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. 2022 Oct;97(10):1836-1848.
doi: 10.1016/j.mayocp.2022.03.019.

Indigenous Smoking Behaviors in Olmsted County, Minnesota: A Longitudinal Population-Based Study

Ann M Rusk  1 , Rachel E Giblon  2 , Alanna M Chamberlain  3 , Christi A Patten  4 , Jamie R Felzer  5 , Yvonne T Bui  6 , Chung-Il Wi  7 , Christopher C Destephano  8 , Barbara A Abbott  9 , Cassie C Kennedy  10
Affiliations

Indigenous Smoking Behaviors in Olmsted County, Minnesota: A Longitudinal Population-Based Study

Ann M Rusk et al. Mayo Clin Proc. 2022 Oct.

Abstract

Objective: To describe smoking behaviors and pharmaceutical cessation aid uptake in a population-based Indigenous cohort compared with an age- and sex-matched non-Indigenous cohort.

Patients and methods: Using the health record-linkage system of the Rochester Epidemiology Project (January 1, 2006, to December 31, 2019), smoking data of Indigenous residents of Olmsted County in Minnesota were abstracted to define the smoking prevalence, incidence, cessation, relapse after cessation, and pharmaceutical smoking cessation aid uptake compared with a matched non-Indigenous cohort. Prevalence was analyzed with a modified Poisson regression; cessation and relapse were evaluated with generalized estimating equations. Incidence was evaluated with a Cox proportional hazards model.

Results: Smoking prevalence was higher in the Indigenous cohort (39.0% to 47.0%; n=898) than the matched cohort (25.6% to 30.3%; n=1780). Pharmaceutical uptake was higher among the Indigenous cohort (35.8% of n=584 ever smokers vs 16.3% of n=778 ever smokers; P<.001). Smoking cessation events occurred more frequently in the Indigenous cohort (relative risk, 1.10; 95% CI, 1.06 to 1.13; P<.001). Indigenous former smokers were more likely to resume smoking (relative risk, 3.03; 95% CI, 2.93 to 3.14; P<.001) compared with the matched cohort. These findings were independent of socioeconomic status, age, and sex.

Conclusion: Smoking in this Indigenous cohort was more prevalent compared with a sex- and age-matched non-Indigenous cohort despite more smoking cessation events and higher use of smoking cessation aids in the Indigenous cohort. The relapse rate after achieving cessation in the Indigenous cohort was more than three times higher than the non-Indigenous cohort. This finding has not been previously described and represents a potential target for relapse prevention efforts in US Indigenous populations.

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Conflict of interest statement

Conflict of Interest Disclosures:

Yvonne T. Bui and Jamie R. Felzer M.D., M.P.H have no disclosures to report.

Figures

Figure 1:
Figure 1:
Diagram outlining cohort inclusion and exclusion criteria, and subsequent criteria applied to defined smoking status.
Figure 2:
Figure 2:
Socioeconomic status represented by the individual HOUsing-based index of SocioEconomic Status (HOUSES) index for the Indigenous population in Olmsted County, Minnesota, and the sex and age matched non-Indigenous cohort in Olmsted County, Minnesota, from 2006 to 2019.
Figure 3:
Figure 3:
Smoking prevalence comparing the Olmsted County, Minnesota Indigenous cohort and age and sex matched non-Indigenous cohort over time from 2006 to 2019.
Figure 4:
Figure 4:
Cessation events represented as the proportion of current smokers achieving cessation annually comparing the Olmsted County, Minnesota Indigenous cohort and age and sex matched non- Indigenous cohort from 2006 to 2019.
Figure 5:
Figure 5:
Relapse events represented as the proportion of former smokers resuming smoking annually comparing the Olmsted County, Minnesota Indigenous cohort and age and sex matched non- Indigenous cohort from 2006 to 2019.
See this image and copyright information in PMC

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References

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