Rurality, tobacco use, and COPD: an analysis of two national datasets

农村、烟草使用和慢性阻塞性肺病：对两个国家数据集的分析

• 批准号: 10366172
• 负责人: LAURA Marie PAULIN
• 金额: $ 25.22万
• 依托单位: DARTMOUTH-HITCHCOCK CLINIC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10366172
• 关键词: Address; American; Behavior; Belief; Benefits and Risks; Chronic Obstructive Airway Disease; Cigarette; Data; Data Set; Disease Outcome; Electronic cigarette; Epidemiology; Exposure to; Future; Generations; Geographic Locations; Geography; Goals; Health; Incidence; Individual; Intervention; Location; Mission; Motivation; National Health Interview Survey; Outcome; Pattern; Perception; Population; Population Assessment of Tobacco and Health; Prevalence; Public Health; Research; Respiratory Signs and Symptoms; Risk; Risk Factors; Rural; Rural Population; Testing; Tobacco use; United States; United States National Institutes of Health; Urban Population; Vulnerable Populations; airway obstruction; base; cigarette smoking; disorder risk; experience; geographic difference; health disparity; improved outcome; insight; regional difference; risk perception; rural area; rural residence; rurality; smoking cessation; social; tailored messaging; therapy design; tobacco exposure; tobacco products; trend

Project Abstract Individuals with chronic obstructive pulmonary disease (COPD) who live in rural areas of the United States have worse health outcomes compared with their non-rural counterparts. Although it is known that rural areas have higher rates of cigarette smoking, and that cigarette smoking is associated with worse outcomes in COPD, less is known about geographic variations in the motivations and beliefs that influence tobacco product appeal and use, especially among newer tobacco products including e-cigarettes. Further, it is largely unknown how much variability in tobacco use accounts for the geographic differences seen in COPD outcomes. Our long-term goal is to identify potentially modifiable determinants of tobacco product use that contribute to worse COPD in rural US, leading to future geographically tailored interventions designed to improve outcomes. Our overall objective for this application, which is the next step toward attainment of our long-term goal, is to quantify the perceptions of risk and benefit on the pattern of tobacco use in rural and urban populations in the United States, and to determine the impact of such patterns on COPD outcomes. Our central hypothesis is that perceptions of risk and benefit of tobacco products differ by geographic location in the US, and that tobacco exposure contributes significantly to the increased COPD risks associated with rural location. The rationale for this project is that identifying factors that influence tobacco product appeal and use will provide detailed insight into potentially modifiable contributors to geographic disparities in health outcomes and inform regulatory strategy. Using existing datasets, we will test our hypothesis in two specific aims: 1) To quantify and compare patterns of tobacco product use by geographic location, and to determine how perceptions of risk and benefit of tobacco products differ by geographic location; 2) To determine the relationship between geographic location and COPD prevalence, incidence, and respiratory symptoms, and to quantify the contribution of tobacco product exposure to these relationships. To address our aims, will use data from the Population Assessment of Tobacco and Health (PATH) Study and the National Health Interview Survey (NHIS).The PATH Study is a longitudinal, nationally representative study that includes detailed questions on the motivations, beliefs, and perceptions influencing tobacco product use, allowing us to analyze the longitudinal association of these trends with COPD risk and respiratory symptoms within a broad definition of urbanicity. In a separate, focused analysis, we will determine the cross-sectional association between tobacco products and COPD prevalence across urban/rural continuum using nationally representative data from the NHIS study. Our research team has extensive experience working with these datasets, each providing complimentary longitudinal and cross sectional perspectives to allow for comprehensive assessment of the contribution of tobacco use to observed disparities in COPD outcomes in rural populations.

项目摘要 居住在美国农村地区的慢性阻塞性肺病 (COPD) 患者 与非农村地区相比，他们的健康状况较差。虽然众所周知，农村 吸烟率较高，并且吸烟与不良后果相关 慢性阻塞性肺病，人们对影响烟草产品的动机和信念的地理差异知之甚少 吸引力和使用，特别是在包括电子烟​​在内的新型烟草产品中。此外，很大程度上是 未知烟草使用的变异性在多大程度上解释了慢性阻塞性肺病的地理差异 结果。我们的长期目标是确定烟草产品使用的潜在可改变决定因素， 导致美国农村地区慢性阻塞性肺病的恶化，从而导致未来针对地理特征的干预措施旨在 改善结果。我们对此应用程序的总体目标，这是实现我们的目标的下一步 长期目标是量化农村和农村地区烟草使用模式的风险和收益认知 美国城市人口，并确定这种模式对慢性阻塞性肺病结果的影响。 我们的中心假设是，对烟草产品的风险和益处的看法因地理位置而异 在美国，接触烟草会显着增加与以下疾病相关的慢性阻塞性肺病 (COPD) 风险 乡村位置。该项目的基本原理是确定影响烟草产品吸引力的因素 和使用将提供对健康地理差异的潜在可改变贡献者的详细见解 结果并为监管策略提供信息。使用现有数据集，我们将在两个特定的方面测试我们的假设 目标： 1) 按地理位置量化和比较烟草制品的使用模式，并确定 对烟草产品风险和益处的看法如何因地理位置而异； 2）确定 地理位置与 COPD 患病率、发病率和呼吸道症状之间的关系，以及 量化烟草产品接触对这些关系的贡献。为了实现我们的目标，将使用 数据来自人口烟草与健康评估 (PATH) 研究和全国健康访谈 调查 (NHIS)。 PATH 研究是一项纵向的、具有全国代表性的研究，包括详细的 关于影响烟草产品使用的动机、信念和看法的问题，使我们能够分析 这些趋势与广义定义内的 COPD 风险和呼吸道症状的纵向关联 的都市性。在单独的、集中的分析中，我们将确定之间的横截面关联 使用全国代表性数据计算城市/农村连续体中的烟草制品和慢性阻塞性肺病患病率 来自 NHIS 研究。我们的研究团队在处理这些数据集方面拥有丰富的经验 提供互补的纵向和横截面视角，以便进行全面的了解 评估烟草使用对观察到的农村人口慢性阻塞性肺病结果差异的影响。