants could: (1) earn money to delay smoking reinstatement, and (2) subsequently purchase cigarettes to smoke. Results Tobacco dependence was positively associated with increased abstinence effects in composite withdrawal, urge to smoke, PA, and latency to smoking reinstatement (ps < .04). SH significantly moderated the relation between dependence and abstinence-induced increases in composite withdrawal (β = -.17, p < .001), such that the predictive power of dependence on withdrawal severity grew proportionately weaker as levels of SH increased. Conclusions SH may insulate against adverse effects of dependence on withdrawal during acute smoking abstinence, particularly withdrawal symptom clusters that are craving- and mood-based. Consideration of positive emotional traits as stress-coping factors in the dependence-withdrawal link may be warranted in research and practice with AA smokers. Implications The current study contributes to a growing body of literature examining the potentially advantageous role of positive emotional traits to smokers. We do so by identifying a relatively understudied psychological construct within tobacco research-subjective happiness-that may suppress the extent to which more severe tobacco dependence increases risk for subjective withdrawal-related distress during acute smoking abstinence in AA smokers. In doing so, the study provides a primer for future targeting of subjective happiness and other positive emotional traits as means to understand and treat acute tobacco abstinence effects among dependent AA smokers.
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Affiliation(s)
- Madalyn M Liautaud
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
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12
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Geller AC, Borrelli B, Davine JA, Burtner J, Heeren TC, Rees VW, Adegoke A, Brooks DR. Factors Associated with Recent Use of Nicotine Replacement Therapy Among Multiethnic Smokers Residing in Public Housing. J Smok Cessat 2018; 13:162-170. [PMID: 38911966 PMCID: PMC11193361 DOI: 10.1017/jsc.2017.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction Understanding factors associated with increased use of nicotine replacement therapy (NRT) is critical to implementing cessation interventions for low-income individuals yet the factors associated with NRT use among low-income smokers are poorly understood. Aims Assess factors associated with NRT use among low-income public housing residents. Methods 'Kick it for Good' was a randomised smoking cessation intervention study conducted among residents of public housing sites in Boston, MA. Secondary, cross-sectional analyses were conducted on smokers from a community-based intervention cessation intervention who reported making a quit attempt and use of NRT in the past 12 months (n = 234). Results Among smokers who made a quit attempt in the past year, 29% reported using NRT. Black (prevalence ratio,PR = 0.52, 95% CI: 0.38-0.71) and Hispanic (PR = 0.52, 95% CI: 0.31-0.88) participants were less likely to report use of NRT compared with Whites. The prevalence of recent NRT use was greatest among those both asking for and receiving provider advice (PR = 1.90, 95% CI: 0.96-3.78). Conclusions Minority race and ethnicity and low provider engagement on NRT use were associated with lower NRT use. Providing barrier-free access to NRT and facilitating provider engagement with smokers regarding NRT use can increase NRT use among low-income populations.
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Affiliation(s)
- Alan C. Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Belinda Borrelli
- Boston University Graduate School of Dental Medicine, Boston, Massachusetts
| | - Jessica A. Davine
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Joanna Burtner
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Timothy C. Heeren
- Departments of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Vaughan W. Rees
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Abdulkabir Adegoke
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Daniel R. Brooks
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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13
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Pulvers K, Cupertino AP, Scheuermann TS, Sanderson Cox L, Ho YY, Nollen NL, Cuellar R, Ahluwalia JS. Daily and Nondaily Smoking Varies by Acculturation among English-Speaking, US Latino Men and Women. Ethn Dis 2018; 28:105-114. [PMID: 29725195 DOI: 10.18865/ed.28.2.105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Higher smoking prevalence and quantity (cigarettes per day) has been linked to acculturation in the United States among Latinas, but not Latino men. Our study examines variation between a different and increasingly important target behavior, smoking level (nondaily vs daily) and acculturation by sex. Methods An online English-language survey was administered to 786 Latino smokers during July through August 2012. The Brief Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) and other acculturation markers were used. Multinomial logistic regression models were implemented to assess the association between smoking levels (nondaily, light daily, and moderate/heavy daily) with acculturation markers. Results Greater ARMSA-II scores (relative risk ratio, RRR=.81, 95% CI: .72-.91) and being born inside the United States (RRR=.42, 95% CI: .24-.74) were associated with lower relative risk of nondaily smoking. Greater Latino orientation (RRR=1.29, 95% CI: 1.11-1.48) and preference for Spanish language (RRR=1.06, 95% CI: 1.02-1.10) and media (RRR=1.12, 95% CI: 1.05-1.20) were associated with higher relative risk of nondaily smoking. The relationship between acculturation and smoking level did not differ by sex. Conclusion This study found that among both male and female, English-speaking Latino smokers, nondaily smoking was associated with lower acculturation, while daily smoking was linked with higher acculturation.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - A Paula Cupertino
- Center for Cancer Disparities, Hackensack Meridian Health, Hackensack, NJ
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Yen-Yi Ho
- Department of Statistics, University of South Carolina, Columbia, SC
| | - Nicole L Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Ruby Cuellar
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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14
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Bello MS, Pang RD, Chasson GS, Ray LA, Leventhal AM. Obsessive-compulsive symptoms and negative affect during tobacco withdrawal in a non-clinical sample of African American smokers. J Anxiety Disord 2017; 48:78-86. [PMID: 27769664 PMCID: PMC5380588 DOI: 10.1016/j.janxdis.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
The association between obsessive-compulsive (OC) symptomatology and smoking is poorly understood, particularly in African Americans-a group subject to smoking- and OC-related health disparities. In a non-clinical sample of 253 African American smokers, we tested the negative reinforcement model of OC-smoking comorbidity, purporting that smokers with higher OC symptoms experience greater negative affect (NA) and urge to smoke for NA suppression upon acute tobacco abstinence. Following a baseline visit involving OC assessment, participants completed two counterbalanced experimental visits (non-abstinent vs. 16-h tobacco abstinence) involving affect, smoking urge, and nicotine withdrawal assessment. OC symptom severity predicted larger abstinence-provoked increases in overall NA, anger, anxiety, depression, fatigue, urge to smoke to suppress NA, and composite nicotine withdrawal symptom index. African American smokers with elevated OC symptoms appear to be vulnerable to negative reinforcement-mediated smoking motivation and may benefit from cessation treatments that diminish NA or the urge to quell NA via smoking.
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Affiliation(s)
- Mariel S Bello
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
| | - Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Gregory S Chasson
- Illinois Institute of Technology, Department of Psychology, Chicago, IL, USA
| | - Lara A Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California, Department of Psychology, Los Angeles, CA, USA; University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.
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15
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Reyes-Guzman CM, Pfeiffer RM, Lubin J, Freedman ND, Cleary SD, Levine PH, Caporaso NE. Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys. Cancer Epidemiol Biomarkers Prev 2017; 26:228-239. [PMID: 27760782 PMCID: PMC5296280 DOI: 10.1158/1055-9965.epi-16-0028] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Light and/or intermittent smokers have been the fastest growing segment of cigarette smokers in the United States over the past two decades. Defining their behavioral characteristics is a critical public health priority. METHODS Our sample included 78,229 U.S. adults from three pooled contemporary population-based surveys: the 2012 NHIS, 2012 NSDUH, and 2011-2012 NHANES. We classified current smokers into four categories (light and intermittent [LITS], light-daily, heavier-intermittent, and heavier-daily) and assessed smoking behaviors, illicit drug use, and mental health indicators using weighted analyses. RESULTS Analyses associated smoking categories with nicotine dependence, age of smoking initiation, race/ethnicity, and other demographic and behavioral factors. Compared with heavier-daily smokers, smokers who were LITS were most likely to have mild or no nicotine dependence (weighted odds ratio [OR], 16.92; 95% confidence interval [CI], 13.10-21.85), to start smoking cigarettes regularly after age 21 (OR, 3.42; 95% CI, 2.84-4.12), and to be Hispanic (OR, 5.38; 95% CI, 4.38-6.61). Additional significant results were found for other categories of smokers. CONCLUSIONS Based on pooled data from three large national surveys, light and/or intermittent smokers differed in smoking, drug use, and mental health behaviors from heavier-daily, former, and never smokers. Notable differences by level of smoking frequency and intensity were observed for nicotine dependence, age of smoking initiation, and race/ethnicity. IMPACT Our results may help focus preventive measures and policies for the growing number of light and/or intermittent smokers in the United States because smoking patterns vary by behavioral and socioeconomic factors. Cancer Epidemiol Biomarkers Prev; 26(2); 228-39. ©2016 AACR.
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Affiliation(s)
- Carolyn M Reyes-Guzman
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland.
- Department of Epidemiology and Biostatistics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Jay Lubin
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Sean D Cleary
- Department of Epidemiology and Biostatistics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia
| | - Paul H Levine
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, Nebraska Medical Center, Omaha, Nebraska
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
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16
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Sakuma KLK, Felicitas-Perkins JQ, Blanco L, Fagan P, Pérez-Stable EJ, Pulvers K, Romero D, Trinidad DR. Tobacco use disparities by racial/ethnic groups: California compared to the United States. Prev Med 2016; 91:224-232. [PMID: 27575315 PMCID: PMC5554114 DOI: 10.1016/j.ypmed.2016.08.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/01/2016] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
Abstract
Racial/ethnic disparities in cigarette use and cessation persist. This study compared cigarette consumption and former smoking trends in California (CA) with the rest of the United States (US) by racial/ethnic categories of non-Hispanic White, Black, Hispanic/Latino, and Asian/Pacific Islander groups. Data were analyzed from the 1992 to 2011 Tobacco Use Supplement to the Current Population Survey. Consumption levels across decades were examined and adjusted logistic regression models were fit to compare across CA and US. Results indicated steady declines in ever smoking prevalence for all groups with much lower magnitudes of change among US Blacks and Whites compared to their CA counterparts. After controlling for age, gender, and education, CA had significantly fewer heavy smokers (OR=0.45, 95% CI:0.38-0.54), more light and intermittent smokers (LITS; OR=1.68, 95%CI: 1.45-1.93), and a greater proportion of former smokers (OR=1.35, 95%CI: 1.24-1.48) than the rest of US. Data were stratified by race/ethnicity and the patterns shown were mostly consistent with CA performing statistically better than their US counterparts with the exception of Black LITS and Asian/Pacific Islander former smokers. California's success in reducing tobacco use disparities may serve as a prime example of tobacco control policy for the country. CA and the US will need to continue to address tobacco use and cessation in the context of the growing diversity of the population.
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Affiliation(s)
- Kari-Lyn K Sakuma
- Oregon State University, College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Corvallis, OR, United States.
| | | | - Lyzette Blanco
- Claremont Graduate University, School of Community and Global Health, Claremont, CA, United States
| | - Pebbles Fagan
- University of Hawaii, Cancer Center, Honolulu, HI, United States
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, United States
| | - Kim Pulvers
- California State University San Marcos, San Marcos, CA, United States
| | - Devan Romero
- California State University San Marcos, San Marcos, CA, United States
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17
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O'Rourke KY, Touchette JC, Hartell EC, Bade EJ, Lee AM. Voluntary co-consumption of alcohol and nicotine: Effects of abstinence, intermittency, and withdrawal in mice. Neuropharmacology 2016; 109:236-246. [PMID: 27342124 DOI: 10.1016/j.neuropharm.2016.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 06/16/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022]
Abstract
Alcohol and nicotine are often used together, and there is a high rate of co-occurrence between alcohol and nicotine addiction. Most animal models studying alcohol and nicotine interactions have utilized passive drug administration, which may not be relevant to human co-addiction. In addition, the interactions between alcohol and nicotine in female animals have been understudied, as most studies have used male animals. To address these issues, we developed models of alcohol and nicotine co-consumption in male and female mice that utilized voluntary, oral consumption of unsweetened alcohol, nicotine and water. We first examined drug consumption and preference in single-drug, sequential alcohol and nicotine consumption tests in male and female C57BL/6 and DBA/2J mice. We then tested chronic continuous and intermittent access alcohol and nicotine co-consumption procedures. We found that male and female C57BL/6 mice readily co-consumed unsweetened alcohol and nicotine. In our continuous co-consumption procedures, we found that varying the available nicotine concentration during an alcohol abstinence period affected compensatory nicotine consumption during alcohol abstinence, and affected rebound alcohol consumption when alcohol was re-introduced. Consumption of alcohol and nicotine in an intermittent co-consumption procedure produced higher alcohol consumption levels, but not nicotine consumption levels, compared with the continuous co-consumption procedures. Finally, we found that intermittent alcohol and nicotine co-consumption resulted in physical dependence. Our data show that these voluntary co-consumption procedures can be easily performed in mice and can be used to study behavioral interactions between alcohol and nicotine consumption, which may better model human alcohol and nicotine co-addiction.
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Affiliation(s)
- Kyu Y O'Rourke
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA
| | | | - Elizabeth C Hartell
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Elizabeth J Bade
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Anna M Lee
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA.
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18
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Plantinga L, Gander JC. Intermittent smoking and chronic kidney disease. Nephrol Dial Transplant 2016; 31:1558-60. [PMID: 27235423 DOI: 10.1093/ndt/gfw207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/29/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Laura Plantinga
- Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, GA, USA Division of Geriatrics and General Medicine, Department of Medicine, Emory University, Atlanta, GA, USA Department of Epidemiology, Emory University, Atlanta, GA, USA
| | - Jennifer C Gander
- Division of Transplantation, Department of Surgery, Emory University, Atlanta, GA, USA
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19
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Sakuma KLK, Felicitas J, Fagan P, Gruder CL, Blanco L, Cappelli C, Trinidad DR. Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California. Nicotine Tob Res 2015; 17:1491-8. [PMID: 25666813 PMCID: PMC5967264 DOI: 10.1093/ntr/ntv032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/26/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. METHODS Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. RESULTS A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. DISCUSSION Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.
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Affiliation(s)
- Kari-Lyn Kobayakawa Sakuma
- College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR;
| | - Jamie Felicitas
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | | | | | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Christopher Cappelli
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Dennis R Trinidad
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
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20
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Bello MS, Pang RD, Cropsey KL, Zvolensky MJ, Reitzel LR, Huh J, Leventhal AM. Tobacco Withdrawal Amongst African American, Hispanic, and White Smokers. Nicotine Tob Res 2015; 18:1479-87. [PMID: 26482061 DOI: 10.1093/ntr/ntv231] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/01/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Persistent tobacco use among racial and ethnic minority populations in the United States is a critical public health concern. Yet, potential sources of racial/ethnic disparities in tobacco use remain unclear. The present study examined racial/ethnic differences in tobacco withdrawal-a clinically-relevant underpinning of tobacco use that has received sparse attention in the disparities literature-utilizing a controlled laboratory design. METHODS Daily smokers (non-Hispanic African American [n = 178], non-Hispanic white [n = 118], and Hispanic [n = 28]) attended two counterbalanced sessions (non-abstinent vs. 16-hour abstinent). At both sessions, self-report measures of urge, nicotine withdrawal, and affect were administered and performance on an objective behavioral task that assessed motivation to reinstate smoking was recorded. Abstinence-induced changes (abstinent scores vs. non-abstinent scores) were analyzed as a function of race/ethnicity. RESULTS Non-Hispanic African American smokers reported greater abstinence-induced declines in several positive affect states in comparison to other racial/ethnic groups. Relative to Hispanic smokers, non-Hispanic African American and non-Hispanic white smokers displayed larger abstinence-provoked increases in urges to smoke. No racial/ethnic differences were detected for a composite measure of nicotine withdrawal symptomatology, negative affect states, and motivation to reinstate smoking behavior. CONCLUSIONS These results suggest qualitative differences in the expression of some components of tobacco withdrawal across three racial/ethnic groups. This research helps shed light on bio-behavioral sources of tobacco-related health disparities, informs the application of smoking cessation interventions across racial/ethnic groups, and may ultimately aid the overall effort towards reducing the public health burden of tobacco addiction in minority populations. IMPLICATIONS The current study provides some initial evidence that there may be qualitative differences in the types of tobacco withdrawal symptoms experienced among non-Hispanic African American, Hispanic, and non-Hispanic white smokers. Extending this line of inquiry may elucidate mechanisms involved in tobacco-related health disparities and ultimately aid in reducing the public health burden of smoking in racial/ethnic minority populations.
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Affiliation(s)
- Mariel S Bello
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Karen L Cropsey
- Department of Psychiatry, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | | | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA; Department of Psychology, University of Southern California, Los Angeles, CA;
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