Population smoking characteristics and cessation behaviors in a nationally representative cohort of hispanic veterans and hispanic non-veterans

Abstract

Introduction: The proportion of Hispanics in the U.S. Veteran population is expected to increase rapidly in the next several decades. Although Veterans have a heightened smoking risk relative to the civilian population,few studies have examined whether this risk extends to Hispanic Veterans. The aims of the present study were toexamine differences in the smoking and cessation characteristics of Hispanic Veterans and Hispanic non-Veterans, andto determine whether these differences persist after controlling for demographics and markers of acculturation.Materials and Methods: This was a secondary analysis of the 2014-2015 Tobacco Use Supplement of the CurrentPopulation Survey administered by the U.S. Census Bureau. The main analysis included Hispanics aged 18 or older(N = 27,341). Additional analyses were restricted to participants who had smoked at least 100 cigarettes in their lifetime (N = 4,951), and current smokers (N = 2,345). Regressions modeled the associations between Veteran status anddemographics, markers of acculturation, smoking characteristics, and cessation behaviors. Additional regressions modeled the associations between Veteran status and the smoking and cessation outcomes while adjusting for demographics and the acculturation variables of U.S. nativity, U.S. citizenship, and English interview language. Probabilityweights produced nationally representative findings. Results: Hispanic Veterans were older, more likely to be male,and more acculturated than Hispanic non-Veterans. Unadjusted analyses revealed that Hispanic Veterans were morelikely to be current daily smokers (8.6% vs. 5.7%, p = 0.015) and much less likely to be never smokers (59.3% vs.81.0%, p < 0.001) compared to Hispanic non-Veterans. These differences were reduced after adjusting for the demographic and acculturation characteristics of the two groups. However, Hispanic Veterans were still less likely to benever smokers compared to non-Veterans after this adjustment (74.3% vs 80.7%, p < 0.001). In unadjusted analyses,Veterans were less likely to have stopped smoking for one day or longer as part of a quit attempt than non-Veterans(33.2% vs 45.4%, p = 0.056), although this was not a significant difference. Use of telephone quit line was very lowfor both Hispanic Veterans and Hispanic non-Veterans (4.3%). After adjustment, the difference in the likelihood ofstopping smoking for one day or longer as part of a quit attempt was increased, becoming statistically significant(31.4% vs 45.8%, p = 0.030). Conclusion: Demographic and acculturation differences account for much, but not all,of the differences in the smoking characteristics and cessation behaviors of Hispanic Veterans and Hispanicnon-Veterans. These findings suggest that Hispanic Veterans, and Veterans more broadly, should be a focal point forcessation efforts. These efforts should include facilitating access to under-utilized cessation treatments, and providingcoordinated cessation care for Veterans being treated for comorbid health conditions.