摘要：Objectives. We compared use of smoking cessation treatments and factors associated with treatment use among young adult smokers and other adult smokers. Methods. We used data from the 2005 National Health Interview Survey core and cancer control supplement. The sample consisted of 6511 current smokers, of whom 759 were aged 18–24 years. Our analyses were weighted to account for differential sampling probabilities and nonresponse rates. We compared continuous measures using the t test; logistic regression was used to obtain odds ratios and confidence intervals. Multiple logistic regression was used to identify correlates of treatment use. Results. Behavioral treatment use was infrequent among all smokers (4%–5%). Young adult smokers were less likely than other smokers to use pharmacotherapy (18% vs 32%). Correlates of pharmacotherapy use for young adult smokers were receiving advice from a health care provider, heavier smoking, and higher educational attainment. Compared with other smokers, young adult smokers were less likely to have received advice to quit from a health care provider (49% vs 60%). Conclusions. Evidence-based tobacco cessation treatments are underused by young adult smokers. In past years, smoking prevalence among young adults (aged 18–24 years) was lower than among adults aged 25 to 44 years, but this pattern is changing. 1 Recent data show young adult smoking rates becoming equivalent to or even greater than those of other adults. For example, the 2004 National Health Interview Survey (NHIS) found that approximately 24% of each age group reported smoking on most or some days. 2 The 2005 National Survey on Drug Use and Health showed that rates of current cigarette smoking (defined as use of cigarettes in the past month) among adults peaked at 41.2% among young adults aged 21 to 25 years, compared with a rate of 22.3% for persons aged 35 years or older. 3 Young adult smokers’ quit ratio (the proportion of ever smokers who are former smokers) is lower than that of older smokers. 4 Although young adult smokers attempt to quit, they are more likely to relapse and less likely to achieve long-term abstinence compared with older smokers. 5 Evidence-based treatments can improve cessation rates among young adult smokers. Although few smoking cessation studies present outcome data by age, a recent study of the efficacy of telephone counseling found significant treatment effects with both young adult and older adult smokers. Although there were no significant age group differences in outcome, the study’s highest success rate was among young adults who received both telephone counseling and pharmacotherapy. 6 Unfortunately, most smokers, including young adults, fail to use evidence-based treatments to support their quit attempts. The 1986 Adult Use of Tobacco Survey indicated that young adult smokers were least likely to use an assisted smoking cessation method compared with other adults. 7 Low use of treatment persists: the 2000 NHIS found that only 22.4% of smokers aged 18 years and older who tried to quit in the previous year reported using any cessation aids, and those who did use cessation aids were more likely to use pharmacological (21.7%) than behavioral (1.3%) treatment. 8 Insurance status (private or military), advice from a health care provider to quit smoking, and smoking a greater number of cigarettes per day (more than 7) were associated with treatment use. The 2000 NHIS analysis did not directly examine differences in treatment use between young adult and other adult smokers. In 2003, data from the National Youth Smoking Cessation Survey on current smokers aged 16 to 24 years was used to assess the use of quitting methods among smokers who had tried to quit at least once in their lifetime. 9 Ever using pharmacotherapy ranged from 0.2% (nicotine spray) to17.4% (nicotine gum), and ever using behavioral treatment ranged from 0.7% (support group) to 4.8% (counselor). Twenty percent reported ever talking with a health professional as a quitting method. Because the 2003 study did not examine correlates of treatment use or describe use of treatment during a recent quit attempt, direct comparisons with data from the 2000 NHIS survey were not possible. We directly compared the use of smoking cessation treatments among young adult smokers (aged 18–24 years) and the rest of the adult smoking population and examined correlates of treatment use for each age group.
