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DISPARITIES IN PEDIATRIC INDIGENOUS SMOKING BEHAVIORS: A POPULATION-BASED STUDY

      TOPIC: Tobacco Cessation and Prevention
      TYPE: Original Investigations
      PURPOSE: Smoking prevalence in Indigenous North Americans is the highest of any ethnicity in the United States for adults and children. Smoking prevalence in Indigenous youth is estimated to be as high as 40%. Limited data suggests greater smoking prevalence in Indigenous youth; however, this data has not been described longitudinally and is limited to survey data. Understanding pediatric smoking behaviors is critical to ultimately create interventions to address smoking prevention in this critical disparity. Our objective is to define smoking prevalence, incidence, relapse, and cessation in a longitudinal cohort of pediatric Indigenous patients in Olmsted County, Minnesota from 2006 to 2019 included in the Rochester Epidemiology Project.
      METHODS: In a longitudinal cohort study of 899 Indigenous patients 85 were identified with pediatric data (age < 18 at any time from 2006 – 2019). Annual smoking status was abstracted with 95.0% accurate algorithm verified with manual audit of 13% of cohort. A total of 308 annual data points identifying smoking status over time were available for analysis. Smoking behaviors and demographics were reviewed and compared to an age and gender matched cohort representative of the general Olmsted County population. In the match cohort, 341 patients with data under age 18 were identified with 1198 annual data points.
      RESULTS: The annual proportion of Indigenous pediatric patients smoking commercial tobacco products varied from 11.1% to 57.1%, with an average smoking prevalence of 35.1%. Incidence was defined as conversion from never smoker to current in consecutive years, cessation was defined as conversion from current to former smoker in consecutive years, and relapse was defined as conversion from former to current smoker in consecutive years. There were 2 incident cases identified, with 7 cessation events (2.3% of all events) and 7 relapse events. The matched cohort annual proportion of smokers ranged from 4.0% to 17.5%, with an average smoking prevalence of 8.1%. There were 11 incident cases identified, 5 quit events (0.42% of all events), and 7 relapse events (0.58% of all events). Gender demographics of the two cohorts were similar.
      CONCLUSIONS: Indigenous pediatric patients in Olmsted County, Minnesota are more likely to smoke commercial tobacco products compared to an age and gender matched non-Indigenous cohort. Although there is a disparity in smoking prevalence, individuals in the Indigenous cohort were more likely to quit smoking than the matched cohort but had more relapse events as well. Limitations include lack of availability of vaping and electronic cigarette data, as this is the most popular inhaled substance by high school students currently.
      CLINICAL IMPLICATIONS: Indigenous pediatric patients are more likely to smoke with higher rates of cessation and relapse compared to a matched cohort.
      DISCLOSURES: No relevant relationships by Barbara Abbott, source=Web Response
      No relevant relationships by Yvonne Bui, source=Web Response
      No relevant relationships by Alanna Chamberlain, source=Web Response
      No relevant relationships by Jamie Felzer, source=Web Response
      No relevant relationships by Rachel Giblon, source=Web Response
      No relevant relationships by Cassie Kennedy, source=Web Response
      No relevant relationships by Christi Patten, source=Web Response
      No relevant relationships by Ann Rusk, source=Web Response