American Journal of Preventive Medicine最新文献_第3页

Impact of Self-Reported Patient-Provider Communication on the Use of High- and Low-Value Care among U.S. Adults. 自我报告的患者-提供者沟通对美国成年人使用高价值和低价值护理的影响。

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-28 DOI: 10.1016/j.amepre.2026.108289

Sungchul Park, A Mark Fendrick, David D Kim

Introduction: Effective patient-provider communication may promote high-value services while discouraging low-value services. This study examined associations between patient-provider communication and the use of high- and low-value services among U.S. adults.

Methods: A cross-sectional study using the 2010-2021 Medical Expenditure Panel Survey was conducted in 2025. Self-reported patient-provider communication was assessed in four domains (attentive listening, clear explanation, respectfulness, time spent) and categorized as low versus moderate/high. Outcomes include 10 high-value services (appropriate cancer screenings, diagnostic and preventive tests, and diabetes care) and 12 low-value services (inappropriate cancer screenings, medication use, and imaging tests). Inverse probability of treatment weighting was applied to balance covariates, followed by weighted generalized linear models to estimate adjusted mean differences in the use of high- and low-value services across levels of patient-provider communication.

Results: Compared to adults reporting low communication, those reporting moderate/high communication had consistently greater use of all 10 high-value services, with adjusted differences ranging from +1.7 percentage points (95% CI: 1.2-2.2) for blood pressure measurement to +8.8 (6.8-10.8) for breast cancer screening. For low-value services, adults reporting moderate/high communication showed increased use of antibiotics for influenza (+3.1;1.1-5.0), but lower use of opioids for headaches (-2.3;-3.7,-0.8) and three back pain-related services: opioids (-6.7;-9.8,-3.6), MRI/CT scans (-4.2;-4.7,-3.7), and radiographs (-2.3;-4.2,-0.4).

Conclusions: Better patient-provider communication was consistently associated with greater use of high-value services, but associations with low-value services were mixed. Efforts to improve communication may help promote high-value care; however, reducing low-value care may require additional, service-specific approaches beyond communication alone.

导读：有效的医患沟通可以促进高价值服务，抑制低价值服务。这项研究调查了美国成年人中医患沟通与使用高价值和低价值服务之间的关系。方法：采用2025年2010-2021年医疗费用面板调查进行横断面研究。自我报告的患者-提供者沟通在四个领域（注意倾听，清楚解释，尊重，时间花费）进行评估，并分为低与中/高。结果包括10项高价值服务（适当的癌症筛查、诊断和预防测试以及糖尿病护理）和12项低价值服务（不适当的癌症筛查、药物使用和影像学检查）。应用治疗加权的逆概率来平衡协变量，然后使用加权广义线性模型来估计在不同水平的医患沟通中使用高价值和低价值服务的调整后平均差异。结果：与报告低沟通的成年人相比，报告中度/高度沟通的成年人始终更多地使用所有10项高价值服务，调整后的差异范围从血压测量的+1.7个百分点（95% CI: 1.2-2.2）到乳腺癌筛查的+8.8个百分点（6.8-10.8）。对于低价值服务，报告中度/高度沟通的成年人显示流感抗生素使用增加（+3.1;1.1-5.0），但阿片类药物用于头痛（-2.3;-3.7,-0.8）和三种背痛相关服务：阿片类药物（-6.7;-9.8,-3.6），MRI/CT扫描（-4.2;-4.7,-3.7）和x线片（-2.3;-4.2,-0.4）。结论：更好的医患沟通始终与更多地使用高价值服务相关，但与低价值服务的关联是混合的。努力改善沟通可能有助于促进高价值护理；然而，减少低价值护理可能需要额外的、针对服务的方法，而不仅仅是沟通。

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引用次数: 0

Intended Behaviors in Anticipation of a National Menthol Flavor Ban: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023–2024 预期全国薄荷香料禁令的预期行为：来自美国多州快速反应调查的结果，2023-2024

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108118

Samuel Asare PhD, Tyler Nighbor PhD, Minal Patel PhD, J. Lee Westmaas PhD, Zheng Xue MSPH, Shanshan Wang MPH, Eva Orr-Souza MPH, Nigar Nargis PhD

Introduction

The U.S. Food and Drug Administration proposed a product standard to restrict menthol as a characterizing flavor in cigarettes in 2022. Evidence since this announcement on intended tobacco use behavior among individuals who currently smoke menthol cigarettes may inform further policy development.

Methods

Data were from 2 years of a rapid-response survey of a probability sample of 12,300 adults (aged 18–65 years) in 13 high-tobacco-burden U.S. states and 4 low-tobacco-burden U.S. states collected in April–May 2023 and April–May 2024. In 2025, the authors analyzed intended tobacco-use behaviors in anticipation of an impending national menthol ban among 1,685 individuals (1,202 from high-tobacco-burden states and 483 from low-tobacco-burden states) who smoked menthol cigarettes. Weighted multinomial logistic regression examined which sociodemographic characteristics were associated with intended tobacco-use behaviors.

Results

Among respondents who smoked menthol cigarettes in high-tobacco-burden U.S. states, 25.2% reported intentions to quit all tobacco use or cigarette smoking, 15.2% reported intentions to quit menthol cigarette smoking or reduce cigarette smoking, and 53.0% reported intentions to switch to other tobacco products should menthol cigarettes become unavailable. In the low-tobacco-burden U.S. states, these percentages were 24.2%, 10.4%, and 62.0%, respectively. The multinomial logistic regression estimates indicated that in high-tobacco-burden U.S. states but not in low-tobacco-burden U.S. states, individuals of Black (RRR=2.4; 95% CI=1.6, 3.5; p<0.001) and Hispanic (RRR=2.8; 95% CI=1.6, 4.8; p<0.001) race/ethnicity were more likely to endorse quitting or reducing tobacco use relative to switching to other tobacco products than those of non-Hispanic White race/ethnicity.

Conclusions

Banning menthol cigarettes nationwide may substantially benefit the U.S. population, particularly Black and Hispanic individuals in high-tobacco-burden U.S. states.

美国食品和药物管理局于2022年提出了一项产品标准，以限制薄荷醇作为香烟的特征香料。自本公告发布以来，有关目前吸食薄荷香烟的个人有意烟草使用行为的证据可能为进一步的政策制定提供信息。数据来自于2023年4月至5月和2024年4月至5月对美国13个高烟草负担州和4个低烟草负担州的12300名成年人（18-65岁）进行的为期2年的快速反应调查。2025年，作者分析了1685名吸烟薄荷香烟的人（1202名来自高烟草负担州，483名来自低烟草负担州）在预计即将实施的全国薄荷禁令下的预期烟草使用行为。加权多项逻辑回归检验了哪些社会人口学特征与预期的烟草使用行为相关。结果在美国高烟草负担州的薄荷卷烟受访者中，25.2%的人报告有意放弃所有烟草使用或吸烟，15.2%的人报告有意戒烟或减少吸烟，53.0%的人报告说，如果没有薄荷卷烟，他们打算转向其他烟草制品。在美国烟草负担较低的州，这些百分比分别为24.2%、10.4%和62.0%。多项logistic回归估计表明，在烟草负担高的美国各州，而在烟草负担低的美国各州，黑人（RRR=2.4; 95% CI=1.6, 3.5; p<0.001）和西班牙裔（RRR=2.8; 95% CI=1.6, 4.8; p<0.001）种族/族裔的个体比非西班牙裔白人/族裔的个体更有可能支持戒烟或减少烟草使用，而不是转向其他烟草制品。结论：在全国范围内禁止薄荷香烟可能会大大有利于美国人口，特别是在美国烟草负担高的州的黑人和西班牙人。

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引用次数: 0

Understanding the Sources of Subnational Disparities in Cigarette Smoking Prevalence: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023–2024 了解地方吸烟率差异的来源：来自美国多州快速反应调查的结果，2023-2024

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108060

Nigar Nargis PhD , Zheng Xue MSPH , Tyler Nighbor PhD , Samuel Asare PhD , J. Lee Westmaas PhD , Priti Bandi PhD , Minal Patel PhD

Introduction

Cigarette smoking prevalence among U.S. adults varies widely across states. This study examines major sociodemographic and economic factors underlying subnational smoking disparities.

Methods

Data were from a rapid-response online survey of a probability sample of 12,300 adults (aged ≥18 years) in 13 high-tobacco-burden states (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia) and 4 low-tobacco-burden comparison states (California, Illinois, Maryland, and Virginia), conducted in 2023 and 2024 and analyzed in 2024. Threefold Oaxaca–Blinder linear decomposition analysis was used to identify sources of disparities in cigarette smoking prevalence between high- and low-tobacco-burden states.

Results

Differences in smoking propensities by population characteristics (population composition held constant) accounted for 56.7% of the subnational disparity in smoking prevalence. This was largely driven by higher smoking prevalence in high-tobacco-burden states among older adults (aged 40–65 years) and individuals with less than a high-school education. Convergence of smoking prevalence of college graduates and those aged 18–20 years partially offset the difference. Variation in population composition (smoking propensities held constant) contributed 22.9% of the difference, driven by larger proportions of individuals in the group with less than college education in high-tobacco-burden states with significantly higher smoking rates. The residual 20.4% was attributable to unmeasured macrolevel differences simultaneously affecting individual smoking propensities and population composition by educational status.

Conclusions

The mitigation of subnational smoking disparities requires concerted tobacco control efforts tailored to smoking cessation among older adults and persons with less than college education and population-level advancement in educational attainment.

美国成年人的吸烟率在各州之间差别很大。本研究考察了地方吸烟差异背后的主要社会人口和经济因素。方法数据来自于2023年和2024年对13个高烟草负担州（阿拉巴马州、阿肯色州、印第安纳州、肯塔基州、路易斯安那州、密歇根州、密西西比州、密苏里州、俄亥俄州、俄克拉何马州、南卡罗来纳州、田纳西州和西弗吉尼亚州）和4个低烟草负担比较州（加利福尼亚州、伊利诺伊州、马里兰州和弗吉尼亚州）的12300名成年人（年龄≥18岁）进行的快速响应在线调查，并于2024年进行分析。使用三重瓦哈卡-盲器线性分解分析来确定高烟草负担州和低烟草负担州之间吸烟率差异的来源。结果人口特征吸烟倾向差异（人口构成不变）占地方吸烟率差异的56.7%。这主要是由于在高烟草负担州，老年人（40-65岁）和高中教育程度以下的人的吸烟率较高。大学毕业生和18-20岁人群吸烟率的趋同部分抵消了这一差异。人口构成的变化（吸烟倾向保持不变）造成了22.9%的差异，这是由于在吸烟率明显较高的高烟草负担州，受教育程度低于大学的人群比例较大。剩余的20.4%可归因于未测量的宏观水平差异，同时影响个人吸烟倾向和受教育程度影响的人口组成。结论：国家以下地区吸烟差异的缓解需要协调一致的控烟努力，以适应老年人和大学以下教育程度人群的戒烟需求，以及人口水平教育程度的提高。

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引用次数: 0

Dual Use of Combustible and Electronic Cigarettes: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023 可燃和电子烟的双重使用：来自美国多州快速反应调查的结果，2023

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108059

Tyler Nighbor PhD , Laurel Gibson PhD, MPH , Presley Cannon MS, MPH , Eva Orr-Souza MPH , Shanshan Wang MPH , Zheng Xue MSPH , Samuel Asare PhD , Johann Lee Westmaas PhD , Nigar Nargis PhD , Minal Patel PhD, MPH

Introduction

Dual use of cigarettes and E-cigarettes is common in the U.S. Although some people report using E-cigarettes to quit combustible cigarettes, continued dual use may exacerbate existing health disparities in states with disproportionately high smoking rates.

Methods

Respondents (N=4,550) were adults (aged 18–65 years) living in the 13 U.S. states with the highest prevalence of cigarette smoking who completed an online probability-based rapid-response survey in 2023. Weighted logistic regression models, adjusted for sociodemographic characteristics, compared responses on smoking cessation attempts and methods between individuals reporting dual use and those reporting exclusive current cigarette use.

Results

Exclusive cigarette use was reported by 9.4% of respondents, and dual use was reported by 3.8%. Individuals reporting dual use were significantly more likely than those reporting exclusive cigarette use to report at least 1 past-year quit attempt (AOR=1.90; 95% CI=1.11, 3.24, p=0.018), including those lasting 1 day or longer (AOR=2.98, 95% CI=1.76, 5.03, p<0.001), and reducing to less than 1 cigarette per day (AOR=3.38, 95% CI=1.55, 7.39, p=0.002). Individuals reporting dual use were also more likely to report using nonpharmacologic (e.g., telephone counseling) (AOR=2.47, 95% CI=1.01, 6.04, p=0.048) and non–Food and Drug Administration–approved (e.g., switching to E-cigarettes) (AOR=17.38, 95% CI=6.97, 43.36, p<0.001) cessation methods.

Conclusions

Dual use may be associated with greater motivation to quit than exclusive cigarette use. However, given continued combustible cigarette consumption, additional resources are needed to support complete abstinence to reduce tobacco-related disparities in high-tobacco-burden states.

香烟和电子烟的双重使用在美国很常见，尽管有些人报告使用电子烟戒烟，但在吸烟率过高的州，继续双重使用可能会加剧现有的健康差距。方法受访者（N= 4550）是居住在美国13个吸烟率最高的州的成年人（18-65岁），他们在2023年完成了一项基于概率的在线快速反应调查。加权逻辑回归模型，根据社会人口学特征进行调整，比较报告双重使用的个体和报告目前只使用香烟的个体对戒烟尝试和方法的反应。结果有9.4%的被调查者表示吸烟是专门的，有3.8%的被调查者表示吸烟是双重的。报告双重使用的个体比报告单独使用香烟的个体更有可能报告至少一次过去一年的戒烟尝试（AOR=1.90; 95% CI=1.11, 3.24, p=0.018），包括持续1天或更长时间的戒烟（AOR=2.98, 95% CI=1.76, 5.03, p<0.001），以及减少到每天少于1支香烟（AOR=3.38, 95% CI=1.55, 7.39, p=0.002）。报告双重使用的个体也更有可能报告使用非药物（例如，电话咨询）（AOR=2.47, 95% CI=1.01, 6.04, p=0.048）和非食品和药物管理局批准的戒烟方法（例如，改用电子烟）（AOR=17.38, 95% CI=6.97, 43.36, p<0.001）。结论双重使用可能比完全使用香烟更有戒烟动机。然而，鉴于可燃卷烟的持续消费，需要额外的资源来支持完全戒烟，以减少烟草高负担州的烟草相关差异。

{"title":"Dual Use of Combustible and Electronic Cigarettes: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023","authors":"Tyler Nighbor PhD , Laurel Gibson PhD, MPH , Presley Cannon MS, MPH , Eva Orr-Souza MPH , Shanshan Wang MPH , Zheng Xue MSPH , Samuel Asare PhD , Johann Lee Westmaas PhD , Nigar Nargis PhD , Minal Patel PhD, MPH","doi":"10.1016/j.amepre.2025.108059","DOIUrl":"10.1016/j.amepre.2025.108059","url":null,"abstract":"<div><h3>Introduction</h3><div>Dual use of cigarettes and E-cigarettes is common in the U.S. Although some people report using E-cigarettes to quit combustible cigarettes, continued dual use may exacerbate existing health disparities in states with disproportionately high smoking rates.</div></div><div><h3>Methods</h3><div>Respondents (N=4,550) were adults (aged 18–65 years) living in the 13 U.S. states with the highest prevalence of cigarette smoking who completed an online probability-based rapid-response survey in 2023. Weighted logistic regression models, adjusted for sociodemographic characteristics, compared responses on smoking cessation attempts and methods between individuals reporting dual use and those reporting exclusive current cigarette use.</div></div><div><h3>Results</h3><div>Exclusive cigarette use was reported by 9.4% of respondents, and dual use was reported by 3.8%. Individuals reporting dual use were significantly more likely than those reporting exclusive cigarette use to report at least 1 past-year quit attempt (AOR=1.90; 95% CI=1.11, 3.24, <em>p</em>=0.018), including those lasting 1 day or longer (AOR=2.98, 95% CI=1.76, 5.03, <em>p</em><0.001), and reducing to less than 1 cigarette per day (AOR=3.38, 95% CI=1.55, 7.39, <em>p</em>=0.002)<em>.</em> Individuals reporting dual use were also more likely to report using nonpharmacologic (e.g., telephone counseling) (AOR=2.47, 95% CI=1.01, 6.04, <em>p</em>=0.048) and non–Food and Drug Administration–approved (e.g., switching to E-cigarettes) (AOR=17.38, 95% CI=6.97, 43.36, <em>p</em><0.001) cessation methods.</div></div><div><h3>Conclusions</h3><div>Dual use may be associated with greater motivation to quit than exclusive cigarette use. However, given continued combustible cigarette consumption, additional resources are needed to support complete abstinence to reduce tobacco-related disparities in high-tobacco-burden states.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 2","pages":"Article 108059"},"PeriodicalIF":4.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitigating Tobacco-Related Disparities: A Subnational View of Tobacco Use Behaviors and Tobacco Control in High-Tobacco-Burden U.S. States 减轻与烟草有关的差异：美国烟草高负担州的烟草使用行为和烟草控制的次国家观点

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108161

Nigar Nargis PhD, Tyler Nighbor PhD, Minal Patel PhD, Samuel Asare PhD, J. Lee Westmaas PhD

引用次数: 0

Tobacco Use Behaviors and Related Disparities in 13 High-Tobacco-Burden U.S. States: An Overview of Evidence 美国13个高烟草负担州的烟草使用行为和相关差异：证据综述

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108160

Minal Patel PhD, MPH , Tyler Nighbor PhD , Johann Lee Westmaas PhD , Shanshan Wang MPH , Laurel Gibson PhD, MPH , Eva Orr-Souza MPH , Angela Giaquinto MSPH , Farhad Islami MD, PhD , Nigar Nargis PhD

Progress in reducing cigarette smoking prevalence in the U.S. substantially varies by states, with the prevalence up to 50% higher than the national average in many states (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia; high-tobacco-burden states). However, potential correlates and causes of tobacco use and health disparities have not been well documented in this region. The authors aimed to (1) establish recent estimates of lung cancer incidence, mortality, and smoking-attributable cancer rates and (2) review existing research on tobacco use behaviors in these states.

Recent prevalence of lung cancer incidence/mortality and smoking-attributable mortality by states were obtained from the Behavioral Risk Factor Surveillance System, National Center for Health Statistics, Centers for Disease Prevention and Control (2020), American Cancer Society, and published meta-analyses or pooled analyses. Original research and systematic reviews were assessed using PubMed and Medline through November 2024 to document the prevalence of cigarette, E-cigarette, and other tobacco use and related risk factors and health outcomes.

Age-adjusted lung cancer incidence/mortality and smoking-attributable mortality were high in the high-tobacco-burden states. Only 2 states had comprehensive smokefree air laws, whereas 9 states had pre-emption laws that hinder additional policy implementation. Research on tobacco use patterns, tobacco control policies, and regulations specific to the high-tobacco-burden states was scarce.

Despite higher than national average cancer incidence and mortality rates, existing research in these states lacks the systematic and comparative approach needed to draw strong conclusions.

美国各州在降低吸烟率方面取得的进展差别很大，许多州（阿拉巴马州、阿肯色州、印第安纳州、肯塔基州、路易斯安那州、密歇根州、密西西比州、密苏里州、俄亥俄州、俄克拉荷马州、南卡罗来纳州、田纳西州和西弗吉尼亚州；烟草负担高的州）的吸烟率比全国平均水平高出50%。然而，在本区域，烟草使用与健康差异的潜在相关因素和原因尚未得到很好的记录。作者的目的是(1)建立最近对肺癌发病率、死亡率和吸烟导致的癌症发病率的估计；(2)回顾这些州现有的烟草使用行为研究。从行为风险因素监测系统、国家卫生统计中心、疾病预防和控制中心（2020年）、美国癌症协会和已发表的荟萃分析或汇总分析中获得了各州最近的肺癌发病率/死亡率和吸烟导致的死亡率。到2024年11月，通过PubMed和Medline对原始研究和系统评价进行了评估，以记录香烟、电子烟和其他烟草使用的流行程度以及相关的风险因素和健康结果。在高烟草负担州，年龄调整后的肺癌发病率/死亡率和吸烟导致的死亡率很高。只有2个州有全面的无烟空气法，而9个州有阻碍额外政策实施的优先法律。针对高烟草负担州的烟草使用模式、烟草控制政策和法规的研究很少。尽管这些州的癌症发病率和死亡率高于全国平均水平，但现有的研究缺乏得出有力结论所需的系统和比较方法。

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引用次数: 0

Methods of a Multi-State Rapid-Response Survey Designed to Close Evidence Gaps in Tobacco Use and Related Disparities in the U.S. 多州快速反应调查方法，旨在缩小美国烟草使用和相关差异的证据差距

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108061

Minal Patel PhD, MPH , Presley Cannon MS, MPH , Laurel Gibson PhD, MPH , Tyler Nighbor PhD , Aya Carus BA , Shanshan Wang MPH , Michele Salomon JD , Nigar Nargis PhD

Introduction

Tobacco use remains a significant public health challenge in the U.S., particularly in high-tobacco-burden states in the Midwest and South (Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia). Despite higher smoking prevalence and tobacco-related health disparities, little up-to-date information on correlates of tobacco use and emerging issues specific to this region is available for advocates and policymakers. Therefore, an online rapid-response survey was developed to provide timely and cost-effective information.

Methods

A total of 12,300 adults (aged 18–65 years) were surveyed from April to May 2023 and 2024 on tobacco use behaviors, harm perceptions, attitudes toward tobacco control policies, and access and use of cessation resources in high- versus 4 low-tobacco-burden states (California, Illinois, Maryland, and Virginia). Data were weighted to each state's population, enabling comprehensive analysis of regional and subpopulation differences.

Results

Weighted pooled data from both waves in high-tobacco-burden states revealed the highest prevalence of current tobacco use in Arkansas (42.8%) and the lowest in Missouri (29.7%). Cigarette use was most common in West Virginia (25.8%) and least common in South Carolina (17.6%), notably higher than the 10.9%–14.3% rates in low-tobacco-burden states. The use of other tobacco products, including E-cigarettes (16.6%) and oral nicotine pouches (3.5%), was also relatively high in high-tobacco-burden states.

Conclusions

This rapid-response survey provides timely data to inform tobacco control policies in high-tobacco-burden states. Tobacco use and related data can aid in developing more effective interventions and clinical guidelines.

烟草使用在美国仍然是一个重大的公共卫生挑战，特别是在中西部和南部的高烟草负担州（阿拉巴马州、阿肯色州、印第安纳州、肯塔基州、路易斯安那州、密歇根州、密西西比州、密苏里州、俄亥俄州、俄克拉荷马州、南卡罗来纳州、田纳西州和西弗吉尼亚州）。尽管吸烟率较高，与烟草有关的健康差异也较大，但关于烟草使用的相关因素和本区域特有的新出现问题的最新信息很少提供给倡导者和决策者。因此，制定了一项在线快速反应调查，以提供及时和具有成本效益的信息。方法于2023年4月至2024年5月在4个低烟草负担州（加利福尼亚州、伊利诺伊州、马里兰州和弗吉尼亚州）对12300名成年人（18-65岁）进行了烟草使用行为、危害认知、对烟草控制政策的态度以及戒烟资源的获取和使用调查。数据加权到每个州的人口，使区域和亚人口差异的综合分析。结果来自高烟草负担州的两波加权汇总数据显示，阿肯色州目前的烟草使用率最高（42.8%），密苏里州最低（29.7%）。卷烟使用在西弗吉尼亚州最常见（25.8%），在南卡罗来纳州最不常见（17.6%），明显高于低烟草负担州10.9%-14.3%的比例。其他烟草制品的使用，包括电子烟（16.6%）和口服尼古丁袋（3.5%），在烟草负担高的州也相对较高。结论该快速反应调查为高烟草负担州的控烟政策提供了及时的数据。烟草使用和相关数据有助于制定更有效的干预措施和临床指南。

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引用次数: 0

Prevalence and Sources of E-Cigarette Use: Findings From a Rapid-Response Survey in High-Tobacco-Burden U.S. States, 2023–2024 电子烟使用的流行程度和来源：2023-2024年美国高烟草负担州快速反应调查结果

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108062

Shanshan Wang MPH, Tyler Nighbor PhD, Johann Lee Westmaas PhD, Samuel Asare PhD, Minal Patel PhD, MPH, Nigar Nargis PhD

Introduction

The overall effectiveness of E-cigarette regulations may be undermined by access to unregulated sources for obtaining E-cigarettes. Data on sources of E-cigarettes are limited, particularly in places with the highest tobacco burden in the U.S.

Methods

Data were from a rapid-response survey of a probability sample of 9,100 adults (aged 18–65 years) in 13 high-tobacco-burden U.S. states collected in April–May 2023 and April–May 2024. Weighted bivariate analyses and multinomial logistic regression were used to examine E-cigarette prevalence and correlates of E-cigarette sources.

Results

In high-tobacco-burden states, 16.6% of adults reported current E-cigarette use, purchasing mostly from retail stores (75.9%), followed by receiving/purchasing from informal sources; for example, family, friends, free samples, others (16.6%); and purchasing online (7.5%). The likelihood of obtaining E-cigarettes from informal sources over store purchases was higher among adults aged 18–20 years (RRR=3.26, 95% CI=1.27, 8.35 versus among those aged 45–65 years), Hispanics (RRR=2.26, 95% CI=1.09, 4.69 versus non-Hispanic Whites), individuals who were not employed (RRR=1.79, 95% CI=1.01, 3.18 versus employed individuals), and individuals reporting nondaily use (RRR=2.78, 95% CI=1.66, 4.64 versus those reporting daily use). The likelihood of purchasing E-cigarettes online over store purchases was higher among college graduates (RRR=2.09, 95% CI=1.14, 3.82 than among those with less than a 4-year college degree) and individuals who use refillable (RRR=3.06, 95% CI=1.38, 6.76 than among those who use disposable E-cigarettes) or those who use mod E-cigarettes (RRR=3.55, 95% CI=1.54, 8.20 than those who use disposable E-cigarettes).

Conclusions

Informal sources and online retailers remain largely unregulated, yet they account for a quarter of E-cigarette use and are disproportionately high among certain population subgroups. Enhanced E-cigarette market surveillance is critical for uncovering and closing regulatory loopholes in both high-tobacco-burden states and nationally.

电子烟法规的整体有效性可能会因获取电子烟的不受管制来源而受到损害。关于电子烟来源的数据有限，特别是在美国烟草负担最高的地方。方法数据来自于2023年4月至5月和2024年4月至5月对美国13个烟草负担高的州的9100名成年人（18-65岁）的概率样本进行的快速反应调查。使用加权双变量分析和多项逻辑回归来检查电子烟的流行程度和电子烟来源的相关因素。结果在高烟草负担州，16.6%的成年人报告目前使用电子烟，主要从零售商店购买（75.9%），其次是从非正式渠道接收/购买；例如，家人、朋友、免费样品、其他（16.6%）；网上购物（7.5%）。18-20岁的成年人（RRR=3.26, 95% CI=1.27, 8.35，而45-65岁的成年人）、西班牙裔（RRR=2.26, 95% CI=1.09, 4.69，而非西班牙裔白人）、非就业人群（RRR=1.79, 95% CI=1.01, 3.18，而就业人群）和非日常使用人群（RRR=2.78, 95% CI=1.66, 4.64，而日常使用人群）从非正式渠道获得电子烟的可能性高于从商店购买的可能性。在大学毕业生（RRR=2.09, 95% CI=1.14, 3.82）和使用可再填充式电子烟（RRR=3.06, 95% CI=1.38, 6.76，比使用一次性电子烟的人）或使用mod电子烟（RRR=3.55, 95% CI=1.54, 8.20，比使用一次性电子烟的人）中，在线购买电子烟的可能性比在商店购买的可能性更高。正式来源和在线零售商在很大程度上仍不受监管，但它们占电子烟使用量的四分之一，在某些人群中比例高得不成比例。加强电子烟市场监测对于在高烟草负担州和全国范围内发现和弥补监管漏洞至关重要。

{"title":"Prevalence and Sources of E-Cigarette Use: Findings From a Rapid-Response Survey in High-Tobacco-Burden U.S. States, 2023–2024","authors":"Shanshan Wang MPH, Tyler Nighbor PhD, Johann Lee Westmaas PhD, Samuel Asare PhD, Minal Patel PhD, MPH, Nigar Nargis PhD","doi":"10.1016/j.amepre.2025.108062","DOIUrl":"10.1016/j.amepre.2025.108062","url":null,"abstract":"<div><h3>Introduction</h3><div>The overall effectiveness of E-cigarette regulations may be undermined by access to unregulated sources for obtaining E-cigarettes. Data on sources of E-cigarettes are limited, particularly in places with the highest tobacco burden in the U.S.</div></div><div><h3>Methods</h3><div>Data were from a rapid-response survey of a probability sample of 9,100 adults (aged 18–65 years) in 13 high-tobacco-burden U.S. states collected in April–May 2023 and April–May 2024. Weighted bivariate analyses and multinomial logistic regression were used to examine E-cigarette prevalence and correlates of E-cigarette sources.</div></div><div><h3>Results</h3><div>In high-tobacco-burden states, 16.6% of adults reported current E-cigarette use, purchasing mostly from retail stores (75.9%), followed by receiving/purchasing from informal sources; for example, family, friends, free samples, others (16.6%); and purchasing online (7.5%). The likelihood of obtaining E-cigarettes from informal sources over store purchases was higher among adults aged 18–20 years (RRR=3.26, 95% CI=1.27, 8.35 versus among those aged 45–65 years), Hispanics (RRR=2.26, 95% CI=1.09, 4.69 versus non-Hispanic Whites), individuals who were not employed (RRR=1.79, 95% CI=1.01, 3.18 versus employed individuals), and individuals reporting nondaily use (RRR=2.78, 95% CI=1.66, 4.64 versus those reporting daily use). The likelihood of purchasing E-cigarettes online over store purchases was higher among college graduates (RRR=2.09, 95% CI=1.14, 3.82 than among those with less than a 4-year college degree) and individuals who use refillable (RRR=3.06, 95% CI=1.38, 6.76 than among those who use disposable E-cigarettes) or those who use mod E-cigarettes (RRR=3.55, 95% CI=1.54, 8.20 than those who use disposable E-cigarettes).</div></div><div><h3>Conclusions</h3><div>Informal sources and online retailers remain largely unregulated, yet they account for a quarter of E-cigarette use and are disproportionately high among certain population subgroups. Enhanced E-cigarette market surveillance is critical for uncovering and closing regulatory loopholes in both high-tobacco-burden states and nationally.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"70 2","pages":"Article 108062"},"PeriodicalIF":4.5,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence and Patterns of Tobacco Use: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023–2024 烟草使用的流行和模式：来自美国多州快速反应调查的结果，2023-2024

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108058

Minal Patel PhD, MPH , Laurel Gibson PhD, MPH , Presley Cannon MS, MPH , Tyler Nighbor PhD , Aya Carus MPH , Nigar Nargis PhD

Introduction

Overall tobacco use prevalence is higher in 13 Midwestern and Southern states (high-tobacco-burden states) than in the rest of the U.S., with limited recent data available to keep pace with an evolving tobacco marketplace. This study examined demographic correlates of current tobacco use among residents in these high- versus lower-tobacco-burden states.

Methods

The American Cancer Society collected 2 waves of a cross-sectional rapid-response survey in 2023 and 2024 among adults aged 18–65 years residing in the 13 high- and 4 low-tobacco-burden comparison states (N=12,300), analyzed in 2024–2025. Weighted bivariate and multivariable analyses examined demographic correlates of cigarette, E-cigarette, and cigar use.

Results

The prevalence of tobacco use was higher in high-tobacco-burden states than in lower-tobacco-burden states overall (35.3% vs 28.3%) and for each commonly used tobacco product, including cigarettes (19.3% vs 14.7%), E-cigarettes (16.6% vs 14.5%), and cigars (7.4% vs 6.3%). In high-tobacco-burden states, living in households of 2 or more people (p<0.05) and being aged between 25 and 65 years (p<0.01) had greater odds of current smoking, whereas greater education was associated with lower odds of current smoking (p<0.01). Respondents identifying as Black (p<0.01) had greater odds of current cigar use. Those identifying as female had lower odds of current cigarette, E-cigarette, and cigar use (p<0.01).

Conclusions

Besides a higher overall prevalence of tobacco use, the authors observed disparities by various demographic characteristics among residents of high-tobacco-burden states. Findings highlight specific populations that could benefit from targeted cessation efforts.

中西部和南部13个州（高烟草负担州）的总体烟草使用流行率高于美国其他地区，但近期可获得的数据有限，无法跟上不断变化的烟草市场。本研究调查了这些高烟草负担州与低烟草负担州居民当前烟草使用的人口统计学相关性。方法美国癌症协会于2023年和2024年收集了居住在13个高烟草负担和4个低烟草负担比较州的18-65岁成年人（N=12,300）的2波横断面快速反应调查，分析了2024 - 2025年的情况。加权双变量和多变量分析检验了香烟、电子烟和雪茄使用的人口统计学相关性。结果总体而言，高烟草负担州的烟草使用患病率高于低烟草负担州（35.3%对28.3%），每种常用烟草产品的烟草使用患病率，包括卷烟（19.3%对14.7%）、电子烟（16.6%对14.5%）和雪茄（7.4%对6.3%）。在高烟草负担州，生活在2人或2人以上的家庭（p < 0.05）和年龄在25至65岁之间（p < 0.01）的人目前吸烟的几率更大，而受教育程度更高的人目前吸烟的几率更低（p < 0.01）。被确定为黑色（p<0.01）的受访者目前使用雪茄的几率更大。那些被认为是女性的人使用香烟、电子烟和雪茄的几率较低（p < 0.01）。结论：除了烟草使用的总体流行率较高外，作者还观察到高烟草负担州居民的各种人口统计学特征存在差异。研究结果强调了可以从有针对性的戒烟努力中受益的特定人群。

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引用次数: 0

Tobacco Use Among Individuals With Medical Conditions: Findings From a Multi-State Rapid-Response Survey in the U.S., 2023–2024 患病人群的烟草使用：2023-2024年美国多州快速反应调查结果

IF 4.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

American Journal of Preventive Medicine

Pub Date : 2026-01-27 DOI: 10.1016/j.amepre.2025.108117

Eva Orr-Souza MPH , Tyler Nighbor PhD , Presley Cannon MS, MPH , Laurel P. Gibson PhD, MPH , Shanshan Wang MPH , Zheng Xue MSPH , Samuel Asare PhD , Priti Bandi PhD , J. Lee Westmaas PhD , Nigar Nargis PhD , Minal Patel PhD, MPH

Introduction

Smoking cessation can improve outcomes in individuals with smoking-related medical conditions. This study examined cigarette smoking and quitting behavior among those with a history of cardiovascular conditions, pulmonary conditions, and cancer within 13 high-tobacco-burden states with high smoking prevalence in the American South and Midwest versus 4 low-tobacco-burden comparison states with lower prevalence.

Methods

Respondents in high- (n=9,099) and low- (n=3,200) tobacco-burden states were from 2 waves of an American Cancer Society online probability-based rapid-response survey of U.S. adults (aged 18–65 years) conducted in April–May 2023 and 2024. Associations of place of residence (high- versus low-tobacco-burden states) with tobacco use and quitting behavior in a self-reported medical condition-stratified sample was examined.

Results

There was a significantly higher prevalence of ever-diagnosed cardiovascular conditions (26.9% [95% CI=25.5%, 28.3%] vs 21.4% [95% CI=19.3%, 23.6%], p=0.0001) and elevated prevalence of pulmonary conditions (16.8% [95% CI=15.6%, 18.0%] vs 14.5% [95% CI=12.7%, 16.5%], p=0.0505) but not cancer (4.2% [95% CI=3.7%, 4.9%] vs 4.1% [95% CI=3.2%, 5.3%], p=0.8653) in high- than in low-tobacco-burden states. Individuals in high-tobacco-burden states with pulmonary conditions were more likely to be currently smoking than their counterparts in low-tobacco-burden states (AOR=1.68, 95% CI=1.19, 2.40, p=0.003) despite no differences in quitting behavior.

Conclusions

Elevated medical condition prevalence and higher odds of current smoking were found among respondents with a history of pulmonary conditions in high-tobacco-burden states. Increased cessation resources targeted at individuals with pulmonary conditions is warranted.

戒烟可以改善患有吸烟相关疾病的个体的预后。本研究调查了美国南部和中西部13个高烟草负担州和4个低烟草负担州的吸烟和戒烟行为，这些州的吸烟率较高，有心血管疾病、肺部疾病和癌症病史。方法烟草高负担州（n= 9099）和低负担州（n= 3200）的受访者来自美国癌症协会于2023年4月至2024年5月对美国成年人（18-65岁）进行的两波基于概率的在线快速反应调查。在自我报告的医疗状况分层样本中，研究了居住地（高烟草负担州与低烟草负担州）与烟草使用和戒烟行为的关系。结果高烟草负担州的确诊心血管疾病患病率（26.9% [95% CI=25.5%, 28.3%] vs 21.4% [95% CI=19.3%, 23.6%], p=0.0001）和肺部疾病患病率（16.8% [95% CI=15.6%, 18.0%] vs 14.5% [95% CI=12.7%, 16.5%], p=0.0505）显著高于低烟草负担州，但没有癌症患病率（4.2% [95% CI=3.7%, 4.9%] vs 4.1% [95% CI=3.2%, 5.3%], p=0.8653）。尽管在戒烟行为上没有差异，但高烟草负担州的肺部疾病患者目前吸烟的可能性高于低烟草负担州（AOR=1.68, 95% CI=1.19, 2.40, p=0.003）。结论在高烟草负担州，有肺部病史的调查对象的疾病患病率和当前吸烟的几率较高。有必要增加针对肺病患者的戒烟资源。

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引用次数: 0