Smoking status and mammography among women aged 50-75 in the 2002 behavioral risk factor surveillance system

Since the late 1980's, data show an association between smoking status and mammography. Women smokers reported 12-15% lower rates than non-smokers. This study investigated whether an association persists in a recent national-level database.

The sample was women aged 50-75 years from the 2002 Behavioral Risk Factor Surveillance System (N = 52,300). Analyses used two definitions of recent mammography, one based on a one-year interval between exams, the other on a two-year interval. Smoking was classified as current, former, or never. Other covariates included sociodemographic variables, health practices, insurance status and usual source of care.

The rate of mammography for current smokers was 16% lower than for never smokers for the past-year interval, and 14.0% lower for the two-year interval. Multiple logistic regression supported the smoking/mammography association. Other covariates associated with lower mammography on both dependent variables were recent Pap test, health insurance/usual source of care, recent dental visit, seat belt use, marital status and age.

Reasons for the persistent association between smoking and mammography must be determined. These variables will inform interventions with women who smoke. A key question is whether to intervene on smoking directly or whether mediating variables are sufficient targets of intervention.