PDF(Pubmed)
Abstract：
BACKGROUND: Smoking continues to be the single largest cause of preventable disease and death and a major contributor to health inequalities. Dental professionals are well placed to offer behavioural support in combination with pharmacotherapy to increase smoking cessation rates across the population. We aimed to assess the trends and socioeconomic inequalities in the dental attendance of adult smokers in Scotland from 2009 to 2019 and examine the potential population reach of dental settings for smoking cessation interventions.
METHODS: A secondary analysis was conducted of combined Scottish Health Surveys (SHeS) from 2009/11, 2013/15 and 2017/19. \'Recent\' dental attendance (within the past two years) was the focus and descriptive analysis examined attendance of self-reported smokers compared to non-smokers and stratified by the area-based Scottish Index of Multiple Deprivation (SIMD) and individual socioeconomic measures (income, education, and occupation). Generalised linear models were used to model recent attendance in non-smokers relative to smokers adjusted by the socioeconomic measures, for each of the survey cohorts separately. Absolute differences and risk ratios were calculated with 95% Confidence Intervals (CI).
RESULTS: Recent dental attendance was generally high and increased in both smokers (70-76%) and non-smokers (84-87%) from 2009/11 to 2017/19 and increased across all SIMD groups. After adjustment for sociodemographic variables, the adjusted Risk Difference (aRD) for recent attendance between non-smokers and smokers was 8.9% (95% CI 4.6%, 13.2%) by 2017/19. Within smokers, recent attendance was 7-9% lower in those living in the most deprived areas compared to those living in the least deprived areas over the three surveys.
CONCLUSIONS: SHeS data from 2009 to 2019 demonstrated that a high and increasing proportion of smokers in the population attend the dentist, albeit slightly less frequently than non-smokers. There were large inequalities in the dental attendance of smokers, to a lesser extent in non-smokers, and these persisted over time. Dental settings provide a good potential opportunity to deliver population-level smoking cessation interventions, but smokers in the most deprived groups and older age groups may be harder to reach. Consideration should be given to ensure that these groups are given appropriate proportionate support to take up preventive interventions.
METHODS: A secondary analysis was conducted of combined Scottish Health Surveys (SHeS) from 2009/11, 2013/15 and 2017/19. \'Recent\' dental attendance (within the past two years) was the focus and descriptive analysis examined attendance of self-reported smokers compared to non-smokers and stratified by the area-based Scottish Index of Multiple Deprivation (SIMD) and individual socioeconomic measures (income, education, and occupation). Generalised linear models were used to model recent attendance in non-smokers relative to smokers adjusted by the socioeconomic measures, for each of the survey cohorts separately. Absolute differences and risk ratios were calculated with 95% Confidence Intervals (CI).
RESULTS: Recent dental attendance was generally high and increased in both smokers (70-76%) and non-smokers (84-87%) from 2009/11 to 2017/19 and increased across all SIMD groups. After adjustment for sociodemographic variables, the adjusted Risk Difference (aRD) for recent attendance between non-smokers and smokers was 8.9% (95% CI 4.6%, 13.2%) by 2017/19. Within smokers, recent attendance was 7-9% lower in those living in the most deprived areas compared to those living in the least deprived areas over the three surveys.
CONCLUSIONS: SHeS data from 2009 to 2019 demonstrated that a high and increasing proportion of smokers in the population attend the dentist, albeit slightly less frequently than non-smokers. There were large inequalities in the dental attendance of smokers, to a lesser extent in non-smokers, and these persisted over time. Dental settings provide a good potential opportunity to deliver population-level smoking cessation interventions, but smokers in the most deprived groups and older age groups may be harder to reach. Consideration should be given to ensure that these groups are given appropriate proportionate support to take up preventive interventions.
摘要：
背景：吸烟仍然是可预防疾病和死亡的最大原因，也是健康不平等的主要原因。牙科专业人员可以很好地提供与药物治疗相结合的行为支持，以提高整个人群的戒烟率。我们旨在评估2009年至2019年苏格兰成年吸烟者牙科就诊的趋势和社会经济不平等，并研究戒烟干预措施的牙科设置的潜在人群。
方法：对2009/11、2013/15和2017/19年的合并苏格兰健康调查（SHeS）进行了二次分析。\“最近\”牙科出勤（在过去两年内）是重点，描述性分析检查了自我报告的吸烟者与非吸烟者相比的出勤情况，并通过基于地区的苏格兰多重剥夺指数（SIMD）和个人社会经济措施（收入，教育,和职业)。使用广义线性模型对非吸烟者的近期出勤率进行建模，相对于由社会经济指标调整的吸烟者，分别为每个调查队列。以95%置信区间(CI)计算绝对差异和风险比。
结果：从2009/11年到2017/19年，吸烟者（70-76％）和非吸烟者（84-87％）的近期牙科出勤率普遍较高，并且在所有SIMD组中都有所增加。在调整社会人口统计学变量后，非吸烟者和吸烟者最近就诊的调整后风险差异(aRD)为8.9%(95%CI4.6%，13.2%）到2017/19。在吸烟者中，在三项调查中，生活在最贫困地区的人最近的出勤率比生活在最贫困地区的人低7-9%。
结论：2009年至2019年的SHES数据表明，吸烟者在人群中参加牙医的比例很高，而且越来越高。尽管频率略低于不吸烟者。吸烟者的牙科护理存在很大的不平等，在不吸烟者的较小程度上，这些随着时间的推移而持续。牙科环境提供了一个很好的潜在机会，以提供人口水平的戒烟干预措施，但是在最贫困的人群和年龄较大的人群中，吸烟者可能更难接触到。应考虑确保为这些群体提供适当的比例支持，以采取预防性干预措施。
方法：对2009/11、2013/15和2017/19年的合并苏格兰健康调查（SHeS）进行了二次分析。\“最近\”牙科出勤（在过去两年内）是重点，描述性分析检查了自我报告的吸烟者与非吸烟者相比的出勤情况，并通过基于地区的苏格兰多重剥夺指数（SIMD）和个人社会经济措施（收入，教育,和职业)。使用广义线性模型对非吸烟者的近期出勤率进行建模，相对于由社会经济指标调整的吸烟者，分别为每个调查队列。以95%置信区间(CI)计算绝对差异和风险比。
结果：从2009/11年到2017/19年，吸烟者（70-76％）和非吸烟者（84-87％）的近期牙科出勤率普遍较高，并且在所有SIMD组中都有所增加。在调整社会人口统计学变量后，非吸烟者和吸烟者最近就诊的调整后风险差异(aRD)为8.9%(95%CI4.6%，13.2%）到2017/19。在吸烟者中，在三项调查中，生活在最贫困地区的人最近的出勤率比生活在最贫困地区的人低7-9%。
结论：2009年至2019年的SHES数据表明，吸烟者在人群中参加牙医的比例很高，而且越来越高。尽管频率略低于不吸烟者。吸烟者的牙科护理存在很大的不平等，在不吸烟者的较小程度上，这些随着时间的推移而持续。牙科环境提供了一个很好的潜在机会，以提供人口水平的戒烟干预措施，但是在最贫困的人群和年龄较大的人群中，吸烟者可能更难接触到。应考虑确保为这些群体提供适当的比例支持，以采取预防性干预措施。
