Prevalence of cigarette smoking in Northeast Pennsylvania in 2002 T Coleman* and SM Lesko

Northeast Regional Cancer Institute, Scranton, PA*colemang2@scranton.edu

ABSTRACTTobacco is the most common preventable cause of death and disability in the US. Incidence rates for several tobacco-related cancers in Northeast Pennsylvania (NEPA) are significantly higher than the corresponding US rates. We used data from an on-going population-based study of cancer risk factors to estimate the prevalence of current cigarette smoking among adult residents of six NEPA counties. A total of 1,096 participants, identified by random digit dialing, were interviewed by telephone. Prevalence estimates were adjusted for sex and education, and 95% Confidence Intervals (CI) were calculated. The prevalence of current cigarette smoking among all adults was 27.5% (95%CI, 24.9%-30.1%). This proportion was significantly higher than 2001 Behavioral Risk Factor Surveillance Study figures for PA and the US (24.5%, 22.7% respectively). Among men and women in NEPA, the prevalence of current smoking was 28.9% (95%CI, 24.3%-33.5%) and 26.1% (95%CI, 22.9%-29.3%), respectively. The prevalence of smoking among women was significantly higher than the US figure (20.6%). When examined by age, the prevalence of current smoking in NEPA was greatest among 30-44 year olds (40.7%, 95%CI, 35.3%-46.1%). This proportion was significantly greater than both the PA (29.1%) and the US figures (26.4%). The high prevalence of smoking in NEPA underscores the need for more effective tobacco control efforts for adults in this six county region. Women and younger adults (30-44 years old) are two subgroups who may particularly benefit from targeted interventions.

OBJECTIVES•Document prevalence of cigarette smoking in NEPA•Establish baseline data for county tobacco control initiatives •Explore professional and patient practices related to quitting

BACKGROUND• Tobacco is the most common preventable cause of death and disability in the US • In NEPA, incidence rates for tobacco-related cancers are high

•Lung•Bladder•Cervix

•Behavioral Risk Factor Study (BRFSS) data suggest that smoking prevalence is high in several NEPA counties

METHODS•Population-based study

•Subjects: adult residents of NEPA•Six Counties- Lackawanna, Luzerne, Pike, Susquehanna, Wayne, Wyoming

•Selected by random digit dialing•Interviewed by telephone

LIMITATIONS•Self-reported data•Limited statistical power for stratified analyses

CONCLUSIONS•Prevalence of cigarette smoking is high•Majority of smokers would like to quit•29% of adults not asked about smoking•24.5% of smokers not advised to quit

DISCUSSION•The high prevalence of smoking in NEPA underscores the need for more effective tobacco control efforts for adults. •Women and younger adults (ages 30-44) may particularly benefit from targeted interventions.

ACKNOWLEDGEMENTThis research was supported by grant number DE-FG02-98ER62592 from the U.S. Department of Energy and grants from the Lackawanna County Commission on Drug and Alcohol, and the Luzerne-Wyoming Counties’ Drug and Alcohol Program. This project was funded, in part, under a contract with the Pennsylvania Department of Health, Harrisburg, PA. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.

RESULTS•Participants interviewed in 2002, n= 1,096

•34.4% male•Age, range 18-93 yrs

mean = 51 yrs•9.7% with <high school education•1.8% non-white

•Participants interviewed in 2003, n= 1,466•35.3% male•Age, range 18-92 yrs

mean = 53yrs•7% with <high school education•2.7% non-white

•Prevalence of cigarette smoking in 2002 is shown in Table 1.

•Prevalence of cigarette smoking in 2002 by age is shown in Figure 1.

•In NEPA, current smoking was highest in 30-44 year age group

•40.7% (95% CI, 35.3%-46.1%)•This figure was significantly higher than 2001 BRFSS figures for PA and the US (29.1% and 26.4%, respectively; p <0.001)

•Prevalence of past smoking was unusually high in several age categories

•In 18-29 year age group, it was 21.9% (95% CI, 14.1%-29.7%)

- This figure was significantly higher than 2001 BRFSS figures for PA and the US (8.9% and10.7%,respectively; p <0.001)

•In 30-44 year age group, it was 23.0% (95% CI, 18.4%-27.6%)

- This figure was significantly higher than 2001 BRFSS for the US (17.8%, p <0.05)

•Prevalence of cigarette smoking in 2002 by education is shown in Figure 2.

•In NEPA, current smoking was more common among those with some college education

•Prevalence 29.5% (95% CI, 24.6%-34.4%)•This figure was significantly greater than 2001

BRFSS data for the US (23.7%, p <0.05)

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•Outcomes•Prevalence of cigarette smoking (current and past) in

2002•Adjusted for age and education•Compared to BRFSS data from 2001

•Professional Practices (in 2003)•Inquiries regarding smoking•Recommendations regarding quitting

•Smokers’ intentions (in 2003)•Previous quit attempts•Plans for quitting

Figure 1. Cigarette Smoking in 2002 by Age

Figure 2. Cigarette Smoking in 2002 by Education

•Professional Practices (in 2003)•Of 1,215 respondents in NEPA, 29.6% (95% CI; 27%, 32.2%) reported that they had not been asked by a healthcare professional in the past year if they smoked cigarettes

•66% (95% CI; 63.3%, 68.7%) had been asked•Of 275 current smokers, 24.5% (95% CI; 19.4%, 29.6%) reported that they had not been advised by a healthcare professional in the past year to quit smoking

•69.2% (95% CI; 63.7%, 74.7%) had been advised to quit

•Smoking Cessation (in 2003)•Of 336 current smokers, 82.6% (95% CI; 78.5%, 86.7%) reported that they had stopped smoking for one day or longer because they were trying to quit smoking

•Median number of quit attempts =3•Plans for quitting smoking are shown in Figure 3.

•Of 273 current smokers 29.7% (95% CI; 24.3%, 35.1%) planned to quit within six

months•24.6% (95% CI; 19.5%, 29.7%) had no intention

of quitting

Figure 3. Readiness to Quit Smoking in 2003

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Table 1. Prevalence of Cigarette Smoking in 2002 Category

NEPA

95% CI

PA*

p-value**

US*

p-value**

All adults§ Current 27.5% 24.9%-30.1% 24.5% <0.05 22.7% <0.001 Past 32.3% 30.1%-35.1% 24.2% <0.001 24.5% <0.001 Men§§ Current 28.9% 24.3%-33.5% 26.3% 0.3 25.0% 0.1 Past 37.2% 32.3%-42.1% 28.9% <0.01 28.3% <0.001 Women§§ Current 26.1% 22.9%-29.3% 22.8% 0.1 20.6% <0.001 Past 27.7% 24.4%-31.0% 20.1% <0.001 20.9% <0.001 * Calculated using CDC 2001 BRFSS Data ** Compared to NEPA § Adjusted for sex & education §§ Adjusted for education only