Estimating dementia incidence in insured older Asian Americans and Pacific Islanders in California: an application of inverse odds of selection weights.

Literature shows heterogeneous age-standardized dementia incidence rates across US Asian American, Native Hawaiian, and Pacific Islanders (AANHPI), but no estimates of population-representative dementia incidence exist due to lack of AANHPI longitudinal probability samples. We compared harmonized characteristics between AANHPI Kaiser Permanente Northern California members (KPNC cohort) and the target population of AANHPI 60+ with private or Medicare insurance using the California Health Interview Survey. We used stabilized inverse odds of selection weights (sIOSW) to estimate ethnicity-specific crude and age-standardized dementia incidence rates and cumulative risk by age 90 in the target population. Differences between the KPNC cohort and target population varied by ethnicity. sIOSW eliminated most differences in larger ethnic groups; some differences remained in smaller groups. Estimated crude dementia incidence rates using sIOSW (versus unweighted) were similar in Chinese, Filipinos, Pacific Islanders and Vietnamese, and higher in Japanese, Koreans, and South Asians. Unweighted and weighted age-standardized incidence rates differed for South Asians. Unweighted and weighted cumulative risk were similar for all groups. We estimated the first population-representative dementia incidence rates and cumulative risk in AANHPI ethnic groups. We encountered some estimation problems and weighted estimates were imprecise, highlighting challenges using weighting to extend inferences to target populations.

Tobacco Use and Uptake of COVID-19 Vaccinations in Finland: A Population-Based Study.

INTRODUCTION: People who smoke are at higher risk of Coronavirus Disease-2019 (COVID-19) hospitalizations and deaths and might benefit greatly from high COVID-19 vaccination coverage. Studies on tobacco use and COVID-19 vaccine uptake in the general population are lacking. AIMS AND METHODS: We conducted a cohort study utilizing linked data from 42 935 participants from two national surveys in Finland (FinSote 2018 and 2020). Exposures were smoking and smokeless tobacco (snus) use. The primary outcome was the uptake of two COVID-19 vaccine doses. Secondary outcomes were the uptake of one COVID-19 vaccine dose; three COVID-19 vaccine doses; time between the first and second dose; and time between the second and third dose. We examined the association between tobacco use and COVID-19 vaccine uptake and between-dose spacing in Finland. RESULTS: People who smoke had a 7% lower risk of receiving two COVID-19 vaccine doses (95% confidence interval [CI] = 0.91; 0.96) and a 14% lower risk of receiving three doses (95% CI = 0.78; 0.94) compared to never smokers. People who smoked occasionally had a lower risk of receiving three vaccine doses. People who currently used snus had a 28% lower uptake of three doses (95% CI = 0.56; 0.93) compared to never users but we did not find evidence of an association for one or two doses. We did not find evidence of an association between tobacco use and spacing between COVID-19 vaccine doses. CONCLUSIONS: People who smoke tobacco products daily, occasionally, and use snus had a lower uptake of COVID-19 vaccines. Our findings support a growing body of literature on lower vaccination uptake among people who use tobacco products. IMPLICATIONS: People who smoke or use snus might be a crucial target group of public health efforts to increase COVID-19 vaccinations and plan future vaccination campaigns. CLINICAL TRIALS REGISTRATION NUMBER: NCT05479383.