Tobacco Use and Depression: A Hidden Epidemic among Smokers 18 Years and Older, Puerto Rico, 2018-2020.

OBJECTIVE: According to the literature, depression and tobacco use are closely linked. This study's main objectives were to provide the first population-based epidemiological profile of smokers with depression (SWD) who were 18 years and older and living in Puerto Rico (PR) from 2018 to 2020 and identify any statistically significant differences between SWD and smokers without depression (SWOD). METHODS: A descriptive cross-sectional study was carried out using PR Behavioral Risk Factor Surveillance System (PRBRFSS) data (2018-2020). Univariate analysis was performed to obtain an epidemiological profile of smokers who had depression. Likewise, using bivariate analysis, SWD and SWOD were compared to identify statistically significant differences in terms of chronic conditions, risk factors, and quit attempts. RESULTS: Depression prevalence among smokers 18 years and over in PR from 2018-2020 was 23.7%. Smokers with depression were more likely to be physically inactive (P < .001), overweight or obese (P < .001), have arthritis (P < .001), chronic obstructive pulmonary disease (P < .001), asthma (P < .001), high cholesterol (P < .001), hypertension (P < .001), coronary heart disease (P < .001), diabetes (P < .001), stroke (P < .001), and heart attack (P < .001) compared with SWOD. Likewise, SWD made more quitting attempts in the past year than did SWOD (P < .001). CONCLUSION: Our results indicate that SWD should be targeted in any health-based tobacco-control efforts to develop evidence-based strategies to reduce or eliminate tobacco use in this same population.

Tobacco Use and Associated Health Conditions and Risk Factors in the Lesbian, Gay, Bisexual, Transgender, and Transsexual Populations of Puerto Rico, 2013-2015.

OBJECTIVE: The objectives of this research were to develop an epidemiological profile of tobacco use in the Puerto Rico lesbian, gay, bisexual, transgender, and transsexual (LGBTT) populations and identify whether there are any statistically significant differences (in terms of health conditions and risk factors) between LGBTT smokers (LGBTT-S), LGBTT non-smokers (LGBTT-NS), general-populationnon-smokers (GP-NS), and general-population smokers (GP-S). METHODS: Using the Puerto Rico Behavioral Risk Factor Surveillance System database (2013-2015), we conducted a univariate analysis to obtain an epidemiological profile, and a bivariate analysis was performed to compare LGBTT-S, LGBTT-NS, GP-NS, and GP-S. Finally, to determine the odds ratios (ORs), an age-adjusted logistic regression model with a 95% level of reliability was used. RESULTS: During the period of 2013 through 2015, the Puerto Rico LGBTT population was reported to have a higher tobacco use prevalence than the general population had (21.6% vs. 10.8%). The LGBTT-S were more likely to have depression (OR: 2.63, p = 0.030) than the LGBTT-NS were. Likewise, LGBTT-S were more likely to suffer from COPD (OR: 4.81, p = 0.014), depression (OR: 3.27, p = 0.002), and heart attack (OR: 0.12, p = 0.038) than were GP-NS. Finally, LGBTT-S were more likely to suffer from COPD (OR: 5.07, p = 0.013) and heart attack (OR: 0.13, p = 0.046) than GP-S were. CONCLUSION: The results of this research demonstrate that tobacco use is one of the most critical public health issues affecting the LGBTT populations in Puerto Rico. For that reason, specific interventions and treatments directed to LGBTT populations are needed to help to reduce the impact of this addiction on the health of their members.

Disproportionate Tobacco Use in the Puerto Rico Lesbian, Gay, Bisexual, and Transgender Community of 18 Years and Over-A Descriptive Profile.

PURPOSE: Tobacco use is currently one of the most critical public health issues affecting sexual and gender minority individuals. The primary objective of this research was to provide the first population-based epidemiological profile of tobacco use in the LGBT community in Puerto Rico. The secondary objective was to identify differences between LGBT smokers (LGBT-S) versus LGBT nonsmokers (LGBT-NS). METHODS: We conducted a secondary data analysis of the 2011 Puerto Rico Behavioral Risk Surveillance System database through a cross-sectional study methodology. A univariate analysis was performed to obtain an epidemiological profile of the LGBT-S. Through a bivariate analysis, we compared LGBT-S with LGBT-NS to identify differences. RESULTS: A higher prevalence of tobacco use was found in the Puerto Rico LGBT community (20.8%) compared with the Puerto Rico general population (14.8%). The groups with higher prevalence were females (23.2%), bisexuals (23.9%), people aged 25-34 years (52.0%), people with some years in university or technical school (23.9%), people who reported being out of work for more than 1 year (45.5%), and people who reported an annual income of $50,000 or more (12.5%). LGBT-S were more likely to report a history of cancer, arthritis, kidney disease, overweight or obesity, depressive disorder, and anxiety disorder than LGBT-NS. CONCLUSION: Health surveys should incorporate sexual and gender identity questions in order to learn more about the health status of the LGBT community, especially given the disproportionate use of tobacco. The data may be useful to implement health promotion strategies related to tobacco control in this community.

Descriptive profile of people with diabetes who use the Puerto Rico Quitline.

OBJECTIVE: To provide a descriptive profile of the people with diabetes (PWD) who received the services of the Puerto Rico Quitline (PRQ) during 2008, compared to non-diabetic people (NDP) to establish a significant statistical difference. METHODS: Using a cross-sectional study methodology, the Quitline database was analyzed. Ninety-four percent of the 1,137 people who received the services of the PRQ during 2008 and completed all the interviews were included in the analysis. Frequency distributions and means calculation were performed to describe the PWD. Chi-square tests, odds ratio, t test and 95% confidence intervals were calculated to identify statistically significant differences between the PWD and NDP. RESULTS: Nearly 11 percent (10.9%) of the people who received the services of the PRQ during 2008 and completed all the interviews reported a diabetes diagnosis. Health conditions were reported by 95.7% of PWD vs. 62.3% of NDP (P < .01). People with diabetes were more likely to have hypertension (P < .01), circulatory problems (P < .01), and respiratory infections (P = .02) than NDP. They also reported a higher mean number of smoking years than the NDP (P < .01), but the PWD were less likely to use menthol cigarettes Sthan NDP (P =.01). A physician's recommendation is the only reason for trying to quit smoking with a statically significant difference between the PWD and the NDP (P = .02). The mean number of alcoholic beverages consumed per day for the PWD was 8 and for the NDP it was 5 (P < .01). CONCLUSION: This study provides important evidence that can help increase the chances of success in the smoking cessation process in the PWD who access the services of the Quitline program.