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Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project

BACKGROUND: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia...

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Autores principales: Cardarelli, Kathryn, Westneat, Susan, Dunfee, Madeline, May, Beverly, Schoenberg, Nancy, Browning, Steven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856720/
https://www.ncbi.nlm.nih.gov/pubmed/33530976
http://dx.doi.org/10.1186/s12889-021-10334-6
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author Cardarelli, Kathryn
Westneat, Susan
Dunfee, Madeline
May, Beverly
Schoenberg, Nancy
Browning, Steven
author_facet Cardarelli, Kathryn
Westneat, Susan
Dunfee, Madeline
May, Beverly
Schoenberg, Nancy
Browning, Steven
author_sort Cardarelli, Kathryn
collection PubMed
description BACKGROUND: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior. METHODS: A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015–2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed. RESULTS: MAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51–2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking. CONCLUSIONS: Despite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use.
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spelling pubmed-78567202021-02-04 Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project Cardarelli, Kathryn Westneat, Susan Dunfee, Madeline May, Beverly Schoenberg, Nancy Browning, Steven BMC Public Health Research Article BACKGROUND: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior. METHODS: A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015–2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. Adjusted prevalence ratios for current smoking versus not smoking were also computed. RESULTS: MAP participants reported current smoking prevalence (33%) more than double the national adult smoking prevalence. Current smoking among participants with a reported diagnosis of chronic obstructive pulmonary disease and emphysema was 51.5 and 53.3%, respectively. Compared to participants age 65 years and older, those age 45 years or younger reported double the prevalence of smoking (PR: 2.04, 95% CI: 1.51–2.74). Adjusted analyses identified younger age, lower education, unmet financial need, and depression to be significantly associated with current smoking. CONCLUSIONS: Despite declining rates of smoking across the United States, smoking remains a persistent challenge in Central Appalachia, which continues to face marked disparities in education funding and tobacco control policies that have benefitted much of the rest of the nation. Compared with national data, our cohort demonstrated higher rates of smoking among younger populations and reported a greater intensity of cigarette use. BioMed Central 2021-02-02 /pmc/articles/PMC7856720/ /pubmed/33530976 http://dx.doi.org/10.1186/s12889-021-10334-6 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Cardarelli, Kathryn
Westneat, Susan
Dunfee, Madeline
May, Beverly
Schoenberg, Nancy
Browning, Steven
Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title_full Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title_fullStr Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title_full_unstemmed Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title_short Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project
title_sort persistent disparities in smoking among rural appalachians: evidence from the mountain air project
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7856720/
https://www.ncbi.nlm.nih.gov/pubmed/33530976
http://dx.doi.org/10.1186/s12889-021-10334-6
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