SMOKING, SMOKING CESSATION, AND UNDERSTANDING OF THE ROLE OF MULTIPLECARDIAC RISK-FACTORS AMONG THE URBAN-POOR

Objective. To determine in a population of low socioeconomic status (S ES) patients: (a) rates of current smoking and smoking cessation, (b) persons' understanding of the adverse health impact of multiple cardio vascular disease (CVD) risk factors, and (c) if the diagnosis of other CVD risk factors, specifically hypertension or hypercholesterolemia, was related to smoking cessation. Design. Cross-sectional interview su rvey. Setting. Community clinics and eligibility centers of the Harris County Hospital District (HD), which provides primary care to over 16 6,000 indigent persons in Houston, Texas. Subjects. Randomly selected adults attending an HD setting for eligibility screening or primary ca re. Results. Over 93% of subjects approached participated (n = 547). T heir mean age was 40.7 years, 55% were female, and 39% had >9 years of education. The ethnic distribution was 54% Hispanic, 28% black, and 1 4% non-Hispanic white. Current smoking ranged from 10% among Hispanic females to 56% among black males. The percentage of ever smokers who h ad quit was 24% among black males, 44% among black females, 43% among Hispanic males, and 70% among Hispanic females. The majority recognize d the increase in danger from smoking in the presence of hypertension or hypercholesterolemia. Among patients who were smokers when they fou nd out they had hypertension (n = 70), 65% reported it increased their desire to quit. After adjustment for other variables including age an d known CVD, predictors of being an ex-smoker were being female (OR 2. 1, 95% CI 1.3-3.5), being Hispanic (OR 2.8 95% CI 1.5-5.7), and having hypertension (OR 2.3, 95% CI 1.3-4.2). Conclusion. In this low SES po pulation, there was substantial smoking cessation, widespread acknowle dgment of the cumulative effect of smoking and other CVD risk factors, and some evidence that smoking cessation increased after the diagnosi s of hypertension. (C) 1996 Academic Press, Inc.