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Nancy L Fleischer
OA09 - Lung Cancer: A Preventable Disease? (ID 134)
- Event: WCLC 2019
- Type: Oral Session
- Track: Prevention and Tobacco Control
- Presentations: 1
- Now Available
- Moderators:Bienvenido Barreiro, Carolyn Dresler
- Coordinates: 9/09/2019, 11:00 - 12:30, Melbourne (1991)
OA09.03 - Patterns of Birth Cohort-Specific Smoking Histories by Family Income in the USA, 1982-2017 (Now Available) (ID 2734)
11:00 - 12:30 | Author(s): Nancy L Fleischer
Although cigarette smoking has been declining significantly in the US over last several decades, disparities in tobacco use remain across different groups by race/ethnicity, education, socioeconomic status (SES), or regions. Specifically, people in lower family income have higher smoking prevalence, longer smoking durations and lower cessation rates than other income groups. However, little is known about how smoking patterns, including rates of initiation, cessation, and intensity, differ by birth cohort across various income levels.Method
Using the National Health Interview Survey (NHIS) family income data, we calculated individual income-to-poverty ratios from 1982-2017. Missing family income data from 1982-1996 was imputed using a sequential regression multivariate imputation method, the NHIS approach to impute missing continuous income from 1997-2017. Age-period-cohort models with constrained natural splines were used to estimate the annual probabilities of smoking initiation, cessation, and intensity by sex and birth-cohort for five income-to-poverty ratio groups (<1, 1-2,2-3,3-4 and 4+ times the poverty threshold). Age- and sex-specific smoking prevalence was also estimated for different income groups and birth cohorts.Result
Smoking prevalence and initiation rates are decreasing by birth-cohort in all income-to-poverty ratio groups, while cessation rates are increasing. However, the relative smoking prevalence between low- and high-income groups is markedly increasing by birth-cohort (Figure 1). Smoking initiation probabilities are highest among those living below the poverty threshold, and inversely associated with income level. Conversely, people living below the poverty threshold have the lowest probabilities of quitting, with increasing smoking cessation probabilities in higher income groups. Age-specific smoking cessation probabilities vary considerably by income, especially in recent birth-cohorts for both men and women.
Figure 1. Age-specific current smoker prevalence for females (upper panels) and males (lower panels) for five income-to-poverty ratio groups (<1, 1-2,2-3,3-4 and 4+ times the poverty threshold) and selected birth cohorts.
Smoking prevalence has been decreasing in all income groups, however, disparities in smoking pattern between high and low-income populations are increasing with more recent birth-cohorts. Future studies evaluating disparities in smoking should account for differences by birth-cohort. The establishment of effective smoking intervention strategies specifically for low-income groups will be important to reduce tobacco-related health disparities.
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