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Kratzer TB, Bandi P, Freedman ND, Smith RA, Travis WD, Jemal A, Siegel RL. Lung cancer statistics, 2023. Cancer 2024; 130:1330-1348. [PMID: 38279776 DOI: 10.1002/cncr.35128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 01/28/2024]
Abstract
Despite decades of declining mortality rates, lung cancer remains the leading cause of cancer death in the United States. This article examines lung cancer incidence, stage at diagnosis, survival, and mortality using population-based data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Over the past 5 years, declines in lung cancer mortality became considerably greater than declines in incidence among men (5.0% vs. 2.6% annually) and women (4.3% vs. 1.1% annually), reflecting absolute gains in 2-year relative survival of 1.4% annually. Improved outcomes likely reflect advances in treatment, increased access to care through the Patient Protection and Affordable Care Act, and earlier stage diagnosis; for example, compared with a 4.6% annual decrease for distant-stage disease incidence during 2013-2019, the rate for localized-stage disease rose by 3.6% annually. Localized disease incidence increased more steeply in states with the highest lung cancer screening prevalence (by 3%-5% annually) than in those with the lowest (by 1%-2% annually). Despite progress, disparities remain. For example, Native Americans have the highest incidence and the slowest decline (less than 1% annually among men and stagnant rates among women) of any group. In addition, mortality rates in Mississippi and Kentucky are two to three times higher than in most western states, largely because of elevated historic smoking prevalence that remains. Racial and geographic inequalities highlight longstanding opportunities for more concerted tobacco-control efforts targeted at high-risk populations, including improved access to smoking-cessation treatments and lung cancer screening, as well as state-of-the-art treatment.
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Affiliation(s)
- Tyler B Kratzer
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Priti Bandi
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Neal D Freedman
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert A Smith
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - William D Travis
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
| | - Rebecca L Siegel
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia, USA
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Wang R, LeLaurin J, Carrier A, Churba B, Karanth S, Yoon HS, Braithwaite D, Salloum RG, Hong YR. Trends and factors associated with secondhand smoke exposure among US cancer survivors, 2013-2020. Cancer 2023; 129:3053-3063. [PMID: 37254857 DOI: 10.1002/cncr.34891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Secondhand smoke (SHS) poses a significant public health threat. Cancer survivors are at a greater risk of adverse health outcomes from SHS because of its association with poor prognosis and other downstream clinical events. METHODS A nationally representative sample of US adults aged 20 years and older was analyzed from the National Health and Nutrition Examination Survey between 2013 and 2020. Data on indoor SHS exposure were reported by 16,778 adults who were not currently smoking (1775 cancer survivors; 15,003 individuals without a cancer history). The weighted prevalence of SHS exposure was estimated and compared across sociodemographic and health-related characteristics. Multivariable logistic regression models were fitted to identify correlates of SHS exposure. RESULTS Of the 1775 nonsmoking cancer survivors (mean age, 64.9 years; 57.0% female; 84.4% non-Hispanic Whites), 15.8% reported SHS exposure. No significant change in trends of SHS exposure was observed during the study period. The prevalence of SHS exposure was higher in cancer survivors who were younger, racial minorities, and had a household income below 130% of the federal poverty level. After adjustment for multiple correlates, age below 40 years, low income, smoking history, and diagnosis within 2 years were associated with SHS exposure. Cancer survivors were most likely to report that SHS exposure occurred at home or in a car. CONCLUSIONS The prevalence of SHS exposure among cancer survivors remained steady in the past decade. However, disparities exist in SHS exposure among cancer survivors across sociodemographic characteristics and smoking status. Smoking cessation programs should be promoted among caregivers and families of cancer survivors.
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Affiliation(s)
- Ruixuan Wang
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Jennifer LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Allison Carrier
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Benjamin Churba
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Shama Karanth
- Department of Epidemiology and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Hyung-Suk Yoon
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Dejana Braithwaite
- Department of Epidemiology and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Department of Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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Gutierrez JA, Hirth JM, Zoorob R, Levine RS. Racial, ethnic and gender trends in lung cancer mortality rates in the United States-Mexico border and non-border areas. Prev Med 2023; 175:107686. [PMID: 37648086 DOI: 10.1016/j.ypmed.2023.107686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Geographic patterns of lung cancer mortality rate differ in the region bordering Mexico in contrast to the US. This study compares lung cancer mortality between border and non-border counties by race/ethnicity and gender. METHODS This study utilized population-level death certificate data from US Centers for Disease Control and Prevention Public Internet Wide-Ranging Online Data for Epidemiologic Research dataset between 1999 and 2020. Established algorithms were implemented to examine lung cancer deaths among US residents. We analyzed the age-adjusted data by year, race/ethnicity, gender, and geographic region. Joinpoint regression was used to determine mortality trends across time. RESULTS Lung cancer mortality rates were lower in border counties compared to non-border counties across time (p < 0.05). Hispanic lung cancer mortality rates were not different in border counties compared to non-border counties during the same period (p > 0.05). Lung cancer mortality among non-Hispanic White living in border counties was lower than non-Hispanic White residing in non-border counties (p < 0.01), and non-Hispanic Black living in border counties had lower lung cancer mortality than non-Hispanic Black in non-border counties in all but three years (p < 0.05). Both female and male mortality rates were lower in border counties compared to non-border counties (p < 0.05). CONCLUSION Differences in lung cancer mortality between border counties and non-border counties reflect lower mortality in Hispanics overall and a decline for non-Hispanic White and non-Hispanic Black living in border counties experiencing lower lung cancer mortality rates than non-border counties. Further studies are needed to identify specific causes for lower mortality rates in border counties.
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Affiliation(s)
- Judith A Gutierrez
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA.
| | - Jacqueline M Hirth
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
| | - Roger Zoorob
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
| | - Robert S Levine
- Baylor College of Medicine, Family and Community Medicine Department, 3701 Kirby Drive, Suite 600, Houston, TX 77098, USA
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Meza R, Cao P, Jeon J, Fleischer NL, Holford TR, Levy DT, Tam J. Patterns of Birth Cohort‒Specific Smoking Histories by Race and Ethnicity in the U.S. Am J Prev Med 2023; 64:S11-S21. [PMID: 36653232 PMCID: PMC10362802 DOI: 10.1016/j.amepre.2022.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/08/2022] [Accepted: 06/29/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION U.S. smoking prevalence varies greatly by race/ethnicity. However, little is known about how smoking initiation, cessation, and intensity vary by birth cohort and race/ethnicity. METHODS Adult smoking data were obtained from the 1978-2018 National Health Interview Surveys. Age‒period‒cohort models with constrained natural splines were developed to estimate historical smoking patterns among non-Hispanic White, non-Hispanic Black, Hispanic, non-Hispanic Asian and Pacific Islander, and non-Hispanic American Indian and Alaskan Native individuals. Annual smoking prevalence and probabilities of smoking initiation, cessation, and intensity by age, year, gender, and race/ethnicity were estimated for the 1900 to 2000 birth cohorts. Analysis was conducted in 2020-2021. RESULTS Smoking initiation probabilities were highest for the American Indian and Alaskan Native population, second highest among the non-Hispanic White population, and lowest among Asian and Pacific Islander and Hispanic populations across birth cohorts. Historically, initiation probabilities among non-Hispanic Black populations were comparable with those among non-Hispanic White populations but have decreased since the 1970 birth cohort. Cessation probabilities were lowest among American Indian and Alaskan Native and non-Hispanic Black populations and highest among non-Hispanic White and Asian and Pacific Islander populations across cohorts and ages. Initiation and cessation probabilities produce observed patterns of smoking where prevalence among American Indian and Alaskan Native populations is highest across all ages and cohorts. Across cohorts, smoking prevalence among non-Hispanic Black populations, particularly males, is lower than among non-Hispanic White populations at younger ages but higher at older ages. CONCLUSIONS There are important and persistent racial/ethnic differences in smoking prevalence, initiation, cessation, and intensity across U.S. birth cohorts. Targeted interventions should address widening smoking disparities by race/ethnicity, particularly for American Indian and Alaskan Native and non-Hispanic Black populations.
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Affiliation(s)
- Rafael Meza
- From the Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan.
| | - Pianpian Cao
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Jihyoun Jeon
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Theodore R Holford
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - David T Levy
- Department of Oncology, Georgetown University, Washington, District of Columbia
| | - Jamie Tam
- and the Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
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Fennell BS, Piñeiro B, Vidrine DJ, Frank-Pearce SG, Wetter DW, Simmons VN, Vidrine JI. Ask-Advise-Connect: Differential Enrollment and Smoking Cessation Outcomes Between Primary Care Patients Who Received Quitline-Delivered Treatment in Spanish vs English. Ann Fam Med 2022; 20:519-525. [PMID: 36443074 PMCID: PMC9705036 DOI: 10.1370/afm.2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/19/2022] [Accepted: 06/30/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study examined differences in Quitline treatment enrollment, engagement, and smoking cessation outcomes among primary care patients preferring Spanish and English using the evidence-based tobacco treatment Ask-Advise-Connect. METHODS Ask-Advise-Connect was implemented April 2013 through February 2016 in a large safety-net health system to connect smokers with treatment via a link in the electronic health record. Rates of treatment enrollment, engagement, acceptance of nicotine replacement therapy, and smoking abstinence (self-reported and biochemically confirmed) were compared at 6 months among patients who received treatment in Spanish and English using χ 2 tests. Logistic regression examined language and nicotine replacement therapy and their interaction as predictors of abstinence. RESULTS The smoking status of 218,915 patients was assessed and recorded in the electronic health record. Smoking prevalence was 8.4% among patients preferring Spanish and 27.0% among those preferring English. Spanish-preferring patients were less likely to enroll in treatment (10.7% vs 12.0%, χ 2 = 12.06, P = .001) yet completed more counseling calls when enrolled (median = 2 vs 1, P <.001). Patients who received treatment in Spanish (vs English) were twice as likely to be abstinent at 6 months (self-reported: 25.1% vs 14.5%, odds ratio [OR] = 1.98, 95% CI, 1.62-2.40; biochemically confirmed: 7.6% vs 3.7%, OR = 2.13, 95% CI, 1.52-2.97). Receipt of nicotine replacement therapy increased abstinence for all patients and language did not interact with nicotine replacement therapy to predict abstinence. CONCLUSIONS Automated point-of-care approaches such as Ask-Advise-Connect have great potential to reach Spanish-preferring smokers. Those who received tobacco treatment in Spanish (vs English) demonstrated better engagement and cessation outcomes.
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Affiliation(s)
| | - Bárbara Piñeiro
- Centre d'Estudis Demogràfics, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Summer G Frank-Pearce
- Stephenson Cancer Center and Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - David W Wetter
- Huntsman Cancer Institute and the Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
| | - Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida
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Min JY, Levin J, Weinberger AH. Associations of tobacco cigarette use and dependence with substance use disorder treatment completion by sex/gender and race/ethnicity. J Subst Abuse Treat 2022; 140:108834. [PMID: 35803029 DOI: 10.1016/j.jsat.2022.108834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/29/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Individuals with substance use disorders (SUD) are approximately five times more likely to smoke cigarettes than the general population. Individuals who smoke cigarettes have greater odds of SUD relapse compared to individuals who do not smoke cigarettes, but we know little about how cigarette use is related to SUD treatment completion overall by sex/gender or race/ethnicity. METHODS This study examined 2855 adults (71.98 % male; >70 % racial/ethnic minority) in outpatient and residential SUD treatment at a New York-based treatment agency over a six-month period in 2018. RESULTS Overall, approximately three-fourths of SUD treatment-seeking participants smoked cigarettes, with high rates across sex/gender and racial/ethnic groups. Nicotine dependence did not differ by sex/gender, and White Non-Hispanic adults had the highest levels of nicotine dependence across racial/ethnic groups. Those who smoked cigarettes were significantly less likely to complete treatment compared to those who did not smoke cigarettes (OR = 0.69; 95 % CI: 0.58, 0.82). The study found no overall differences in SUD treatment completion and length of stay by sex/gender or race/ethnicity. CONCLUSIONS Given the high prevalence of cigarette smoking and lower odds of completing SUD treatment, the current system of care for SUD treatment may be enhanced by addressing cigarette smoking from onset of treatment.
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Affiliation(s)
- Jung-Yun Min
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Jacob Levin
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Medina-Ramirez P, Casas L, Sutton SK, Calixte-Civil P, Brandon KO, Martinez U, Meade CD, Byrne MM, Brandon TH, Simmons VN. Hispanic/Latinx ethnic subgroup differences in sociodemographic, sociocultural, and smoking characteristics in a cessation trial: An exploratory study. Nicotine Tob Res 2022; 24:1589-1596. [PMID: 35366328 PMCID: PMC9575968 DOI: 10.1093/ntr/ntac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/10/2022] [Accepted: 03/30/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Hispanic/Latinx smokers in the United States are often treated as a homogeneous group. However, population-based studies suggest cigarette use differs among Hispanic/Latinx subgroups by sociodemographic or sociocultural characteristics. This secondary analysis aimed to advance the limited literature by examining differences in smoking-related variables. METHODS We used baseline data from a randomized controlled trial testing a self-help Spanish-language smoking cessation intervention. Puerto Rican (PR), Mexican, and Cuban, the three largest Hispanic/Latinx subgroups in the sample (N=1028), were first compared on sociodemographic and sociocultural variables (acculturation and familism). Primary analyses assessed subgroup differences in cigarette use variables [e.g., cigarettes per day (CPD), nicotine dependence (Fagerström Test for Nicotine Dependence), daily smoking] and smoking-related cognitive constructs (motivation to quit, smoking outcome expectancies and abstinence self-efficacy) controlling for sociodemographic and sociocultural variables. Additional analyses explored differences between men and women within subgroups. RESULTS Mexicans exhibited the lowest levels of daily smoking (90% vs. 95% Cubans and 96% PR; p=.001), CPD (M=13.5, SD=9.5 vs. M=20.1, SD=9.9 Cubans and M=16.7, SD=10.1 PR; p=.016), and nicotine dependence (M=4.2, SD=2.3 vs. M=6.0, SD=2.1 Cubans and M=5.7, SD=2.2 PR; p< .001), with no differences between PRs and Cubans. Within-subgroup comparisons between men and women showed the most differences among PRs [e.g., men were more nicotine dependent (M=6.0, SD=1.9) than women (M=5.4, SD=2.3; p=.041)] and Cubans [e.g., men smoked more CPD (M=22.2, SD=12.2) than women (M=19.3, SD=12.0; p=.042)], and the fewest among Mexicans. CONCLUSIONS Findings support heterogeneity within Hispanic/Latinx smokers and highlight the potential utility of examining sociodemographic, sociocultural, and smoking characteristics important for developing salient cessation interventions. IMPLICATIONS Findings demonstrate that treatment-seeking Hispanic/Latinx smokers in the US differ in sociodemographic, sociocultural, and smoking-related variables (cigarette use and smoking-related cognitive constructs) by subgroup (i.e., Puerto Rican, Mexican, Cuban) and within subgroups by sex. These differences suggest that heterogeneity among subgroups should be considered when developing cessation interventions for Hispanics/Latinxs. Future research should examine how differences in sociodemographic and smoking-related variables impact intervention outcomes and explore the role of sociocultural factors (e.g., acculturation and familism) as determinants of cessation.
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Affiliation(s)
| | - Laura Casas
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Patricia Calixte-Civil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA
| | - Ursula Martinez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Margaret M Byrne
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Psychology, University of South Florida, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL. USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL. USA
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Hoeppner BB, Siegel KR, Carlon HA, Kahler CW, Park ER, Hoeppner SS. A Smoking Cessation App for Nondaily Smokers (Version 2 of the Smiling Instead of Smoking App): Acceptability and Feasibility Study. JMIR Form Res 2021; 5:e29760. [PMID: 34787577 PMCID: PMC8663587 DOI: 10.2196/29760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 12/18/2022] Open
Abstract
Background Recent evidence highlights the significant detrimental impact of nondaily smoking on health and its disproportionate prevalence in underserved populations; however, little work has been done to develop treatments specifically geared toward quitting nondaily smoking. Objective This study aims to test the feasibility, acceptability, and conceptual underpinnings of version 2 of the Smiling Instead of Smoking (SiS2) smartphone app, which was developed specifically for nondaily smokers and uses a positive psychology approach. Methods In a prospective, single-group study, nondaily smokers (N=100) were prescribed use of the SiS2 app for 7 weeks while undergoing a quit attempt. The app assigned daily positive psychology exercises and behavioral tasks every 2 to 3 days, which guided smokers through using the smoking cessation tools offered in the app. Participants answered surveys at baseline and at 2, 6, 12, and 24 weeks postquit. Feasibility was evaluated based on app use and acceptability based on survey responses. The underlying conceptual framework was tested by examining whether theorized within-person changes occurred from baseline to end of treatment on scales measuring self-efficacy, desire to smoke, and processing of self-relevant health information (ie, pros and cons of smoking, importance of the pros and cons of quitting, and motivation). Results Participants used the SiS2 app on an average of 24.7 (SD 13.8) days out of the 49 prescribed days. At the end of treatment, most participants rated the functions of the app as very easy to use (eg, 70/95, 74% regarding cigarette log and 59/95, 62% regarding happiness exercises). The average score on the System Usability Scale was 79.8 (SD 17.3; A grade; A+ ≥84.1, B+ <78.8). Most participants reported that the app helped them in their quit attempt (83/95, 87%), and helped them stay positive while quitting (78/95, 82%). Large effects were found for within-person decreases in the desire to smoke (b=−1.5, 95% CI −1.9 to −1.1; P<.001; gav=1.01), the importance of the pros of smoking (b=-20.7, 95% CI −27.2 to −14.3; P<.001; gav=0.83), and perceived psychoactive benefits of smoking (b=−0.8, 95% CI −1.0 to −0.5; P<.001; gav=0.80). Medium effects were found for increases in self-efficacy for remaining abstinent when encountering internal (b=13.1, 95% CI 7.6 to 18.7; P<.001; gav=0.53) and external (b=11.2, 95% CI 6.1 to 16.1; P<.001; gav=0.49) smoking cues. Smaller effects, contrary to expectations, were found for decreases in motivation to quit smoking (P=.005) and the perceived importance of the pros of quitting (P=.009). Self-reported 30-day point prevalence abstinence rates were 40%, 56%, and 56% at 6, 12, and 24 weeks after the quit day, respectively. Conclusions The SiS2 app was feasible and acceptable, showed promising changes in constructs relevant to smoking cessation, and had high self-reported quit rates by nondaily smokers. The SiS2 app warrants testing in a randomized controlled trial.
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Affiliation(s)
- Bettina B Hoeppner
- Recovery Research Institute, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Kaitlyn R Siegel
- Recovery Research Institute, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Hannah A Carlon
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Elyse R Park
- Health Promotion and Resiliency Research Intervention Program, Psychiatry & Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Susanne S Hoeppner
- Center for Anxiety and Traumatic Stress Disorders, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
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Miller KD, Ortiz AP, Pinheiro PS, Bandi P, Minihan A, Fuchs HE, Martinez Tyson D, Tortolero-Luna G, Fedewa SA, Jemal AM, Siegel RL. Cancer statistics for the US Hispanic/Latino population, 2021. CA Cancer J Clin 2021; 71:466-487. [PMID: 34545941 DOI: 10.3322/caac.21695] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 01/03/2023] Open
Abstract
The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population-based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non-Hispanic Whites (NHWs), Hispanic men and women had 25%-30% lower incidence (2014-2018) and mortality (2015-2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection-related cancers, including approximately two-fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized-stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence-based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community-based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID-19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored.
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Affiliation(s)
- Kimberly D Miller
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ana P Ortiz
- Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, Florida
| | - Priti Bandi
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Adair Minihan
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Hannah E Fuchs
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | | | - Guillermo Tortolero-Luna
- Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Stacey A Fedewa
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Ahmedin M Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Rebecca L Siegel
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Lozano P, Homan S. Disparities in Smoking Behavior by Race/Ethnicity in 10 Diverse Communities in Chicago: Findings from Sinai Community Health Survey 2.0. J Immigr Minor Health 2021; 23:1206-1213. [PMID: 33608824 DOI: 10.1007/s10903-021-01155-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 11/24/2022]
Abstract
Disparities in smoking prevalence persist among and within racial/ethnic groups in the U.S. This study aimed to identify racial/ethnic smoking behavior disparities in Chicago between 2015 and 2016. We used data from the Sinai Community Health Survey 2.0, a population-based survey conducted among adults living in ten diverse communities in Chicago. A total of 1543 adults completed the survey. We estimated the prevalence of smoking behavior among participants who had smoked at least 100 cigarettes in their lives (N = 598). We stratified by race/ethnicity and sex, reporting statistically significant differences at p < 0.05 threshold. Current smoking was highest among NHBs (40%), followed by Puerto Ricans (28%), NHWs (24%), and Mexicans (13%). Among participants who had smoked 100 cigarettes in their life, over 60% of Puerto Rican (65%) and NHB (63%) participants were daily smokers. Although 72% of NHB smokers tried to quit smoking in the previous year, only 15% of them quit smoking for more than 12 months. Among Puerto Rican current smokers, 44% smoked a pack of cigarettes per day or more while only 6% of NHBs smoked more than a pack a day. Only 20% of Mexican participants were advised by a health professional to quit smoking in the past year. Among Puerto Rican females, 55% started smoking before the age of 15. We found important differences in smoking behavior by race/ethnicity groups and sex. These disparities highlight the importance of implementing targeted evidence-based strategies to reduce tobacco use, particularly among those groups with the highest prevalence.
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Affiliation(s)
- Paula Lozano
- Sinai Health Systems, Sinai Urban Health Institute, 1500 S. Fairfield Ave., Chicago, IL, 60608, USA.
| | - Sharon Homan
- Sinai Health Systems, Sinai Urban Health Institute, 1500 S. Fairfield Ave., Chicago, IL, 60608, USA
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11
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Badanta B, Lucchetti G, Fernández-García E, Barrientos-Trigo S. Prevalence and factors associated with substance use among Chinese immigrants in Spain: A mixed-design study. Public Health Nurs 2020; 38:339-349. [PMID: 33368553 DOI: 10.1111/phn.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the use of tobacco, alcohol, and illicit drugs and its associated factors among Chinese immigrants living in Spain. DESIGN AND MEASURES A mixed-method design, using surveys and semi-structured interviews. SAMPLE A total of 133 Chinese immigrants and stakeholders were assessed in the quantitative study and 7 stakeholders were interviewed in the qualitative study. RESULTS The use of tobacco and alcohol was higher than the use of illicit drugs in Chinese immigrants. The prevalence of daily smokers was greater in men than in women (37.3% vs. 2.5%, p < .001). Men consumed more alcohol (76% vs. 50.6%, p = .004) and more frequently (21.6% daily vs. 2.4%, p = .024) than women. The use of illicit drugs was low and Cannabis was the most illicit drug consumed (4%). Qualitative data revealed that due to a great workload, the workers tended to avoid behaviors of illicit drug consumption, but not of alcohol and tobacco, in which the consumption is associated with business meetings and leisure. CONCLUSION This study found that Chinese immigrants in Spain consume more alcohol and tobacco than illicit drugs and that men have a high consumption compared to women. These findings reveal important cultural differences that should be addressed by public health managers in order to develop strategies that consider the characteristics of this population.
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Affiliation(s)
- Bárbara Badanta
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
| | - Giancarlo Lucchetti
- Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain.,School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Elena Fernández-García
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
| | - Sergio Barrientos-Trigo
- Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Seville, Spain.,Research Group under the Andalusian Research CTS 1050 Complex Care, Chronic and Health Outcomes Seville, Seville, Spain
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12
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Medina-Ramirez P, Calixte-Civil P, Meltzer LR, Brandon KO, Martinez U, Sutton SK, Meade CD, Byrne MM, Brandon TH, Simmons VN. Comparing Methods of Recruiting Spanish-Preferring Smokers in the United States: Findings from a Randomized Controlled Trial. J Med Internet Res 2020; 22:e19389. [PMID: 32795986 PMCID: PMC7455877 DOI: 10.2196/19389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022] Open
Abstract
Background There is a pressing need to address the unacceptable disparities and underrepresentation of racial and ethnic minority groups, including Hispanics or Latinxs, in smoking cessation trials. Objective Given the lack of research on recruitment strategies for this population, this study aims to assess effective recruitment methods based on enrollment and cost. Methods Recruitment and enrollment data were collected from a nationwide randomized controlled trial (RCT) of a Spanish-language smoking cessation intervention (N=1417). The effectiveness of each recruitment strategy was evaluated by computing the cost per participant (CPP), which is the ratio of direct cost over the number enrolled. More effective strategies yielded lower CPPs. Demographic and smoking-related characteristics of participants recruited via the two most effective strategies were also compared (n=1307). Results Facebook was the most effective method (CPP=US $74.12), followed by TV advertisements (CPP=US $191.31), whereas public bus interior card advertising was the least effective method (CPP=US $642.50). Participants recruited via Facebook had lower average age (P=.008) and had spent fewer years in the United States (P<.001). Among the participants recruited via Facebook, a greater percentage of individuals had at least a high school education (P<.001) and an annual income above US $10,000 (P<.001). In addition, a greater percentage of individuals were employed (P<.001) and foreign born (P=.003). In terms of subethnicity, among the subjects recruited via Facebook, a lower percentage of individuals were of Mexican origin (P<.001) and a greater percentage of individuals were of Central American (P=.02), South American (P=.01), and Cuban (P<.001) origin. Conclusions Facebook was the most effective method for recruiting Hispanic or Latinx smokers in the United States for this RCT. However, using multiple methods was necessary to recruit a more diverse sample of Spanish-preferring Hispanic or Latinx smokers.
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Affiliation(s)
- Patricia Medina-Ramirez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Patricia Calixte-Civil
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Lauren R Meltzer
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Karen O Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Ursula Martinez
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, United States.,Biostatistics and Bioinformatics Department, Moffitt Cancer Center & Research Institute, Tampa, FL, United States
| | - Cathy D Meade
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,College of Nursing, University of South Florida, Tampa, FL, United States
| | - Margaret M Byrne
- Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, United States
| | - Thomas H Brandon
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Vani N Simmons
- Tobacco Research & Intervention Program, Department of Health Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.,Department of Psychology, University of South Florida, Tampa, FL, United States
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13
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Shepherd JM, Bakhshaie J, Nizio P, Garey L, Viana AG, Zvolensky MJ. Anxiety symptoms and smoking outcome expectancies among Spanish-speaking Latinx adult smokers: Exploring the role of anxiety sensitivity. J Ethn Subst Abuse 2020; 21:304-324. [DOI: 10.1080/15332640.2020.1759476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | | | | | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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14
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Sisti JS, Jasek JP, Farley SM. Heterogeneity in Current Cigarette Smoking among Hispanic/Latino Heritage Groups in New York City, 2003-2016. Ethn Dis 2020; 30:97-108. [PMID: 31969789 DOI: 10.18865/ed.30.1.97] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives We assessed differences in trends, prevalence, and sociodemographic correlates of current smoking among several predominant Hispanic/Latino heritage groups (Puerto Ricans, Dominicans, Central and South Americans, and other Hispanic/Latinos) in New York City (NYC). We additionally compared current smoking prevalence between heritage groups and non-Hispanic/Latino Whites. Design and Methods Data from the Community Health Survey, a representative, dual-frame landline/cellphone survey, were analyzed to assess age-adjusted prevalence of current smoking, separately among heritage groups from 2003-2016. Logistic regression was used to estimate odds ratios and 95% CIs for current smoking by Hispanic/Latino heritage group relative to non-Hispanic/Latino Whites in combined 2012-2016 data. Logistic regression was also used to examine correlates of smoking among each heritage group, separately. Results Between 2003-2016, current smoking prevalence decreased among all Hispanic/Latinos heritage groups except Puerto Ricans, who had the highest smoking prevalence among all groups examined. Sex-stratified trend analyses showed decreases among all groups except Puerto Rican and other Hispanic/Latino males. In multivariable-adjusted models, relative to non-Hispanic/Latino Whites, there was no association with current smoking among Puerto Ricans, but odds of smoking were lower among all other heritage groups. Female sex was inversely associated with current smoking among all heritage groups, and acculturation was positively associated with smoking among all groups except Central/South Americans. Lower educational attainment was strongly associated with smoking among Puerto Ricans. Conclusions Lack of progress in reducing smoking among Puerto Ricans in NYC is concerning. Opportunities for cultural, sex-specific, and other targeted outreach to this community should be explored.
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Affiliation(s)
- Julia S Sisti
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
| | - John P Jasek
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
| | - Shannon M Farley
- Bureau of Chronic Disease Prevention, New York City Department of Health and Mental Hygiene, Queens, NY
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15
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Wainwright K, Perrotte JK, Bibriescas N, Baumann MR, Garza RT. Smoking expectancies and health perceptions: An analysis of Hispanic subgroups. Addict Behav 2019; 98:106008. [PMID: 31238236 DOI: 10.1016/j.addbeh.2019.05.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/01/2019] [Accepted: 05/30/2019] [Indexed: 11/15/2022]
Abstract
Research suggests different patterns of cigarette smoking behaviors across Hispanic subgroups. However, research examining differences in known cognitive correlates of smoking behavior (e.g., beliefs about smoking and perceived consequences of smoking) is lacking. The purpose of this study was two-fold. First, given the dearth of research examining cigarette smoking across Hispanic subgroups, we sought to replicate previous findings related to disparities in smoking behavior across four subgroups (i.e., Mexican American, Puerto Rican, Cuban American, and Dominican American). Second, we sought to extend previous work by examining Hispanic subgroup differences across a range of smoking-related cognitive factors (i.e., positive and negative beliefs, perceived health risks, and perceived social consequences). This study used data from 1021 Hispanic individuals from four universities in the U.S. (i.e., Texas, California, New York, Florida) in a project funded by the American Legacy Foundation. Results indicated that Cuban Americans reported more current smoking than any other subgroup and the most positive beliefs about smoking, although Puerto Ricans endorsed the fewest negative beliefs about smoking out of all the groups. There were also differences across subgroups on some perceived health risks of smoking (e.g., Cubans were most likely to believe that smoking was a risk factor for diabetes) and perceived social consequences of smoking (e.g., Mexican Americans were less likely to perceive negative social consequences from not smoking). This study underscores the need to account for heterogeneity within the Hispanic population in tobacco research to more effectively inform future research and prevention practices.
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Affiliation(s)
| | | | | | | | - Raymond T Garza
- Department of Psychology, University of Texas at San Antonio, USA
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16
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Schlumbrecht M, Huang M, Hurley J, George S. Endometrial cancer outcomes among non-Hispanic US born and Caribbean born black women. Int J Gynecol Cancer 2019; 29:ijgc-2019-000347. [PMID: 31055453 PMCID: PMC7039733 DOI: 10.1136/ijgc-2019-000347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/29/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Data on endometrial cancer outcomes among immigrant women in the USA are lacking. The objective was to determine the effect of Caribbean nativity on outcomes in black women with endometrial cancer compared with women born in the USA, with attention paid to the effects of tumor grade, sociodemographic factors, and treatment approaches. METHODS A review of the institutional cancer registry was performed to identify black, non-Hispanic women with known nativity and treated for endometrial cancer between 2001 and 2017. Sociodemographic, treatment, and outcomes data were collected. Analyses were done using the χ2 test, Cox proportional hazards models, and the Kaplan-Meier method, with significance set at P<0.05. RESULTS 195 women were included in the analysis. High grade histologies were present in a large proportion of both US born (64.5%) and Caribbean born (72.2%) patients. Compared with US born women, those of Caribbean nativity were more likely to be non-smokers (P=0.01) and be uninsured (P=0.03). Caribbean born women had more cases of stage III disease (27.8% versus 12.5%, P<0.01), while carcinosarcoma was more common in US born black women (23.6% versus 10.6%, P=0.05). Caribbean nativity trended towards improvement in overall survival (hazard ratio (HR) 0.65 (0.40-1.07)). Radiation (HR 0.53 (0.29-1.00)) was associated with improved survival while advanced stage (HR 3.81 (2.20-6.57)) and high grade histology (HR 2.34 (1.17-4.72)) were predictive of worse survival. CONCLUSIONS The prevalence of high grade endometrial cancer histologies among black women of Caribbean nativity is higher than previously reported. Caribbean nativity may be associated with improved overall survival although additional study is warranted.
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Affiliation(s)
| | - Marilyn Huang
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Judith Hurley
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Sophia George
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
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17
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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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18
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Martinez Tyson D, Medina-Ramirez P, Flores AM, Siegel R, Aguado Loi C. Unpacking Hispanic Ethnicity-Cancer Mortality Differentials Among Hispanic Subgroups in the United States, 2004-2014. Front Public Health 2018; 6:219. [PMID: 30234082 PMCID: PMC6127245 DOI: 10.3389/fpubh.2018.00219] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/13/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction: National data on the epidemiology of cancer are commonly reported by broad racial/ethnic categories, such as "Hispanic." However, few studies have disaggregated Hispanic groups and explored mortality differentials in this heterogeneous population. This paper aims to further examine cancer mortality differentials among Hispanic subgroups in the U.S. Materials and Methods: The study examined cancer deaths in the United States from 2004 to 2014 among decedents classified as Mexican, Puerto Rican, Cuban, Dominican, Central/South American and non-Hispanic white on the death certificate among those who were 20 years or older at the time of death. Data were obtained from the National Vital Statistics System. Sex-specific age-adjusted mortality rates were computed for a 10-year period and each individual year, for all cancers combined. Differences by age group, cancer sites, and age distribution were also assessed. Results: A total of 296,486 Hispanic cancer deaths were identified. Mortality rates of the Hispanic subgroups compare favorably with those of non-Hispanic whites. The mortality rates for Mexicans are very similar to those of all Hispanics combined, whereas the rates for Cuban and Puerto Ricans are higher. Dominicans and Central/South Americans had the overall lowest mortality rates. Statistically significant decreases in cancer mortality rates were noted in some sub-groups, but rates increased among Dominican women. Age-adjusted mortality rates by cancer site varied among Hispanics subgroups and gender. Among Cubans, only 5% of cancer deaths occurred before the age of 50 compared to 16% of cancer deaths among Central/South American. Conclusion: While it is common to present data on the burden of cancer among Hispanics as an aggregate group, this study illustrates that the burden of cancer varies by Hispanic subgroups. The disaggregation of Hispanics by ancestry/country of origin allows for a clearer understanding of the health status of this growing population and is needed if health disparities are to be adequately identified, understood and addressed.
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Affiliation(s)
- Dinorah Martinez Tyson
- Department of Community and Family Health, University of South Florida, Tampa, FL, United States
| | | | - Ann M. Flores
- Feinberg school of Medicine, Northwestern University, Chicago, IL, United States
| | - Rebecca Siegel
- Surveillance Information Services, American Cancer Society, Atlanta, GA, United States
| | - Claudia Aguado Loi
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, FL, United States
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19
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Felicitas-Perkins JQ, Sakuma KLK, Blanco L, Fagan P, Pérez-Stable EJ, Bostean G, Xie B, Trinidad DR. Smoking Among Hispanic/Latino Nationality Groups and Whites, Comparisons Between California and the United States. Nicotine Tob Res 2018; 20:1085-1094. [PMID: 29059350 PMCID: PMC6093426 DOI: 10.1093/ntr/ntx191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/25/2017] [Indexed: 11/14/2022]
Abstract
Introduction Although California is home to the largest Hispanic/Latino population, few studies have compared smoking behavior trends of Hispanic/Latino nationality groups in California to the remaining United States, which may identify the impact of the states antitobacco efforts on these groups. This study compared smoking status, frequency, and intensity among Mexican Americans, Central/South Americans, and non-Hispanic Whites in California to the remaining United States in the 1990s and 2000s. Methods Data were analyzed using the 1992-2011 Current Population Survey Tobacco Use Supplement to report the estimated prevalence of smoking status, frequency, and intensity by decade, race/ethnicity, and state residence. Weighted logistic regression explored sociodemographic factors associated with never and heavy smoking (≥20 cigarettes per day). Results There were absolute overall increases from 6.8% to 9.6% in never smoking across all groups. Compared to the remaining United States, there was a greater decrease in heavy smoking among Mexican American current smokers in California (5.1%) and a greater increase in light and intermittent smokers among Central/South American current smokers in California (9.3%) between decades. Compared to those living in the remaining United States, smokers living in California had lower odds of heavy smoking (1990s: odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.62, 0.66; 2000s: 0.54, 95% CI = 0.52, 0.55). Conclusions California state residence significantly impacted smoking behaviors as indicated by significant differences in smoking intensity between California and the remaining United States among Hispanic/Latino nationality groups. Understanding smoking behaviors across Hispanic/Latino nationality groups in California and the United States can inform tobacco control and smoking prevention strategies for these groups. Implications The present study explored the differences in smoking behaviors between Whites, Mexican Americans, and Central South/Americans living in California versus the rest of the United States in the 1990s and the 2000s. The results contribute to our current knowledge as there have been minimal efforts to provide disaggregated cigarette consumption information among Hispanic/Latino nationality groups. Additionally, by comparing cigarette consumption between those in California and the remaining United States, our data may provide insight into the impact of California's antitobacco efforts in reaching Hispanic/Latino subpopulations relative to the remaining US states, many of which have had less tobacco control policy implementation.
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Affiliation(s)
| | - Kari-Lyn K Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
- Lyzette Blanco is now at Touro University Worldwide, Los Alamitos, CA, USA
| | - Pebbles Fagan
- Cancer Center, University of Hawaii, Honolulu, HI
- Pebbles Fagan is now at College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Georgiana Bostean
- Department of Sociology and Environmental Science & Policy, Chapman University, Orange, CA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
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20
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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: 6] [Impact Index Per Article: 1.0] [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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Reynales-Shigematsu LM, Guerrero-López CM, Hernández Ávila M, Irving H, Jha P. Divergence and convergence in cause-specific premature adult mortality in Mexico and US Mexican Hispanics from 1995 to 2015: analyses of 4.9 million individual deaths. Int J Epidemiol 2018; 47:97-106. [PMID: 29040557 PMCID: PMC5837401 DOI: 10.1093/ije/dyx185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/04/2017] [Accepted: 08/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background Mexicans and US Mexican Hispanics share modifiable determinants of premature mortality. We compared trends in mortality at ages 30-69 in Mexico and among US Mexican Hispanics from 1995 to 2015. Methods We examined nationally representative statistics on 4.2 million Mexican and 0.7 million US deaths to examine cause-specific mortality. We used lung cancer indexed methods to estimate smoking-attributable deaths stratified by high and lower burden Mexican states. Results In 1995-99, Mexican men had about 30% higher relative risk of death from all causes than US Mexican Hispanic men, and this difference nearly doubled to 58% by 2010-15. The divergence between Mexican and US Mexican Hispanic women over this time period was less marked. Among US Mexican Hispanics, declines in the risk of smoking-attributable death constituted about 25-30% of the declines in the overall risk of death. However, among Mexican men the declines in the risk of smoking-attributable deaths were offset by increases in causes of death not due to smoking. Homicide rates (mostly from guns) rose among men in Mexico from 2005 to 2010, but not among Mexican women or US Mexican Hispanic men or women. The probability at 30-69 years of death from cardiac disease diverged significantly between Mexicans and US Mexican Hispanics, reaching 10% and 5% for men, and 7% and 2% for women, respectively. Conclusions Large differences in premature mortality between otherwise genetically and culturally similar groups arise from a few modifiable factors, most notably smoking, untreated diabetes and homicide.
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Affiliation(s)
| | | | | | - Hyacinth Irving
- Centre for Global Health Research, St Michael’s Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Prabhat Jha
- Centre for Global Health Research, St Michael’s Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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22
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Pagano A, Gubner N, Le T, Guydish J. Cigarette smoking and quit attempts among Latinos in substance use disorder treatment. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:660-667. [PMID: 29333890 DOI: 10.1080/00952990.2017.1417417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Differences in tobacco use behaviors have been identified between Latinos and non-Latino whites in the general US population. Little is known about cigarette smoking and quitting behaviors of Latinos in treatment for substance use disorders (SUDs), who represent two major tobacco-vulnerable groups. OBJECTIVES To compare, in a national sample of persons enrolled in SUD treatment, demographic, drug use, and smoking and quitting prevalence and behaviors between Latinos and non-Latino whites. METHODS We surveyed 777 SUD treatment clients, sampled from 24 clinics selected at random from the National Institute on Drug Abuse Clinical Trials Network (Latino client n = 141; 40% female). We then conducted univariate and multivariate analyses to identify correlates of smoking behaviors by Latino/non-Latino white ethnicity. RESULTS Latinos' smoking prevalence resembled that of non-Latino whites (78.7% vs. 77.4%). In regression analyses, Latino smokers (n = 111) tended to smoke fewer cigarettes per day (CPD) than non-Latino white smokers (n = 492); were more often nondaily smokers and menthol smokers; more often reported a smoking quit attempt in the last year; and tended to report higher numbers of past-year quit attempts. Among Latino smokers, those with less education and those reporting opioids as their primary drug of use reported higher CPD. CONCLUSIONS Latinos in SUD treatment are at equally high risk of being current heavy smokers as compared to non-Latino whites in SUD treatment. At the same time, Latinos in SUD treatment exhibit ethnic-specific smoking and quitting behaviors that should be considered when designing smoking interventions for this group.
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Affiliation(s)
- Anna Pagano
- a Prevention Research Center , Pacific Institute for Research and Evaluation , Oakland , CA , USA
| | - Noah Gubner
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
| | - Thao Le
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
| | - Joseph Guydish
- b Philip R. Lee Institute for Health Policy Studies, University of California San Francisco , San Francisco , CA , USA
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Yao T, Ong MK, Max W, Keeler C, Wang Y, Yerger VB, Sung HY. Responsiveness to cigarette prices by different racial/ethnic groups of US adults. Tob Control 2017; 27:301-309. [DOI: 10.1136/tobaccocontrol-2016-053434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 03/29/2017] [Accepted: 05/08/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveTo evaluate the impact of cigarette prices on adult smoking for four US racial/ethnic groups: whites, African–Americans, Asians and Hispanics.MethodsWe analysed pooled cross-sectional data from the 2006/2007 and 2010/2011 Tobacco Use Supplement to the Current Population Survey (n=339 921 adults aged 18+) and cigarette price data from the Tax Burden on Tobacco. Using a two-part econometric model of cigarette demand that controlled for sociodemographic characteristics, state-level antismoking sentiment, local-level smoke-free air laws and monthly indicator, we estimated for each racial/ethnic group the price elasticities of smoking participation, smoking intensity and total demand for cigarettes.ResultsSmoking prevalence for whites, African–Americans, Asians and Hispanics during the study period was 18.3%, 16.1%, 8.2% and 11.3%, respectively. The price elasticity of smoking participation was statistically significant for whites, African–Americans, Asians and Hispanics at −0.26, –0.10, −0.42 and −0.11, respectively. The price elasticity of smoking intensity was statistically significant among whites (−0.22) and African–Americans (−0.17). Overall, the total price elasticity of cigarette demand was statistically significant for all racial/ethnic groups: 0.48 for whites, −0.27 for African–Americans, −0.22 for Asians and −0.15 for Hispanics.ConclusionsOur results suggest that raising cigarette prices, such as via tobacco tax increases, would result in reduced cigarette consumption for all racial/ethnic groups. The magnitude of the effect and the impact on cessation and reduced smoking intensity differ across these groups.
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24
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Fleischer NL, Ro A, Bostean G. Smoking selectivity among Mexican immigrants to the United States using binational data, 1999-2012. Prev Med 2017; 97:26-32. [PMID: 28087468 DOI: 10.1016/j.ypmed.2017.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/23/2016] [Accepted: 01/09/2017] [Indexed: 11/19/2022]
Abstract
Mexican immigrants have lower smoking rates than US-born Mexicans, which some scholars attribute to health selection-that individuals who migrate are healthier and have better health behaviors than their non-migrant counterparts. Few studies have examined smoking selectivity using binational data and none have assessed whether selectivity remains constant over time. This study combined binational data from the US and Mexico to examine: 1) the extent to which recent Mexican immigrants (<10years) in the US are selected with regard to cigarette smoking compared to non-migrants in Mexico, and 2) whether smoking selectivity varied between 2000 and 2012-a period of declining tobacco use in Mexico and the US. We combined repeated cross-sectional US data (n=10.901) on adult (ages 20-64) Mexican immigrants and US-born Mexicans from the 1999/2000 and 2011/2012 National Health Interview Survey, and repeated cross-sectional Mexican data on non-migrants (n=67.188) from the 2000 Encuesta Nacional de Salud and 2012 Encuesta Nacional de Salud y Nutrición. Multinomial logistic regressions, stratified by gender, predicted smoking status (current, former, never) by migration status. At both time points, we found lower overall smoking prevalence among recent US immigrants compared to non-migrants for both genders. Moreover, from the regression analyses, smoking selectivity remained constant between 2000 and 2012 among men, but increased among women. These findings suggest that Mexican immigrants are indeed selected on smoking compared to their non-migrating counterparts, but that selectivity is subject to smoking conditions in the sending countries and may not remain constant over time.
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Affiliation(s)
- Nancy L Fleischer
- 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.
| | - Annie Ro
- Program in Public Health, UC Irvine, 653 E. Peltason Road, Irvine, CA 92697, USA
| | - Georgiana Bostean
- Sociology Department and Environmental Science & Policy Program, Chapman University, One University Drive, Orange, CA 92866, USA
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25
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Smoking Trends among U.S. Latinos, 1998-2013: The Impact of Immigrant Arrival Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030255. [PMID: 28257125 PMCID: PMC5369091 DOI: 10.3390/ijerph14030255] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/25/2017] [Indexed: 11/17/2022]
Abstract
Few studies examine nativity disparities in smoking in the U.S., thus a major gap remains in understanding whether immigrant Latinos' smoking prevalence is stable, converging, or diverging, compared with U.S.-born Latinos. This study aimed to disentangle the roles of period changes, duration of U.S. residence, and immigrant arrival cohort in explaining the gap in smoking prevalence between foreign-born and U.S.-born Latinos. Using repeated cross-sectional data spanning 1998-2013 (U.S. National Health Interview Survey), regressions predicted current smoking among foreign-born and U.S.-born Latino men and women (n = 12,492). We contrasted findings from conventional regression analyses that simply include period and duration of residence effects, to two methods of assessing arrival cohort effects: the first accounted for baseline differences in smoking among arrival cohorts, while the second examined smoking probabilities by tracking foreign-born arrival cohorts as they increase their duration of U.S. residence. Findings showed that Latino immigrants maintained lower prevalence of current smoking compared with U.S.-born Latinos over the period 1998-2013, and that longer duration of U.S. residence is associated with lower odds of smoking among men. Two findings are particularly novel: (1) accounting for immigrant arrival cohort dampens the overall protective effect of duration of residence among men; and (2) the earliest arrival cohort of Latino immigrant men experienced the steepest decline in smoking over duration of U.S. residence. Results have methodological and theoretical implications for smoking studies and the Latino mortality paradox.
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26
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Pinheiro PS, Callahan KE, Siegel RL, Jin H, Morris CR, Trapido EJ, Gomez SL. Cancer Mortality in Hispanic Ethnic Groups. Cancer Epidemiol Biomarkers Prev 2017; 26:376-382. [PMID: 28223429 DOI: 10.1158/1055-9965.epi-16-0684] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/12/2016] [Accepted: 10/12/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Cancer is the leading cause of death among Hispanics. The burden of cancer mortality within Hispanic groups has not been well quantified.Methods: Cancer mortality rates for 2008-2012 in Florida were computed on the basis of race, ethnicity, and birthplace, specifically focusing on major Hispanic groups-Mexicans, Puerto Ricans, Cubans, Central Americans, South Americans, and Dominicans. Age-adjusted mortality rate ratios derived from negative binomial regression were used to compare Hispanics, aggregated and by group, to nonHispanic whites (NHW).Results: A total of 205,369 cancer deaths from 2008-2012 were analyzed, of which 22,042 occurred in Hispanics. Overall cancer mortality rates were lower for Hispanics, 159 and 100 per 100,000 in males and females, respectively, compared with 204 and 145 per 100,000 in NHWs, largely driven by relatively low rates of lung and breast cancers among Hispanics. However, Hispanics had a higher risk of death from stomach and liver cancers, both infection-related. Of all Hispanic groups, Mexicans had the lowest mortality, whereas Cubans had the highest, with significantly higher mortality for colorectal, endometrial, and prostate cancers.Conclusions: Compared with other Hispanic groups, Cubans and Puerto Ricans had significantly higher rates. For these longer-established populations in the United States, increases in diet and obesity-related cancers are evident. Some groups show excesses that clearly fall out of the common Hispanic patterns, with implications for public health: Cubans for colorectal cancer, Puerto Ricans for liver cancer, and Dominicans for prostate cancer.Impact: Cancer mortality outcomes in Hispanics vary between ethnic groups. Research and public health strategies should consider this heterogeneity. Cancer Epidemiol Biomarkers Prev; 26(3); 376-82. ©2017 AACR.
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Affiliation(s)
- Paulo S Pinheiro
- School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada.
| | - Karen E Callahan
- School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada
| | - Rebecca L Siegel
- Information, Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Hongbin Jin
- School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada
| | - Cyllene R Morris
- California Cancer Reporting and Epidemiologic Surveillance Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California
| | - Edward J Trapido
- Department of Epidemiology, Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana
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27
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Anguiano B, Brown-Johnson C, Rosas LG, Pechmann C, Prochaska JJ. Latino Adults' Perspectives on Treating Tobacco Use Via Social Media. JMIR Mhealth Uhealth 2017; 5:e12. [PMID: 28179217 PMCID: PMC5322200 DOI: 10.2196/mhealth.6684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 10/26/2016] [Accepted: 12/22/2016] [Indexed: 11/17/2022] Open
Abstract
Background Latinos are the largest minority group in the United States, and in California they outnumber non-Hispanic whites. Smoking cessation programs tailored for Latino culture, and this population’s specific smoking patterns, are needed. Online social networks for smoking cessation have high potential for Latinos, but have not been tested to date. Objective Building a research program on social media apps for cancer prevention in diverse populations, this qualitative study assessed acceptability of tobacco treatment that was distributed via social media for Latino smokers. Methods We conducted three focus groups with Latino adults who were former and current smokers recruited from Santa Clara County, California in 2015 (N=32). We assessed participants’ smoking histories, attempts to quit, social media exposure, and receptivity to a social media-based smoking cessation intervention. Audio transcripts were translated and coded for themes. Results Participants reported factors driving their tobacco use and motivations to quit, and emphasized the importance of community and family in influencing their smoking initiation, cravings and triggers, attempts to quit, and abstinence. Participants valued the communal aspect of social media and suggested strategically tailoring groups based on key features (eg, age, gender, language preference). Participants reported preferring visual, educational, and motivational messages that were connected with existing services. Conclusions Participants generally voiced acceptability of a social media-delivered intervention to help them quit smoking, viewed the intervention as well-equipped for catering to the strong community orientation of Latinos, and suggested that the platform was able to address variation within the population through strategic group creation. As a group member reflected, “Podemos hacerlo juntos” (We can do it together).
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Affiliation(s)
- Beatriz Anguiano
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Cati Brown-Johnson
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
| | - Lisa G Rosas
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, United States
| | - Cornelia Pechmann
- The Paul Merage School of Business, University of California, Irvine, Irvine, CA, United States
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, United States
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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: 53] [Impact Index Per Article: 7.6] [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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29
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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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Lee JE, Park EC, Chun SY, Park HK, Kim TH. Socio-demographic and clinical factors contributing to smoking cessation among men: a four-year follow up study of the Korean Health Panel Survey. BMC Public Health 2016; 16:908. [PMID: 27581873 PMCID: PMC5006525 DOI: 10.1186/s12889-016-3583-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/24/2016] [Indexed: 12/02/2022] Open
Abstract
Background To examine factors contributing to smoking cessation among male smokers, we looked at how socio-demographic and clinical characteristics influence stopping smoking with passage of time. Methods Data from the Korea Health Panel during 2009–2012 were used. In 2009 a total of 2,941 smokers were followed up until 2012. Statistical analysis using a generalized linear mixed model was performed for all smokers, and a subgroup analysis was also performed to determine whether individual characteristics influence smoking cessation differently based on health condition. Results Male smokers who have married or graduated college or above were more likely to succeed in smoking cessation. Those with chronic disease(s) were also more likely to quit smoking than those without. Among those without chronic disease, higher education showed significant association with smoking cessation, however, being married or ever married showed significant association with smoking cessation among those with chronic disease. Conclusions The finding that higher education helped smokers without chronic disease succeed in smoking cessation suggests that a smoking cessation campaign should focus on those with lower education. In addition, quit smoking programs may be particularly helpful for male smokers with chronic disease(s) who have never married.
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Affiliation(s)
- Joo Eun Lee
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Sung Youn Chun
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Hye Ki Park
- Department of Public Health, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.,Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Tae Hyun Kim
- Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea. .,Department of Hospital Administration, Graduate School of Public Health, Yonsei University, 50 Yonsei-ro,Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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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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Merzel CR, Isasi CR, Strizich G, Castañeda SF, Gellman M, Maisonet Giachello AL, Lee DJ, Penedo FJ, Perreira KM, Kaplan RC. Smoking cessation among U.S. Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prev Med 2015; 81:412-9. [PMID: 26515291 PMCID: PMC6391117 DOI: 10.1016/j.ypmed.2015.10.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 10/14/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022]
Abstract
This paper examines patterns of smoking cessation among Hispanics/Latinos with particular attention to gender, acculturation, and national background. Data are from the Hispanic Community Health Study/Study of Latinos, a population-based study of 16,415 non-institutionalized Hispanics/Latinos ages 18-74 from a stratified random sample of households in Chicago, Miami, the Bronx, and San Diego. Face-to-face interviews, in English or Spanish, were conducted from 2008 to 2011. Findings are based on 6398 participants who reported smoking at least 100 cigarettes in their lifetime. Associations with smoking cessation outcomes were assessed in bivariate and multivariable analyses. Findings indicate that approximately equal proportions of men and women were former smokers. There was little difference by gender in socioeconomic characteristics associated with smoking cessation. Both men and women who lived in households with smokers were less likely to be abstinent. Multivariable analysis indicated that the likelihood of quitting varied by national background primarily among men, however, Puerto Rican and Cuban smokers of both genders were the least likely to successfully quit smoking. Among women, but not men, younger and more socially acculturated individuals had lower odds of sustaining cessation. Over 90% of female and male former smokers reported quitting on their own without cessation aids or therapy. The results suggest that many Hispanics/Latinos are self-motivated to quit and are able to do so without clinical assistance. Heterogeneity in smoking behaviors among Hispanics/Latinos should be taken into account when developing and delivering smoking cessation interventions and public health campaigns.
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Affiliation(s)
- Cheryl R Merzel
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States.
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
| | - Garrett Strizich
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
| | - Sheila F Castañeda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, United States
| | - Marc Gellman
- Department of Psychology, University of Miami, United States
| | - Aida L Maisonet Giachello
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, United States
| | - David J Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, United States
| | - Frank J Penedo
- Department of Medical Social Science, Feinberg School of Medicine, Northwestern University, United States
| | - Krista M Perreira
- Department of Public Policy, University of North Carolina Chapel Hill, United States
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, United States
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Higgins ST, Kurti AN, Redner R, White TJ, Gaalema DE, Roberts ME, Doogan NJ, Tidey JW, Miller ME, Stanton CA, Henningfield JE, Atwood GS. A literature review on prevalence of gender differences and intersections with other vulnerabilities to tobacco use in the United States, 2004-2014. Prev Med 2015; 80:89-100. [PMID: 26123717 PMCID: PMC4592404 DOI: 10.1016/j.ypmed.2015.06.009] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/19/2015] [Accepted: 06/21/2015] [Indexed: 01/27/2023]
Abstract
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.
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Affiliation(s)
- Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA.
| | - Allison N Kurti
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Ryan Redner
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Thomas J White
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA
| | - Megan E Roberts
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Nathan J Doogan
- Center of Excellence in Regulatory Tobacco Science, The Ohio State University, USA
| | - Jennifer W Tidey
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
| | - Mollie E Miller
- Vermont Center on Tobacco Regulatory Science, University of Vermont, USA; Department of Psychiatry and Human Behavior, Brown University, USA
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Nodora JN, Cooper R, Talavera GA, Gallo L, Meza Montenegro MM, Komenaka I, Natarajan L, Gutiérrez Millán LE, Daneri-Navarro A, Bondy M, Brewster A, Thompson P, Martinez ME. Acculturation, Behavioral Factors, and Family History of Breast Cancer among Mexican and Mexican-American Women. Womens Health Issues 2015; 25:494-500. [PMID: 26189937 PMCID: PMC4739633 DOI: 10.1016/j.whi.2015.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 05/22/2015] [Accepted: 05/26/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Incidence rates for breast cancer are higher among Mexican-American (MA) women in the United States than women living in Mexico. Studies have shown higher prevalence of breast cancer risk factors in more acculturated than less acculturated Hispanic/Latinas in the United States. We compared the prevalence of behavioral risk factors and family history of breast cancer by level of acculturation and country of residence in women of Mexican descent. METHODS Data were collected from 1,201 newly diagnosed breast cancer patients living in Mexico (n = 581) and MAs in the United States (n = 620). MA participants were categorized into three acculturation groups (Spanish dominant, bilingual, and English dominant); women living in Mexico were used as the referent group. The prevalence of behavioral risk factors and family history of breast cancer were assessed according to acculturation level, adjusting for age at diagnosis and education. RESULTS In the adjusted models, bilingual and English-dominant MAs were significantly more likely to have a body mass index of 30 kg/m(2) or greater, consume more than one alcoholic beverage a week, and report having a family history of breast cancer than women living in Mexico. All three U.S. acculturation groups were significantly more likely to have lower total energy expenditure (≤533 kcal/d) than women in Mexico. English-dominant women were significantly less likely to ever smoke cigarettes than the Mexican group. CONCLUSIONS Our findings add to the limited scientific literature on the relationships among acculturation, health behavior, and family history of breast cancer in Mexican and MA women.
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Affiliation(s)
- Jesse N Nodora
- Moores Cancer Center, University of California, San Diego, La Jolla, California.
| | - Renee Cooper
- Graduate School of Public Health, San Diego State University, Graduate School of Public Health, San Diego, California
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, Graduate School of Public Health, San Diego, California
| | - Linda Gallo
- Department of Psychology, San Diego State University, Graduate School of Public Health, San Diego, California
| | | | - Ian Komenaka
- Department of Surgery, Maricopa Medical Center, Phoenix, Arizona
| | - Loki Natarajan
- Moores Cancer Center, University of California, San Diego, La Jolla, California
| | | | - Adrian Daneri-Navarro
- Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Mexico
| | - Melissa Bondy
- Department of Pediatrics, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Abenaa Brewster
- University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Hale WJ, Perrotte JK, Baumann MR, Garza RT. Low self-esteem and positive beliefs about smoking: a destructive combination for male college students. Addict Behav 2015; 46:94-9. [PMID: 25838000 DOI: 10.1016/j.addbeh.2015.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 02/24/2015] [Accepted: 03/07/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Men exhibit higher rates of smoking relative to women (CDC, 2014). Given the associated health and socio-economic consequences, it would be valuable to explore the psychological factors underlying this variance. We contend that positive beliefs about smoking influence this difference, and that self-esteem moderates these beliefs. METHOD As part of a multi-institutional collaborative study funded by the American Legacy Foundation, 445 participants who reported being either steady or occasional smokers completed a series of questionnaires assessing their beliefs and behaviors involving smoking as well as several dispositional variables. Moderated mediation was used to test for conditional indirect effects. RESULTS The total, indirect, and direct effects of gender were significant for individuals with lower, but not higher self-esteem. Males with lower self-esteem exhibited more positive beliefs and smoking behavior than females with lower self-esteem. No differences between males and females with higher self-esteem were observed. CONCLUSION The gender gap in smoking behavior appears to occur primarily among individuals with lower self-esteem. It is a particularly detrimental risk factor for males, as it is related to higher positive views about smoking and increased tobacco consumption. These results highlight the importance of developing multifaceted gender specific belief-based preventative interventions to address smoking related behaviors.
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Abstract
BACKGROUND Light smoking, consuming a few cigarettes daily, and intermittent, or nondaily, smoking patterns are increasingly common but carry health risks comparable to heavier smoking patterns. Nearly all smokers begin smoking as adolescents, who are at risk for developing these smoking patterns. Previous research suggests that smokers underestimate the risks associated with smoking. The extent to which adolescents perceive light and intermittent smoking as harmful has not been previously assessed. METHODS Data from 24,658 US adolescents sampled by the 2012 National Youth Tobacco Survey, a national, school-based, cross-sectional survey, were examined. Cross-tabulations and multivariate ordered probit regression models were constructed to describe correlates of US adolescents' perception of light and intermittent smoking. RESULTS Although most adolescents (88.0%; 95% confidence interval [CI], 87.2% to 88.8%) reported beliefs that a heavier smoking pattern is very harmful, only 64.3% (95% CI; 63.2% to 65.3%) and 33.3% (95% CI; 32.0% to 34.6%) reported that light and intermittent smoking, respectively, are very harmful. Conversely, nearly one-quarter of US adolescents believed intermittent smoking causes little or no harm. Males, younger adolescents, Hispanics, and non-Hispanic blacks were more likely than their peers to view light and intermittent smoking patterns as less harmful. Those who were already light or intermittent smokers, those who used other tobacco products, and those who had a family member who used tobacco were also less likely to view their smoking patterns as harmful. CONCLUSIONS Misconceptions about the safety of light and intermittent smoking are widespread among US adolescents. Significant public health attention is needed to redress these misperceptions.
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Affiliation(s)
| | - Michael Weitzman
- Departments of Pediatrics, and,Environmental Medicine, New York University School of Medicine, New York, New York; and,Global Institute of Public Health, New York University, New York, New York
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