Clearing the Air: Exploring Smoking Cessation in Patients With Airflow Obstruction in Urban-dwelling Black/African American Patients
Bibliographic record
Abstract
Abstract Rationale: Tobacco use disorder affects nearly 50 million adults in United States and puts them at greater risk for chronic obstructive pulmonary disease (COPD). Analysis of the Behavior Risk Factor Surveillance System found that patients with COPD were less successful at quitting than those without COPD despite more attempts. There have also been mixed results in using spirometry data to motivate patients to quit smoking. The majority of patients studied have been Non-Hispanic White, living in rural areas, and/or Canadian or European. Our study examined if airflow obstruction (AO) increased the prevalence of smoking cessation in an urban cohort of African-Americans. We additionally examined the use of pharmacologic cessation aids (PCAs) in this cohort. Methods: The Temple Lung Health Cohort Study, a prospective cohort study that enrolled self-identified Black/African-American current smokers between 40-68 years-old, was analyzed to assess for smoking cessation at 1 year. Data collected included carbon monoxide (CO) level and spirometry. Current smokers were defined based on either self-report or CO > 10ppm. Patients were categorized as obstructed based on FEV1/FVC below the lower limit of normal. Pharmacotherapy for smoking cessation (nicotine replacement therapy (NRT), Bupropion, and/or Varenicline) was recorded. Fisher's Exact Test was used to assess the association between AO and smoking cessation at one year follow up. Results: At 1 year, 134 patients were included in the study with an average CO level of 16 ppm and an average of 8.3 cigarettes per day. 47 patients had AO (35.1%) and 87 did not (64.9%). For smoking cessation, 0 patients in the AO group quit smoking whereas 7 patients in the non-AO group quit (8%) (p=0.086). For PCA use, 7 patients in the AO group (14.9%) used PCAs (3 patients on Bupropion, 4 on NRT) while 14 patients in the non-AO group used PCAs (2 patients on Bupropion, 8 on NRT, 3 on Varenicline, 1 on Bupropion and NRT). Only one patient in the non-AO group successfully quit while on Varenicline. Conclusion: Our results demonstrated that AO in an urban African-American population did not increase smoking cessation rates. Utilization of PCAs was low but similar across AO and non-AO groups. This data suggests that presence of AO may not be associated with smoking cessation in this population. It also underscores the need to increase access and utilization of evidence-based smoking cessation treatments in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".