Covariates of Current Cigarette Smoking among Secondary School Students in Budapest, Hungary, 1999

ERIC Educational Resources Information Center

Easton, Alyssa; Kiss, Eva

2005-01-01

To date, few studies have examined the relationship between health behavior risk factors and cigarette smoking in Hungary. From 1995 to 1999, the prevalence of current smoking increased from 35.9 to 46.0% among secondary students in Budapest, Hungary. The objective of the present study was to examine the association between smoking and other…

The influence of estimated retail tobacco sale price increase on smokers' smoking habit in Jiangxi province, China: a cross-sectional study.

PubMed

Wang, Ruiping; Zhu, Liping; Yan, Wei; Zeng, Guang; Michael, Engelgau

2015-01-01

China is the biggest tobacco producer and consumer in the world. Raising cigarette taxes and increasing tobacco retail prices have been prove as effective strategies to reduce tobacco consumption and the prevalence of smoking in western countries. But in China, it is uncertain how an increase of cigarette retail price will influence the tobacco consumption. From April to July, 2012, we selected 4025 residents over 15 years by a three stage random sampling in four cities, Jiangxi Province, China. We conducted interviews of their current smoking habits and how they would change their smoking behavior if tobacco retail prices increase. Overall, the prevalence of smoking is 27 % (47 % for male, 3.1 % for female). 15 % of smokers have tried to quit smoking in the past but all relapsed (168/1088), and over 50 % of current smokers do not want to quit, The average cigarette price per pack is 1.1 USD (range = 0.25-5.0). If retail cigarette prices increases by 50 %, 45 % of smokers say they will smoke fewer cigarettes, 20 % will change to cheaper brands and 5 % will attempt to quit smoking. Smokers who have intention to quit smoking are more sensitive to retail cigarette price increase. With retail cigarette price increases, more smokers will attempt to quit smoking. Chinese smokers will change their smoking habits if tobacco retail prices increase. Consequently the Chinese government should enact tobacco laws which increase the retail cigarette price. The implementation of new tobacco laws could result in lowering the prevalence of smoking. Meanwhile, price increase measures need to apply to all cigarette brands to avoid smokers switching cigarettes to cheaper brands.

Smoking Behaviors and Intentions among Current E-Cigarette Users, Cigarette Smokers, and Dual Users: A National Survey of U.S. High School Seniors

PubMed Central

McCabe, Sean Esteban; Veliz, Phil; McCabe, Vita V.; Boyd, Carol J.

2017-01-01

E-cigarette use among adolescents has increased significantly in recent years, but it remains unclear whether cigarette smoking behaviors and intentions differ among current (i.e., 30-day) non-users, only e-cigarette users, only cigarette smokers, and dual users. A nationally representative sample of 4385 U.S. high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires in 2014. An estimated 9.6% of U.S. high school seniors reported current (30-day) e-cigarette use only, 6.3% reported current cigarette smoking only, and 7.2% reported current dual use of e-cigarettes and cigarette smoking. There were no significant differences between current only cigarette smokers and dual users in the odds of early onset of cigarette smoking, daily cigarette smoking, future cigarette smoking intentions, friends’ cigarette smoking behaviors, attempts to quit cigarette smoking, or the inability to quit cigarette smoking. Adolescents who only used e-cigarettes had higher odds of cigarette smoking behaviors and intentions than current non-users, including intentions for future cigarette smoking in the next 5 years (AOR = 2.57, 95% CI: 1.21—5.24). Dual users and only cigarette smokers had higher odds of cigarette smoking behaviors and intentions than non-users or only e-cigarette users. Adolescents who engage in current dual use appear to have cigarette smoking behaviors and intentions that more closely resemble cigarette smokers than e-cigarette users. Adolescents who only use e-cigarettes have higher intentions to engage in cigarette smoking in the future relative to their peers who do not engage in e-cigarette use or cigarette smoking. PMID:28257785

Time trends of cigarette and waterpipe smoking among a cohort of school children in Irbid, Jordan, 2008-11.

PubMed

McKelvey, Karma L; Wilcox, Meredith L; Madhivanan, Purnima; Mzayek, Fawaz; Khader, Yousef S; Maziak, Wasim

2013-10-01

Coordinated high-impact interventions and community-level changes in smoking behaviour norms effectively reduced prevalence of smoking among youth in many developed countries. Smoking trends among Jordanian adolescents are likely different than their Western counterparts and must be understood in the context of their daily lives to tailor interventions specifically for adolescents in this setting. Between 2008 and 2011, a school-based longitudinal study was conducted in Irbid, Jordan. All seventh-grade students in 19 randomly selected schools (of 60) were surveyed annually for 4 years. Outcomes of interest were time trends in smoking behaviour, age at initiation and change in frequency of smoking. Among 1781 participants, baseline prevalence of current smoking (cigarettes or waterpipe) for boys was 22.9% and 8.7% for girls. Prevalence of ever-smoking and current any smoking, cigarette smoking, waterpipe smoking and dual cigarette/waterpipe smoking was significantly higher in boys than girls each year (P < 0.001). Smoking prevalence increased every year after year 2 for current smoking (P < 0.05) across all methods (any, cigarette, waterpipe and dual). At all time points for both boys and girls, prevalence of waterpipe smoking was higher than that of cigarette smoking (P < 0.001). This study shows intensive smoking patterns at early ages among Jordanian youth in Irbid, characterized by a predominance of waterpipe smoking and steeper age-related increase in cigarette smoking. It also points to the possibility of waterpipe being the favourite method for introducing youth to tobacco, as well as being a vehicle for tobacco dependence and cigarette smoking.

Effect of Smoking on Blood Pressure and Resting Heart Rate: A Mendelian Randomisation Meta-Analysis in the CARTA Consortium

PubMed Central

Linneberg, Allan; Jacobsen, Rikke K.; Skaaby, Tea; Taylor, Amy E.; Fluharty, Meg E.; Jeppesen, Jørgen L.; Bjorngaard, Johan H.; Åsvold, Bjørn O.; Gabrielsen, Maiken E.; Campbell, Archie; Marioni, Riccardo E.; Kumari, Meena; Marques-Vidal, Pedro; Kaakinen, Marika; Cavadino, Alana; Postmus, Iris; Ahluwalia, Tarunveer S.; Wannamethee, S. Goya; Lahti, Jari; Räikkönen, Katri; Palotie, Aarno; Wong, Andrew; Dalgård, Christine; Ford, Ian; Ben-Shlomo, Yoav; Christiansen, Lene; Kyvik, Kirsten O.; Kuh, Diana; Eriksson, Johan G.; Whincup, Peter H.; Mbarek, Hamdi; de Geus, Eco J.C.; Vink, Jacqueline M.; Boomsma, Dorret I.; Smith, George Davey; Lawlor, Debbie A.; Kisialiou, Aliaksei; McConnachie, Alex; Padmanabhan, Sandosh; Jukema, J. Wouter; Power, Chris; Hyppönen, Elina; Preisig, Martin; Waeber, Gerard; Vollenweider, Peter; Korhonen, Tellervo; Laatikainen, Tiina; Salomaa, Veikko; Kaprio, Jaakko; Kivimaki, Mika; Smith, Blair H.; Hayward, Caroline; Sørensen, Thorkild I.A.; Thuesen, Betina H.; Sattar, Naveed; Morris, Richard W.; Romundstad, Pål R.; Munafò, Marcus R.; Jarvelin, Marjo-Riitta; Husemoen, Lise Lotte N.

2015-01-01

Background Smoking is an important cardiovascular disease risk factor, but the mechanisms linking smoking to blood pressure are poorly understood. Methods and Results Data on 141,317 participants (62,666 never, 40,669 former, 37,982 current smokers) from 23 population-based studies were included in observational and Mendelian randomisation (MR) meta-analyses of the associations of smoking status and smoking heaviness with systolic and diastolic blood pressure (SBP, DBP), hypertension, and resting heart rate. For the MR analyses, a genetic variant rs16969968/rs1051730 was used as a proxy for smoking heaviness in current smokers. In observational analyses, current as compared with never smoking was associated with lower SBP, DBP, and lower hypertension risk, but with higher resting heart rate. In observational analyses amongst current smokers, one cigarette/day higher level of smoking heaviness was associated with higher (0.21 beats/minute; 95% CI 0.19; 0.24) resting heart rate, and slightly higher DBP (0.05 mmHg; 95% CI 0.02; 0.08) and SBP (0.08 mmHg; 95% CI 0.03; 0.13). However, in MR analyses amongst current smokers, while each smoking increasing allele of rs16969968/rs1051730 was associated with higher resting heart rate (0.36 beats/minute/allele; 95% CI 0.18; 0.54), there was no strong association with DBP, SBP, or hypertension. This would suggest a 7 beats/minute higher heart rate in those who smoke 20 cigarettes/day. Conclusions This MR meta-analysis supports a causal association of smoking heaviness with higher level of resting heart rate, but not with blood pressure. These findings suggest that part of the cardiovascular risk of smoking may operate through increasing resting heart rate. PMID:26538566

Exploring Alternate Processes Contributing to the Association Between Maternal Smoking and the Smoking Behavior Among Young Adult Offspring

PubMed Central

2013-01-01

Introduction: Maternal smoking during pregnancy (MSP) is a known risk factor for regular smoking in young adulthood and may pose a risk independently of mother’s lifetime smoking. The processes through which MSP exerts this influence are unknown but may occur through greater smoking quantity and frequency following initiation early in adolescence or increased sensitivity to nicotine dependence (ND) at low levels of smoking. Methods: This study used path analysis to investigate adolescent smoking quantity, smoking frequency, and ND as potential simultaneous mediating pathways through which MSP and mother’s lifetime smoking (whether she has ever smoked) increase the risk of smoking in young adulthood among experimenters (at baseline, <100 cigarettes/lifetime) and current smokers (>100 cigarettes/lifetime). Results: For experimenters, MSP was directly associated with more frequent young adult smoking and was not mediated by adolescent smoking behavior or ND. Independently of MSP, the effect of mother’s lifetime smoking was fully mediated through frequent smoking and was heightened ND during adolescence. Controlling for MSP eliminated a previously observed direct association between mother’s lifetime smoking and future smoking among experimenters. For current smokers, only prior smoking behavior was associated with future smoking frequency. Conclusions: These results seem to rule out sensitivity to ND and increased smoking behavior as contributing pathways of MSP. Further, the impact of MSP on young adult smoking extends beyond that of having an ever-smoking mother. Future work should test other possible mediators; for example, MSP-related epigenetic changes or gene variants influencing the brain’s nicotine response. PMID:23766342

Sensitivity of Claims-Based Algorithms to Ascertain Smoking Status More Than Doubled with Meaningful Use.

PubMed

Huo, Jinhai; Yang, Ming; Tina Shih, Ya-Chen

2018-03-01

The "meaningful use of certified electronic health record" policy requires eligible professionals to record smoking status for more than 50% of all individuals aged 13 years or older in 2011 to 2012. To explore whether the coding to document smoking behavior has increased over time and to assess the accuracy of smoking-related diagnosis and procedure codes in identifying previous and current smokers. We conducted an observational study with 5,423,880 enrollees from the year 2009 to 2014 in the Truven Health Analytics database. Temporal trends of smoking coding, sensitivity, specificity, positive predictive value, and negative predictive value were measured. The rate of coding of smoking behavior improved significantly by the end of the study period. The proportion of patients in the claims data recorded as current smokers increased 2.3-fold and the proportion of patients recorded as previous smokers increased 4-fold during the 6-year period. The sensitivity of each International Classification of Diseases, Ninth Revision, Clinical Modification code was generally less than 10%. The diagnosis code of tobacco use disorder (305.1X) was the most sensitive code (9.3%) for identifying smokers. The specificities of these codes and the Current Procedural Terminology codes were all more than 98%. A large improvement in the coding of current and previous smoking behavior has occurred since the inception of the meaningful use policy. Nevertheless, the use of diagnosis and procedure codes to identify smoking behavior in administrative data is still unreliable. This suggests that quality improvements toward medical coding on smoking behavior are needed to enhance the capability of claims data for smoking-related outcomes research. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Effect of Exposure to Smoking in Movies on Young Adult Smoking in New Zealand.

PubMed

Gendall, Philip; Hoek, Janet; Edwards, Richard; Glantz, Stanton

2016-01-01

Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents' exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012. Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies. Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents' likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents, (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it is legal to view smoking in movies would support New Zealand's smokefree 2025 goal.

Smoking and depressive symptoms in a college population.

PubMed

Lee Ridner, S; Staten, Ruth R; Danner, Fred W

2005-08-01

A number of studies have documented the relationship between smoking and depression in adolescent and adult populations. The purpose of this study was to examine the level of depressive symptoms among college-age smokers and to determine whether or not increases in cigarette use were associated with increases in the number of depressive symptoms. A non-experimental cross-sectional design was used. Of the random sample (N = 895), 28% were current smokers, and more than 26% of the total sample reported high levels of depressive symptoms. Current smokers were more likely to report an increased level of depressive symptoms than nonsmokers were. Correlates of depressive symptoms included grade point average, marijuana use, and increased work hours. When controlling for these variables, the number of days smoked was predictive of depressive symptoms. School nurses have an important role in preventing smoking and treating smokers, as well as in preparing adolescents for the transition to college where many begin smoking.

Cigarette smoking and military deployment: a prospective evaluation.

PubMed

Smith, Besa; Ryan, Margaret A K; Wingard, Deborah L; Patterson, Thomas L; Slymen, Donald J; Macera, Caroline A

2008-12-01

The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment. The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007. Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked. Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.

Effect of Cigarette Smoking and Passive Smoking on Hearing Impairment: Data from a Population–Based Study

PubMed Central

Chang, Jiwon; Ryou, Namhyung; Jun, Hyung Jin; Hwang, Soon Young; Song, Jae-Jun; Chae, Sung Won

2016-01-01

Objectives In the present study, we aimed to determine the effect of both active and passive smoking on the prevalence of the hearing impairment and the hearing thresholds in different age groups through the analysis of data collected from the Korea National Health and Nutrition Examination Survey (KNHANES). Study Design Cross-sectional epidemiological study. Methods The KNHANES is an ongoing population study that started in 1998. We included a total of 12,935 participants aged ≥19 years in the KNHANES, from 2010 to 2012, in the present study. Pure-tone audiometric (PTA) testing was conducted and the frequencies tested were 0.5, 1, 2, 3, 4, and 6 kHz. Smoking status was categorized into three groups; current smoking group, passive smoking group and non-smoking group. Results In the current smoking group, the prevalence of speech-frequency bilateral hearing impairment was increased in ages of 40−69, and the rate of high frequency bilateral hearing impairment was elevated in ages of 30−79. When we investigated the impact of smoking on hearing thresholds, we found that the current smoking group had significantly increased hearing thresholds compared to the passive smoking group and non-smoking groups, across all ages in both speech-relevant and high frequencies. The passive smoking group did not have an elevated prevalence of either speech-frequency bilateral hearing impairment or high frequency bilateral hearing impairment, except in ages of 40s. However, the passive smoking group had higher hearing thresholds than the non-smoking group in the 30s and 40s age groups. Conclusion Current smoking was associated with hearing impairment in both speech-relevant frequency and high frequency across all ages. However, except in the ages of 40s, passive smoking was not related to hearing impairment in either speech-relevant or high frequencies. PMID:26756932

[Acceptance of a total smoking ban in schools: students' attitudes].

PubMed

Morgenstern, M; Wiborg, G; Hanewinkel, R

2008-06-01

The purpose of this study was to measure students' attitudes towards a total smoking ban in schools and towards impositions in cases of violation. Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the "Heaviness of Smoking Index". 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase

PubMed Central

Tanihara, Shinichi; Momose, Yoshito

2015-01-01

Objectives To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. Design Cross-sectional study. Setting A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). Participants A total of 2251 male current smokers 20–69 years old. Primary and secondary outcome measures Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. Results The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. ‘The rise in cigarette prices since October 2010’ as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). ‘Feeling unhealthy’ was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. Conclusions The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed. PMID:25795690

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase.

PubMed

Tanihara, Shinichi; Momose, Yoshito

2015-03-20

To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. Cross-sectional study. A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). A total of 2251 male current smokers 20-69 years old. Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Smoking in korean-chinese middle school students: prevalence and risk factors.

PubMed

Park, Soonbok E; Yun, Soon-Nyung; Cui, Wenying; Kim, Hyang

2013-06-01

Cigarette smoking is rising among Chinese adolescents, and adolescent smoking is a crucial public health issue. Despite the number of studies that have explored the prevalence and various aspects of adolescent smoking in China, we know of no data currently available on smoking behavior among Korean-Chinese adolescents. This article studies the prevalence of smoking and factors affecting smoking behavior among Korean-Chinese adolescents. Data were collected from six Korean-Chinese middle schools in the Yanbian region of Jilin, China. The differences in data from three groups (never-smokers, ever-smokers, and current smokers) were analyzed using χ2 tests and analysis of variance. Logistic regression was used to analyze the factors affecting smoking behavior. Among the 2,116 participants, 7.3% of the boys and 3.7% of the girls were ever-smokers, and 7.2% of the boys and 0.8% of the girls were current smokers. Differences among groups in terms of gender, number of friends currently smoking, parental smoking behavior, academic performance, alcohol consumption, and intention not to smoke were all significant (p < .001, .05). Compared with never-smoking and ever-smoking students, currently smoking students perceived a significantly less antismoking environment (p = .000). The smoking rate was 2.24 times higher in boys than girls and was 11.57 times higher in students who had three smoking friends compared with those who had no smoking friends. The findings may help develop more effective intervention approaches to prevent adolescent smoking. Preventive programs should involve smoking parents by increasing the value they place on their children's nonsmoking behavior and equipping them to help deter adolescent smoking.

Income, income inequality and youth smoking in low- and middle-income countries.

PubMed

Li, David X; Guindon, G Emmanuel

2013-04-01

To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Cigarette smoking habits among schoolchildren.

PubMed

Meijer, B; Branski, D; Knol, K; Kerem, E

1996-10-01

Cigarette smoking is a major preventable cause of morbidity and mortality worldwide. Most adult smokers start smoking regularly some time before 18 years of age. The aim of this study was to determine the age at which children begin cigarette smoking, to study the environmental factors that influence children to smoke, and to understand the reasons why children smoke. The results of this study may help lead to the development of more effective smoking prevention programs. We carried out a cross-sectional survey of all students in grades 6 to 11 (ages: 11 to 17 years) in two high schools in the Jerusalem area, using an anonymous self-completion questionnaire. The students were asked questions regarding the age at which they began smoking, initiation, their smoking habits, their reasons for smoking, and their views on children who smoke. In addition, they were asked about the smoking status of their parents, siblings, and friends. Finally they were asked about the health hazards of smoking. Of the 847 students who answered the questionnaire, 35% stated that they had smoked at least once and 14% stated that they were currently smoking. The percentage of students who were currently smoking increased gradually with age to 36%. There was a sharp increase in experimental smoking after seventh grade (ages 12 to 13 years). Having a friend who smoked substantially increased the likelihood of smoking, whereas parental smoking or having a sibling who smoked did not increase the likelihood of smoking. The most common reason for starting to smoke was "to try something new" (55%). There was a significant difference between the views of students with different smoking statuses regarding children who smoke: nonsmoking children associated more negative characteristics to smoking. All of the children studied were well aware of the health hazards of cigarette smoking. Smoking is highly prevalent among schoolchildren in Jerusalem. The increase in the rate of smoking at the age of 12 years indicates that smoking prevention programs need to be started at an earlier age. Peer pressure is a very strong stimulus for smoking in children. Since children are aware of the health hazards of smoking, prevention policy should be aimed more at associating smoking with negative images and addressing peer pressure.

The Association between Tobacco Smoke and Serum Immunoglobulin E Levels in Korean Adults.

PubMed

Kim, Young Soo; Kim, Hee Yeon; Ahn, Hyo-Suk; Sohn, Tae Seo; Song, Jae Yen; Lee, Young Bok; Lee, Dong-Hee; Lee, Jae-Im; Jeong, Seong Cheol; Chae, Hiun Suk; Han, Kyungdo; Yeo, Chang Dong

2017-10-01

Objective Smoking is common in patients with allergic diseases. The aim of this study was to evaluate the cross-sectional association between the current smoking status and total and specific Immunoglobulin E (IgE) levels in Korean adults. Methods Data were obtained from the 2010 Korean National Health and Nutrition Examination Survey, a national cross-sectional study. We analyzed the data of subjects whose smoking status and serum IgE levels were of acceptable quality. Results A total of 1,963 subjects (1,118 never smokers, 340 ex-smokers, and 505 current smokers) were included. The total IgE levels and specific IgE levels to house dust mite Dermatophagoides farinae (Df), cockroach, and dog allergens in never smokers were significantly (p<0.0001) lower than in ex-smokers or current smokers. After adjusting for other variables, current smokers independently had significantly higher levels of total IgE and cockroach-specific IgE than ex-smokers or never smokers. The proportions of subjects with total IgE ≥150 kU/L and specific IgE ≥0.35 kU/L to Df-specific IgE were significantly (p value for trend <0.05) increased in ex-smokers and current smokers. The total IgE levels and IgE levels specific to Df, cockroaches, and dogs significantly (p value for trend <0.05) and proportionally increased with increasing numbers of cigarettes smoked daily. Conclusion Smoking was associated with elevated total IgE levels and IgE levels specific to Df, cockroach, and dog allergens in a cumulative, dose-dependent manner. Furthermore, current smoking status was an independent risk factor for elevated total IgE levels and IgE levels specific to cockroach allergen.

Factors Associated With Smoking Status among HIV-Positive Patients in Routine Clinical Care.

PubMed

Zyambo, Cosmas M; Willig, James H; Cropsey, Karen L; Carson, April P; Wilson, Craig; Tamhane, Ashutosh R; Westfall, Andrew O; Burkholder, Greer A

2015-07-01

Treatment-related reductions in morbidity and mortality among human immunodeficiency virus (HIV)-positive patients have been attenuated by cigarette smoking, which increases risk of cardiovascular, respiratory, and neoplastic diseases. This study investigated factors associated with smoking status among HIV-positive patients. This cross-sectional study included 2,464 HIV-positive patients attending the HIV Clinic at the University of Alabama at Birmingham between April 2008 and December 2013. Smoking status (current, former, never), psychosocial factors, and clinical characteristics were assessed. Multinomial logistic regression was used to obtain unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association of the various factors with smoking status. Among HIV-positive patients (mean age 45 years, 75% male, 55% African-American), the majority reported a history of smoking (39% current and 22% former smokers). In adjusted models, patient characteristics associated with increased odds of current smoking were male gender (OR for heterosexual men, 1.8 [95% CI: 1.3-2.6]; for men who have sex with men, 1.5 [1.1-1.9]), history of respiratory diseases (1.5 [1.2-1.9]), unsuppressed HIV viral load (>50 copies/mL) (1.5 [1.1-1.9]), depression (1.6 [1.3-2.0]), anxiety (1.6 [1.2-2.1]), and prior and current substance abuse (4.7 [3.6-6.1] and 8.3 [5.3-13.3] respectively). Male gender, anxiety, and substance abuse were also associated with being a former smoker. Smoking was common among HIV-positive patients, with several psychosocial factors associated with current and former smoking. This suggests smoking cessation programs in HIV clinic settings may achieve greater impact by integrating interventions that also address illicit substance abuse and mental health.

Social influences on smoking in American workers: the role of the presence of smokers in the workplace and in the home.

PubMed

Holahan, Carole K; Holahan, Charles J; Li, Xiaoyin; Jung, Sooin

2013-01-01

To examine the relationship between the presence of smokers in the workplace and smokers in the home and current smoking status among employed men and women. Analysis of data from the second wave of the nationally representative Survey of Midlife Development in the United States (2004-2006). Sample of 627 currently employed men and women, aged 34 to 82 (M = 51), who had been regular cigarette smokers at some time. Survey items indexing presence of smokers in the respondents' immediate work area and home and their current smoking status. Multiple logistic regression analyses, controlling for age, gender, education, race, and job type. Examined together, smokers in the workplace (OR = 2.83) and smokers in the home (OR = 6.09) were uniquely associated with current smoking status. Moreover, smokers in the home reduced the association between smokers in the workplace and current smoking. The presence of smokers in the workplace was associated with a more than fourfold increase in current smoking among respondents with no smokers in the home, but was unrelated to current smoking among respondents with smokers in the home. Failure to consider the presence of smokers in the home significantly limits the potential impact of workplace smoking interventions.

Multiple imputation to account for measurement error in marginal structural models

PubMed Central

Edwards, Jessie K.; Cole, Stephen R.; Westreich, Daniel; Crane, Heidi; Eron, Joseph J.; Mathews, W. Christopher; Moore, Richard; Boswell, Stephen L.; Lesko, Catherine R.; Mugavero, Michael J.

2015-01-01

Background Marginal structural models are an important tool for observational studies. These models typically assume that variables are measured without error. We describe a method to account for differential and non-differential measurement error in a marginal structural model. Methods We illustrate the method estimating the joint effects of antiretroviral therapy initiation and current smoking on all-cause mortality in a United States cohort of 12,290 patients with HIV followed for up to 5 years between 1998 and 2011. Smoking status was likely measured with error, but a subset of 3686 patients who reported smoking status on separate questionnaires composed an internal validation subgroup. We compared a standard joint marginal structural model fit using inverse probability weights to a model that also accounted for misclassification of smoking status using multiple imputation. Results In the standard analysis, current smoking was not associated with increased risk of mortality. After accounting for misclassification, current smoking without therapy was associated with increased mortality [hazard ratio (HR): 1.2 (95% CI: 0.6, 2.3)]. The HR for current smoking and therapy (0.4 (95% CI: 0.2, 0.7)) was similar to the HR for no smoking and therapy (0.4; 95% CI: 0.2, 0.6). Conclusions Multiple imputation can be used to account for measurement error in concert with methods for causal inference to strengthen results from observational studies. PMID:26214338

Association between current smoking and cognitive impairment depends on age: A cross-sectional study in Xi'an, China.

PubMed

Liu, Jie; Shang, Suhang; Li, Pei; Deng, Meiying; Chen, Chen; Jiang, Yu; Dang, Liangjun; Qu, Qiumin

2017-09-08

Cigarette smoking is a modifiable risk factor for cognitive impairment, while the relationship between current smoking and cognitive impairment is not fully understood. The objectives were to identify a possible association between current smoking and cognitive impairment depending on age in the Chinese rural population. Data for the study consisted of 1,782 participants (40 years and older) who lived in a rural village in the vicinity of Xi'an, China. Data about smoking history and cognitive function were collected. Cognitive function was scored by the Mini-Mental State Examination. The effect of age on the relationship between current smoking and cognitive impairment was analyzed with interaction and stratified analysis by logistic regression models. Interaction analysis showed that current smoking is positively related with cognitive impairment (odds ratio [OR]=9.067; 95% confidence interval [95% CI] 1.305-62.979; P=.026). However, the interaction term, age by current smoking, is negatively related with cognitive impairment (OR=0.969; 95%CI 0.939-0.999; P=.045). Stratified logistic regression showed that in the 40-65 years of age sublayer, OR of current smoking is 1.966 (P=.044), whereas in the>65 years of age sublayer, the OR is 0.470 (P=.130). This means that the association between current smoking and cognitive impairment with age might be positive (OR>1) in lower age sublayers, but no significant difference in higher age sublayers. In conclusion, current smoking might be positively associated with cognitive impairment in the middle-aged but the relationship declines with increasing age. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

LDRD report: Smoke effects on electrical equipment

DOE Office of Scientific and Technical Information (OSTI.GOV)

TANAKA,TINA J.; BAYNES JR.,EDWARD E.; NOWLEN,STEVEN P.

2000-03-01

Smoke is known to cause electrical equipment failure, but the likelihood of immediate failure during a fire is unknown. Traditional failure assessment techniques measure the density of ionic contaminants deposited on surfaces to determine the need for cleaning or replacement of electronic equipment exposed to smoke. Such techniques focus on long-term effects, such as corrosion, but do not address the immediate effects of the fire. This document reports the results of tests on the immediate effects of smoke on electronic equipment. Various circuits and components were exposed to smoke from different fields in a static smoke exposure chamber and weremore » monitored throughout the exposure. Electrically, the loss of insulation resistance was the most important change caused by smoke. For direct current circuits, soot collected on high-voltage surfaces sometimes formed semi-conductive soot bridges that shorted the circuit. For high voltage alternating current circuits, the smoke also tended to increase the likelihood of arcing, but did not accumulate on the surfaces. Static random access memory chips failed for high levels of smoke, but hard disk drives did not. High humidity increased the conductive properties of the smoke. The conductivity does not increase linearly with smoke density as first proposed; however, it does increase with quantity. The data can be used to give a rough estimate of the amount of smoke that will cause failures in CMOS memory chips, dc and ac circuits. Comparisons of this data to other fire tests can be made through the optical and mass density measurements of the smoke.« less

Active and passive smoking impacts on asthma with quantitative and temporal relations: A Korean Community Health Survey.

PubMed

Kim, So Young; Sim, Songyong; Choi, Hyo Geun

2018-06-05

This study aimed to evaluate the relations of smoking with asthma and asthma-related symptoms, considering quantitative and temporal influences. The 820,710 Korean adults in the Korean Community Health Survey in 2009, 2010, 2011, and 2013 were included and classified as non-smoker, past smoker or current smoker. Total smoking years, total pack-years, and age at smoking onset were assessed. Information on wheezing, exercise wheezing, and aggravation of asthma in the past 12 months and asthma diagnosis history and current treatment was collected. Multiple logistic regression analysis with complex sampling was used. Current and former smokers showed significant positive relations with wheezing, exercise wheezing, asthma ever, current asthma, and asthma aggravation. Current smokers demonstrated higher adjusted odd ratios (AORs) for wheezing, exercise wheezing, and asthma aggravation than former smokers. Former smokers showed higher AORs than current smokers for current asthma treatment. Longer passive smoking was related to wheezing and exercise wheezing. Greater age at smoking onset and duration since cessation were negatively related to wheezing, exercise wheezing, and current asthma; total pack-years demonstrated proportional associations with these symptoms. Former, current, and passive smoking was positively correlated with wheezing and exercise wheezing. Total pack-years and early initiation were increasingly related to asthma.

Evaluating the validity of self-reported smoking in Mexican adolescents

PubMed Central

Valladolid-López, María del Carmen; Barrientos-Gutiérrez, Tonatiuh; Reynales-Shigematsu, Luz Myriam; Thrasher, James F; Peláez-Ballestas, Ingris; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2015-01-01

Objectives We aimed to evaluate the validity of the self-reported smoking indicator used in the Global Youth Tobacco Survey (GYTS). Setting 43 middle and high-school classrooms from 26 schools were selected from Mexico City and Cuernavaca, Morelos. Participants A total of 1257 students provided both a questionnaire and a urine sample. Primary and secondary outcome Sensitivity and specificity of self-reported smoking compared to urinary cotinine. Validity indices were evaluated by subgroups of gender, social acceptability of smoking (ie, smoking parents or friends) and smoking frequency. Results Sensitivity and specificity for current smoking were 93.2% and 81.7%, respectively. Validity indices remained stable across gender. Parental smoking status moderated the validity of self-report, which had lower sensitivity in adolescents with non-smoking parents (86.7%) than in adolescents with smoking parents (96.6%). Sensitivity and specificity increased with smoking frequency. Conclusions This first validation study of self-reported current smoking used in the GYTS among Mexican adolescents suggests that self-reported smoking in the past 30 days is a valid and stable indicator of current smoking behaviour. This measure appears suitable for public health research and surveillance. PMID:26453588

Social patterns of adolescent cigarette smoking in a rural community.

PubMed

Stanhope, J M

1978-05-24

A survey of a secondary school serving a small town and rural district in New Zealand revealed that 46 percent of the students, aged 12 to 18, were current cigarette smokers. The smoking habits of elder siblings and peers were closely related to subjects' smoking. Parental opposition to smoking, beliefs that smoking was bad for health and a degree of self-esteem appeared to have protective value. The key to prevention of cigarette smoking may lie in parent and early childhood education aimed at increasing awareness of the dangers of smoking, fostering a soical climate of opposition to smoking, and increasing the child's self-confidence.

Prevalence and correlates of tobacco smoking, awareness of hazards, and quitting behavior among persons aged 30 years or above in a resettlement colony of Delhi, India.

PubMed

Garg, Ankur; Singh, Mongjam Meghachandra; Gupta, Vimal Kishore; Garg, Suneela; Daga, Mradul Kumar; Saha, Renuka

2012-10-01

To assess the prevalence and correlates of current smoking, awareness of hazards, and quitting behavior among smokers 30 years and above. Cross-sectional; Gokulpuri, a resettlement colony in East Delhi, India; 911, persons aged 30 years and above using systematic random sampling; Study tools: Semi-structured questionnaire. Prevalence of current smoking was found to be 24.6% (95% CI 21.90 - 27.49). Majority 198 (88.4%) of current smokers smoked bidi exclusively, and on an average 13.5 bidi/cigarette were smoked per day. Multivariate analysis showed the factors associated with current smoking as male sex, advancing age, illiteracy, skilled occupation, low socio-economic status, and low BMI (P < 0.001). 64.2% were aware of the hazards of smoking. 63 (21.9%) had quit smoking in the past, majority due to the health problems. Low educational status was associated with poor hazard awareness and quitting behavior. Smoking is a significant problem among poor and illiterate males, shows an increasing trend with an advancing age and is directly associated with skilled occupation and low BMI. There are significant gaps in knowledge regarding hazards of smoking.

Cigarette smoking among marijuana users in the United States.

PubMed

Richter, Kimber P; Kaur, Haroshena; Resnicow, Ken; Nazir, Niaman; Mosier, Michael C; Ahluwalia, Jasjit S

2004-06-01

The vast majority of drug users smoke cigarettes. Most use marijuana and no other illicit drug. We analyzed adult responses to the 1997 NHSDA (n = 16,661) to explore relationships between marijuana use and cigarette smoking. Multivariate analyses controlled for other illicit drug use and other potential covariates. Nearly three-quarters of current marijuana users (74%) smoked cigarettes. Compared to nonusers, the adjusted odds of being a smoker were 5.43 for current marijuana users, 3.58 for past year marijuana users, and 2.02 for former marijuana users. Odds for cigarette smoking among current poly-drug users, compared to nonusers, were 2.3 to 1. Level of cigarette smoking was directly associated with frequency of marijuana use. Nationwide, an estimated 7 million adults smoke both substances and are at increased risk for respiratory illnesses and mortality. Cigarette smoking is a major co-morbidity of marijuana use and smoking cessation should be addressed among marijuana users in addition to their other illicit drug involvement.

Effect of Exposure to Smoking in Movies on Young Adult Smoking in New Zealand

PubMed Central

Gendall, Philip; Hoek, Janet; Edwards, Richard; Glantz, Stanton

2016-01-01

Onscreen Smoking Is a Form of Tobacco Marketing Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents’ exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012. Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies. Effect of Smoking in Movies on New Zealand Youth Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents’ likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents, (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it is legal to view smoking in movies would support New Zealand’s smokefree 2025 goal. PMID:26960189

Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

PubMed

Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

2012-05-01

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

Development of Novel Pharmacotherapeutics for Tobacco Dependence: Progress and Future Directions

PubMed Central

Kenny, Paul J.

2012-01-01

Introduction: The vast majority of tobacco smokers seeking to quit will relapse within the first month of abstinence. Currently available smoking cessation agents have limited utility in increasing rates of smoking cessation and in some cases there are notable safety concerns related to their use. Hence, there is a pressing need to develop safer and more efficacious smoking cessation medications. Methods: Here, we provide an overview of current efforts to develop new pharmacotherapeutic agents to facilitate smoking cessation, identified from ongoing clinical trials and published reports. Results: Nicotine is considered the major addictive agent in tobacco smoke, and the vast majority of currently available smoking cessation agents act by modulating nicotinic acetylcholine receptor (nAChR) signaling. Accordingly, there is much effort directed toward developing novel small molecule therapeutics and biological agents such as nicotine vaccines for smoking cessation that act by modulating nAChR activity. Our increasing knowledge of the neurobiology of nicotine addiction has revealed new targets for novel smoking cessation therapeutics. Indeed, we highlight many examples of novel small molecule drug development around non-nAChR targets. Finally, there is a growing appreciation that medications already approved for other disease indications could show promise as smoking cessation agents, and we consider examples of such repurposing efforts. Conclusion: Ongoing clinical assessment of potential smoking cessation agents offers the promise of new effective medications. Nevertheless, much of our current knowledge of molecular mechanisms of nicotine addiction derived from preclinical studies has not yet been leveraged for medications development. PMID:23024249

Multilevel analysis of school anti-smoking education and current cigarette use among South African students

PubMed Central

Talley, Brandon; Masyn, Katherine; Chandora, Rachna; Vivolo-Kantor, Alana

2017-01-01

Introduction South Africa (SA) implemented the Global Youth Tobacco Survey (GYTS) four times between 1999 and 2011. Data from the four surveys indicated that downward trends in cigarette use among students may have stalled. Understanding the effect of school anti-smoking education on current smoking among students within schools and variability across schools may provide important insights into policies aimed at preventing or reducing tobacco use among students. The objective was to assess the student- and school-level effects of students' exposure to school anti-smoking education on current cigarette use among the study population using the most recent wave of GYTS data in SA (2011). Methods An analytic sample of students 13-15 years of age was selected (n=3,068) from the SA GYTS 2011. A taxonomy of two-level logistic regression models was fit to assess the relationship of various tobacco use, control, and exposure predictor variables on current cigarette smoking among the study population. Results At the student-level in the full model, secondhand smoke (SHS) exposure, peer smoking, and ownership of a promotional item were significantly associated with higher risk of current smoking. At the school-level in the full model, average exposure to peer smoking was associated with significant increases in the prevalence of current cigarette use, while average family anti-smoking education was significantly associated with decreases in the outcome variable. School anti-smoking education was not a statistically significant predictor at the student- or school-levels. Conclusion in this study, exposure to school anti-smoking education had no association with current cigarette smoking among the study population. Consistent with previous studies, having peers that smoked was highly associated with a student being a current smoker. Interestingly, at the school-level in the multilevel analysis, schools with higher rates of average family anti-smoking education had lower prevalence of current smoking. This finding has potential implications for tobacco control in SA, particularly if the school-level, family-centered protective effect can be operationalized as a prevention tool in the country's tobacco control program. PMID:28451015

Do never smokers make up an increasing share of snus users as cigarette smoking declines? Changes in smoking status among male snus users in Norway 2003-15.

PubMed

Lund, Karl Erik; Vedøy, Tord Finne; Bauld, Linda

2017-02-01

To examine how the relative size of six groups of male ever snus users (current and former users of snus who were current, former or never cigarette smokers) varied over time in Norway, and how these groups differ with regard to important measures of tobacco behaviour. Repeated cross-sectional nationally representative surveys of tobacco use. The association between survey year and the six categories of ever snus use was examined using cross-tabulation and multinomial logistic regression. Differences in tobacco behaviour across snus use categories were examined using logistic and ordinary least squares (OLS) regression. Norway, 2003-15. A total of 2067 males aged 15-79 years. The categories of ever snus use represented all six combinations of cigarette smoking (current, former or never) among current and former users of snus. The variables measuring tobacco behaviour were: order of product uptake (snus or cigarettes first), mean cigarette consumption, reduction from daily to occasional smoking, intention to quit cigarettes, future smoking identity and use of snus in latest quit attempt. During the period 2003-15, the relative share of current snus users who had never smoked, and current snus users who were former smokers, increased. The share of dual users, and smokers who were former snus users, decreased. Among men who reported life-time experience with both products, a large majority had initiated their tobacco use with cigarettes. The average number of cigarettes smoked weekly was lower among dual users compared with current smokers who were former snus users or had never used snus. During the period 2003-15 in Norway, which has a mature snus market, even though smoking has declined and the relative size of the category of never-smokers among male users of snus has increased, the majority of snus users are still former or current smokers. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature.

PubMed

Haddad, Linda; El-Shahawy, Omar; Ghadban, Roula; Barnett, Tracey E; Johnson, Emily

2015-05-29

Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

Smoking in asthma is associated with elevated levels of corticosteroid resistant sputum cytokines-an exploratory study.

PubMed

Spears, Mark; McSharry, Charles; Chaudhuri, Rekha; Weir, Christopher J; de Wet, Carl; Thomson, Neil C

2013-01-01

Current cigarette smoking is associated with reduced acute responses to corticosteroids and worse clinical outcomes in stable chronic asthma. The mechanism by which current smoking promotes this altered behavior is currently unclear. Whilst cytokines can induce corticosteroid insensitivity in-vitro, how current and former smoking affects airway cytokine concentrations and their responses to oral corticosteroids in stable chronic asthma is unclear. To examine blood and sputum cytokine concentrations in never, ex and current smokers with asthma before and after oral corticosteroids. Exploratory study utilizing two weeks of oral dexamethasone (equivalent to 40 mg/day prednisolone) in 22 current, 21 never and 10 ex-smokers with asthma. Induced sputum supernatant and plasma was obtained before and after oral dexamethasone. 25 cytokines were measured by multiplex microbead system (Invitrogen, UK) on a Luminex platform. Smokers with asthma had elevated sputum cytokine interleukin (IL) -6, -7, and -12 concentrations compared to never smokers with asthma. Few sputum cytokine concentrations changed in response to dexamethasone IL-17 and IFNα increased in smokers, CCL4 increased in never smokers and CCL5 and CXCL10 reduced in ex-smokers with asthma. Ex-smokers with asthma appeared to have evidence of an ongoing corticosteroid resistant elevation of cytokines despite smoking cessation. Several plasma cytokines were lower in smokers with asthma compared to never smokers with asthma. Cigarette smoking in asthma is associated with a corticosteroid insensitive increase in multiple airway cytokines. Distinct airway cytokine profiles are present in current smokers and never smokers with asthma and could provide an explanatory mechanism for the altered clinical behavior observed in smokers with asthma.

Smoking among Young Rural to Urban Migrant Women in China: A Cross-Sectional Survey

PubMed Central

Wan, Xia; Shin, Sanghyuk S.; Wang, Qian; Raymond, H. Fisher; Liu, Huilin; Ding, Ding; Yang, Gonghuan; Novotny, Thomas E.

2011-01-01

Background Rural-to-urban migrant women may be vulnerable to smoking initiation as they are newly exposed to risk factors in the urban environment. We sought to identify correlates of smoking among rural-to-urban migrant women in China. Methods/Principal Findings A cross-sectional survey of rural-to-urban migrant women working in restaurants and hotels (RHW) and those working as commercial sex workers (CSW) was conducted in ten provincial capital cities in China. Multiple logistic regression was conducted to identify correlates of smoking. We enrolled 2229 rural-to-urban migrant women (1697 RHWs aged 18–24 years and 532 CSWs aged 18–30 years). Of these, 18.4% RHWs and 58.3% CSWs reported ever tried smoking and 3.2% RHWs and 41.9% CSWs reported current smoking. Participants who first tried smoking after moving to the city were more likely to be current smokers compared to participants who first tried smoking before moving to the city (25.3% vs. 13.8% among RHWs, p = 0.02; 83.6% vs. 58.6% among CSWs, p = <0.01). Adjusting for other factors, “tried female cigarette brands” had the strongest association with current smoking (OR 5.69, 95%CI 3.44 to 9.41) among participants who had ever tried smoking. Conclusions/Significance Exposure to female cigarette brands may increase the susceptibility to smoking among rural-to-urban migrant women. Smoke-free policies and increased taxes may be effective in preventing rural-to-urban migrant women from smoking initiation. PMID:21829683

Impacts of Canada's minimum age for tobacco sales (MATS) laws on youth smoking behaviour, 2000-2014.

PubMed

Callaghan, Russell Clarence; Sanches, Marcos; Gatley, Jodi; Cunningham, James K; Chaiton, Michael Oliver; Schwartz, Robert; Bondy, Susan; Benny, Claire

2018-01-13

Recently, the US Institute of Medicine has proposed that raising the minimum age for tobacco purchasing/sales to 21 years would likely lead to reductions in smoking behavior among young people. Surprisingly few studies, however, have assessed the potential impacts of minimum-age tobacco restrictions on youth smoking. To estimate the impacts of Canadian minimum age for tobacco sales (MATS) laws on youth smoking behaviour. A regression-discontinuity design, using seven merged cycles of the Canadian Community Health Survey, 2000-2014. Survey respondents aged 14-22 years (n=98 320). Current Canadian MATS laws are 18 years in Alberta, Saskatchewan, Manitoba, Quebec, the Yukon and Northwest Territories, and 19 years of age in the rest of the country. Current, occasional and daily smoking status; smoking frequency and intensity; and average monthly cigarette consumption. In comparison to age groups slightly younger than the MATS, those just older had significant and abrupt increases immediately after the MATS in the prevalence of current smokers (absolute increase: 2.71%; 95% CI 0.70% to 4.80%; P=0.009) and daily smokers (absolute increase: 2.43%; 95% CI 0.74% to 4.12%; P=0.005). Average past-month cigarette consumption within age groups increased immediately following the MATS by 18% (95% CI 3% to 39%; P=0.02). There was no evidence of significant increases in smoking intensity for daily or occasional smokers after release from MATS restrictions. The study provides relevant evidence supporting the effectiveness of Canadian MATS laws for limiting smoking among tobacco-restricted youth. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoking cue reactivity in adult smokers with and without depression: A pilot study

PubMed Central

Weinberger, Andrea H.; McKee, Sherry A.; George, Tony P.

2013-01-01

Little is known about the relationship between Major Depressive Disorder (MDD) and smoking-related behaviors such as cue-induced urges to smoke. The purpose of this pilot study was to examine: 1) differences in smoking cue reactivity by MDD history, and; 2) the association of a diagnosis of MDD, current depressive symptoms, and smoking variables to cue-induced urges to smoke. Participants (N=52) were n=31 smokers with no MDD history and n=21 smokers with past MDD. Participants completed a 2-hour laboratory session during which they were exposed to neutral (e.g., pencils) and smoking cues (e.g., cigarettes) after smoking one of their preferred brand cigarettes (Satiated Condition) and when it had been one hour since they smoked (Brief Deprivation Condition). Cue-induced urges increased with exposure to smoking cues and this increase did not significantly differ by diagnosis group. Current symptoms of depression, but not a diagnosis of MDD, were significantly and positively related to cue-induced cravings in satiated adult smokers. The association between depression symptoms and smoking urges was not significant in the Brief Deprivation Condition. Smoking cue reactivity may be a useful procedure for studying aspects of smoking behavior in adults with depression. PMID:22332857

Factors affecting the variability in the observed levels of cadmium in blood and urine among former and current smokers aged 20-64 and ≥ 65years.

PubMed

Jain, Ram B

2017-03-01

Data from National Health and Nutrition Examination Survey for 1999-2012 were used to evaluate factors that affect observed levels of blood cadmium (BCd) and urine cadmium (UCd) among former and current smokers aged 20-64 and ≥65 years. Adjusted levels (AGM) for BCd and UCd were higher among females as compared to males. The order of AGM for BCd by race/ethnicity for 20-64 years old was non-Hispanic white (NHW) < non-Hispanic black (NHB) and NHW > NHB for ≥65 years old. The order of AGMs for UCd for 20-64-year-old current smokers was NHW > NHB and NHW > NHB for former smokers. For 20-64-year-old current smokers, exposure to environmental tobacco smoke at home was associated with higher levels of BCd. Levels of both UCd and BCd increased with age, but the rate of increase was as much as seven times higher among ≥65 years old than 20-64 years old. For current smokers, the number of cigarettes smoked inside home was positively associated with the levels of BCd. For current smokers aged 20-64 years, the number of cigarettes smoked inside home was positively associated with the levels of UCd (p < 0.01), and the number of cigarettes smoked every day on the days they were smoked was also positively associated with the levels of UCd (p < 0.01). Among former smokers, levels of both UCd and BCd were positively associated (p < 0.1) with the number of cigarettes smoked per day at the time of quitting smoking and negatively associated with the time since smoking was quitted (p < 0.01).

Factors Associated with Smoking in HIV-Infected Patients and Potential Barriers to Cessation

PubMed Central

Kesari, Ravi K.; Glesby, Marshall J.

2013-01-01

Abstract Smoking is common in patients with HIV and is associated with increased morbidity and mortality. With the goal of targeting future cessation interventions, we sought to identify factors associated with smoking status, readiness and confidence in cessation, and success in quitting. As part of a larger study in New York City assessing predictors of chronic obstructive pulmonary disease (COPD), we enrolled HIV-infected subjects at least 35 years of age without known asthma or COPD. Current smokers received detailed tobacco history, and smoking status was assessed by chart review at 3 and 6 months post-enrollment. Two hundred subjects were enrolled (29% current smokers, 31.5% never smokers, 39.5% former smokers, mean age of 49, 84% male, 64% had AIDS, and 97% were receiving antiretroviral therapy). Current smokers had higher unemployment and increased rates of other substance use than former smokers or never smokers. In multivariate analysis, being unemployed and having used inhalant drugs were associated with current smoking. Substance abuse history was not correlated with readiness to quit or patient estimated cessation. Lower education was associated with decreased readiness to quit. Follow-up smoking status for baseline current smokers was available for 47/58 enrollees at 6 months; 4 (9%) stopped smoking completely, and 17 (36%) decreased the number of packs-per-day. Smoking and concomitant substance abuse is common in HIV, and special attention should be given to this issue, in addition to a patient's readiness to quit, when implementing tobacco cessation protocols, especially in busy urban HIV care centers. PMID:24138488

Associations of Bar and Restaurant Smoking Bans With Smoking Behavior in the CARDIA Study: A 25-Year Study.

PubMed

Mayne, Stephanie L; Auchincloss, Amy H; Tabb, Loni Philip; Stehr, Mark; Shikany, James M; Schreiner, Pamela J; Widome, Rachel; Gordon-Larsen, Penny

2018-06-01

Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.

Risk Factors for Smoking in Rural Women: The Role of Gender-Based Sexual and Intimate Partner Violence.

PubMed

Nemeth, Julianna M; Bonomi, Amy E; Lu, Bo; Lomax, Richard G; Wewers, Mary Ellen

2016-12-01

Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region. A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey (n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk. Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status (p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21-2.17]). Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation.

Cigarette smoking and mammographic density in the Danish Diet, Cancer and Health cohort.

PubMed

Jacobsen, Katja Kemp; Lynge, Elsebeth; Vejborg, Ilse; Tjønneland, Anne; von Euler-Chelpin, My; Andersen, Zorana J

2016-02-01

Smoking before first childbirth increases breast cancer risk, but the biological mechanism remains unknown and may involve mammographic density (MD), one of the strongest biomarkers of breast cancer risk. We aimed to examine whether active smoking and passive smoking were associated with MD. For the 5,356 women (4,489 postmenopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Active smoking (status, duration, and intensity) and passive smoking were assessed at cohort baseline (1993-1997) via questionnaire, together with other breast cancer risk factors. Logistic regression was used to estimate associations (odds ratios, 95 % confidence intervals) between smoking and MD, adjusting for confounders. Two thousand and twenty-six (56.5 %) women had mixed/dense MD, 2,214 (41.4 %) were current, and 1,175 (21.9 %) former smokers. Current smokers had significantly lower odds (0.86, 0.75-0.99) of having mixed/dense MD compared to never smokers, while former smoking was not associated with MD. Inverse association between smoking and MD was strongest in women who initiated smoking before age of 16 years (0.79, 0.64-0.96), smoked ≥15 cigarettes/day (0.83, 0.71-0.98), smoked ≥5 pack-years (0.62, 0.43-0.89), smoked >30 years (0.86, 0.75-0.99), and smoked ≥11 years before first childbirth (0.70, 0.51-0.96). Association between smoking and MD diminished after smoking cessation, with increased odds of having mixed/dense breasts in women who quit smoking >20 years ago as compared to current smokers (1.37, 1.01-1.67). There was no association between passive smoking and MD. We found an inverse association between active smoking and MD.

Adverse childhood experiences and smoking status in five states.

PubMed

Ford, Earl S; Anda, Robert F; Edwards, Valerie J; Perry, Geraldine S; Zhao, Guixiang; Li, Chaoyang; Croft, Janet B

2011-09-01

Our objective was to examine the associations between adverse childhood experiences (ACEs) and smoking behavior among a random sample of adults living in five U.S. states. We used data from 25,809 participants of the 2009 Behavioral Risk Factor Surveillance System to assess the relationship of each of the 8 adverse childhood experiences and the adverse childhood experience score to smoking status. Some 59.4% of men and women reported at least one adverse childhood experience. Each of the eight adverse childhood experiences measures was significantly associated with smoking status after adjustment for demographic variables. The prevalence ratios for current and ever smoking increased in a positive graded fashion as the adverse childhood experience score increased. Among adults who reported no adverse childhood experiences, 13.0% were currently smoking and 38.3% had ever smoked. Compared to participants with an adverse childhood experience score of 0, those with an adverse childhood experience score of 5 or more were more likely to be a current smoker (adjusted prevalence ratio (aPR): 2.22, 95% confidence interval [CI]: 1.92-2.57) and to have ever smoked (aPR: 1.80, 95% CI: 1.67-1.93). Further research is warranted to determine whether the prevention of and interventions for adverse childhood experiences might reduce the burden of smoking-related illness in the general population. Published by Elsevier Inc.

Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

PubMed Central

Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

2012-01-01

Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

Infrequent and Frequent Nondaily Smokers and Daily Smokers: Their Characteristics and Other Tobacco Use Patterns.

PubMed

Wang, Yingning; Sung, Hai-Yen; Yao, Tingting; Lightwood, James; Max, Wendy

2018-05-03

The proportion of smokers who do not smoke daily has increased over time, but nondaily smokers are a heterogeneous group. We compare characteristics and other tobacco product use of infrequent nondaily, frequent nondaily, and daily US adult smokers. We analyzed data from the 1998, 2000, 2005, and 2010 National Health Interview Surveys. Current smokers were categorized as daily, infrequent nondaily (smoked 1-12 days in the past 30 days), and frequent nondaily (smoked 13-29 days in the past 30 days) smokers. Multinomial logistic regression analysis was used to analyze the correlates of infrequent nondaily, frequent nondaily, and daily smoking. Among current smokers, 8.3% were infrequent nondaily, 8.1% were frequent nondaily, and 83.6% were daily smokers. The prevalence of infrequent versus daily smoking increased over time, with a smaller increase among non-Hispanic Blacks than non-Hispanic Whites. The adjusted odds of both infrequent and frequent smoking versus daily smoking differed by age, race/ethnicity, education, poverty status, marital status, region, quit attempts in the past 12 months, and binge drinking. Snuff users (vs. non-snuff users) were 2.4 times as likely to be infrequent than daily smokers. There were also differences in race/ethnicity, education, marital status, region, quit attempts, and snuff use between infrequent versus frequent smokers. Infrequent smokers differ from both frequent and daily smokers in socio-demographics, quit attempts, and snuff use. The heterogeneity of nondaily smokers should be considered in developing targeted tobacco control and smoking cessation programs. Infrequent and frequent nondaily smokers were found to differ from daily smokers in age, race/ethnicity, education, poverty status, marital status, region, and quit attempts and they were different from each other in race/ethnicity, education, marital status, region, and quit attempts. Binge drinkers were more likely to be infrequent smokers and frequent smokers versus daily smokers. Current snuff users were found to have increased odds of infrequent smoking versus daily smoking and versus frequent smoking. These results highlight the importance of acknowledging the differences among nondaily smokers in smoking frequency in developing targeted tobacco control and smoking cessation programs.

Between a rock and a hard place: Smoking trends in a Manitoba First Nation.

PubMed

Riediger, Natalie D; Lukianchuk, Virginia; Lix, Lisa M; Elliott, Lawrence; Bruce, Sharon G

2015-04-29

The purpose of this study is to estimate and compare smoking prevalence over two time periods in a Manitoba First Nation community. Data fromtwo independent Diabetes Screening Studies in Sandy Bay First Nation, collected in 2002/2003 (n = 482) and 2011/2012 (n = 596),were used. Crude prevalence of current and ever smoking as well as current smoke exposure was estimated. Change over time was tested using a χ² statistic. The crude prevalence of current smoking was 74.0% (95% confidence interval [CI]: 70.1, 78.0) in 2002/2003 and 80.0% (95% CI: 76.8, 83.2) in 2011/2012. The crude prevalence of ever smoking was 83.0% in 2002/2003 and 91.4% in 2011/2012. The prevalence of both current smoking status and ever smoking were significantly higher in 2011/2012 compared to 2002/2003 (p = 0.020 and p < 0.001 respectively). Among participants who were not current smokers, 58.5% (95% CI: 49.6, 67.4) and 76.5% (95% CI: 68.9, 84.1) reported at least one person who smoked in the home in 2002/2003 and 2011/2012 respectively (p = 0.003). In 2011/2012, 96.5% (95% CI: 94.8, 98.2) of those who reported having any children under the age of 18 living in the home were either a current smoker and/or reported that someone else smoked in the home. Public health and policy initiatives are needed to address the increase in smoking prevalence in the study community.

Impact of smoking status on workplace absenteeism and productivity

PubMed Central

Halpern, M.; Shikiar, R.; Rentz, A.; Khan, Z.

2001-01-01

OBJECTIVES—To: evaluate the impact of smoking status on objective productivity and absenteeism measures; evaluate the impact of smoking status on subjective measures of productivity; and assess the correlation between subjective and objective productivity measures.
DESIGN—Prospective cohort study in a workplace environment.
SUBJECTS—Approximately 300 employees (100 each of former, current, and never smokers) at a reservation office of a large US airline.
MAIN OUTCOME MEASURES—Objective productivity and absenteeism data were supplied by the employer. Subjective assessments of productivity were collected using a self report instrument, the Health and Work Questionnaire (HWQ).
RESULTS—Current smokers had significantly greater absenteeism than did never smokers, with former smokers having intermediate values; among former smokers, absenteeism showed a significant decline with years following cessation. Former smokers showed an increase in seven of 10 objective productivity measures as compared to current smokers, with a mean increase of 4.5%. While objective productivity measures for former smokers decreased compared to measures for current smokers during the first year following cessation, values for former smokers were greater than those for current smokers by 1-4 years following cessation. Subjective assessments of "productivity evaluation by others" and "personal life satisfaction" showed significant trends with highest values for never smokers, lowest for current smokers, and intermediate for former smokers.
CONCLUSIONS—Workplace productivity is increased and absenteeism is decreased among former smokers as compared to current smokers. Productivity among former smokers increases over time toward values seen among never smokers. Subjective measures of productivity provide indications of novel ways of productivity assessment that are sensitive to smoking status.


Keywords: smoking cessation; workplace; absenteeism; productivity; questionnaires PMID:11544387

Tobacco and cannabis smoking in secondary school pupils in Bo, Sierra Leone.

PubMed

Abul Bangura, S; Lisk, R D

1995-01-01

A questionnaire survey of 713 pupils of Secondary Schools in Bo town, Southern Sierra Leone, on tobacco and cannabis smoking was carried out in January and February 1994. There were 56.8% males and 43.2% females with a mean age of 17.6 +/- 1.5 years. Lifetime use of both substances was 9% while current use was 4.2%. Current use of cigarettes was 3.2% and of cannabis 2.2%. Forty percent of current users smoked both cigarettes and cannabis. The mean age of onset of smoking was 15.1 +/- 3.1 years. Males smoked significantly more than females (p < 0.001). The prevalence of smoking increased with age and from junior to senior forms. There was also a higher prevalence among muslim students. Smoking within the family was a significant determinant of smoking in School children (p < 0.01). Current smokers were less aware of the health hazards of smoking but the majority of previous smokers stopped the habit because they thought it was bad for their health. In spite of these relatively rates, it is recommended that appropriate health education programme on tobacco and cannabis smoking be incorporated into school curricula. Further studies are indicated in more urbanized areas and in colleges.

Cross-sectional association between smoking depictions in films and adolescent tobacco use nested in a British cohort study

PubMed Central

Waylen, Andrea E; Leary, Sam D; Ness, Andrew R; Tanski, Susanne E; Sargent, James D

2012-01-01

Objective To assess associations between exposure to smoking depictions in films and adolescent tobacco use in a British population cohort. Methods Data on exposure to smoking in films and smoking behaviour were collected from 5166 15-year-old adolescents in the UK. Main outcome measures were smoking initiation (ever tried a cigarette) and current smoking status. Social, family and behavioural factors were adjusted for, together with alcohol use and peer smoking as potential mediators. Data from all existing cross-sectional studies examining the effects of exposure to smoking in films were summarised in a meta-analysis. Results Higher exposure to smoking in films was associated with a dose-response increase in the risk of smoking initiation even after adjusting for confounders. Adolescents in the highest exposure quartile were 1.73 (95% CI 1.55 to 1.93) times (RR) more likely to initiate smoking than those in the lowest quartile. They were more likely to report current smoking after adjusting for social and familial factors (RR 1.47 (95% CI 1.07 to 2.02)), but the association attenuated after including behavioural factors (RR 1.34 (95% CI 0.95 to 1.87)). The meta-analysis shows that, after aggregation of all relevant data, viewing smoking in films increases the risk of smoking onset by over 100% (combined RR 2.13 (95% CI 1.76 to 2.57)) and the risk of current or established smoking behaviour by 68% (combined RR 1.68 (95% CI 0.40 to 2.01)). Conclusions This study provides evidence that adolescents in the UK and elsewhere who are exposed to smoking depictions in films are more likely to initiate smoking. Given the association between smoking and poor health outcomes, these data justify a review of film ratings. PMID:21933947

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, T.J.; Antonescu, C.

A program to assess the impact of smoke on digital instrumentation and control (I and C) safety systems began in 1994, funded by the US Nuclear Regulatory Commission Office of Research. Digital I and C safety systems are likely replacements for today`s analog systems. The nuclear industry has little experience in qualifying digital electronics for critical systems, part of which is understanding system performance during plant fires. The results of tests evaluating the performance of digital circuits and chip technologies exposed to the various smoke and humidity conditions representative of cable fires are discussed. Tests results show that low tomore » moderate smoke densities can cause intermittent failures of digital systems. Smoke increases leakage currents between biased contacts, leading to shorts. Chips with faster switching times, and thus higher output drive currents, are less sensitive to leakage currents and thus to smoke. Contact corrosion from acidic gases in smoke and inductance of stray capacitance are less important contributors to system upset. Transmission line coupling was increased because the smoke acted as a conductive layer between the lines. Permanent circuit damage was not obvious in the 24 hr of circuit monitoring. Test results also show that polyurethane, parylene, and acrylic conformal coatings are more effective in protecting against smoke than epoxy or silicone. Common-sense mitigation measures are discussed. Unfortunately the authors are a long way from standard tests for smoke exposure that capture the variations in smoke exposure possible in an actual fire.« less

Characteristics of cigarette smoking and quitting among university students in Syria.

PubMed

Maziak, W; Hammal, F; Rastam, S; Asfar, T; Eissenberg, T; Bachir, M E; Fouad, M F; Ward, K D

2004-08-01

No study to date in Syria has documented the smoking and quitting characteristics in a representative sample of university students, and this study aims to fill this void. In 2003, a cross-sectional survey was carried out among students at Aleppo University using an interviewer-administered questionnaire. Overall, 587 students participated in the study (278 males, 309 females; mean age, 21.8 +/- 2.1 years; response rate, 98.8%). Experiences and attitudes related to smoking and quitting were assessed for two popular forms of tobacco use in Syria-cigarettes and narghile (waterpipe). Current cigarette smoking was reported by 30.9% of male and 7.4% of female students and daily smoking by 24.8% of male and 5.2% of female students. Narghile smoking was seen among 25.5% of men and 4.9% of women, mostly on an occasional basis. More than half of current smokers (56%) believed they could quit cigarettes, 75.2% were interested in quitting, and 78% of those had made a quit attempt in the past year. Important correlates of cigarette smoking among students were being older, male, and smoking narghile, while being older and from a poorer family were associated with increased interest in quitting. Interestingly, peers' smoking was associated with current smoking among students, but inversely with their willingness to quit. Cigarette smoking is mainly a problem of male students, whose narghile smoking is likely to be dramatically increasing as well, sometimes practiced as a substitute for cigarettes. The findings that most smokers in this sample are interested in quitting smoking and have tried unsuccessfully to do so indicate that cessation support for youths in this country is urgently needed.

Wildfire smoke exposure and human health: Significant gaps in research for a growing public health issue.

PubMed

Black, Carolyn; Tesfaigzi, Yohannes; Bassein, Jed A; Miller, Lisa A

2017-10-01

Understanding the effect of wildfire smoke exposure on human health represents a unique interdisciplinary challenge to the scientific community. Population health studies indicate that wildfire smoke is a risk to human health and increases the healthcare burden of smoke-impacted areas. However, wildfire smoke composition is complex and dynamic, making characterization and modeling difficult. Furthermore, current efforts to study the effect of wildfire smoke are limited by availability of air quality measures and inconsistent air quality reporting among researchers. To help address these issues, we conducted a substantive review of wildfire smoke effects on population health, wildfire smoke exposure in occupational health, and experimental wood smoke exposure. Our goal was to evaluate the current literature on wildfire smoke and highlight important gaps in research. In particular we emphasize long-term health effects of wildfire smoke, recovery following wildfire smoke exposure, and health consequences of exposure in children. Copyright © 2017 Elsevier B.V. All rights reserved.

Smoking beliefs and behavior among youth in South Korea, Taiwan, and Thailand.

PubMed

Lee, Joann; Johnson, Carolyn; Rice, Janet; Warren, C Wick; Chen, Ted

2013-09-01

Beliefs about smoking are important predictors of smoking behavior among adolescents, and adolescents who hold positive beliefs about the benefits of smoking are at an increased risk of smoking initiation. An alarming fact is the rising smoking prevalence in Asian countries, particularly the increasing trend in smoking during adolescence. This cross-sectional study examined smoking beliefs and behavior among a nationally representative sample of youth in South Korea, Taiwan, and Thailand. Descriptive statistics, linear regression, and logistic regression methods were used to analyze data from 13-15-year-old adolescents who participated in the 2005 Global Youth Tobacco Survey (GYTS) in South Korea (N = 4,765) and Thailand (N = 15,420) and the 2007 GYTS in Taiwan (N = 3,955). The rate of ever smoking among youth was similar in all three countries and ranged from 26.7 to 28.0 %. The prevalence of current smoking among youth in Thailand (11.4 %) was nearly double the prevalence in South Korea (6.6 %) and Taiwan (6.5 %). Pro-tobacco advertising exposure, as well as older ages, was a positive and significant predictor of positive beliefs about smoking among youth in all three countries. Additionally, youth who reported increased positive smoking-related beliefs, greater pro-tobacco advertising exposure, and were male were more likely to be current smokers in all three countries. Results suggest that greater attention be directed to understanding beliefs and attitudes about smoking among youth. Exploring the relationship between these factors and smoking behavior can provide a strong starting point in the development of effective smoking prevention interventions and tobacco control policies in this region.

Understanding the association between authoritative parenting and adolescent smoking.

PubMed

Castrucci, Brian C; Gerlach, Karen K

2006-03-01

Research on adolescent cigarette smoking has attempted to measure the role of parents in preventing smoking experimentation and uptake. However, aspects of parental influence have often been limited to parental smoking behavior or antismoking socialization. Only a limited number of studies considered the hypothesis that the influence of parenting on adolescent current cigarette smoking may extend beyond parental behavior and antismoking socialization to consider broader measures of the parent-child relationship, such as parenting style. The sample was nationally representative and included 17,287 high school students nationwide. Data were used to categorize the parenting style--authoritative, permissive, autocratic, and unengaged--experienced by each respondent. Logistic regression analysis was used to assess the association between parenting style and adolescent current cigarette smoking. Authoritative parenting was associated with a reduction in the odds of adolescent current cigarette smoking (OR: 0.74, 99% CI: 0.58, 0.95). When authoritative parenting is simultaneously considered with believing parents' opinions about smoking are important, authoritative parenting was no longer a significant correlate of adolescent current cigarette smoking, while believing parents' opinions about smoking are important was associated with a 45% (99% CI: 0.48, 0.64) reduction in the odds of adolescent current cigarette smoking. Authoritative parenting was associated with a more than three-fold increase (OR: 3.65, 99% CI: 2.87, 4.66) in the odds of believing parents' opinions about smoking are important. Interventions may want to educate parents about authoritative parenting, which includes the importance of having appropriate and routine conversations with their children, requiring chores, and implementing general rules and boundaries.

Changes in smoking prevalence in Ukraine in 2001–5

PubMed Central

Andreeva, Tatiana I; Krasovsky, Konstantin S

2007-01-01

Objectives To analyse trends in smoking prevalence in Ukraine from three surveys conducted in 2001–5, and to explore correlates of observed changes, in order to estimate the stage of tobacco epidemic in Ukraine. Design Repeated national interview surveys in Ukraine in 2001, 2002 and 2005. Main outcome measure Prevalence of current smoking among the population aged ⩾15 years. Results The age‐standardised prevalence of current smoking in Ukrainian men was 54.8% in 2001 and 66.8% in 2005. Among Ukrainian women, prevalence increased from 11.5% in 2001 to 20.0% in 2005. ORs for yearly increase in prevalence were estimated as 1.164 (95% CI 1.111 to 1.220) for men and 1.187 (1.124 to 1.253) for women, which implies that, on average, 3–4% of men and 1.5–2% of women living in Ukraine join the smoking population each year. Conclusions In Ukraine, smoking prevalence is increasing in most population groups. Among men, the medium deprivation group with secondary education has the highest smoking prevalence. Among women, while the most educated, young and those living in larger cities are the leading group for tobacco use, other groups are also increasing their tobacco use. Tobacco promotion efforts appear to have been significantly more effective in Ukraine than smoking control efforts. The decrease in real cigarette prices in Ukraine in 2001–5 could be the main factor explaining the recent growth in smoking prevalence. PMID:17565141

Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

PubMed Central

Haddad, Linda; El-Shahawy, Omar; Ghadban, Roula; Barnett, Tracey E.; Johnson, Emily

2015-01-01

Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States. PMID:26110330

Experimental Investigations on Combustion Behaviors of Live PVC Cables

NASA Astrophysics Data System (ADS)

Wang, Liufang; Zhang, Jiaqing; Zhang, Bosi; Liu, Min; Fan, Minghao; Li, Qiang

2018-03-01

This paper investigated the combustion behaviors of live PVC cables with overload currents experimentally. The smoke coefficient of released smoke and the released gas concentration were examined. The results indicate that the combustion of live PVC cables can be divided into four stages, i.e., core exposed with a little smoke, obvious flame, maximum smoke and smoke depress. For most cases, using blue laser is better than using rad laser, since the extinction coefficient of the rad laser was larger than that of the blue laser. The response time of the detection of the released typical gases due to cable pyrolysis decreased and the peak values of the typical gases increased with the overload currents. In addition, the time to reach the peak value of gas concentration also decreased with the overload currents.

Health Care Utilization and Expenditures Attributable to Cigar Smoking Among US Adults, 2000-2015.

PubMed

Wang, Yingning; Sung, Hai-Yen; Yao, Tingting; Lightwood, James; Max, Wendy

Cigar use in the United States is a growing public health concern because of its increasing popularity. We estimated health care utilization and expenditures attributable to cigar smoking among US adults aged ≥35. We analyzed data on 84 178 adults using the 2000, 2005, 2010, and 2015 National Health Interview Surveys. We estimated zero-inflated Poisson (ZIP) regression models on hospital nights, emergency department (ED) visits, physician visits, and home-care visits as a function of tobacco use status-current sole cigar smokers (ie, smoke cigars only), current poly cigar smokers (smoke cigars and smoke cigarettes or use smokeless tobacco), former sole cigar smokers (used to smoke cigars only), former poly cigar smokers (used to smoke cigars and smoke cigarettes or use smokeless tobacco), other tobacco users (ever smoked cigarettes and used smokeless tobacco but not cigars), and never tobacco users (never smoked cigars, smoked cigarettes, or used smokeless tobacco)-and other covariates. We calculated health care utilization attributable to current and former sole cigar smoking based on the estimated ZIP models, and then we calculated total health care expenditures attributable to cigar smoking. Current and former sole cigar smoking was associated with excess annual utilization of 72 137 hospital nights, 32 748 ED visits, and 420 118 home-care visits. Annual health care expenditures attributable to sole cigar smoking were $284 million ($625 per sole cigar smoker), and total annual health care expenditures attributable to sole and poly cigar smoking were $1.75 billion. Comprehensive tobacco control policies and interventions are needed to reduce cigar smoking and the associated health care burden.

Noticing e-cigarette advertisements and associations with use of e-cigarettes, disapproval of smoking, and quitting smoking. Findings from the International Tobacco Control (ITC) Netherlands Survey

PubMed Central

Heijndijk, Suzanne M.; Cummings, K. Michael; Willemsen, Marc C.; van den Putte, Bas; Heckman, Bryan W.; Hummel, Karin; de Vries, Hein; Hammond, David; Borland, Ron

2016-01-01

Background Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviors of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success. Methods We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months. Results There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807). Conclusion Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation. PMID:26818084

Smoking and human papillomavirus (HPV) infection in the HPV in Men (HIM) study.

PubMed

Schabath, Matthew B; Villa, Luisa L; Lazcano-Ponce, Eduardo; Salmerón, Jorge; Quiterio, Manuel; Giuliano, Anna R

2012-01-01

The influence of smoking on the natural history of HPV infection in men is not well understood. Smoking could influence the incidence and persistence of HPV infections by suppressing local immune function, increased cellular proliferation, upregulated proinflammatory factors, or induced host DNA damage resulting in increased susceptibility to infection. The purpose of this analysis is to assess prevalent HPV infections by smoking status in men, and to determine baseline risk of HPV infection associated with smoking. The HPV in Men (HIM) study is a multinational prospective study of the natural history of HPV infections in men. Samples from the coronal sulcus, glans penis, shaft, and scrotum were combined for HPV DNA testing. Multivariable logistic regression was used to assess the association between smoking and any-, oncogenic-, and nononcogenic HPV infections. Our analyses revealed that current smoking was associated with an increased risk of any HPV infection (OR = 1.19; 95% CI: 1.01-1.41) and oncogenic HPV infection (OR = 1.24; 95% CI: 1.05-1.47). However, the association between smoking and any HPV infection (OR = 1.35; 95% CI: 1.05-1.73) and oncogenic HPV infection (OR = 1.46; 95% CI: 1.11-1.92) was only evident among men reporting fewer lifetime sexual partners. These results suggest that current smokers with the fewest number of sexual partners are associated with an increased risk for oncogenic HPV infection. The relationship between smoking and HPV infection remains understudied in men; these data shed new light on the interplay between smoking, sexual activity, and risk of HPV infection.

The effect of secondhand smoke exposure on the association between active cigarette smoking and colorectal cancer

PubMed Central

Peppone, Luke J.; Reid, Mary E.; Moysich, Kirsten B.; Morrow, Gary R.; Jean-Pierre, Pascal; Mohile, Supriya G.; Darling, Tom V.; Hyland, Andrew

2011-01-01

Background Studies published prior to 1980 failed to find an association between smoking and colorectal cancer, while subsequent studies reported an association after accounting for a three to four decade initiation period. The aims of this study were to determine the effect of accounting for secondhand smoke (SHS) exposure on the association between smoking and colorectal cancer and to determine the association between SHS and colorectal cancer. Methods Approximately 1,200 colorectal cancer cases treated at Roswell Park Cancer Institute between 1982 and 1998 were matched to 2,400 malignancy-free controls. The effect of accounting for SHS exposure was determined by comparing the odds ratios (OR) for each smoking variable in the overall sample and then for those who reported no current SHS exposure. Results A small, significant increase in colorectal cancer odds was noted for heavy, long-term smoking males when not accounting for SHS exposure (>45 PY: OR = 1.34; 95% CI 1.04–1.72). OR increased when the analyses were restricted to individuals reporting no current SHS exposure (>45 PY: OR = 2.40; 95% CI 1.36–4.23). Conclusions Accounting for SHS exposure resulted in a substantial increase in the odds of colorectal cancer for all smoking variables in this study. Future studies should account for SHS exposure when examining the association between smoking and colorectal cancer. PMID:20376547

Risk Factors for Smoking in Rural Women: The Role of Gender-Based Sexual and Intimate Partner Violence

PubMed Central

Nemeth, Julianna M.; Bonomi, Amy E.; Lu, Bo; Lomax, Richard G.; Wewers, Mary Ellen

2016-01-01

Abstract Background: Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region. Methods: A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey (n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk. Results: Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status (p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21–2.17]). Discussion: Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation. PMID:27548468

Smoking and Barrett's Esophagus in Women who Undergo Upper Endoscopy

PubMed Central

Jacobson, Brian C.; Giovannucci, Edward L.; Fuchs, Charles S.

2011-01-01

Background Cigarette use is associated with esophageal adenocarcinoma, and cross-sectional studies suggest an association between smoking and Barrett's esophagus. Aims We sought to examine prospectively the influence of smoking on the risk for Barrett's esophagus. Methods This was a prospective cohort study among 20,863 women within the Nurses’ Health Study who underwent upper gastrointestinal endoscopy for any reason between 1980 and 2006. We assessed the association between smoking and pathologically-confirmed Barrett's esophagus (n=377). Self-reported data on smoking and potential confounding variables were collected from biennial questionnaires. Results Compared to women who never smoked, former smokers who used 1-24 cigarettes/day had a multivariate odds ratio for Barrett's esophagus of 1.25 (95% CI 0.99-1.59), former smokers who used ≥25 cigarettes/day had a multivariate odds ratio of 1.52 (95% CI 1.04-2.22), current smokers who used 1-24 cigarettes/day had a multivariate odds ratio of 0.89 (95% CI 0.54-1.45), and current smokers who used ≥25 cigarettes/day had a multivariate odds ratio of 0.92 (95% CI 0.34-2.54). The risk for Barrett's esophagus increased significantly with increasing pack-years smoked among former (P = 0.008), but not current smokers (p=0.99), especially when considering exposure ≥25 years prior to index endoscopy. Results were similar among women reporting regular heartburn/acid-reflux one or more times a week, and were not accounted for by changes in weight. Conclusions Heavy, remote smoking is associated with an increased risk for Barrett's esophagus. This finding suggests a long latency period between exposure and development of the disease, even after discontinuation of smoking. PMID:21448698

Effects of Internet-Based Voucher Reinforcement and a Transdermal Nicotine Patch on Cigarette Smoking

ERIC Educational Resources Information Center

Glenn, Irene M.; Dallery, Jesse

2007-01-01

Nicotine replacement products are commonly used to promote smoking cessation, but alternative and complementary methods may increase cessation rates. The current experiment compared the short-term effects of a transdermal nicotine patch to voucher-based reinforcement of smoking abstinence on cigarette smoking. Fourteen heavy smokers (7 men and 7…

Young Women's Responses to Smoking and Breast Cancer Risk Information

ERIC Educational Resources Information Center

Bottorff, Joan L.; McKeown, Stephanie Barclay; Carey, Joanne; Haines, Rebecca; Okoli, Chizimuzo; Johnson, Kenneth C.; Easley, Julie; Ferrence, Roberta; Baillie, Lynne; Ptolemy, Erin

2010-01-01

Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer…

Effects of transcranial direct current stimulation on craving, heart-rate variability and prefrontal hemodynamics during smoking cue exposure.

PubMed

Kroczek, A M; Häußinger, F B; Rohe, T; Schneider, S; Plewnia, C; Batra, A; Fallgatter, A J; Ehlis, A-C

2016-11-01

Drug-related cue exposure elicits craving and risk for relapse during recovery. Transcranial direct current stimulation is a promising research tool and possible treatment for relapse prevention. Enhanced functional neuroconnectivity is discussed as a treatment target. The goal of this research was to examine whether transcranial direct current stimulation affected cortical hemodynamic indicators of functional connectivity, craving, and heart rate variability during smoking-related cue exposure in non-treatment-seeking smokers. In vivo smoking cue exposure supported by a 2mA transcranial direct current stimulation (anode: dorsolateral prefrontal cortex, cathode: orbitofrontal cortex; placebo-controlled, randomized, double-blind) in 29 (age: M=25, SD=5) German university students (smoking at least once a week). Cue reactivity was assessed on an autonomous (heart rate variability) and a subjective level (craving ratings). Functional near-infrared spectroscopy measured changes in the concentration of deoxygenated hemoglobin, and seed-based correlation analysis was used to quantify prefrontal connectivity of brain regions involved in cue reactivity. Cue exposure elicited increased subjective craving and heart rate variability changes in smokers. Connectivity between the orbitofrontal and dorsolateral prefrontal cortex was increased in subjects receiving verum compared to placebo stimulation (d=0.66). Hemodynamics in the left dorsolateral prefrontal cortex, however, increased in the group receiving sham stimulation (η 2 =0.140). Transcranial direct current stimulation did not significantly alter craving or heart rate variability during cue exposure. Prefrontal connectivity - between regions involved in the processing of reinforcement value and cognitive control - was increased by anodal transcranial direct current stimulation during smoking cue exposure. Possible clinical implications should be considered in future studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Smoking behaviors and intentions among adolescents in rural China: the application of the Theory of Planned Behavior and the role of social influence.

PubMed

Su, Xuefen; Li, Liping; Griffiths, Sian M; Gao, Yang; Lau, Joseph T F; Mo, Phoenix K H

2015-09-01

This study investigated the associations between the variables of the theory of planned behavior (TPB), influence of significant others, and smoking intentions and behaviors among adolescents living in rural southern China. A cross-sectional study was conducted among 2609 students in two junior high schools in rural Shantou, Guangdong province, using a self-administered questionnaire. Logistic regression models were fitted to estimate univariate and adjusted odds ratios and corresponding 95% confidence intervals. Multivariate analyses showed that having favorable attitudes towards smoking on psychological and social aspects, perceived behavioral control, and having most friends who were current smokers were significantly associated with smoking intentions in the next six months and in the next five years. Having most family members who were current smokers was also significantly related to smoking intention in the next five years. Having favorable attitudes towards smoking on psychological aspect and negative attitudes on physical aspect, perceived support from friends on smoking, and having most friends and senior relatives being current smokers were significantly associated with increased likelihood of ever smoking. Perceived behavioral control and having most friends being current smokers were also significantly associated with regular smoking and smoking in the past 30days. Our results suggest that the key constructs of the TPB model and friends' smoking behaviors play important roles in accounting for smoking intentions and behaviors among a sample of rural Chinese adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk of community-acquired pneumonia in chronic obstructive pulmonary disease stratified by smoking status: a population-based cohort study in the United Kingdom.

PubMed

Braeken, Dionne Cw; Rohde, Gernot Gu; Franssen, Frits Me; Driessen, Johanna Hm; van Staa, Tjeerd P; Souverein, Patrick C; Wouters, Emiel Fm; de Vries, Frank

2017-01-01

Smoking increases the risk of community-acquired pneumonia (CAP) and is associated with the development of COPD. Until now, it is unclear whether CAP in COPD is due to smoking-related effects, or due to COPD pathophysiology itself. To evaluate the association between COPD and CAP by smoking status. In total, 62,621 COPD and 191,654 control subjects, matched by year of birth, gender and primary care practice, were extracted from the Clinical Practice Research Datalink (2005-2014). Incidence rates (IRs) were estimated by dividing the total number of CAP cases by the cumulative person-time at risk. Time-varying Cox proportional hazard models were used to estimate the hazard ratios (HRs) for CAP in COPD patients versus controls. HRs of CAP by smoking status were calculated by stratified analyses in COPD patients versus controls and within both subgroups with never smoking as reference. IRs of CAP in COPD patients (32.00/1,000 person-years) and controls (6.75/1,000 person-years) increased with age and female gender. The risk of CAP in COPD patients was higher than in controls (HR 4.51, 95% CI: 4.27-4.77). Current smoking COPD patients had comparable CAP risk (HR 0.92, 95% CI: 0.82-1.02) as never smoking COPD patients (reference), whereas current smoking controls had a higher risk (HR 1.23, 95% CI: 1.13-1.34) compared to never smoking controls. COPD patients have a fourfold increased risk to develop CAP, independent of smoking status. Identification of factors related with the increased risk of CAP in COPD is warranted, in order to improve the management of patients at risk.

Influence of smoking status and intensity on discovery of blood pressure loci through gene-smoking interactions

PubMed Central

Fuentes, Lisa de las; Schwander, Karen; Cupples, L. Adrienne; Rao, D. C.

2015-01-01

Background Genetic variation accounts for approximately 30% of blood pressure (BP) variability but most of that variability hasn't been attributed to specific variants. Interactions between genes and BP-associated factors may explain some ‘missing heritability.’ Cigarette smoking increases BP after short-term exposure and decreases BP with longer exposure. Gene-smoking interactions have discovered novel BP loci, but the contribution of smoking status and intensity to gene discovery is unknown. Methods We analyzed gene-smoking intensity interactions for association with systolic BP (SBP) in three subgroups from the Framingham Heart Study: current smokers only (N = 1,057), current and former smokers (‘ever smokers’, N = 3,374), and all subjects (N = 6,710). We used three smoking intensity variables defined at cutoffs of 10, 15, and 20 cigarettes per day (CPD). We evaluated the 1 degree-of-freedom (df) interaction and 2df joint test using generalized estimating equations. Results Analysis of current smokers using a CPD cutoff of 10 produced two loci associated with SBP. The rs9399633 minor allele was associated with increased SBP (5 mmHg) in heavy smokers (CPD>10) but decreased SBP (7 mmHg) in light smokers (CPD≤10). The rs11717948 minor allele was associated with decreased SBP (8 mmHg) in light smokers but decreased SBP (2 mmHg) in heavy smokers. Across all nine analyses, 19 additional loci reached p < 1×10−6. Discussion Analysis of current smokers may have the highest power to detect gene-smoking interactions, despite the reduced sample size. Associations of loci near SASH1 and KLHL6/KLHL24 with SBP may be modulated by tobacco smoking. PMID:25940791

Influence of Smoking Status and Intensity on Discovery of Blood Pressure Loci Through Gene-Smoking Interactions.

PubMed

Basson, Jacob; Sung, Yun Ju; Fuentes, Lisa de Las; Schwander, Karen; Cupples, L Adrienne; Rao, D C

2015-09-01

Genetic variation accounts for approximately 30% of blood pressure (BP) variability but most of that variability has not been attributed to specific variants. Interactions between genes and BP-associated factors may explain some "missing heritability." Cigarette smoking increases BP after short-term exposure and decreases BP with longer exposure. Gene-smoking interactions have discovered novel BP loci, but the contribution of smoking status and intensity to gene discovery is unknown. We analyzed gene-smoking intensity interactions for association with systolic BP (SBP) in three subgroups from the Framingham Heart Study: current smokers only (N = 1,057), current and former smokers ("ever smokers," N = 3,374), and all subjects (N = 6,710). We used three smoking intensity variables defined at cutoffs of 10, 15, and 20 cigarettes per day (CPD). We evaluated the 1 degree-of-freedom (df) interaction and 2df joint test using generalized estimating equations. Analysis of current smokers using a CPD cutoff of 10 produced two loci associated with SBP. The rs9399633 minor allele was associated with increased SBP (5 mmHg) in heavy smokers (CPD > 10) but decreased SBP (7 mmHg) in light smokers (CPD ≤ 10). The rs11717948 minor allele was associated with decreased SBP (8 mmHg) in light smokers but decreased SBP (2 mmHg) in heavy smokers. Across all nine analyses, 19 additional loci reached P < 1 × 10(-6). Analysis of current smokers may have the highest power to detect gene-smoking interactions, despite the reduced sample size. Associations of loci near SASH1 and KLHL6/KLHL24 with SBP may be modulated by tobacco smoking. © 2015 WILEY PERIODICALS, INC.

Prevalence and factors associated with smoking intentions among non-smoking and smoking adolescents in Kota Tinggi, Johor, Malaysia.

PubMed

Hock, Lim Kuang; Ghazali, Sumarni Mohamad; Cheong, Kee Chee; Kuay, Lim Kuang; Li, Lim Hui; Huey, Teh Chien; Ying, Chan Ying; Yen, Yeo Lay; Ching, Fiona Goh Swee; Yi, Khoo Yi; Lin, Chong Zhuo; Ibrahim, Normala; Mustafa, Amal Nasir

2014-01-01

Intention to smoke is a valid and reliable factor for predicting future smoking habits among adolescents. This factor, however, has received inadequate attention in Malaysia. The present paper elaborates the prevalence and factors associated with intent to initiate or to cease smoking, among adolescent nonsmokers and smokers in Kota Tinggi, Johor, Malaysia. A total of 2,300 secondary school students aged 13-16 years were selected through a two-stage stratified sampling method. A set of standardized questionnaires was used to assess the smoking behavior among adolescents and the inter-personal and intra-personal factors associated with smoking intention (intention to initiate smoking or to cease smoking). Multivariable logistic regression was used to identify factors related to smoking intention. The prevalence of intention to smoke in the future or to cease smoking among non- smoking adolescents and current smokers were 10.7% and 61.7% respectively. Having friends who smoke, social influence, and poor knowledge about the ill effects on health due to smoking showed significant relationships with intention to smoke in the future among non-smokers. Conversely, perceived lower prevalence of smoking among peers, weak contributory social influence, and greater awareness of the ill effects of smoking are factors associated with the intention to cease smoking sometime in the future. The study found that prevalence of intention to initiate smoking is low among non-smokers while the majority of current smokers intended to cease smoking in the future. Existing anti-smoking programmes that integrate the factors that have been identified in the current study should be put in motion to reduce the prevalence of intention to initiate smoking and increase the intention to cease smoking among adolescents.

Young adult smoking behavior: a national survey.

PubMed

Ling, Pamela M; Neilands, Torsten B; Glantz, Stanton A

2009-05-01

Young adults have the highest smoking rate of any age group in the U.S., and new strategies to decrease young adult smoking are needed. The objective of the current study was to identify psychographic and demographic factors associated with current smoking and quitting behaviors among young adults. Attitudes, social groups, and self-descriptors, including supporting action against the tobacco industry, advertising receptivity, depression, alcohol use, and other factors associated with smoking were tested for associations with smoking behaviors in a 2005 cross-sectional survey of 1528 young adults (aged 18-25 years) from a web-enabled panel. Analyses were conducted in 2007. Being older was associated with current smoking, whereas having some higher education and being African American or Hispanic were negatively associated with smoking. Supporting action against the tobacco industry was negatively associated with smoking (AOR=0.34 [95% CI=0.22, 0.52]). Perceived usefulness of smoking, exposure to smokers, increased perceived smoking prevalence, receptivity to tobacco advertising, binge drinking, and exposure to tobacco advertising in bars and clubs were associated with smoking. Supporting action against the tobacco industry was associated with intentions to quit smoking (AOR=4.43 [95% CI=2.18, 8.60]). Young adults are vulnerable to tobacco-industry advertising. Media campaigns that denormalize the tobacco industry and appeal to young adults appear to be a powerful intervention to decrease young adult smoking.

STABILITY OF SMOKING STATUS IN THE U.S. POPULATION: A LONGITUDINAL INVESTIGATION

PubMed Central

Weinberger, Andrea H.; Pilver, Corey E.; Mazure, Carolyn M.; McKee, Sherry A.

2014-01-01

Aims To determine smoking transitions in a representative sample of United States (U.S.) adults. Design Longitudinal study using data from the National Epidemiologic Survey on Alcohol and Related Conditions (Wave 1, 2001–2002; Wave 2, 2004–2005). Setting The general U.S. adult population. Participants 33,309 adults (54% female) classified as Wave 1 Current Daily, Current Non-Daily, Former Daily, Former Non-Daily, or Never Smokers. Measurements Smoking transitions were determined from Wave 1 and Wave 2 data. Findings Smoking status remained stable for the majority of current daily (79.8%), former daily (95.8%), former non-daily (96.3%), and never (97.1%) smokers. Among current non-daily smokers, 54.5% quit smoking while 22.5% increased to daily smoking. Current daily smokers who were older (30–44, OR=0.62; 95% CI=0.49–0.87; 45+, OR=0.75; 95% CI=0.61–0.93) and unmarried (OR=0.80, 95% CI=0.66–0.96) were less likely to report smoking cessation. Current daily smokers who were Hispanic (OR=2.15, 95% CI=1.65–2.81) and college educated (OR=1.27, 95% CI=1.05–1.53) were more likely to report smoking cessation. Relapse in former daily smokers was greater in women (OR=1.44, 95% CI=0.27–0.74) and lower in older adults (OR=0.44; 95% CI=0.27–0.74). Smoking initiation occurred less in women (OR=0.65; 95% CI=0.49–0.87) and Hispanic adults (OR=0.57; 95% CI=0.36–0.91) and more in unmarried adults (OR=1.84; 95% CI=1.09–2.44) and adults with less education (OR=1.63; 95% CI=1.09–2.44). Conclusions From 2001 to 2005, smoking status was extremely stable in the United States population. Specific gender, race, and educational groups need increased prevention and intervention efforts. PMID:24916157

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood

PubMed Central

Talley, Anna E.; Fromme, Kim

2016-01-01

Introduction: Almost one-third of college students report recent cigarette use, primarily as “social smoking,” and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students’ drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Methods: Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Results: Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Conclusions: Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. PMID:25744964

Cigarette Smoking Prior to First Cancer and Risk of Second Smoking-Associated Cancers Among Survivors of Bladder, Kidney, Head and Neck, and Stage I Lung Cancers

PubMed Central

Shiels, Meredith S.; Gibson, Todd; Sampson, Joshua; Albanes, Demetrius; Andreotti, Gabriella; Beane Freeman, Laura; Berrington de Gonzalez, Amy; Caporaso, Neil; Curtis, Rochelle E.; Elena, Joanne; Freedman, Neal D.; Robien, Kim; Black, Amanda; Morton, Lindsay M.

2014-01-01

Purpose Data on smoking and second cancer risk among cancer survivors are limited. We assessed associations between smoking before first cancer diagnosis and risk of second primary smoking-associated cancers among survivors of lung (stage I), bladder, kidney, and head/neck cancers. Methods Data were pooled from 2,552 patients with stage I lung cancer, 6,386 with bladder cancer, 3,179 with kidney cancer, and 2,967 with head/neck cancer from five cohort studies. We assessed the association between prediagnostic smoking and second smoking-associated cancer risk with proportional hazards regression, and compared these estimates to those for first smoking-associated cancers in all cohort participants. Results Compared with never smoking, current smoking of ≥ 20 cigarettes per day was associated with increased second smoking-associated cancer risk among survivors of stage I lung (hazard ratio [HR] = 3.26; 95% CI, 0.92 to 11.6), bladder (HR = 3.67; 95% CI, 2.25 to 5.99), head/neck (HR = 4.45; 95% CI, 2.56 to 7.73), and kidney cancers (HR = 5.33; 95% CI, 2.55 to 11.1). These estimates were similar to those for first smoking-associated cancer among all cohort participants (HR = 5.41; 95% CI, 5.23 to 5.61). The 5-year cumulative incidence of second smoking-associated cancers ranged from 3% to 8% in this group of cancer survivors. Conclusion Understanding risk factors for second cancers among cancer survivors is crucial. Our data indicate that cigarette smoking before first cancer diagnosis increases second cancer risk among cancer survivors, and elevated cancer risk in these survivors is likely due to increased smoking prevalence. The high 5-year cumulative risks of smoking-associated cancers among current smoking survivors of stage I lung, bladder, kidney, and head/neck cancers highlight the importance of smoking cessation in patients with cancer. PMID:25385740

Cigarette smoking prior to first cancer and risk of second smoking-associated cancers among survivors of bladder, kidney, head and neck, and stage I lung cancers.

PubMed

Shiels, Meredith S; Gibson, Todd; Sampson, Joshua; Albanes, Demetrius; Andreotti, Gabriella; Beane Freeman, Laura; Berrington de Gonzalez, Amy; Caporaso, Neil; Curtis, Rochelle E; Elena, Joanne; Freedman, Neal D; Robien, Kim; Black, Amanda; Morton, Lindsay M

2014-12-10

Data on smoking and second cancer risk among cancer survivors are limited. We assessed associations between smoking before first cancer diagnosis and risk of second primary smoking-associated cancers among survivors of lung (stage I), bladder, kidney, and head/neck cancers. Data were pooled from 2,552 patients with stage I lung cancer, 6,386 with bladder cancer, 3,179 with kidney cancer, and 2,967 with head/neck cancer from five cohort studies. We assessed the association between prediagnostic smoking and second smoking-associated cancer risk with proportional hazards regression, and compared these estimates to those for first smoking-associated cancers in all cohort participants. Compared with never smoking, current smoking of ≥ 20 cigarettes per day was associated with increased second smoking-associated cancer risk among survivors of stage I lung (hazard ratio [HR] = 3.26; 95% CI, 0.92 to 11.6), bladder (HR = 3.67; 95% CI, 2.25 to 5.99), head/neck (HR = 4.45; 95% CI, 2.56 to 7.73), and kidney cancers (HR = 5.33; 95% CI, 2.55 to 11.1). These estimates were similar to those for first smoking-associated cancer among all cohort participants (HR = 5.41; 95% CI, 5.23 to 5.61). The 5-year cumulative incidence of second smoking-associated cancers ranged from 3% to 8% in this group of cancer survivors. Understanding risk factors for second cancers among cancer survivors is crucial. Our data indicate that cigarette smoking before first cancer diagnosis increases second cancer risk among cancer survivors, and elevated cancer risk in these survivors is likely due to increased smoking prevalence. The high 5-year cumulative risks of smoking-associated cancers among current smoking survivors of stage I lung, bladder, kidney, and head/neck cancers highlight the importance of smoking cessation in patients with cancer. © 2014 by American Society of Clinical Oncology.

Disparities in current cigarette smoking prevalence by type of disability, 2009-2011.

PubMed

Courtney-Long, Elizabeth; Stevens, Alissa; Caraballo, Ralph; Ramon, Ismaila; Armour, Brian S

2014-05-01

Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age. We used data from the 2009-2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18-49 years. Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77). The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur.

Which group of smokers is more vulnerable to the economic crisis?

PubMed

Gallus, S; Asciutto, R; Muttarak, R; Pacifici, R; La Vecchia, C; Lugo, A

2016-05-01

Studies investigating whether smoking increases or decreases during economic downturn provided contrasting results. For the first time, we used direct questions to analyse changes in smoking behaviour due to the 2008 financial crisis, comparing socio-economic characteristics of smokers who changed with those who kept their smoking intensity. Cross-sectional survey. We used data from three annual surveys conducted in Italy in 2012-2014 on representative samples of the Italian general population aged ≥15 years. A total of 1919 current smokers were asked specific questions on the influence of the economic crisis that started in 2008 on their smoking behaviour. Overall, 77.4% of 1919 current smokers reported not to have changed their smoking behaviour, 19.1% to have reduced, and 3.5% to have increased their smoking intensity as a consequence of the economic crisis. The reduction in cigarette smoking increased with age: compared to the respondents aged <25 years, the multivariate odds ratio (OR) for those aged 25-44, 45-64 and ≥65 years were 0.65, 0.46 and 0.33, respectively (P for trend<0.001). Reduction was significantly lower among intermediate (OR = 0.68 compared to low) and high education levels (OR = 0.28; P for trend<0.001). A significant inverse trend for increasing consumption was observed with age (P = 0.022), education (P = 0.003) and family income (P < 0.001). The large majority of current smokers did not change their smoking habit following the economic crisis. However, there are specific vulnerable subgroups of smokers, constituted by the young and subjects with low socio-economic status, that were reactive to the global economic crisis. These groups are more prone to change their smoking behaviours, either for better or -, in a smaller proportion -, for worse. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Cigarette smokers' intention to quit smoking in Dire Dawa town Ethiopia: an assessment using the Transtheoretical Model

PubMed Central

2010-01-01

Background Cessation of smoking reduces morbidity and mortality related to tobacco smoking. It is essential to explore the intention of individuals to quit smoking to design effective interventions. The objective of this study was to assess cigarette smokers' intention to quit smoking in Dire Dawa town using the Transtheoretical model. Methods From February 15 to 19, 2009, we conducted a community based cross-sectional study among 384 current cigarette smokers in Dire Dawa town east Ethiopia. Data was collected by trained personnel using a pretested structured questionnaire. The data was analyzed using SPSS version 16.0. Results Two hundred and nineteen (57%) smokers in the study area had the intention to quit cigarette smoking within the next six months and all the process of change had an increasing trend across the stages. Based on the Fragestrom test of nicotine dependence of cigarette, 35 (9.1%), 69 (18%) and 48(12.5%) were very high, high and medium dependent on nicotine respectively. For the majority 247(64.3%) of the respondents, the mean score of cons of smoking outweighs the pros score (negative decisional balance). Only 66(17.2%) had high self efficacy not to smoke in places and situations that can aggravate smoking. Conclusions Majority of the smokers had the intention to quit smoking. All the process of change had an increasing trend across the stages. Those who had no intention to quit smoking had high level of dependence on nicotine and low self efficacy. The pros of smoking were decreasing while the cons were increasing across the stages. Stage based interventions should be done to move the smokers from their current stage to an advanced stages of quitting cigarette smoking. PMID:20529337

A community based study on the prevalence and factors affecting smoking in Kampong Jenderam Hilir, Sepang, Selangor.

PubMed

Rampal, L; Narasimman, S

2003-03-01

i) To determine the prevalence of smoking among the community aged 15 and above in Kg. Jenderam Hilir in Sepang District, Selangor state. ii) To determine the relationship between smoking and age, sex, household income and education. iii) To determine the parental and peer influence on smoking in Kg Jenderam Hilir. A study was conducted in Kg. Jenderam Hilir, Sepang. All residents aged 15 years and above from all the 381 households of Kg. Jenderam Hilir were included in this study. A standardized pre-tested structured questionnaire was used in this study. Out of 894 respondents interviewed 69% were males compared to 3.9% of the females (overall 33.6%) reported to have smoked at least once in his/her lifetime. The difference was statistically significant. The mean duration of smoking was 17.7 years. The age at which smoking was first attempted ranged from 4 years to 51 years with a mean of 18.7 years. The mean initiation age for the males was significantly lower as compared to the mean initiation age for the females. The prevalence of current smokers was significantly higher amongst males (52.8%) as compared to the females (1.4%). The prevalence of smoking among current smokers increased with age (p < 0.01). There was no significant difference in the prevalence of smoking by household income and educational level. The mean number of cigarettes smoked by males was significantly higher than the females (p < 0.05). The mean duration of smoking among current smokers was 20 years. There was a significant difference in the level of addiction to smoking and the duration of smoking (p < 0.05). The high level of addiction increased with the duration of smoking (p < 0.05). Sixty five percent of the current smokers reported to have tried to quit smoking while 26% of ever smokers had reported to quit smoking and remained nonsmokers. The quit ratio was calculated to be 26.0%. The quit ratio was 52.6% among those with college or university education. There was a significant difference in the quit ratio by education level (p < 0.01). There was no significant difference in smokers whose parents were smokers as compared to nonsmokers whose parents were smokers. However, there was a significant association between smoking and peer influence (p < 0.01).

Evaluation of smoking status identification using electronic health records and open-text information in a large mental health case register.

PubMed

Wu, Chia-Yi; Chang, Chin-Kuo; Robson, Debbie; Jackson, Richard; Chen, Shaw-Ji; Hayes, Richard D; Stewart, Robert

2013-01-01

High smoking prevalence is a major public health concern for people with mental disorders. Improved monitoring could be facilitated through electronic health record (EHR) databases. We evaluated whether EHR information held in structured fields might be usefully supplemented by open-text information. The prevalence and correlates of EHR-derived current smoking in people with severe mental illness were also investigated. All cases had been referred to a secondary mental health service between 2008-2011 and received a diagnosis of schizophreniform or bipolar disorder. The study focused on those aged over 15 years who had received active care from the mental health service for at least a year (N=1,555). The 'CRIS-IE-Smoking' application used General Architecture for Text Engineering (GATE) natural language processing software to extract smoking status information from open-text fields. A combination of CRIS-IE-Smoking with data from structured fields was evaluated for coverage and the prevalence and demographic correlates of current smoking were analysed. Proportions of patients with recorded smoking status increased from 11.6% to 64.0% through supplementing structured fields with CRIS-IE-Smoking data. The prevalence of current smoking was 59.6% in these 995 cases for whom this information was available. After adjustment, younger age (below 65 years), male sex, and non-cohabiting status were associated with current smoking status. A natural language processing application substantially improved routine EHR data on smoking status above structured fields alone and could thus be helpful in improving monitoring of this lifestyle behaviour. However, limited information on smoking status remained a challenge.

Military Factors Associated with Smoking in Veterans.

PubMed

Golden, Sara E; Thakurta, Sujata; Slatore, Christopher G; Woo, Hyeyoung; Sullivan, Donald R

2018-05-18

Given the high prevalence of smoking among Veterans and the economic, social, and clinical implications, it is important to understand the factors that contribute to smoking in order to focus efforts to mitigate these factors and improve smoking cessation efforts among Veterans. The availability of research on smoking in Veterans compared with civilians is limited given the military-specific differences in their life course. We aimed to identify military-specific factors combined with sociodemographic factors for ever smoking and current smoking among Veterans to inform future interventions. We used data from the 2010 National Survey of Veterans, the most current, to analyze the association of sociodemographic and military-specific factors with ever versus never smoking, and current versus past smoking using multiple variable logistic regression models (IRB#4125). Among 8,618 respondents, the proportions of current, past, and never smokers were 17%, 48%, and 34%, respectively. Sociodemographic factors associated with ever smoking were female gender, educational attainment of less than a bachelor's degree, and being divorced/separated/widowed. Military-specific factors associated with ever smoking were exposure to dead/dying/wounded soldiers during service, and past, current, and unsure enrollment in Veterans Affairs healthcare. Never smoking was associated with Hispanic ethnicity, income over $75,000, and reporting fair or poor health. Military factors associated with never smoking were presence of a service-connected disability and military service July 1964 or earlier (i.e., pre-Vietnam). Among 5,652 ever smokers, sociodemographic factors associated with current smoking were age less than 65, being non-Hispanic black, educational attainment of less than a bachelor's degree, being divorced/separated/widowed, never married, and having no insurance. Factors associated with reduced likelihood of current smoking compared with past smoking included income >$41,000 and reporting fair or poor health. Military-specific variables associated with reduced likelihood of current smoking were service era of May 1975 or later (i.e., post-Vietnam) and 5 or more years of service. Military-specific variables are associated with smoking behaviors among Veterans. Findings from this study that exposure to dead/dying/wounded soldiers, service era, duration of service, service-connected disability status, and enrollment in VA care all influence smoking in Veterans, can inform prevention and cessation efforts in part by encouraging alternative healthy habits or cessation techniques in subgroups of Veterans with particular military backgrounds. By assessing risk factors in this unique population future research can leverage these findings to determine mechanisms that help explain these associations. Identifying factors associated with smoking offers insights for smoking cessation and prevention interventions given the military experiences and increased smoking incidence among Veterans.

Enforcement of underage sales laws as a predictor of daily smoking among adolescents: a national study.

PubMed

DiFranza, Joseph R; Savageau, Judith A; Fletcher, Kenneth E

2009-04-17

With a goal to reduce youth smoking rates, the U.S. federal government mandated that states enforce laws prohibiting underage tobacco sales. Our objective was to determine if state compliance with tobacco sales laws is associated with a decreased risk of current daily smoking among adolescents. Data on tobacco use were obtained from a nationally representative sample of 16,244 adolescents from the 2003 Monitoring the Future survey. The association between merchant compliance with the law from 1997-2003 and current daily smoking was examined using logistic regression while controlling for cigarette prices, state restaurant smoking policies, anti-tobacco media, and demographic variables. Higher average state merchant compliance from 1997-2003 predicted lower levels of current daily smoking among adolescents when controlled for all other factors. The odds ratio for daily smoking was reduced by 2% for each 1% increase in merchant compliance. After controlling for price changes, media campaigns and smoking restrictions, a 20.8% reduction in the odds of smoking among 10th graders in 2003 was attributed to the observed improvement in merchant compliance between 1997 and 2003. A 47% reduction in the odds of daily smoking could be attributed to price increases over this period. Federally mandated enforcement efforts by states to prevent the sale of tobacco to minors appear to have made an important contribution to the observed decline in smoking among youth in the U.S. Given similar results from long-term enforcement efforts in Australia, other countries should be encouraged to adopt the World Health Organization Framework on Tobacco Control strategies to reduce the sale of tobacco to minors.

Increasing the Value of an Alternative Monetary Reinforcer Reduces Cigarette Choice in Adolescents

PubMed Central

Tidey, Jennifer W.; Kahler, Christopher W.; Wray, Tyler B.; Colby, Suzanne M.

2015-01-01

Introduction: Smoking can be conceptualized as an operant behavior maintained by the reinforcing effects of cigarettes. Changing the magnitude and availability of alternative reinforcers should shift behavior away from smoking. Adults’ smoking behavior is sensitive to the magnitude and availability of alternative reinforcers; however, the extent to which the same is true for adolescents has not yet been shown in the laboratory. Methods: To test the sensitivity of adolescent smoking behavior to changes in the magnitude of alternative reinforcement, we gave adolescents who abstained overnight the opportunity to make 20 choices between receiving two puffs of their usual-brand cigarette or money. The magnitude of the monetary reinforcer was varied across sessions in counterbalanced order ($0.00, $0.10, and $0.50). Results: Results indicated that adolescents’ choices for puffs decreased as a function of increasing monetary reinforcer magnitude, while money choices increased. This effect was moderated by baseline smoking level and by gender, such that heavier-smoking participants and males made more cigarette choices when the alternative monetary value was zero, and decreased their choices more steeply in response to increasing monetary value. Conclusions: The current study validates a laboratory choice procedure for studying smoking in adolescents, and demonstrates that adolescent smoking behavior is sensitive to changes in the magnitude of concurrently available monetary reinforcers. The current paradigm can be adapted and applied to explore the effects of other variables that may affect cigarette choice in adolescents. PMID:25666814

Smoking among troops deployed in combat areas and its association with combat exposure among navy personnel in Sri Lanka

PubMed Central

2012-01-01

Background Among military personnel alcohol consumption and binge-drinking have increased but cigarette smoking has declined in the recent past. Although there is a strong association between smoking and PTSD the association between combat exposure and smoking is not clear. Methods This cross sectional study was carried out among representative samples of SLN Special Forces and regular forces deployed in combat areas. Both Special Forces and regular forces were selected using simple random sampling. Only personnel who had served continuously in combat areas during the one year period prior to end of combat operations were included in the study. Females were not included in the sample. The study assessed several mental health outcomes as well as alcohol use, smoking and cannabis use. Sample was classified according to smoking habits as never smokers, past smokers (those who had smoked in the past but not within the past year) and current smokers (those smoking at least one cigarette within the past 12 months). Results Sample consisted of 259 Special Forces and 412 regular navy personnel. Prevalence of current smoking was 17.9% (95% CI 14.9-20.8). Of the sample 58.4% had never smoked and 23.7% were past smokers. Prevalence of current smoking was significantly higher among Special Forces personnel compared to regular forces. (OR 1.90 (95% CI 1.20-3.02). Personnel aged ≥35 years had the lowest prevalence of smoking (14.0%). Commissioned officers had a lower prevalence (12.1%) than non commissioned officers or other ranks. After adjustment for demographic variables and service type there was significant association between smoking and combat experiences of seeing dead or wounded [OR 1.79 (95%CI 1.08-2.9)], handling dead bodies [OR 2.47(95%CI 1.6-3.81)], coming under small arms fire [OR 2.01(95%CI 1.28-3.15)] and coming under mortar, missile and artillery fire [OR 2.02(95%CI 1.29-3.17)]. There was significant association between the number of risk events and current smoking [OR 1.22 (95%CI1.11-1.35)]. Conclusions There was significant association between current smoking and combat experiences. Current smoking was strongly associated with current alcohol use. Prevalence of current smoking was less among military personnel than in the general population. Prevalence of smoking was significantly higher among Special Forces personnel. PMID:22776004

Surveillance for selected tobacco-use behaviors--United States, 1900-1994.

PubMed

Giovino, G A; Schooley, M W; Zhu, B P; Chrismon, J H; Tomar, S L; Peddicord, J P; Merritt, R K; Husten, C G; Eriksen, M P

1994-11-18

Surveillance of tobacco use is an essential component of any tobacco-control program. The information gathered can be used to guide research initiatives, intervention programs, and policy decisions. REPORTING PERIODS: This report covers the period 1900-1994 for per capita cigarette consumption; 1965-1991 for trends in cigarette smoking prevalence and cessation; 1974-1991 for trends in the number of cigarettes smoked daily by current smokers; 1987-1991 for recent patterns of tobacco use; 1970, 1987, and 1991 for trends in cigar/pipe smoking and snuff/chewing tobacco use; 1984-1992 for trends in state-specific prevalences of regular cigarette smoking; 1987-1992 for state-specific estimates of smokeless-tobacco use; and 1976-1993 for trends in cigarette smoking among U.S. high school seniors. Estimates of cigarette consumption are reported by the U.S. Department of Agriculture, which uses data from the U.S. Department of the Treasury, the U.S. Department of Commerce, the Tobacco Institute, and other sources. The National Health Interview Survey uses household interviews to provide nationally representative estimates (for the civilian, noninstitutionalized population) of cigarette smoking and other behaviors related to tobacco use. The Behavioral Risk Factor surveillance System uses telephone surveys of civilian, noninstitutionalized adults (> or = 18 years of age) to provide state-specific estimates of current cigarette smoking and use of smokeless tobacco. The University of Michigan's Institute for Social Research uses school-based, self-administered questionnaires to gather data on cigarette smoking from a representative sample of U.S. high school seniors. During the period 1900-1963, per capita cigarette consumption increased; after 1964, consumption declined. During the years 1965-1991, current cigarette smoking prevalence among persons ages > or = 18 years declined overall and in every sociodemographic category examined. Decrease in current smoking prevalence was slow in some groups (e.g., among persons with fewer years of formal education). Both the prevalence of never smoking and the prevalence of cessation increased from 1965 through 1991. The prevalence of current cigarette smoking, any tobacco smoking, and any tobacco use was highest among American Indians/Alaska Natives and non-Hispanic blacks and lowest among Asians/Pacific Islanders. The prevalence of cigar smoking and pipe smoking has declined substantially since 1970. The prevalence of smokeless-tobacco use among white males ages 18-34 years was higher in 1987 and 1991 than in 1970; among persons > or = 45 years of age, the use of smokeless tobacco was more common among blacks than whites in 1970 and 1987. Cigarette smoking prevalence has decreased in most states. The prevalence of smokeless tobacco use was especially high among men in West Virginia, Montana, and several southern states. From 1984-1993, prevalence of cigarette smoking remained constant among U.S. high school seniors. However, prevalence increased slightly for male seniors and white seniors, decreased slightly for female high school seniors, and decreased sharply for black high school seniors. With the exceptions of increases in cigarette smoking among white and male high school seniors and in the use of smokeless tobacco among white males ages 18-34 years, reductions in tobacco use occurred in every subgroup examined. This decrease must continue if the national health objectives for the year 2000 are to be reached. Surveillance of tobacco use is ongoing. Effective interventions that discourage initiation and encourage cessation are being disseminated throughout the United States.

Intimate Partner Violence and Cigarette Smoking: Association Between Smoking Risk and Psychological Abuse With and Without Co-Occurrence of Physical and Sexual Abuse

PubMed Central

Jun, Hee-Jin; Rich-Edwards, Janet W.; Boynton-Jarrett, Renée; Wright, Rosalind J.

2008-01-01

Objectives. We examined the association between psychological abuse in a current relationship and current cigarette smoking among women, with and without the co-occurrence of physical or sexual abuse. Methods. Women’s experience of psychological abuse, experience of physical or sexual abuse, and smoking status were ascertained through a survey of female nurses. A score of 20 or more on the Women’s Experience With Battering scale defined psychological abuse. We used logistic regression to predict current smoking, adjusting for demographic and social covariates. Analyses included women in a current relationship (n=54200). Results. Adjusted analyses demonstrated that women experiencing only psychological abuse alone were 33% (95% confidence interval [CI]=13%, 57%) more likely to smoke than nonabused women. Compared with nonabused women, psychologically abused women’s risk of smoking was greater if they reported a single co-occurrence of physical or sexual abuse (odds ratio [OR]=1.5; 95% CI=1.3, 1.8) or multiple co-occurrences (OR=1.9; 95% CI=1.7, 2.3). Conclusions. Psychological abuse in a current relationship was associated with an increased risk of smoking in this cohort of largely White, well-educated, and employed women. The co-occurrence of physical or sexual abuse enhanced that risk. Further research is needed to see if these associations hold for other groups. PMID:17600272

Use Behaviors, Dependence, and Nicotine Exposure Associated with Ad Libitum Cigar Smoking

PubMed Central

Claus, Eric D.; Moeller, Benjamin C.; Harbour, Darlene; Kuehl, Philip J.; McGuire, Michael; Vivar, Juan C.; Schroeder, Megan J.

2018-01-01

Objectives To examine factors important to cigar smoking and subsequent nicotine exposure, we evaluated the impact of cigar type, cigarette smoking history, and inhalation behaviors on nicotine dependence, smoking topography, and biomarkers of exposure in current exclusive cigar smokers. Methods Adult, exclusive cigar smokers (N = 77) were recruited based on cigar type, cigarette smoking history, and self-reported inhalation behaviors. Participants smoked their own brand product ad libitum for up to one hour; dependence symptoms, smoking topography, and biomarkers of exposure were assessed. Results Cigar smokers showed low levels of dependence. Cigar smoking alleviated withdrawal and craving symptoms, increased plasma nicotine concentration, and increased exhaled CO. Multiple regression analyses indicate that inhalation behaviors were associated with increased dependence and greater reductions in withdrawal symptoms upon cigar smoking. Large cigar smokers smoked longer and smoked more tobacco than small cigar and cigarillo smokers. Furthermore, large cigar smokers and self-reported inhalers were exposed to more nicotine than small cigar smokers and non-inhalers. Conclusions Our study suggests that cigar type and smoking behaviors affect dependence and nicotine exposure upon cigar smoking. These findings provide additional insight into the substantial risks associated with cigar smoking. PMID:29516029

The impact of changes in tobacco control funding on healthcare expenditures in California, 2012-2016.

PubMed

Max, Wendy; Sung, Hai-Yen; Lightwood, James

2013-05-01

This study presents estimates of the impact of changes in California tobacco control funding on healthcare expenditures for 2012-2016 under four funding scenarios. Smoking prevalence is projected using a cointegrated time series regression model. Smoking-attributable healthcare expenditures are estimated with econometric models that use a prevalence-based annual cost approach and an excess cost methodology. If tobacco control spending in California remains at the current level of 5 cents per pack (base case), smoking prevalence will increase from 12.2% in 2011 to 12.7% in 2016. If funding is cut in half, smoking prevalence will increase to 12.9% in 2016 and smoking-attributable healthcare expenditures will be $307 million higher over this time period than in the base case. If the tobacco tax is increased by $1.00 per pack with 20 cents per pack allocated to tobacco control, smoking prevalence will fall to 10.4% in 2016 and healthcare expenditures between 2012 and 2016 will be $3.3 billion less than in the base case. If funding is increased to the Centers for Disease Control and Prevention recommended level, smoking prevalence will fall to 10.6% in 2016 and there will be savings in healthcare expenditures of $4.7 billion compared to the base case due to the large reduction in heavy smoking prevalence. California's highly successful tobacco control program will become less effective over time because inflation is eroding the 5 cents per pack currently allocated to tobacco control activities. More aggressive action needs to be taken to reduce smoking prevalence and healthcare expenditures in the future.

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey.

PubMed

Ozge, C; Toros, F; Bayramkaya, E; Camdeviren, H; Sasmaz, T

2006-08-01

The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey. Using in-class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method. The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity. It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed.

Longitudinal study of the association between smoking as a periodontitis risk and salivary biomarkers related to periodontitis.

PubMed

Kibayashi, Miyuki; Tanaka, Muneo; Nishida, Nobuko; Kuboniwa, Masae; Kataoka, Kosuke; Nagata, Hideki; Nakayama, Kunio; Morimoto, Kanehisa; Shizukuishi, Satoshi

2007-05-01

Insufficient data exist regarding the long-term influence of lifestyle factors including smoking on periodontal health. The objective of this study was to examine the prospective association between smoking and periodontal disease progression and the effects of smoking on salivary biomarkers related to periodontitis. Probing depth (PD) was measured at health checkups of workers in 1999 and 2003; additionally, lifestyle information was obtained through a questionnaire. In 2003, 219 of 256 (86%) workers examined at baseline completed PD measurements; saliva samples were also collected. Change in PD was used for assessment of periodontitis progression when three or more sites displayed an increase of >or=2 mm over 4 years. Salivary biomarker levels were determined by real-time polymerase chain reaction and enzyme assay. Statistical methods included bivariate and multivariate regression analyses. In the multiple logistic model, in which lifestyle-related factors served as independent variables, significant variables were current smoking and hours of sleep; respective odds ratios were 2.3 and 2.1. Additionally, 38.5% of periodontal disease progression was attributable to current smoking. Moreover, pack-years of smoking showed a dose-response relationship with disease progression. Levels of salivary markers including prostaglandin E(2), lactoferrin, albumin, aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase were significantly lower in current smokers than in non-current smokers. However, no meaningful differences in the proportions of six periodontal pathogens were observed between current and non-current smokers. Smoking exerted the greatest influence on periodontitis risk among lifestyle factors. Smoking may suppress the host-defense system, which may promote periodontal disease progression.

Prevalence and socioeconomic factors associated with smoking in people living with HIV by sex, in Recife, Brazil.

PubMed

Batista, Joanna d'Arc Lyra; Militão de Albuquerque, Maria de Fátima Pessoa; Ximenes, Ricardo Arraes de Alencar; Miranda-Filho, Demócrito de Barros; Lacerda de Melo, Heloisa Ramos; Maruza, Magda; Moura, Libia Vilela; Pinto da Costa Ferraz, Eduardo Jaime Seara; Rodrigues, Laura Cunha

2013-06-01

Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases.

Impact of Age at Smoking Initiation on Smoking-Related Morbidity and All-Cause Mortality.

PubMed

Choi, Seung Hee; Stommel, Manfred

2017-07-01

Using a nationally representative sample of U.S. adults, the aims of this study were to examine the impact of early smoking initiation on the development of self-reported smoking-related morbidity and all-cause mortality. National Health Interview Survey data from 1997 through 2005 were linked to the National Death Index with follow-up to December 31, 2011. Two primary dependent variables were smoking-related morbidity and all-cause mortality; the primary independent variable was age of smoking initiation. The analyses included U.S. population of current and former smokers aged ≥30 years (N=90,278; population estimate, 73.4 million). The analysis relied on fitting logistic regression and Cox proportional hazards models. Among the U.S. population of smokers, 7.3% started smoking before age 13 years, 11.0% at ages 13-14 years, 24.2% at ages 15-16 years, 24.5% at ages 17-18 years, 14.5% at ages 19-20 years, and 18.5% at ages ≥21 years. Early smoking initiation before age 13 years was associated with increased risks for cardiovascular/metabolic (OR=1.67) and pulmonary (OR=1.79) diseases as well as smoking-related cancers (OR=2.1) among current smokers; the risks among former smokers were cardiovascular/metabolic (OR=1.38); pulmonary (OR=1.89); and cancers (OR=1.44). Elevated mortality was also related to early smoking initiation among both current (hazard ratio, 1.18) and former smokers (hazard ratio, 1.19). Early smoking initiation increases risks of experiencing smoking-related morbidities and all-cause mortality. These risks are independent of demographic characteristics, SES, health behaviors, and subsequent smoking intensity. Comprehensive tobacco control programs should be implemented to prevent smoking initiation and promote cessation among youth. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Correlates of experimentation with smoking and current cigarette consumption among adolescents* **

PubMed Central

Bonilha, Amanda Gimenes; Ruffino-Netto, Antonio; Sicchieri, Mayara Piani; Achcar, Jorge Alberto; Rodrigues-Júnior, Antonio Luiz; Baddini-Martinez, José

2014-01-01

OBJECTIVE: The aim of this study was to analyze social characteristics and stress as correlates of cigarette smoking in adolescence. The main intent was to identify elements that distinguish adolescents who had experimented with smoking and did not progress to regular smoking from those who became current smokers. METHODS: Students at 10 high schools in the city of Ribeirão Preto, Brazil, completed a questionnaire based on an instrument employed in a similar large-scale study. The students were classified as never-smokers or experimenters. The experimenters were subcategorized as having become current smokers or nonprogressors. Analyses were performed using adjusted logistic models. RESULTS: A total of 2,014 students (mean age, 16.2 ± 1.1 years; females, 53%) completed the questionnaire. We categorized 1,283 students (63.7%) as never-smokers, 244 (12.1%) as current smokers, and 487 (24.2%) as nonprogressors. We found that experimentation with smoking was associated with being held back a grade in school (OR = 1.80), alcohol intake (low/occasional, OR = 8.92; high/regular, OR = 2.64), illicit drug use (OR = 9.32), having a sibling or cousin who smokes (OR = 1.39), having a friend who smokes (OR = 2.08), and high levels of stress (in females only, OR = 1.32). Factors associated with an increased risk of transitioning from experimenter to current smoker were alcohol intake (low/occasional, OR = 3.28; high/regular, OR = 2.16), illicit drug use (OR = 3.61), and having a friend who smokes (OR = 7.20). CONCLUSIONS: Current smoking was associated with a profile of socioeconomic correlates different from that associated with experimentation only. Our data (showing that current smoking was associated with having a friend who smokes, alcohol intake, and illicit drug use) suggest the need for comprehensive approaches to discourage substance use during adolescence. PMID:25610504

Tobacco retail outlet density and risk of youth smoking in New Zealand.

PubMed

Marsh, Louise; Ajmal, Ali; McGee, Rob; Robertson, Lindsay; Cameron, Claire; Doscher, Crile

2016-12-01

Evidence suggests inconsistent findings on the relationship between density of tobacco outlets around schools and risk of smoking among students. This study examines the density of tobacco outlets around secondary schools in New Zealand (NZ) and current smoking, experimental smoking, susceptibility to smoking, and attempted and successful tobacco purchasing. Smoking data came from the 2012 ASH Year 10 survey, a national survey of youth smoking in NZ. Geographic Information Systems were used to map tobacco retail outlets; a layer of secondary school locations was obtained from Koordinates.com. Logistic regression examined the relationship between density of outlets around schools and smoking behaviours, adjusting for individual-level and school-level confounders. Of the 27 238 students surveyed, 3.5% (952) were current smokers, 4.1% (n=1 128) were experimental smokers, and 39.8% (10 454) of nonsmokers were susceptible to smoking. An inverse relationship was found between the density of tobacco retail outlets and current smoking. Current smokers were significantly more likely to attempt to purchase tobacco if the density of tobacco retail outlets around their school was high. Non-smoking students were more likely to be susceptible to smoking if the density of tobacco outlets around their school was high. There was no statistically significant association between density of tobacco outlets and successful purchasing, nor experimental smoking. Restricting the permitted density of tobacco retail outlets around schools should be part of comprehensive tobacco control. In this regard, both smokers and non-smokers support the introduction of increased regulation of the tobacco retail environment to achieve our national smoke-free 2025 goal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Association of intracranial aneurysm rupture with smoking duration, intensity, and cessation.

PubMed

Can, Anil; Castro, Victor M; Ozdemir, Yildirim H; Dagen, Sarajune; Yu, Sheng; Dligach, Dmitriy; Finan, Sean; Gainer, Vivian; Shadick, Nancy A; Murphy, Shawn; Cai, Tianxi; Savova, Guergana; Dammers, Ruben; Weiss, Scott T; Du, Rose

2017-09-26

Although smoking is a known risk factor for intracranial aneurysm (IA) rupture, the exact relationship between IA rupture and smoking intensity and duration, as well as duration of smoking cessation, remains unknown. In this case-control study, we analyzed 4,701 patients with 6,411 IAs diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016. We divided individuals into patients with ruptured aneurysms and controls with unruptured aneurysms. We performed univariable and multivariable logistic regression analyses to determine the association between smoking status and ruptured IAs at presentation. In a subgroup analysis among former and current smokers, we assessed the association between ruptured aneurysms and number of packs per day, duration of smoking, and duration since smoking cessation. In multivariable analysis, current (odds ratio [OR] 2.21, 95% confidence interval [CI] 1.89-2.59) and former smoking status (OR 1.56, 95% CI 1.31-1.86) were associated with rupture status at presentation compared with never smokers. In a subgroup analysis among current and former smokers, years smoked (OR 1.02, 95% CI 1.01-1.03) and packs per day (OR 1.46, 95% CI 1.25-1.70) were significantly associated with ruptured aneurysms at presentation, whereas duration since cessation among former smokers was not significant (OR 1.00, 95% CI 0.99-1.02). Current cigarette smoking, smoking intensity, and smoking duration are significantly associated with ruptured IAs at presentation. However, the significantly increased risk persists after smoking cessation, and smoking cessation does not confer a reduced risk of aneurysmal subarachnoid hemorrhage beyond that of reducing the cumulative dose. © 2017 American Academy of Neurology.

Momentary changes in craving predict smoking lapse behavior: a laboratory study.

PubMed

Motschman, Courtney A; Germeroth, Lisa J; Tiffany, Stephen T

2018-04-27

Current research on factors that predict smoking lapse behavior is limited in its ability to fully characterize the critical moments leading up to decisions to smoke. We used a validated and widely used experimental analogue for smoking lapse to assess how moment-to-moment dynamics of craving relate to decisions to smoke. Heavy smokers (N = 128, M age = 35.9) participated in a 50-min laboratory delay to smoking task on 2 consecutive days, earning money for each 5 min they remained abstinent or ending the task by choosing to smoke. Participants rated craving and negative affect levels immediately prior to each choice. Participants were randomized to smoking as usual (n = 50) or overnight abstinence (n = 50 successfully abstained, n = 22 failed abstaining) prior to session 2. Discrete-time hazard models were used to examine craving and negative affect as time-varying predictors of smoking. Higher craving levels prior to smoking opportunities predicted increased risk of smoking. When controlling for craving levels, incremental increases in craving predicted increased smoking risk. Increases in negative affect incrementally predicted increased smoking risk at session 2 only. Smokers who failed to abstain were at a higher risk of smoking than those who successfully abstained, whereas abstinent and non-abstinent smokers did not differ in smoking risk. Findings demonstrate an extension of the smoking lapse paradigm that can be utilized to capture momentary changes in craving that predict smoking behavior. Evaluations of nuanced craving experiences may inform clinical and pharmacological research on preventing smoking lapse and relapse.

Effects of Escalating and Descending Schedules of Incentives on Cigarette Smoking in Smokers without Plans to Quit

ERIC Educational Resources Information Center

Romanowich, Paul; Lamb, R. J.

2010-01-01

Contingent incentives can reduce substance abuse. Escalating payment schedules, which begin with a small incentive magnitude and progressively increase with meeting the contingency, increase smoking abstinence. Likewise, descending payment schedules can increase cocaine abstinence. The current experiment enrolled smokers without plans to quit in…

Trends in cigarette smoking among adults with HIV compared with the general adult population, United States - 2009-2014.

PubMed

Frazier, Emma L; Sutton, Madeline Y; Brooks, John T; Shouse, R Luke; Weiser, John

2018-06-01

Smoking increases HIV-related and non-HIV-related morbidity and mortality for persons with HIV infection. We estimated changes in cigarette smoking among adults with HIV and adults in the general U.S. population from 2009 to 2014 to inform HIV smoking cessation programs. Among HIV-positive adults, rates of current smoking declined from 37.6% (confidence interval [CI]: 34.7-40.6) in 2009 to 33.6% (CI: 29.8-37.8) in 2014. Current smoking among U.S. adults declined from 20.6% (CI: 19.9-21.3) in 2009 to 16.8% (CI: 16.2-17.4) in 2014. HIV-positive adults in care were significantly more likely to be current smokers compared with the general U.S. population; they were also less likely to quit smoking. For both HIV-positive adults in care and the general population, disparities were noted by racial/ethnic, educational level, and poverty-level subgroups. For most years, non-Hispanic blacks, those with less than high school education, and those living below poverty level were more likely to be current smokers and less likely to quit smoking compared with non-Hispanic whites, those with greater than high school education, and those living above poverty level, respectively. To decrease smoking-related causes of illness and death and to decrease HIV-related disparities, smoking cessation interventions are vital as part of routine care with HIV-positive persons. Clinicians who care for HIV-positive persons who smoke should utilize opportunities to discuss and implement smoking cessation strategies during routine clinical visits. Published by Elsevier Inc.

The link between smoking status and co-morbid conditions in individuals with multiple sclerosis (MS).

PubMed

Newland, Pamela; Flick, Louise; Salter, Amber; Dixon, David; Jensen, Mark P

2017-10-01

In individuals with multiple sclerosis (MS) comorbidities and quality of life (QOL) may be affected by tobacco use. To evaluate the associations between smoking status, in particular quit attempts, and comorbidities among individuals with MS. We used a web-based survey to obtain cross-sectional data from 335 individuals with MS who were members of the Gateway Chapter of the National MS Society email registry. We then examined the associations between smoking variables (current use, frequency, and quit attempts) and comorbidities. The prevalence of participants who ever smoked was 50%, which is greater than that reported for the general population; 20% were current smokers. Migraine headaches were associated with current use and everyday smoking, and those with recent failed quit attempts had a higher prevalence of depression than those who were current smokers but who did not attempt to quit or had successfully quit in the past year. Given the associations between smoking and comorbidities in individuals with MS, health care providers should both (1) assess smoking history and quit attempts, and (2) encourage individuals with MS who smoke to become non-smokers and refer for treatment, as indicated. In order to increase the chances that individuals will be successful in becoming non-smokers, clinicians would do well to also assess and treat depression in their patients who smoke and are also depressed. Copyright © 2017 Elsevier Inc. All rights reserved.

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood.

PubMed

Cance, Jessica Duncan; Talley, Anna E; Fromme, Kim

2016-02-01

Almost one-third of college students report recent cigarette use, primarily as "social smoking," and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students' drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Smoking Behaviors Among Adolescents in Foster Care: A Gender-Based Analysis.

PubMed

Shpiegel, Svetlana; Sussman, Steve; Sherman, Scott E; El Shahawy, Omar

2017-09-19

Adolescents in foster care are at high risk for cigarette smoking. However, it is not clear how their smoking behaviors vary by gender. The present study examined lifetime and current smoking among males and females, and explored gender-specific risk factors for engagement in smoking behaviors. Data from the Multi Site Evaluation of Foster Youth Programs was used to evaluate patterns of smoking among adolescents aged 12-18 years (N = 1121; 489 males, 632 females). Males and females did not differ significantly in rates of lifetime and current smoking, or in the age of smoking initiation and number of cigarettes smoked on a typical day. Gender-based analyses revealed that older age and placement in group homes or residential treatment facilities were associated with heightened risk of smoking among males. In contrast, sexual minority status (i.e., nonheterosexual orientation) and increased childhood victimization were associated with heightened risk of smoking among females. A history of running away was linked to smoking in both genders. Gender should be considered when designing intervention programs to address cigarette smoking among foster youth, as the stressors associated with smoking may differ for males and females.

Effects of Smoking on Cost of Hospitalization and Length of Stay among Patients with Lung Cancer in Iran: a Hospital-Based Study.

PubMed

Sari, Ali Akbari; Rezaei, Satar; Arab, Mohammad; Majdzadeh, Reza; Matin, Behzad Karami; Zandian, Hamed

2016-01-01

Smoking is recognized as a main leading preventable cause of mortality and morbidity worldwide. It is responsible for a considerable nancial burden both on the health system and in society. This study aimed to examine the effect of smoking on cost of hospitalization and length of stay (LoS) among patients with lung cancer in Iran in 2014. A total of 415 patients were included in the study. Data on age, sex, insurance status, type of hospitals, type of insurance, geographic local, length of stay and cost of hospitalization was extracted by medical records and smoking status was obtained from a telephone survey. To compare cost of hospitalization and LoS for different smoking groups, current smokers, former smokers, and never smokers, a gamma regression model and zero-truncated poisson regression were used, respectively. Compared with never smokers, current and former smokers showed a 48% and 35% increase in hospitalization costs, respectively. Also, hospital LoS for current and former smokers was 72% and 31% higher than for never smokers, respectively. Our study indicated that cigarette smoking imposes a signi cant nancial burden on hospitals in Iran. It is, however, recommended that more research should be done to implement and evaluate hospital based smoking cessation interventions to better increase cessation rates in these settings.

Breast tumor DNA methylation patterns associated with smoking in the Carolina Breast Cancer Study.

PubMed

Conway, Kathleen; Edmiston, Sharon N; Parrish, Eloise; Bryant, Christopher; Tse, Chiu-Kit; Swift-Scanlan, Theresa; McCullough, Lauren E; Kuan, Pei Fen

2017-06-01

Tobacco smoking is a risk factor in several cancers, yet its roles as a putative etiologic exposure or poor prognostic factor in breast cancer are less clear. Altered DNA methylation contributes to breast cancer development and may provide a mechanistic link between smoking and gene expression changes leading to cancer development or progression. Using a cancer-focused array, we examined methylation at 933 CpGs in 517 invasive breast tumors in the Carolina Breast Cancer Study to determine whether methylation patterns differ by exposure to tobacco smoke. Multivariable generalized linear regression models were used to compare tumor methylation profiles between smokers and never smokers, overall, or stratified on hormone receptor (HR) status. Modest differences in CpG methylation were detected at p < 0.05 in breast tumors from current or ever smokers compared with never smokers. In stratified analyses, HR- tumors from smokers exhibited primarily hypomethylation compared with tumors from never smokers; hypomethylation was similarly detected within the more homogeneous basal-like subtype. Most current smoking-associated CpG loci exhibited methylation levels in former smokers that were intermediate between those in current and never smokers and exhibited progressive changes in methylation with increasing duration of smoking. Among former smokers, restoration of methylation toward baseline (never smoking) levels was observed with increasing time since quitting. Moreover, smoking-related hypermethylation was stronger in HR+ breast tumors from blacks than in whites. Our results suggest that breast tumor methylation patterns differ with tobacco smoke exposure; however, additional studies are needed to confirm these findings.

Harm perception, attitudes and predictors of waterpipe (shisha) smoking among secondary school adolescents in Al-Hassa, Saudi Arabia.

PubMed

Amin, Tarek Tawfik; Amr, Mostafa Abdel Monem; Zaza, Burhan Omar; Suleman, Wassem

2010-01-01

This study aimed to determine the prevalence and social determinants of waterpipe (WP) smoking among secondary school students in Al-Hassa, Saudi Arabia and to assess their health related knowledge and attitudes toward WP. A cross-sectional study was conducted with 1,652 Saudi secondary school students of both genders aged between 15-19 years selected by multistage sampling method. A self-administered anonymous Arabic version of Global Youth Tobacco Survey modified with items dedicated to WP smoking and to assess perception of health related hazards and attitudes towards WP was employed for data collection. Prevalence of current smokers 'all forms' was 30.3% among males (C.I= 27.5- 33.2%) and 8.5% in females (C.I= 6.6-10.9%). WP was used by 53.9% of the current tobacco users, significantly higher among older age students. Of the regular WP smokers, 20.7% smoked WP on daily basis, 23.8% weekly, 64.2% stated using flavored " Muassel " tobacco. Primary motives for WP smoking were outings with friends, company, boredom and wasting time. Of the total, 49.7% of students stated that WP smoking is less harmful than cigarettes, 60.5% believed that harmful substances were purified through water filtration, with non-addictive properties in 67.8%. Knowledge about health hazards of WP smoking was low, irrespective of student's smoking status. WP smoking is more socially acceptable than cigarettes (52.1%), represents a good opportunity for gathering of friends and family (33.8%), and smoking of WP can relieve stress and tensions (37.8%). Hierarchical regression analysis showed that socializing motives, cigarette smoking, smoking among close family and friends, male gender and increasing age were positive predictors for WP smoking. Social acceptability, poor knowledge of WP health related hazards and certain socio demographics are favoring the increasing current trend of WP use among adolescents in Al Hassa, Saudi Arabia.

Cigarette smoking and associated factors among in-school adolescents in Jamaica: comparison of the Global Youth Tobacco Surveys 2000 and 2006.

PubMed

Muula, Adamson S; Siziya, Seter; Rudatsikira, Emmanuel

2008-07-28

We conducted this study to estimate the correlates of current cigarette smoking among in-school adolescents in Jamaica 2006 and compare prevalence of smoking and associated factors between 2000 and 2006. In 2006, 1854 participated of whom 49.5 were males and 50.5% females. 1752 adolescents, 48.8% male and 51.2% females participated in the 2000 survey. Between 2000 and 2006, the prevalence of smoking among Jamaican school-going adolescents went up slightly from 15.2% to 16.7% but this was not statistically significant (p = 0.22). The perception that smoking is not harmful increased from 10.9% to 15.9% while parental smoking decreased from 39.4% to 35.5%. There was a decrease in the rates of adolescents exposed to tobacco adverts on billboards (p-value = 0.037) and in newspapers/magazine (p-value < 0.001). The percentage of adolescents who reported having an item with a tobacco brand logo on it increased from 13.9% to 16.4%. The perception that boys and girls who smoked had more friends increased between 2000 and 2006 (p-values = 0.016 and 0.004 respectively). Current smoking was associated with male gender (OR = 1.55; 95% CI [1.09-2.19]), having smoking parents (OR = 1.75; 95% CI [1.23-2.50]), and smoking friends (OR = 14.94; 95% CI [8.61-25.92] for most or all friends smokers and OR = 4.38; 95% CI [2.93-6.56] for some friends smokers)). Results from this study indicate smoking was positively associated with male gender, having smoking friends or parents. We observed a slightly non significant increase in the prevalence of smoking between 2000 and 2006 among adolescents in Jamaica. Although there was a decrease in the rates of adolescents exposed to advertisement, the percentage of those who had an item with a tobacco brand logo had increased. The possible impact of the Jamaica's ratification of the Framework Convention on Tobacco control remains to be observed.

Disparities in Current Cigarette Smoking Prevalence by Type of Disability, 2009–2011

PubMed Central

Stevens, Alissa; Caraballo, Ralph; Ramon, Ismaila; Armour, Brian S.

2014-01-01

Objectives Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age. Methods We used data from the 2009–2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18–49 years. Results Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77). Conclusions The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur. PMID:24791023

The relation between tobacco taxes and youth and young adult smoking: what happened following the 2009 U.S. federal tax increase on cigarettes?

PubMed

van Hasselt, Martijn; Kruger, Judy; Han, Beth; Caraballo, Ralph S; Penne, Michael A; Loomis, Brett; Gfroerer, Joseph C

2015-06-01

On April 1, 2009, the federal government raised cigarette taxes from $0.39 to $1.01 per pack. This study examines the impact of this increase on a range of smoking behaviors among youth aged 12 to 17 and young adults aged 18 to 25. Data from the 2002-2011 National Survey on Drug Use and Health (NSDUH) were used to estimate the impact of the tax increase on five smoking outcomes: (1) past year smoking initiation, (2) past-month smoking, (3) past year smoking cessation, (4) number of days cigarettes were smoked during the past month, and (5) average number of cigarettes smoked per day. Each model included individual and state-level covariates and other tobacco control policies that coincided with the tax increase. We examined the impact overall and by race and gender. The odds of smoking initiation decreased for youth after the tax increase (odds ratio (OR)=0.83, p<0.0001). The odds of past-month smoking also decreased (youth: OR=0.83, p<0.0001; young adults: OR=0.92, p<0.0001), but the odds of smoking cessation remained unchanged. Current smokers smoked on fewer days (youth: coefficient=-0.97, p=0.0001; young adults: coefficient=-0.84, p<0.0001) and smoked fewer cigarettes per day after the tax increase (youth: coefficient=-1.02, p=0.0011; young adults: coefficient=-0.92, p<0.0001). The 2009 federal cigarette tax increase was associated with a substantial reduction in smoking among youths and young adults. The impact of the tax increase varied across male, female, white and black subpopulations. Copyright © 2015 Elsevier Ltd. All rights reserved.

The relation between tobacco taxes and youth and young adult smoking: What happened following the 2009 U.S. federal tax increase on cigarettes?

PubMed Central

van Hasselt, Martijn; Kruger, Judy; Han, Beth; Caraballo, Ralph S.; Penne, Michael A.; Loomis, Brett; Gfroerer, Joseph C.

2015-01-01

Background On April 1, 2009, the federal government raised cigarette taxes from $0.39 to $1.01 per pack. This study examines the impact of this increase on a range of smoking behaviors among youth aged 12 to 17 and young adults aged 18 to 25. Methods Data from the 2002–2011 National Survey on Drug Use and Health (NSDUH) were used to estimate the impact of the tax increase on five smoking outcomes: (1) past year smoking initiation, (2) past-month smoking, (3) past year smoking cessation, (4) number of days cigarettes were smoked during the past month, and (5) average number of cigarettes smoked per day. Each model included individual and state-level covariates and other tobacco control policies that coincided with the tax increase. We examined the impact overall and by race and gender. Results The odds of smoking initiation decreased for youth after the tax increase (odds ratio (OR) = 0.83, p < 0.0001). The odds of past-month smoking also decreased (youth: OR = 0.83, p < 0.0001; young adults: OR = 0.92, p < 0.0001), but the odds of smoking cessation remained unchanged. Current smokers smoked on fewer days (youth: coefficient = −0.97, p = 0.0001; young adults: coefficient = −0.84, p < 0.0001) and smoked fewer cigarettes per day after the tax increase (youth: coefficient = −1.02, p = 0.0011; young adults: coefficient = −0.92, p < 0.0001). Conclusions The 2009 federal cigarette tax increase was associated with a substantial reduction in smoking among youths and young adults. The impact of the tax increase varied across male, female, white and black subpopulations. PMID:25658771

Sex Differences in Tobacco Use Among Persons Living With HIV/AIDS: A Systematic Review and Meta-Analysis.

PubMed

Weinberger, Andrea H; Smith, Philip H; Funk, Allison P; Rabin, Shayna; Shuter, Jonathan

2017-04-01

Persons living with HIV/AIDS (PLWH) smoke at higher rates than other adults and experience HIV-related and non-HIV-related adverse smoking consequences. This study conducted a systematic review to synthesize current knowledge about sex differences in smoking behaviors among PLWH. Over 3000 abstracts from MEDLINE were reviewed and 79 publications met all the review inclusion criteria (ie, reported data on smoking behaviors for PLWH by sex). Sufficient data were available to conduct a meta-analysis for one smoking variable: current smoking prevalence. Across studies (n = 51), the meta-analytic prevalence of current smoking among female PLWH was 36.3% (95% confidence interval [CI]: 28.0% to 45.4%) and male PLWH was 50.3% (95% CI: 44.4% to 56.2%; meta-analytic odds ratio = 1.78, 95% CI: 1.29 to 2.45). When analyses were repeated just on the US studies (n = 23), the prevalence of current smoking was not significantly different for female PLWH (55.1%, 95% CI: 47.6% to 62.5%) compared with male PLWH (55.5%, 95% CI: 48.2% to 62.5%; meta-analytic odds ratio = 1.04, 95% CI: 0.86 to 1.26). Few studies reported data by sex for other smoking variables (eg, quit attempts, noncigarette tobacco product use) and results for many variables were mixed. Unlike the general US population, there was no difference in smoking prevalence for female versus male PLWH (both >50%) indicating that HIV infection status was associated with a greater relative increase in smoking for women than men. More research is needed in all areas of smoking behavior of PLWH to understand similarities and differences by sex to provide the best interventions to reduce the high smoking prevalence for all sexes.

“How Is Smoking Handled in Your Home?”: Agreement Between Parental Reports on Home Smoking Bans in the United States, 1995–2007

PubMed Central

Zhang, Xiao; Kuo, Daphne; Jones, Nathan R.

2012-01-01

Introduction: Home smoking bans significantly reduce secondhand smoke exposure among children, but parents may offer discordant reports on whether there is a home smoking ban. The purpose of this study was to examine national trends in (a) parental discordance/concordance in the reporting of home smoking bans and (b) correlates of discordant/concordant reports among two-parent households with underage children from 1995 to 2007. Methods: Data from the 1995/1996, 1998/1999, 2001/2002, 2003, and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey were used to estimate prevalence rates and multinomial logistic regression models of discordant/concordant parental smoking ban reports by survey period. Results: Overall, the percentage of households in which the 2 parents gave discordant reports on a complete home smoking ban decreased significantly from 12.7% to 2.8% from 1995 to 2007 (p < .001). Compared with households where both parents reported a complete smoking ban, discordant reports were more likely to be obtained from households with current smokers (p < .01) across survey periods. Compared with households where both parents reported the lack of a complete home smoking ban, discordant reports were more likely among households with college graduates, no current smokers, and parents with Hispanic ethnicity (p < .05). Conclusions: Parental concordance on the existence of a home smoking ban increased from 1995 to 2007. This suggests estimates of home smoking bans based on just one parent may be more reliable now than they were in the past. Interventions to improve the adoption and enforcement of home smoking bans should target households with current smoker parents. PMID:22377935

[Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes].

PubMed

Su, J; Qin, Y; Shen, C; Gao, Y; Pan, E C; Pan, X Q; Tao, R; Zhang, Y Q; Wu, M

2017-11-10

Objective: To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods: From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results: The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers ( P <0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95 %CI : 0.05%-0.49%) and 0.38% (95 %CI : 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers ( P <0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion: Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California

PubMed Central

Felicitas, Jamie; Fagan, Pebbles; Gruder, Charles L.; Blanco, Lyzette; Cappelli, Christopher; Trinidad, Dennis R.

2015-01-01

Objectives: The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. Methods: Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. Results: A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. Discussion: Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers. PMID:25666813

Smoking among adolescents in Muenster, Germany: increase in prevalence (1995-2000) and relation to tobacco advertising.

PubMed

Maziak, Wasim; Rzehak, Peter; Keil, Ulrich; Weiland, Stephan K

2003-02-01

Understanding patterns and trends of smoking among youths is of major importance for the assessment of the burden of smoking in the society and efforts to decrease it. The aims were to determine the prevalence and trends of smoking among adolescents in Muenster, Germany, and to assess its relation to youths' awareness of tobacco advertisement. Information on smoking habits was collected during two school-based surveys (1994/1995 and 1999/2000) of 12- to 15-year-old adolescents (3934 students in 1994/5 and 4028 students in 1999/2000) in Muenster, Germany. In addition, in 1994/1995 information about youths' awareness and appreciation of tobacco advertisement was collected. During the 5-year period, the prevalence of current smoking increased from 21.3 to 28.3%, and daily smoking increased from 10.0 to 14.2%. Among girls, daily smoking increased by 62% during this period. Almost all participants (94%) in 1994/1995 knew a tobacco brand, and appreciation of tobacco advertisement was strongly associated with the frequency of smoking. Smoking is increasing among adolescents in Germany especially among girls. These data are a cause of concern and call for efforts to reverse these trends, which should include a ban on tobacco advertisement in Germany.

Smoking and deployment: perspectives of junior-enlisted U.S. Air Force and U.S. Army personnel and their supervisors.

PubMed

Poston, Walker S C; Taylor, Jennifer E; Hoffman, Kevin M; Peterson, Alan L; Lando, Harry A; Shelton, Suzanne; Haddock, C Keith

2008-05-01

Smoking during deployments is a growing problem, particularly among junior-enlisted personnel, who have the highest smoking rates in the military. Few studies have examined reasons for smoking initiation among never smokers, relapse among former smokers, or increased smoking frequency among current smokers. We conducted 24 focus groups at four Air Force and two Army installations (N = 189) to examine the extent of smoking during deployment and to elucidate factors thought to contribute to new initiation, relapse, and increased smoking in a sample of junior-enlisted personnel and their supervisors. Important reasons for smoking included: (1) managing stress, boredom, anxiety, and sleep deprivation; (2) lack of alternate activities and privileges; (3) the perception that dangers in the field trumps the health impact of smoking; and (4) the role of the military environment in encouraging smoking. In addition, the phenomenon of new initiation and relapse to smoking in the field was discussed.

Smoking duration, respiratory symptoms, and COPD in adults aged ≥45 years with a smoking history

PubMed Central

Liu, Yong; Pleasants, Roy A; Croft, Janet B; Wheaton, Anne G; Heidari, Khosrow; Malarcher, Ann M; Ohar, Jill A; Kraft, Monica; Mannino, David M; Strange, Charlie

2015-01-01

Background The purpose of this study was to assess the relationship of smoking duration with respiratory symptoms and history of chronic obstructive pulmonary disease (COPD) in the South Carolina Behavioral Risk Factor Surveillance System survey in 2012. Methods Data from 4,135 adults aged ≥45 years with a smoking history were analyzed using multivariable logistic regression that accounted for sex, age, race/ethnicity, education, and current smoking status, as well as the complex sampling design. Results The distribution of smoking duration ranged from 19.2% (1–9 years) to 36.2% (≥30 years). Among 1,454 respondents who had smoked for ≥30 years, 58.3% were current smokers, 25.0% had frequent productive cough, 11.2% had frequent shortness of breath, 16.7% strongly agreed that shortness of breath affected physical activity, and 25.6% had been diagnosed with COPD. Prevalence of COPD and each respiratory symptom was lower among former smokers who quit ≥10 years earlier compared with current smokers. Smoking duration had a linear relationship with COPD (P<0.001) and all three respiratory symptoms (P<0.001) after adjusting for smoking status and other covariates. While COPD prevalence increased with prolonged smoking duration in both men and women, women had a higher age-adjusted prevalence of COPD in the 1–9 years, 20–29 years, and ≥30 years duration periods. Conclusion These state population data confirm that prolonged tobacco use is associated with respiratory symptoms and COPD after controlling for current smoking behavior. PMID:26229460

Familial determinants of current smoking among adolescents of Lithuania: a cross-sectional survey 2014.

PubMed

Zaborskis, Apolinaras; Sirvyte, Dainora

2015-09-14

Understanding the role of the family in shaping adolescent health risk behaviours has recently been given increased attention. This study investigated association between current smoking and a range of familial factors in a representative sample of Lithuanian adolescents. Study subjects (N = 3696) were adolescents aged 13- and 15-years from the schools in Lithuania who were surveyed in Spring 2014 according to the methodology of the cross-national Health Behaviour in School-aged Children (HBSC). A standard HBSC international questionnaire was translated into Lithuanian and used anonymously to obtain information about current smoking patterns and family life (family structure, quality of communication in family, parental monitoring, bonding, parenting style, family time, etc.). Logistic regression was used to assess association between smoking and familial variables. The prevalence of current smoking was 16.5 % (20.8 % in boys and 11.9 % in girls; P < 0.001). Adjusting for gender, age and family affluence, adolescents from non-intact families were significantly more likely to be current smokers (OR = 2.10; 95 % CI: 1.74-2.54) compared with intact families. Five independent familial factors were significantly related to increased risk for adolescent smoking: low maternal monitoring (OR = 2.79; 95 % CI: 1.98-3.92), low satisfaction with family relationships (OR = 1.89; 95 % CI: 1.27-2.83), low school-related parental support (OR = 1.40; 95 % CI: 1.01-1.95), easy communication with the father (OR = 0.56; 95 % CI: 0.38-0.80) and often use of electronic media for communication with parents (OR = 0.66; 95 % CI: 0.50-0.88). The last two determinants showed an inverse effect than it was hypothesized. Higher prevalence of smoking among adolescents of Lithuania is associated with a non- intact family structure as well as weaker parental support and bonding. Family life practices are critical components to be incorporated in prevention and intervention programs for adolescent smoking in Lithuania.

E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys.

PubMed

Zhu, Shu-Hong; Zhuang, Yue-Lin; Wong, Shiushing; Cummins, Sharon E; Tedeschi, Gary J

2017-07-26

Objective  To examine whether the increase in use of electronic cigarettes in the USA, which became noticeable around 2010 and increased dramatically by 2014, was associated with a change in overall smoking cessation rate at the population level. Design  Population surveys with nationally representative samples. Setting  Five of the US Current Population Survey-Tobacco Use Supplement (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15. Participants  Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from 2014-15 CPS-TUS were then compared with those from 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys. Main outcome measures  Rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months. Results  Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3-4.5%). Conclusion  The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant increase in the smoking cessation rate at the population level. These findings need to be weighed carefully in regulatory policy making regarding e-cigarettes and in planning tobacco control interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Increasing the Value of an Alternative Monetary Reinforcer Reduces Cigarette Choice in Adolescents.

PubMed

Cassidy, Rachel N; Tidey, Jennifer W; Kahler, Christopher W; Wray, Tyler B; Colby, Suzanne M

2015-12-01

Smoking can be conceptualized as an operant behavior maintained by the reinforcing effects of cigarettes. Changing the magnitude and availability of alternative reinforcers should shift behavior away from smoking. Adults' smoking behavior is sensitive to the magnitude and availability of alternative reinforcers; however, the extent to which the same is true for adolescents has not yet been shown in the laboratory. To test the sensitivity of adolescent smoking behavior to changes in the magnitude of alternative reinforcement, we gave adolescents who abstained overnight the opportunity to make 20 choices between receiving two puffs of their usual-brand cigarette or money. The magnitude of the monetary reinforcer was varied across sessions in counterbalanced order ($0.00, $0.10, and $0.50). Results indicated that adolescents' choices for puffs decreased as a function of increasing monetary reinforcer magnitude, while money choices increased. This effect was moderated by baseline smoking level and by gender, such that heavier-smoking participants and males made more cigarette choices when the alternative monetary value was zero, and decreased their choices more steeply in response to increasing monetary value. The current study validates a laboratory choice procedure for studying smoking in adolescents, and demonstrates that adolescent smoking behavior is sensitive to changes in the magnitude of concurrently available monetary reinforcers. The current paradigm can be adapted and applied to explore the effects of other variables that may affect cigarette choice in adolescents. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cannabis smoking and risk of lung cancer in men: a pooled analysis of three studies in Maghreb.

PubMed

Berthiller, Julien; Straif, Kurt; Boniol, Mathieu; Voirin, Nicolas; Benhaïm-Luzon, Veronique; Ayoub, Wided Ben; Dari, Iman; Laouamri, Slimane; Hamdi-Cherif, Mokhtar; Bartal, Mohamed; Ayed, Fahrat Ben; Sasco, Annie J

2008-12-01

Cannabis is the most widely consumed illicit drug worldwide and the relation between cannabis smoking and lung cancer is suggestive, albeit inconclusive. We conducted three hospital based case-control studies in Tunisia, Morocco, and Algeria, three areas of high prevalence of cannabis consumption as well as production. This paper presents the pooled analysis of these three studies restricted to men with a total of 430 cases and 778 controls. Ninety-six percent of the cases and 67.8% of the controls were tobacco smokers and 15.3% of the cases and 5% of the controls were ever cannabis smokers. All cannabis smokers were tobacco users. Adjusting for country, age, tobacco smoking, and occupational exposure, the odds ratio (OR) for lung cancer was 2.4 (95% confidence interval [CI]: 1.6-3.8) for ever cannabis smoking. This association remained after adjustment for lifetime tobacco packyears as continuous variable, OR = 2.3 (95% CI: 1.5-3.6). The OR adjusted for intensity of tobacco smoking (cigarette/d) among current tobacco smokers and never cannabis smokers was 10.9 (95% CI: 6.0-19.7) and the OR among current tobacco users and ever cannabis smokers was 18.2 (95% CI: 8.0-41.0). The risk of lung cancer increased with increasing joint-years, but not with increasing dose or duration of cannabis smoking. Our results suggest that cannabis smoking may be a risk factor for lung cancer. However, residual confounding by tobacco smoking or other potential confounders may explain part of the increased risk.

Transcranial Direct Current Brain Stimulation Increases Ability to Resist Smoking.

PubMed

Falcone, Mary; Bernardo, Leah; Ashare, Rebecca L; Hamilton, Roy; Faseyitan, Olufunsho; McKee, Sherry A; Loughead, James; Lerman, Caryn

2016-01-01

The ability to exert self-control over temptation is a fundamental component of smoking behavior change. Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits. Although prior studies show that stimulation reduces cigarette craving and self-reported smoking, effects on ability to resist smoking have not been investigated directly. We assessed effects of a single 20-minute session of 1.0 mA anodal stimulation over the left DLPFC with cathodal stimulation over the right supra-orbital area (vs. sham stimulation) on ability to resist smoking in a validated smoking lapse paradigm. Twenty-five participants completed two tDCS sessions (active and sham stimulation) in a within-subject, double-blind, randomized and counterbalanced order with a 2-week washout period. Following overnight abstinence, participants received tDCS in the presence of smoking related cues; they had the option to smoke at any time or receive $1 for every 5 minutes they abstained. After 50 minutes, they participated in a 1 hour ad libitum smoking session. Primary and secondary outcomes were time to first cigarette and cigarette consumption, respectively. In multiple regression models, active tDCS (compared to sham) significantly increased latency to smoke (p = 0.02) and decreased the total number of cigarettes smoked (p = 0.014) during the session. These findings suggest that acute anodal stimulation over the left DLPFC (with cathodal stimulation over the right supra-orbital area) can improve ability to resist smoking, supporting the therapeutic potential of tDCS for smoking cessation treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey

PubMed Central

Özge, C; Toros, F; Bayramkaya, E; Çamdeviren, H; Şaşmaz, T

2006-01-01

Background The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey. Methods Using in‐class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method. Results The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity. Conclusions It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed. PMID:16891446

Smoking Behaviors and Attitudes During Adolescence Prospectively Predict Support for Tobacco Control Policies in Adulthood

PubMed Central

Chassin, Laurie; Presson, Clark C.

2012-01-01

Introduction: Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Methods: Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Results: Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. Conclusions: This study’s findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies. PMID:22193576

Smoking behaviors and attitudes during adolescence prospectively predict support for tobacco control policies in adulthood.

PubMed

Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

2012-07-01

Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. This study's findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies.

Psychosocial and metabolic function by smoking status in individuals with binge eating disorder and obesity.

PubMed

Udo, Tomoko; White, Marney A; Barnes, Rachel D; Ivezaj, Valentina; Morgan, Peter; Masheb, Robin M; Grilo, Carlos M

2016-02-01

Individuals with binge eating disorder (BED) report smoking to control appetite and weight. Smoking in BED is associated with increased risk for comorbid psychiatric disorders, but its impact on psychosocial functioning and metabolic function has not been evaluated. Participants were 429 treatment-seeking adults (72.4% women; mean age 46.2±11.0years old) with BED comorbid with obesity. Participants were categorized into current smokers (n=66), former smokers (n=145), and never smokers (n=218). Smoking status was unrelated to most historical eating/weight variables and to current eating disorder psychopathology. Smoking status was associated with psychiatric, psychosocial, and metabolic functioning. Compared with never smokers, current smokers were more likely to meet lifetime diagnostic criteria for alcohol (OR=5.51 [95% CI=2.46-12.33]) and substance use disorders (OR=7.05 [95% CI=3.37-14.72]), poorer current physical quality of life, and increased risk for metabolic syndrome (OR=1.80 [95% CI=0.97-3.35]) and related metabolic risks (reduced HDL, elevated total cholesterol). On the other hand, the odds of meeting criteria for lifetime psychiatric comorbidity or metabolic abnormalities were not significantly greater in former smokers, relative to never smokers. Our findings suggest the importance of promoting smoking cessation in treatment-seeking patients with BED and obesity for its potential long-term implications for psychiatric and metabolic functioning. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Smoking history worldwide--cigarette smoking, passive smoking and smoke free environment in Switzerland].

PubMed

Brändli, Otto

2010-08-01

After the invention of the cigarette 1881 the health consequences of active smoking were fully known only in 1964. Since 1986 research findings allow increasingly stronger conclusions about the impact of passive smoking on health, especially for lung cancer, cardiovascular and respiratory disease in adults and children and the sudden infant death syndrome. On the basis of current consumption patterns, approximately 450 million adults will be killed by smoking between 2000 and 2050. At least half of these adults will die between age 30 and 69. Cancer and total deaths due to smoking have fallen so far only in men in high-income countries but will rise globally unless current smokers stop smoking before or during middle age. Higher taxes, regulations on smoking, including 100 % smoke free indoor spaces, and information for consumers could avoid smoking-associated deaths. Irland was 2004 the first country worldwide introducing smoke free bars and restaurants with positive effects on compliance, health of employees and business. In the first year after the introduction these policies have resulted in a 10 - 20 % reduction of acute coronary events. In Switzerland smoke free regulations have been accepted by popular vote first in the canton of Ticino in 2006 and since then in 15 more cantons. The smoking rate dropped from 33 to 27 % since 2001.

The moderating role of parental smoking on their children's attitudes toward smoking among a predominantly minority sample: a cross-sectional analysis.

PubMed

Wilkinson, Anna V; Shete, Sanjay; Prokhorov, Alexander V

2008-07-14

In general having a parent who smokes or smoked is a strong and consistent predictor of smoking initiation among their children while authoritative parenting style, open communication that demonstrates mutual respect between child and parent, and parental expectations not to smoke are protective. It has been hypothesized that parental smoking affects their children's smoking initiation through both imitation of the behavior and effects on attitudes toward smoking. The goals of the current analysis were to examine these two potential mechanisms. In 2003, 1,417 high school students in Houston, Texas, completed a cross-sectional survey as part of the evaluation of an interactive smoking prevention and cessation program delivered via CD-ROM. To assess the relationship between number of parents who currently smoke and children's smoking status, we completed an unconditional logistic regression. To determine whether the attitudes that children of smokers hold toward smoking are significantly more positive than the attitudes of children of non-smokers we examined whether the parents smoking status moderated the relationship between children's attitudes toward smoking and their ever smoking using unconditional logistic regressions. Compared to participants whose parents did not currently smoke, participants who reported one or both parents currently smoke, had increased odds of ever smoking (OR = 1.31; 95% CI: 1.03-1.68; Wald chi2 = 4.78 (df = 1) p = 0.03 and OR = 2.16; 95% CI: 1.51-3.10; Wald chi2 = 17.80 (df = 1) p < 0.001, respectively). In addition, the relationship between attitudes and ever smoking was stronger among participants when at least one parent currently smokes (OR = 2.50; 95% CI: 1.96-3.19; Wald chi2 = 54.71 (df = 1) p < 0.001) than among participants whose parents did not smoke (OR = 1.72; 95% CI: 1.40-2.12; Wald chi2 = 26.45 (df = 1) p < 0.001). Children of smokers were more likely to smoke and reported more favorable attitudes toward smoking compared to children of non-smokers. One interpretation of our findings is that parental smoking not only directly influences behavior; it also moderates their children's attitudes towards smoking and thereby impacts their children's behavior. Our results demonstrate a continued need for primary prevention smoking interventions to be sensitive to the family context. They also underscore the importance of discussing parental smoking as a risk factor for smoking initiation, regardless of ethnicity, and of tailoring prevention messages to account for the influence that parental smoking status may have on the smoking attitudes and the associated normative beliefs.

The moderating role of parental smoking on their children's attitudes toward smoking among a predominantly minority sample: a cross-sectional analysis

PubMed Central

Wilkinson, Anna V; Shete, Sanjay; Prokhorov, Alexander V

2008-01-01

Background In general having a parent who smokes or smoked is a strong and consistent predictor of smoking initiation among their children while authoritative parenting style, open communication that demonstrates mutual respect between child and parent, and parental expectations not to smoke are protective. It has been hypothesized that parental smoking affects their children's smoking initiation through both imitation of the behavior and effects on attitudes toward smoking. The goals of the current analysis were to examine these two potential mechanisms. Methods In 2003, 1,417 high school students in Houston, Texas, completed a cross-sectional survey as part of the evaluation of an interactive smoking prevention and cessation program delivered via CD-ROM. To assess the relationship between number of parents who currently smoke and children's smoking status, we completed an unconditional logistic regression. To determine whether the attitudes that children of smokers hold toward smoking are significantly more positive than the attitudes of children of non-smokers we examined whether the parents smoking status moderated the relationship between children's attitudes toward smoking and their ever smoking using unconditional logistic regressions. Results Compared to participants whose parents did not currently smoke, participants who reported one or both parents currently smoke, had increased odds of ever smoking (OR = 1.31; 95% CI: 1.03–1.68; Wald χ2 = 4.78 (df = 1) p = 0.03 and OR = 2.16; 95% CI: 1.51–3.10; Wald χ2 = 17.80 (df = 1) p < 0.001, respectively). In addition, the relationship between attitudes and ever smoking was stronger among participants when at least one parent currently smokes (OR = 2.50; 95% CI: 1.96–3.19; Wald χ2 = 54.71 (df = 1) p < 0.001) than among participants whose parents did not smoke (OR = 1.72; 95% CI: 1.40–2.12; Wald χ2 = 26.45 (df = 1) p < 0.001). Conclusion Children of smokers were more likely to smoke and reported more favorable attitudes toward smoking compared to children of non-smokers. One interpretation of our findings is that parental smoking not only directly influences behavior; it also moderates their children's attitudes towards smoking and thereby impacts their children's behavior. Our results demonstrate a continued need for primary prevention smoking interventions to be sensitive to the family context. They also underscore the importance of discussing parental smoking as a risk factor for smoking initiation, regardless of ethnicity, and of tailoring prevention messages to account for the influence that parental smoking status may have on the smoking attitudes and the associated normative beliefs. PMID:18625061

Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking.

PubMed

Rasmussen, Line D; Helleberg, Marie; May, Margaret T; Afzal, Shoaib; Kronborg, Gitte; Larsen, Carsten S; Pedersen, Court; Gerstoft, Jan; Nordestgaard, Børge G; Obel, Niels

2015-05-01

Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial. From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population-attributable fractions (PAF) of MI associated with smoking. In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75-4.24 and aIRR, 2.83; 95% CI, 1.71-4.70). The PAF associated with ever smoking (previous or current) was 72% (95% CI, 55%-82%) for HIV-infected individuals and 24% (95% CI, 3%-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI, 21%-57%) and 21% (95% CI, 12%-28%) of all MIs could potentially be avoided in these 2 populations. Smoking is associated with a higher risk of MI in the HIV-infected population than in the general population. Approximately 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared with only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals, and smoking cessation should be a primary focus in modern HIV care. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Evaluation of Smoking Status Identification Using Electronic Health Records and Open-Text Information in a Large Mental Health Case Register

PubMed Central

Wu, Chia-Yi; Chang, Chin-Kuo; Robson, Debbie; Jackson, Richard; Chen, Shaw-Ji; Hayes, Richard D.; Stewart, Robert

2013-01-01

Background High smoking prevalence is a major public health concern for people with mental disorders. Improved monitoring could be facilitated through electronic health record (EHR) databases. We evaluated whether EHR information held in structured fields might be usefully supplemented by open-text information. The prevalence and correlates of EHR-derived current smoking in people with severe mental illness were also investigated. Methods All cases had been referred to a secondary mental health service between 2008-2011 and received a diagnosis of schizophreniform or bipolar disorder. The study focused on those aged over 15 years who had received active care from the mental health service for at least a year (N=1,555). The ‘CRIS-IE-Smoking’ application used General Architecture for Text Engineering (GATE) natural language processing software to extract smoking status information from open-text fields. A combination of CRIS-IE-Smoking with data from structured fields was evaluated for coverage and the prevalence and demographic correlates of current smoking were analysed. Results Proportions of patients with recorded smoking status increased from 11.6% to 64.0% through supplementing structured fields with CRIS-IE-Smoking data. The prevalence of current smoking was 59.6% in these 995 cases for whom this information was available. After adjustment, younger age (below 65 years), male sex, and non-cohabiting status were associated with current smoking status. Conclusions A natural language processing application substantially improved routine EHR data on smoking status above structured fields alone and could thus be helpful in improving monitoring of this lifestyle behaviour. However, limited information on smoking status remained a challenge. PMID:24069288

E-cigarettes and National Adolescent Cigarette Use: 2004-2014.

PubMed

Dutra, Lauren M; Glantz, Stanton A

2017-02-01

E-cigarette use is rapidly increasing among adolescents in the United States, with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007. Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004-2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004-2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011-2014 samples. Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette-only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers. The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette-only users would be unlikely to have initiated tobacco product use with cigarettes. Copyright © 2017 by the American Academy of Pediatrics.

E-cigarettes and National Adolescent Cigarette Use: 2004–2014

PubMed Central

Dutra, Lauren M.

2017-01-01

BACKGROUND: E-cigarette use is rapidly increasing among adolescents in the United States, with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007. METHODS: Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004–2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004–2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011–2014 samples. RESULTS: Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette–only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers. CONCLUSIONS: The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette–only users would be unlikely to have initiated tobacco product use with cigarettes. PMID:28115540

Age at smoking initiation and self-rated health among second grade high school boys and girls in Scania, Sweden, a cross-sectional study.

PubMed

Hansen, Kristina; Lindström, Martin; Rosvall, Maria

2015-11-18

Smoking is usually initiated early in life and most adult regular smokers have started smoking before 18 years of age. A younger age at smoking initiation is associated with risk taking behaviours and worse health outcomes regarding psychological and somatic conditions, suggested to be caused by exposure during critical developmental periods. The present study aims to investigate self-rated health among second grade high school boys and girls related to age at smoking initiation (<14 years of age and ≥ 14 years of age) among current and former smokers, compared to never smokers. Data was derived from the Scania public health survey among children and adolescents in 2012. The study was cross-sectional with retrospective information about first time cigarette smoking experiences among 3245 boys and 3434 girls in second grade of high school. Self-rated health was assessed with the question "How do you rate your general health". Associations of age at smoking initiation, current smoking status and poor self-rated health were investigated with logistic regression models. Crude odds ratios of poor self-rated health were increased for all smoking groups compared to never smokers. Former smoking boys and currently smoking girls with early smoking initiation had the highest odds ratios of poor self-rated health, with odds ratios (OR) 2.4 (95 % confidence interval (CI): 1.5-3.7) and OR 2.9 (95 % CI: 2.3-3.6), respectively. After adjustments for sociodemographic factors, health-related behaviours, psychosocial factors, weight and functional disabilities, the results were attenuated, but remained statistically significant regarding former and current smoking boys with early smoking initiation, OR 2.0 (95 % CI: 1.1-3.7) and OR 1.7 (95 % CI: 1.1-2.4) and for current smoking girls with early and later smoking initiation, OR 2.1 (95 % CI: 1.5-2.8) and OR 1.5 (95 % CI: 1.1-2.0). Boys and girls in second grade of high school with early smoking initiation reported poorer self-rated health than later initiators and never smokers. Poorer self-rated health persisted also after smoking cessation among early initiating boys. Further studies are needed to understand the adverse health effects associated with timing of smoking initiation.

A longitudinal study of the reciprocal relationship between ever smoking and urgency in early adolescence.

PubMed

Burris, Jessica L; Riley, Elizabeth; Puleo, Gabriella E; Smith, Gregory T

2017-09-01

Among early adolescents in the United States (U.S.), the prevalence of cigarette smoking is at its lowest level in recent decades. Nonetheless, given the risks of smoking in early development, it remains critically important to study both risk factors for smoking and risks from smoking. This longitudinal study with U.S. early adolescents examines smoking initiation and tests a model of reciprocal prediction between ever smoking and the personality trait of urgency (i.e., mood-based impulsivity), a trait that increases risk for multiple forms of dysfunction. Participants (n=1906; 90% 10-11 years old, 50% female, 39% racial minorities at baseline) completed questionnaires 1-2 times per year starting in 5th grade and ending in 9th grade. Structural equation modeling allowed tests of bidirectional relationships between ever smoking and urgency controlling for pubertal status and negative affect at each wave. Incidence of ever smoking increased from 5% to 27% over time, with current smoking around 5% at the last wave. Urgency at each wave predicted ever smoking at the next wave above and beyond covariates and prior smoking (all p<0.01). Likewise, with one exception, ever smoking predicted an increase in urgency at the subsequent wave above and beyond covariates and prior urgency (all p<0.05). Results show that risk for smoking increases with higher levels of urgency and urgency increases secondary to engagement in smoking. Future work should therefore explore urgency as a point of prevention for smoking and smoking cessation as a means to mitigate mood-based impulsivity. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of a short anti-smoking awareness programme on the knowledge, attitude and practice of cigarette smoking among secondary school students in Lagos state, Nigeria.

PubMed

Odukoya, O O; Odeyemi, K A; Oyeyemi, A S; Upadhyay, R P

2014-06-01

This study aimed to assess the effect of a short school-based anti-smoking program on the knowledge, attitude and practice of cigarette smoking among students in secondary schools in Lagos State. A non-randomized, controlled intervention study was done among respondents selected using multi-stage sampling. Baseline data was collected using self-administered questionnaires. An anti-smoking awareness programme was carried out among students in the intervention group using health talks, information leaflets and posters. Post-intervention data collection took place three months later. There were significant increments in the mean knowledge and attitude scores after the intervention. There was however no statistically significant change in the current smoking habits of respondents (4% vs. 3%; p=0.41)in the intervention group. Nevertheless, in the intervention group, the number of never- smokers who reported that they were likely to initiate cigarette smoking within the next year significantly reduced. There was also a significant increase in the proportion of current smokers who desired to quit smoking. Even brief anti-smoking programs of this nature are effective at improving the knowledge and modifying the attitude of the respondents but do not improve smoking habits. It however motivated the desire to quit among current smokers. Health education sessions and periodic anti-smoking programmes should be introduced into the secondary school curriculum. More intensive approaches may be needed to influence the smoking behaviour of adolescent smokers.

Trends in Home Smoking Bans in the U.S., 1995–2007: Prevalence, Discrepancies, and Disparities

PubMed Central

Zhang, Xiao; Martinez-Donate, Ana P.; Kuo, Daphne; Jones, Nathan R.; Palmersheim, Karen A.

2017-01-01

Background Home smoking bans significantly reduce the likelihood of secondhand smoke exposure among children and non-smoking adults. The purpose of this study was to examine national trends in a) the adoption of home smoking bans; b) discrepancies in parental smoking ban reports; and c) household and parental correlates of home smoking bans among households with underage children from 1995 to 2007. Methods We used data from the 1995/1996, 1998/1999, 2001/2002, 2003 and 2006/2007 Tobacco Use Supplement of the U.S. Current Population Survey to estimate prevalence rates and logistic regression models of parental smoking ban reports by survey period. Results Overall, the prevalence of a complete home smoking bans increased from 58.1% to 83.8% (p<0.01), while discrepancies in parental reports decreased from 12.5% to 4.6% (p<0.01) from 1995 to 2007. Households with single parent, low income, one or two current smokers, parents with less than a college education, or without infants were consistently less likely to report a home smoking ban over this period (p<0.05). Conclusion Despite general improvements in the adoption of home smoking bans and a reduction on parental discrepancies, disparities in the level of protection from secondhand smoke have persisted over time. Children living in households with single parents, low income, current smoker parents, less educated parents, or without infants are less likely to be protected by a home smoking ban. These groups are in need of interventions promoting the adoption of home smoking bans to reduce disparities in tobacco-related diseases. PMID:21813487

Pulse carboxyhemoglobin-oximetry and cigarette smoking.

PubMed

Sokolova-Djokić, L; Milosević, S; Skrbić, R; Salabat, R; Voronov, G; Igić, R

2011-01-01

We used a pulse carbon monoxide (CO)-oximeter to measure the levels of carboxyhemoglobin (COHb) in smokers and non-smokers. Our goal was to determine if this device could not only define smoking status, but also to increase accuracy of self-reported data at various surveys on smoking. Thirty-four healthy volunteers participated in this study. Twenty-two of them were current daily smokers; 12 participants were non-smokers who lived alone or with a nonsmoker, and who worked in non-smoking environment. Nicotine dependency level was determined by the modified Fagerstrom questionnaire. Blood COHb levels were measured with a pulse CO-oximeter (Masimo, Radical 7). The COHb levels in both moderate/heavy smokers and light smokers increased significantly after they smoked a single cigarette. This increase persisted for more than 6 h in the moderate/heavy smokers, while in the light smokers COHb levels returned to the baseline level after one hour. The pulse rate of all smokers increased significantly 20 min after smoking. We conclude that the CO-oximeter can detect smoking by moderate/heavy smokers and light smokers if they smoked 6 h or 20 min earlier, respectively. We concluded that it could be used as a validation test for smoking at the time of admission to the surgical facility and to increase smoking abstinence during preoperative and postoperative periods. This noninvasive, simple and inexpensive test may also be used at various surveys to increase accuracy of self-reports on smoking.

Smoking and subsequent human papillomavirus infection: a mediation analysis.

PubMed

Eldridge, Ronald C; Pawlita, Michael; Wilson, Lauren; Castle, Philip E; Waterboer, Tim; Gravitt, Patti E; Schiffman, Mark; Wentzensen, Nicolas

2017-11-01

Smoking is an established risk factor for a human papillomavirus (HPV) infection advancing to cervical precancer and cancer, but its role earlier in the natural history is less clear. Smoking is inversely associated with possessing HPV antibodies from a past infection suggesting that smoking may influence acquiring subsequent infections. In a cohort of 1976 U.S. women, we evaluate whether reduced antibodies to HPV-16 is a mechanism for smoking's role on acquiring a subsequent HPV-16 infection, through the analytic technique of causal mediation analysis. We posit a causal model and estimate two counterfactually defined effects: a smoking impaired antibody-mediated indirect effect and a nonmediated direct effect representing all other potential mechanisms of smoking. Compared to never smokers, current smokers had increased odds of HPV-16 infection by the antibody-mediated indirect effect (odds ratio [OR] = 1.29; 95% confidence interval [CI]: 1.11, 1.73); the estimated direct effect was very imprecise (OR = 0.57; 95% CI, 0.26-1.13). We observed a stronger estimated indirect effect among women who smoked at least half a pack of cigarettes daily (OR = 1.61, 95% CI, 1.27-2.15) than among women who smoked less than that threshold (OR = 1.09; 95% CI, 0.94-1.44). This is the first study to directly test the mechanism underlying smoking as an HPV cofactor. The results support current smoking as a risk factor earlier in the natural history of HPV and are consistent with the hypothesis that smoking increases the risk of a subsequent infection by reducing immunity. Published by Elsevier Inc.

Association between tobacco use and the upper gastrointestinal microbiome among Chinese men.

PubMed

Vogtmann, Emily; Flores, Roberto; Yu, Guoqin; Freedman, Neal D; Shi, Jianxin; Gail, Mitchell H; Dye, Bruce A; Wang, Guo-Qing; Klepac-Ceraj, Vanja; Paster, Bruce J; Wei, Wen-Qiang; Guo, Hui-Qin; Dawsey, Sanford M; Qiao, You-Lin; Abnet, Christian C

2015-04-01

Tobacco causes many adverse health conditions and may alter the upper gastrointestinal (UGI) microbiome. However, the few studies that studied the association between tobacco use and the microbiome were small and underpowered. Therefore, we investigated the association between tobacco use and the UGI microbiome in Chinese men. We included 278 men who underwent esophageal cancer screening in Henan Province, China. Men were categorized as current, former, or never smokers from questionnaire data. UGI tract bacterial cells were characterized using the Human Oral Microbial Identification Microarray. Counts of unique bacterial species and genera estimated alpha diversity. For beta diversity, principal coordinate (PCoA) vectors were generated from an unweighted UniFrac distance matrix. Polytomous logistic regression models were used for most analyses. Of the 278 men in this study, 46.8% were current smokers and 12.6% were former smokers. Current smokers tended to have increased alpha diversity (mean 42.3 species) compared to never smokers (mean 38.9 species). For a 10 species increase, the odds ratio (OR) for current smoking was 1.29 (95% CI 1.04-1.62). Beta diversity was also associated with current smoking. The first two PCoA vectors were strongly associated with current smoking (PCoA1 OR 0.66; 95% CI 0.51-0.87; PCoA2 OR 0.73; 95% CI 0.56-0.95). Furthermore, Dialister invisus and Megasphaera micronuciformis were more commonly detected in current smokers than in never smokers. Current smoking was associated with both alpha and beta diversity in the UGI tract. Future work should consider how the UGI microbiome is associated with smoking-related diseases.

Effects of wages on smoking decisions of current and past smokers.

PubMed

Du, Juan; Leigh, J Paul

2015-08-01

We used longitudinal data and instrumental variables (IVs) in a prospective design to test for the causal effects of wages on smoking prevalence among current and past smokers. Nationally representative U.S. data were drawn from the 1999-2009 waves of the Panel Study of Income Dynamics. Our overall sample was restricted to full time employed persons, aged 21-65 years. We excluded part time workers and youths because smoking and wage correlations would be complicated by labor supply decisions. We excluded adult never smokers because people rarely begin smoking after the age of 20 years. IVs were created with state-level minimum wages and unionization rates. We analyzed subsamples of men, women, the less educated, the more educated, quitters, and backsliders. Validity and strength of instruments within the IV analysis were conducted with the Sargan-Hansen J statistic and F tests. We found some evidence that low wages lead to more smoking in the overall sample and substantial evidence for men, persons with high school educations or less (<13 years of schooling), and quitters. Results indicated that 10% increases in wages lead to 5.5 and 4.6 percentage point decreases in smoking for men and the less educated; they also increased the average chance of quitting among base-year smokers from 17.0% to 20.4%. Statistical tests suggested that IVs were strong and valid in most samples. Subjects' other family income, including spouses' wages, was entered as a control variable. Increases in an individual's wages, independent of other income, decreased the prevalence of smoking among current and past smokers. Copyright © 2015 Elsevier Inc. All rights reserved.

The impact of passive and active smoking on inflammation, lipid profile and the risk of myocardial infarction.

PubMed

Attard, Ritienne; Dingli, Philip; Doggen, Carine J M; Cassar, Karen; Farrugia, Rosienne; Wettinger, Stephanie Bezzina

2017-01-01

To investigate the effect of passive smoking, active smoking and smoking cessation on inflammation, lipid profile and the risk of myocardial infarction (MI). A total of 423 cases with a first MI and 465 population controls from the Maltese Acute Myocardial Infarction (MAMI) Study were analysed. Data were collected through an interviewer-led questionnaire, and morning fasting blood samples were obtained. ORs adjusted for the conventional risk factors of MI (aORs) were calculated as an estimate of the relative risk of MI. The influence of smoking on biochemical parameters was determined among controls. Current smokers had a 2.7-fold (95% CI 1.7 to 4.2) and ex-smokers a 1.6-fold (95% CI 1.0 to 2.4) increased risk of MI. Risk increased with increasing pack-years and was accompanied by an increase in high-sensitivity C reactive protein levels and an abnormal lipid profile. Smoking cessation was associated with lower triglyceride levels. Exposure to passive smoking increased the risk of MI (aOR 3.2 (95% CI 1.7 to 6.3)), with the OR being higher for individuals exposed to passive smoking in a home rather than in a public setting (aOR 2.0 (95% CI 0.7 to 5.6) vs aOR 1.2 (95% CI 0.7 to 2.0)). Passive smoke exposure was associated with higher levels of total cholesterol, triglycerides and total cholesterol:high-density lipoprotein cholesterol ratio compared with individuals not exposed to passive smoking. Both active and passive smoking are strong risk factors for MI. This risk increased with increasing pack-years and decreased with smoking cessation. Such effects may be partly mediated through the influence of smoking on inflammation and lipid metabolism.

Smoking and Inflammatory Bowel Disease: A Comparison of China, India, and the USA.

PubMed

Wang, Peiqi; Hu, Jun; Ghadermarzi, Shadi; Raza, Ali; O'Connell, Douglas; Xiao, Amy; Ayyaz, Faraz; Zhi, Min; Zhang, Yuanqi; Parekh, Nimisha K; Lazarev, Mark; Parian, Alyssa; Brant, Steven R; Bedine, Marshall; Truta, Brindusa; Hu, Pinjin; Banerjee, Rupa; Hutfless, Susan M

2018-06-04

Cigarette smoking is thought to increase the risk of Crohn's disease (CD) and exacerbate the disease course, with opposite roles in ulcerative colitis (UC). However, these findings are from Western populations, and the association between smoking and inflammatory bowel disease (IBD) has not been well studied in Asia. We aimed to compare the prevalence of smoking at diagnosis between IBD cases and controls recruited in China, India, and the USA, and to investigate the impact of smoking on disease outcomes. We recruited IBD cases and controls between 2014 and 2018. All participants completed a questionnaire about demographic characteristics, environmental risk factors and IBD history. We recruited 337 participants from China, 194 from India, and 645 from the USA. In China, CD cases were less likely than controls to be current smokers (adjusted odds ratio [95% CI] 0.4 [0.2-0.9]). There was no association between current or former smoking and CD in the USA. In China and the USA, UC cases were more likely to be former smokers than controls (China 14.6 [3.3-64.8]; USA 1.8 [1.0-3.3]). In India, both CD and UC had similar current smoking status to controls at diagnosis. Current smoking at diagnosis was significantly associated with greater use of immunosuppressants (4.4 [1.1-18.1]) in CD cases in China. We found heterogeneity in the associations of smoking and IBD risk and outcomes between China, India, and the USA. Further study with more adequate sample size and more uniform definition of smoking status is warranted.

Selective attention to smoking cues in former smokers.

PubMed

Rehme, Anne K; Bey, Katharina; Frommann, Ingo; Mogg, Karin; Bradley, Brendan P; Bludau, Julia; Block, Verena; Sträter, Birgitta; Schütz, Christian G; Wagner, Michael

2018-02-01

Repeated drug use modifies the emotional and cognitive processing of drug-associated cues. These changes are supposed to persist even after prolonged abstinence. Several studies demonstrated that smoking cues selectively attract the attention of smokers, but empirical evidence for such an attentional bias among successful quitters is inconclusive. Here, we investigated whether attentional biases persist after smoking cessation. Thirty-eight former smokers, 34 current smokers, and 29 non-smokers participated in a single experimental session. We used three measures of attentional bias for smoking stimuli: A visual probe task with short (500ms) and long (2000ms) picture stimulus durations, and a modified Stroop task with smoking-related and neutral words. Former smokers and current smokers, as compared to non-smokers, showed an attentional bias in visual orienting to smoking pictures in the 500ms condition of the visual probe task. The Stroop interference index of smoking words was negatively related to nicotine dependence in current smokers. Former smokers and mildly dependent smokers, as compared to non-smokers, showed increased interference by smoking words in the Stroop task. Neither current nor former smokers showed an attentional bias in maintained attention (2000ms visual probe task). In conclusion, even after prolonged abstinence smoking cues retain incentive salience in former smokers, who differed from non-smokers on two attentional bias indices. Attentional biases in former smokers operate mainly in early involuntary rather than in controlled processing, and may represent a vulnerability factor for relapse. Therefore, smoking cessation programs should strengthen self-control abilities to prevent relapses. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

The Prevalence, Attitudes, and Correlates of Waterpipe Smoking Among High School Students in Iran: a Cross-Sectional Study.

PubMed

Ziaei, Reza; Mohammadi, Reza; Dastgiri, Saeed; Viitasara, Eija; Rahimi, Vahab Asl; Jeddi, Abolfazl; Soares, Joaquim

2016-12-01

The purpose of the present study was to determine the correlates of waterpipe (WP) smoking among 15-17-year-old high school students in Iran. Data were collected using the Global Youth Tobacco Survey (GYTS), a self-administrated questionnaire distributed to a representative sample of high school students aged 15-17 in the city of Tabriz. Current WP smoking was defined as past 30-day use, and ever WP smoking was defined as at least one or two lifetime puffs. Differences in WP use, knowledge, and attitudes were analyzed using chi-square and Fisher exact tests. Binary logistic regression estimated the association between relevant independent variables (e.g., age) and the dependent variables (current/ever WP smoking). Of 1517 students, 21.6 % (95 % confidence interval [CI] = 19.5, 23.8) were ever WP smokers, and 9.7 % (95 % CI = 8.2, 11.2) were current WP smokers. Of current WP smokers, 40.3 % have stated that they want to stop smoking now. Moreover, 14.1 % of non-WP smokers reported that they might enjoy smoking WP. Of current WP smokers, 49.0 % have smoked at cafés. Additionally, 95.3 % of current WP smokers reported that their age did not prevent them from being served a WP. Studying in high school third grade (adjusted odds ratios (AORs) = 1.70; 95 % CI [1.10, 2.63]), experience of cigarette smoking (AORs = 1.57; 95 % CI [1.12, 2.20]), and being prepared to accept a WP offered by close friends (AORs = 3.31; 95 % CI [2.17, 5.04]) were independently associated with ever WP smoking, and accepting a WP offered by close friends (AORs = 4.36; 95 % CI [2.69, 7.07]) and gender (female) (AORs = 0.45; 95 % CI [0.30, 0.70] were independently associated with current WP smoking. Prevalence of current and ever WP smoking is high in Tabriz. There is an urgent need to design interventions in order to increase students' and their parents' awareness regarding the harmfulness of WP, and to establish legal measures to restrict adolescents' access to WPs and tobacco in society.

Effects of the nicotinic receptor antagonist mecamylamine on ad-lib smoking behavior, topography, and nicotine levels in smokers with and without schizophrenia: a preliminary study.

PubMed

McKee, Sherry A; Weinberger, Andrea H; Harrison, Emily L R; Coppola, Sabrina; George, Tony P

2009-12-01

Individuals with schizophrenia have higher plasma nicotine levels in comparison to non-psychiatric smokers, even when differences in smoking are equated. This difference may be related to how intensely cigarettes are smoked but this has not been well studied. Mecamylamine (MEC), a non-competitive nicotinic acetylcholine receptor (nAChR) antagonist, which has been shown to increase ad-lib smoking and to affect smoking topography, was used in the current study as a pharmacological probe to increase our understanding of smoking behavior, smoking topography, and resulting nicotine levels in smokers with schizophrenia. This preliminary study used a within-subject, placebo-controlled design in smokers with schizophrenia (n=6) and healthy control smokers (n=8) to examine the effects of MEC (10mg/day) on ad-lib smoking behavior, topography, nicotine levels, and tobacco craving across two smoking deprivation conditions (no deprivation and 12-h deprivation). MEC, compared to placebo, increased the number of cigarettes smoked and plasma nicotine levels. MEC increased smoking intensity and resulted in greater plasma nicotine levels in smokers with schizophrenia compared to controls, although these results were not consistent across deprivation conditions. MEC also increased tobacco craving in smokers with schizophrenia but not in control smokers. Our results suggest that antagonism of high-affinity nAChRs in smokers with schizophrenia may prompt compensatory smoking, increasing the intensity of smoking and nicotine exposure without alleviating craving. Further work is needed to assess whether nicotine levels are directly mediated by how intensely the cigarettes are smoked, and to confirm whether this effect is more pronounced in smokers with schizophrenia.

Effects of cumulative stress and impulsivity on smoking status.

PubMed

Ansell, Emily B; Gu, Peihua; Tuit, Keri; Sinha, Rajita

2012-03-01

The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research. We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity. Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors. Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity. Copyright © 2012 John Wiley & Sons, Ltd.

Effects of cumulative stress and impulsivity on smoking status

PubMed Central

Ansell, Emily B.; Gu, Peihua; Tuit, Keri; Sinha, Rajita

2013-01-01

Objective The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research. Methods We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity. Results Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors. Conclusions Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity. PMID:22389084

Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis: a cross-sectional analysis of US veterans.

PubMed

Sokolove, Jeremy; Wagner, Catriona A; Lahey, Lauren J; Sayles, Harlan; Duryee, Michael J; Reimold, Andreas M; Kerr, Gail; Robinson, William H; Cannon, Grant W; Thiele, Geoffrey M; Mikuls, Ted R

2016-11-01

Cigarette smoking is a major risk factor for RA and has been associated with increased disease severity and lower rates of disease remission. We hypothesized that inflammation and disease activity would be associated with smoking status and this would be related to levels of ACPA. RA patients from the Veterans Affairs RA registry were studied (n = 1466): 76.9% anti-CCP2 positive, 89% male, median age 63 years (interquartile range 57-72), median disease duration 8.45 years (interquartile range 2.8-18). Baseline serum samples were evaluated for levels of anti-CCP2, RF, 19 distinct ACPAs and 17 cytokines. Smoking status at baseline was recorded as current, former or never. The association of smoking status with cytokines, autoantibodies and disease activity (DAS28) was evaluated. Among anti-CCP-positive RA patients, RA-associated cytokines (false-discovery rates q < 0.1%) and DAS28 (P < 0.01) were higher in current smokers compared with former or never smokers. DAS28 and cytokine levels were similar between former and never smokers. In contrast, ACPA concentrations were higher among both current and former smokers compared with never smokers, and levels of ACPA were not associated with DAS28 or cytokine levels. Among anti-CCP2-positive RA patients, current smoking status is associated with elevations in pro-inflammatory cytokines and increased RA disease activity. Similar levels of inflammation and disease activity among former and never smokers suggests that the detrimental effects of smoking could be ameliorated through tobacco cessation. The effect of tobacco cessation on RA disease activity should be evaluated prospectively. Published by Oxford University Press on behalf of the British Society for Rheumatology 2016. This work is written by US Government employees and is in the public domain in the United States.

Social cohesion and the smoking behaviors of adults living with children.

PubMed

Alcalá, Héctor E; Sharif, Mienah Z; Albert, Stephanie L

2016-02-01

The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR=0.92; 95% CI=0.85-0.99) and reduced odds of living in a household in which smoking is allowed (AOR=0.84; 95% CI=0.75-0.93), after controlling for sociodemographic characteristics. Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social Cohesion and the Smoking Behaviors of Adults Living with Children

PubMed Central

Sharif, Mienah Z.; Albert, Stephanie L.

2015-01-01

Introduction The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. Methods Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. Results Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR= 0.92; 95% CI= 0.85–0.99) and reduced odds of living in a household in which smoking is allowed (AOR= 0.84; 95% CI= 0.75–0.93), after controlling for sociodemographic characteristics. Conclusions Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults. PMID:26562680

Current and future avoidable cost of smoking--estimates for Sweden 2007.

PubMed

Bolin, Kristian; Borgman, Benny; Gip, Christina; Wilson, Koo

2011-11-01

To estimate current and future avoidable smoking-attributable costs in Sweden for the year 2007. Disease specific smoking-attributable proportions were calculated for Swedish smoking patterns and applied to estimate costs for smoking-related diseases based on data from public registers. Avoidable future effects of smoking were calculated employing a Markov simulation model. The estimated total cost in 2007 was USD 1.6 billion, or USD 181 per capita. Healthcare (direct) cost accounted for 30% of the total cost. The number of deaths was 97 per 100,000 inhabitants (79 in 2001); the number of years of potential life lost 1,227 per 100,000 inhabitants (1012 in 2001); and the number of years of potential productive life lost 226 (185 in 2001) per 100,000 inhabitants. Avoidable future lifetime costs, per 100,000 inhabitants, amounted to USD 19 million (healthcare), 14,000 years of potential life lost, corresponding to a present value of USD 158 million. Total avoidable cost of current smoking amounted to USD 16 billion. In spite of declining smoking-prevalence rates during the last 30 years, smoking-attributable deaths increased between 2001 and 2007. The number of life years lost per death decreased somewhat, indicating that the age distribution of those dying shifted further towards older age. Simulations indicate that smoking-cessation among young smokers yields considerable more benefits each year than smoking-cessation among older smokers. The health benefits that accrued in 2007, as a result of declining smoking prevalence since 1980, correspond to more than the total cost of smoking in that year. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The effect of successful and unsuccessful smoking cessation on short-term anxiety, depression, and suicidality

PubMed Central

Capron, Daniel W.; Allan, Nicholas P.; Norr, Aaron M.; Zvolensky, Michael J.; Schmidt, Norman B.

2014-01-01

Research on the mental health effects of quitting smoking is limited. Smokers with mental illness appear to be at a higher risk of unsuccessful smoking cessation. Recent work suggests they are at elevated risk for post-cessation increases in anxiety, depression and suicidal ideation. The current study tested the effects of successful and unsuccessful smoking cessation on short-term psychopathology in 192 community participants. Smoking cessation outcomes were classified using expired carbon monoxide levels that were taken at quit week, 1 and 2 week follow-up and 1 month follow-up. We found no psychopathology increases in participants who successfully quit smoking. For individuals struggling to quit our results partially supported a recently proposed struggling quitters hypothesis. However, the vast majority of individuals posited to be vulnerable by the struggling quitters hypothesis did not experience clinically significant increases in psychopathology. These findings have implications for clinicians whose clients are interested in smoking cessation. PMID:24457901

Smoking, cessation and expenditure in low income Chinese: cross sectional survey.

PubMed

Hesketh, Therese; Lu, Li; Jun, Ye Xue; Mei, Wang Hong

2007-03-04

This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day). Smoking was least common in migrant men (51%), compared with 58% of urban workers and 64% rural inhabitants (P < 0.0001). Forty-nine percent of rural males smoke more than 10 cigarettes/day, and 22% over 20/day. The prevalence of smoking increased with age. Overall 9% of the males had successfully quit smoking. Reasons for quitting were to prevent future illness (58%), current illness (31%), family pressures (20%) and financial considerations (20%). Thirteen percent of current smokers had ever tried to quit (cessation for at least one week) while 22% intended to quit, with migrants most likely to intend to quit. Almost all (96%) were aware that smoking was harmful to health, though only 25% were aware of the dangers of passive smoking. A mean of 11% of personal monthly income is spent on smoking rising to a mean of 15.4% in rural smokers. This expenditure was found to have major opportunity costs, including in terms of healthcare access. The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

Epidemiology of smoking in Ukraine, 2000.

PubMed

Gilmore, A B; McKee, M; Telishevska, M; Rose, R

2001-11-01

A clear, up-to-date picture of smoking prevalence and its determinants is needed to inform the development of an effective tobacco control policy in Ukraine, particularly given the way in which the tobacco industry has targeted post-Soviet countries since transition. A nationally representative household survey was undertaken in Ukraine in February 2000. Data were available on 1,590 individuals (response rate 72%). Fifty-seven percent of men and 10% of women were current smokers and an additional 21 and 7%, respectively, were ex-smokers. Smoking behavior has changed considerably over successive generations, with an increase in the proportion of women smoking and a reduction in the mean age at first smoking. Factors associated with smoking include young age, urban residence (among women), and material hardship, particularly unemployment. Involvement in social networks appears to reduce the probability of smoking. Smoking commonly occurs in public places and smokers differ from nonsmokers in their health beliefs about smoking. Levels of smoking among men are already high and among young women are increasing rapidly. Unless an effective tobacco policy response is developed to address the issues identified, tobacco will continue to make an increasingly large contribution to premature morbidity and mortality in Ukraine. Copyright 2001 American Health Foundation and Academic Press.

E-cigarette advertisements, and associations with the use of e-cigarettes and disapproval or quitting of smoking: Findings from the International Tobacco Control (ITC) Netherlands Survey.

PubMed

Nagelhout, Gera E; Heijndijk, Suzanne M; Cummings, K Michael; Willemsen, Marc C; van den Putte, Bas; Heckman, Bryan W; Hummel, Karin; de Vries, Hein; Hammond, David; Borland, Ron

2016-03-01

Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success. We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months. There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807). Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation. Copyright © 2015 Elsevier B.V. All rights reserved.

Prevalence and characteristics of narghile smoking among university students in Syria.

PubMed

Maziak, W; Fouad, F M; Asfar, T; Hammal, F; Bachir, E M; Rastam, S; Eissenberg, T; Ward, K D

2004-07-01

Narghile (waterpipe) smoking is increasing in all Arab societies, but little is known about its pattern of use. In 2003, a cross-sectional survey was conducted among students at Aleppo University using an interviewer-administered questionnaire. A representative sample of 587 students participated (278 males, 309 females; mean age 21.8 +/- 2.1 years; response rate 98.8%). Ever narghile smoking was seen among 62.6% of men and 29.8% of women, while current smoking was seen among 25.5% of men and 4.9% of women. Only 7.0% of the men used narghile daily. Age of initiation was 19.2 +/- 2.2 and 21.7 +/- 3.2 years for men and women, respectively (P < 0.001). The salient feature of narghile smoking was its social pattern, where most users initiated and currently smoked narghile with friends. Narghile and cigarette smoking were related among students, with narghile smoking most prevalent among daily cigarette smokers. Multivariate correlates of narghile smoking were being older, male, originating from the city, smoking cigarettes, having friends who smoke narghile, and coming from a household where a greater number of narghiles were smoked daily. Narghile smoking is prevalent among university students in Syria, where it is mainly practiced by men, intermittently, and in the context of social activities with friends.

Cigarette smoking decreases dynamic inspiratory capacity during maximal exercise in patients with type 2 diabetes.

PubMed

Kitahara, Yoshihiro; Hattori, Noboru; Yokoyama, Akihito; Yamane, Kiminori; Sekikawa, Kiyokazu; Inamizu, Tsutomu; Kohno, Nobuoki

2012-06-01

To investigate the influence of cigarette smoking on exercise capacity, respiratory responses and dynamic changes in lung volume during exercise in patients with type 2 diabetes. Forty-one men with type, 2 diabetes without cardiopulmonary disease were recruited and divided into 28 non-current smokers and 13 current smokers. All subjects received lung function tests and cardiopulmonary exercise testing using tracings of the flow-volume loop. Exercise capacity was compared using the percentage of predicted oxygen uptake at maximal workload (%VO2max). Respiratory variables and inspiratory capacity (IC) were compared between the two groups at rest and at 20%, 40%, 60%, 80% and 100% of maximum workload. Although there was no significant difference in lung function tests between the two groups, venous carboxyhemoglobin (CO-Hb) levels were significantly higher in current smokers. %VO2max was inversely correlated with CO-Hb levels. Changing patterns in respiratory rate, respiratory equivalent and IC were significantly different between the two groups. Current smokers had rapid breathing, a greater respiratory equivalent and a limited increase in IC during exercise. Cigarette smoking diminishes the increase in dynamic IC in patients with type 2 diabetes. As this effect of smoking on dynamic changes in lung volume will exacerbate dynamic hyperinflation in cases complicated by chronic obstructive pulmonary disease, physicians should consider smoking habits and lung function when evaluating exercise capacity in patients with type 2 diabetes.

Depression among current, former, and never smokers from 2005 to 2013: The hidden role of disparities in depression in the ongoing tobacco epidemic

PubMed Central

Goodwin, Renee D.; Wall, Melanie M.; Garey, Lorra; Zvolensky, Michael J.; Dierker, Lisa; Galea, Sandro; Gbedemah, Misato; Weinberger, Andrea H.; Williams, Jill M.; Hu, Mei-Chen; Hasin, Deborah S.

2017-01-01

BACKGROUND After declining for many years, the prevalence of smoking has remained stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers. OBJECTIVES To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income. METHODS Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics. RESULTS Depression appears to have significantly increased in the United States from 2005–2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12–17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19% to 7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as former and never smokers. DISCUSSION Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population. PMID:28209289

Depression among current, former, and never smokers from 2005 to 2013: The hidden role of disparities in depression in the ongoing tobacco epidemic.

PubMed

Goodwin, Renee D; Wall, Melanie M; Garey, Lorra; Zvolensky, Michael J; Dierker, Lisa; Galea, Sandro; Gbedemah, Misato; Weinberger, Andrea H; Williams, Jill M; Hu, Mei-Chen; Hasin, Deborah S

2017-04-01

After declining sharply for many years, the prevalence of smoking has remained fairly stable over the past decade. One possible explanation is that there has been an increase in the prevalence of barriers to cessation, like depression, among remaining smokers. To estimate changes in the prevalence of depression among current, former and never smokers in the United States (U.S.) population from 2005 to 2013 overall and by age, gender, and income. Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N=496,805). The prevalence of past 12-month depression was examined annually among current (past 12-month), former (not past 12-month), and lifetime non-smokers from 2005 to 2013. Data were re-analyzed stratified by age, gender, and household income, and adjusted for demographics. Depression appears to have significantly increased in the United States from 2005 to 2013 among current, former, and never smokers. Depression prevalence increased among current smokers overall, but the increase among former and never smokers was even more prominent. Striking temporal changes emerged by age, gender and income. Specifically, (1) depression increased significantly among current smokers aged 12-17 (from 16% to 22%, p-value=0.0002) and the prevalence was consistently more than twice as high as that of never smokers; (2) depression increased among male smokers (6.19%-7.82%, p-value=0.0099); (3) depression increased significantly among smokers in the highest income group (6.36% to 8.91%, p-value=0.0400). Throughout this period, the prevalence of depression among current smokers was consistently twice as high as among former and never smokers. Public health efforts aimed at decreasing the prevalence of smoking should take depression into account, a common and modifiable barrier whose treatment may help to increase successful smoking cessation. Future work is needed to disentangle the role of smoking and other factors that lead to increases in depression in the US population. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychological and Familial Factors of Depression in Relation to Adolescent Smoking Behavior

PubMed Central

Roohafza, Hamidreza; Omidi, Razieh; Alinia, Tahereh; Heidari, Kamal; Farshad, Marziyeh; Davari, Hossein; Abtin, Zahra; Shahriari, Ezat; Taslimi, Mahshid; Sadeghi, Masoumeh

2017-01-01

Background: Several common factors have been identified for smoking and depression. The The present study explores the relation of psychological and familial factors with depression, by student smoking behavior. Materials and Methods: A total of 5500 middle- and high-school students were selected in Isfahan province in 2010. A self-administered questionnaire collected data on background characteristics, smoking status, depression, and risk factors. Univariate analysis multiple logistic regressions were conducted to compare between depressed and nondepressed people by adolescent smoking status. Odds ratios and the corresponding 95% confidence intervals (CIs) were reported. Results: Fathers lower education attainment was accompanied adolescents higher depression prevalence. Parental smoking and sibling smoking increased the depression likelihood by 1.41 (95% CI: 1.18, 1.68) and 1.43 folds (95% CI: 1.04–1.94) for never-smokers. Positive attitude toward smoking increased the probability of depression by 1.18 among never-smokers. Never-smokers lacking refusal skill had 1.23 (1.03–1.47) higher chance of depression. A higher level of self-efficacy related to lower chance of depression. Taking risky behavior, increased the depression likelihood by 1.56 (95% CI: 1.29–1.89) in never-smokers, by 1.85 (95% CI: 1.37–2.44) in experimental smokers, and by 1.14 times (95% CI: 1.01–1.72) in current smokers. Family conflict increased depression chance by 2.25 times (95% CI: 1.89–2.66) in never-smokers, by 1.95 (95% CI: 1.46–2.61) in experimental smokers, and by 2.06 times (95% CI: 1.38–3.08) in current smokers. Conclusions: Targeting self-efficacy level, risky behavior, and family conflict can drop the comorbidity of smoking and depression simultaneously. This may help public health practitioners and policymakers to develop common strategies in reducing adolescents smoking and depression comorbidity. PMID:28217648

Healthy Migrant Effect on Smoking Behavior Among Asian Immigrants in the United States.

PubMed

Kuerban, Aliya

2016-02-01

Healthy migrant effect (HME) of immigrants has been evidenced in various heath aspects. However, few studies have explored the applicability of HME on Asian immigrants' health risk behavior-smoking. This study used three waves of Current Population Survey-Tobacco Use Supplement data, 1998-1999, 2005-2006, and 2010-2011, to compare the rates of being a current smoker among Asian immigrants and United States born citizens. Further, the odds ratios of gender, age, marital status, socioeconomic status, years of migration, and citizenship status on the likelihood of being a current smoker were examined. Across the three waves, Asian immigrants smoked at a much lower rate than their native-born counterparts. The gender gap of being a current smoker was much wider among Asian immigrants. The longer the Asian immigrants stayed in the United States, the more likely they were to become current smokers. These data confirmed the association of HME and Asian immigrants' smoking behavior, and also provided strong evidence of the importance of smoking prevention among Asian immigrants. This study also implied the possibility of a decline in the effectiveness of HME on Asian immigrants as the time they spent in the United States increased.

Smoking frequency among current college student smokers: distinguishing characteristics and factors related to readiness to quit smoking.

PubMed

Berg, Carla J; Ling, Pamela M; Hayes, Rashelle B; Berg, Erin; Nollen, Nikki; Nehl, Eric; Choi, Won S; Ahluwalia, Jasjit S

2012-02-01

Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1-5 days, 10.5% (n = 281) smoked 6-29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (β = 0.63, 95% CI 0.57-0.69) and more frequent other tobacco use (β = 0.04, 95% CI 0.02-0.05), drinking (β = 0.04, 95% CI 0.02-0.07) and binge drinking (β = 0.09, 95% CI 0.06-0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers.

Influence of cigarette smoking on thyroid gland--an update.

PubMed

Sawicka-Gutaj, Nadia; Gutaj, Paweł; Sowiński, Jerzy; Wender-Ożegowska, Ewa; Czarnywojtek, Agata; Brązert, Jacek; Ruchała, Marek

2014-01-01

Many studies have shown that cigarette smoking exerts multiple effects on the thyroid gland. Smoking seems to induce changes in thyroid function tests, like decrease in TSH and increase in thyroid hormones. However, these alterations are usually mild. In addition, tobacco smoking may also play a role in thyroid autoimmunity. Many studies have confirmed a significant influence of smoking on Graves' hyperthyroidism and particularly on Graves' orbitopathy. Here, smoking may increase the risk of disease development, may reduce the effectiveness of treatment, and eventually induce relapse. The role of smoking in Hashimoto's thyroiditis is not as well established as in Graves' disease. Nonetheless, lower prevalence of thyroglobulin antibodies, thyroperoxidase antibodies and hypothyroidism were found in smokers. These findings contrast with a study that reported increased risk of hypothyroidism in smokers with Hashimoto's thyroiditis. Moreover, cigarette smoking increases the incidence of multinodular goitre, especially in iodine-deficient areas. Some studies have examined cigarette smoking in relation to the risk of thyroid cancer. Interestingly, many of them have shown that smoking may reduce the risk of differentiated thyroid cancer. Furthermore, both active and passive smoking during pregnancy might modify maternal and foetal thyroid function. This review evaluates the current data concerning the influence of cigarette smoking on thyroid gland, including hormonal changes, autoimmunity and selected diseases. These findings, however, in our opinion, should be carefully evaluated and some of them are not totally evidence-based. Further studies are required to explain the effects of smoking upon thyroid pathophysiology.

Individual, Parental, and Environmental Correlates of Cigar, Cigarillo, and Little Cigar Use Among Middle School Adolescents.

PubMed

Trapl, Erika S; Yoder, Laura D; Frank, Jean L; Borawski, Elaine A; Sattar, Abdus

2016-05-01

Youth use of cigars, cigarillos, and little cigars (CCLC) is increasing. While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This study assessed whether smoking beliefs, parenting practices, and environmental exposures were associated with CCLC use among 7th to 8th grade youth in an urban, mid-Western city. The Cleveland Youth Risk Behavior Survey was conducted with 7th to 8th grade students in spring 2012. CCLC use was assessed by asking if students had smoked CCLC in the past 30 days. Covariates include self-reported gender, race, grade, acceptability of smoking, parental monitoring, hours of self-care, visits to corner stores, and current cigarette smoking. Bivariate and multivariate analyses were conducted to determine associations with current CCLC use. Overall, 14.3% of youth reported current CCLC use. Students reporting higher acceptability of smoking, lower parental monitoring, longer periods of self-care, more visits to corner stores and current cigarette smoking were more likely to report current CCLC use in both bivariate and multivariable logistic regression models. CCLC use is associated with multiple levels of influence, indicating that prevention of youth CCLC use must utilize a multilevel approach. Increased utilization of corner stores was associated with higher odds of CCLC use, and could indicate that youth stopping at corner stores may be exposed to increased tobacco retail advertising and tobacco products. The findings of this study have implications for FDA regulation to prevent CCLC initiation among youth. While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This is the first study that has examined the association between individual, family, and environmental characteristics and CCLC use. The results of this study illustrate that youth attitudes, perceived parenting practices, and environmental exposure are associated with adolescent CCLC use. This is important as the tobacco control community begins to identify strategies to prevent and reduce CCLC use. The findings of this study have clear implications for FDA regulation to prevent CCLC initiation among youth. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Individual and combined effects of multiple high-risk triggers on postcessation smoking urge and lapse.

PubMed

Lam, Cho Y; Businelle, Michael S; Aigner, Carrie J; McClure, Jennifer B; Cofta-Woerpel, Ludmila; Cinciripini, Paul M; Wetter, David W

2014-05-01

Negative affect, alcohol consumption, and presence of others smoking have consistently been implicated as risk factors for smoking lapse and relapse. What is not known, however, is how these factors work together to affect smoking outcomes. This paper uses ecological momentary assessment (EMA) collected during the first 7 days of a smoking cessation attempt to test the individual and combined effects of high-risk triggers on smoking urge and lapse. Participants were 300 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants completed EMA, which recorded negative affect, alcohol consumption, presence of others smoking, smoking urge, and smoking lapse, for 7 days starting on their quit date. Alcohol consumption, presence of others smoking, and negative affect were, independently and in combination, associated with increase in smoking urge and lapse. The results also found that the relationship between presence of others smoking and lapse and the relationship between negative affect and lapse were moderated by smoking urge. The current study found significant individual effects of alcohol consumption, presence of other smoking, and negative affect on smoking urge and lapse. Combing the triggers increased smoking urge and the risk for lapse to varying degrees, and the presence of all 3 triggers resulted in the highest urge and lapse risk.

Adult Current Smoking: Differences in Definitions and Prevalence Estimates—NHIS and NSDUH, 2008

PubMed Central

Ryan, Heather; Trosclair, Angela; Gfroerer, Joe

2012-01-01

Objectives. To compare prevalence estimates and assess issues related to the measurement of adult cigarette smoking in the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH). Methods. 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. The standard NHIS current smoking definition, which screens for lifetime smoking ≥100 cigarettes, was used. For NSDUH, both the standard current smoking definition, which does not screen, and a modified definition applying the NHIS current smoking definition (i.e., with screen) were used. Results. NSDUH consistently yielded higher current cigarette smoking estimates than NHIS and lower daily smoking estimates. However, with use of the modified NSDUH current smoking definition, a notable number of subpopulation estimates became comparable between surveys. Younger adults and racial/ethnic minorities were most impacted by the lifetime smoking screen, with Hispanics being the most sensitive to differences in smoking variable definitions among all subgroups. Conclusions. Differences in current cigarette smoking definitions appear to have a greater impact on smoking estimates in some sub-populations than others. Survey mode differences may also limit intersurvey comparisons and trend analyses. Investigators are cautioned to use data most appropriate for their specific research questions. PMID:22649464

Adult current smoking: differences in definitions and prevalence estimates--NHIS and NSDUH, 2008.

PubMed

Ryan, Heather; Trosclair, Angela; Gfroerer, Joe

2012-01-01

To compare prevalence estimates and assess issues related to the measurement of adult cigarette smoking in the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH). 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. The standard NHIS current smoking definition, which screens for lifetime smoking ≥100 cigarettes, was used. For NSDUH, both the standard current smoking definition, which does not screen, and a modified definition applying the NHIS current smoking definition (i.e., with screen) were used. NSDUH consistently yielded higher current cigarette smoking estimates than NHIS and lower daily smoking estimates. However, with use of the modified NSDUH current smoking definition, a notable number of subpopulation estimates became comparable between surveys. Younger adults and racial/ethnic minorities were most impacted by the lifetime smoking screen, with Hispanics being the most sensitive to differences in smoking variable definitions among all subgroups. Differences in current cigarette smoking definitions appear to have a greater impact on smoking estimates in some sub-populations than others. Survey mode differences may also limit intersurvey comparisons and trend analyses. Investigators are cautioned to use data most appropriate for their specific research questions.

Relationship of cotinine-verified and self-reported smoking status with metabolic syndrome in 116,094 Korean adults.

PubMed

Kim, Byung Jin; Han, Ji Min; Kang, Jung Gyu; Rhee, Eun Jung; Kim, Bum Soo; Kang, Jin Ho

No study has reported the relationship between cotinine-verified and self-reported smoking status with metabolic syndrome (MetS). This study was performed to evaluate the relationship between urinary cotinine-verified and self-reported smoking status with MetS and determine the effects of unobserved smokers on MetS in Korean adults. A total of 116,094 individuals (66,875 men and 49,219 women) with mean age of 36.7 ± 6.8 years included in Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013 who had urinary cotinine measurements were enrolled. Cotinine-verified current smoking was defined as urinary cotinine level of above 50 ng/mL. Unobserved smoking was defined as urinary cotinine level of above 50 ng/mL in self-reported never smokers. The overall prevalence rates of cotinine-verified current smokers and MetS were 22.9% and 10.5%, respectively. The misclassification rate to cotinine-verified current smokers among self-reported never smokers was 1.7%. A multivariate logistic regression model adjusted for variables with univariate relationship (model 1) showed that cotinine-verified current smokers significantly increased the odds ratio for MetS compared with cotinine-verified never smokers (odds ratio [95% confidence interval], 1.30 [1.23, 1.37]). Log-transformed cotinine levels were also associated with MetS (1.04 [1.03, 1.05]). However, the association was not significant in the previously mentioned model including the traditional 5 components of MetS (model 2). Unobserved smokers significantly increased the ORs for MetS in both model 1 (1.43 [1.23, 1.67]) and model 2 (1.57 [1.06, 2.33]). This study shows that unobserved smoking and cotinine-verified current smoking are associated with MetS but urinary cotinine could be 1 conditional factor that interacts with traditional MetS components. Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Modifying Risk Factors for Total Joint Arthroplasty: Strategies That Work Nicotine.

PubMed

Springer, Bryan D

2016-08-01

Smoking and nicotine use remain a major health care crisis in the United States. Although rates have dropped dramatically over the last 50 years, approximately 18% of the US adult population still smokes. The musculoskeletal effects of nicotine and other byproducts of smoking place patients at increased risk for perioperative complications including medical complication, wound healing problems, infection, and death. A comprehensive behavioral modification program with or without the use of nicotine replacement therapy has been shown to be most effective at smoking cessation around the time of planned surgery. Although literature suggests that smoking cessation 4-6 weeks before surgery can diminish risk, both current and former smokers are at increased risk for perioperative complications compared with those that have never smoked. Cotinine, a metabolite of nicotine, can be used to monitor smoking cessation before surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Life Course Exposure to Smoke and Early Menopause and Menopausal Transition

PubMed Central

Tawfik, Heba; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D.; Cirillo, Piera; Cohn, Barbara A.; Terry, Mary Beth

2015-01-01

Objective Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at menopausal transition. Using data from two U.S. birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal, childhood exposure to parental smoking and adult smoke exposure) with menopause status in 1,001 women aged 39 – 49 years at follow-up. Methods We used logistic regression analysis, adjusting for age at follow-up, to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and menopausal transition. Results The magnitudes of the associations for natural menopause were similar, but not statistically significant after adjustment for confounders for i) women with prenatal smoke exposure who did not smoke at adult follow-up (OR= 2.7 [95% CI 0.8, 9.4]) and ii) current adult smokers who were not exposed prenatally (OR= 2.8 [95% CI 0.9, 9.0]). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing natural menopause (adjusted OR=3.4 [95% CI 1.1, 10.3]) compared to women without smoke exposure in either time period. Only current smoking of long duration (>26 years) was associated with the timing of the menopausal transition. Conclusion Our data suggest that exposure to smoke both prenatally and around the time of menopause accelerates ovarian aging. PMID:25803667

Life course exposure to smoke and early menopause and menopausal transition.

PubMed

Tawfik, Hebatullah; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D; Cirillo, Piera; Cohn, Barbara A; Terry, Mary Beth

2015-10-01

Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis, and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at the menopausal transition. Using data from two US birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal exposure, childhood exposure to parental smoking, and adult smoke exposure) and menopause status in 1,001 women aged 39 to 49 years at follow-up. We used logistic regression analysis (adjusting for age at follow-up) to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and the menopausal transition. The magnitudes of the associations for natural menopause were similar but not statistically significant after adjustment for confounders among (i) women with prenatal smoke exposure who did not smoke on adult follow-up (OR, 2.7; 95% CI, 0.8-9.4) and (ii) current adult smokers who were not exposed prenatally (OR, 2.8; 95% CI, 0.9-9.0). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing earlier natural menopause (adjusted OR, 3.4; 95% CI, 1.1-10.3) compared with women without smoke exposure in either period. Only current smoking of long duration (>26 y) was associated with the timing of the menopausal transition. Our data suggest that exposure to smoke both prenatally and around the time of menopause accelerates ovarian aging.

Differential subjective responsiveness to a future cigarette price increase among South Korean youth smokers.

PubMed

Do, Young Kyung; Farooqui, Muhammad Assad

2012-02-01

While higher sensitivity to tobacco price increases among younger smokers as a group has been well recognized, little information is available on heterogeneity among youth smokers. This study examined differential responsiveness to an unspecified future cigarette price increase by smoking rate. This study used a subsample of 6,187 current youth smokers derived from the 2007 Korea Youth Health Survey, an annually repeated cross-sectional survey designed to monitor adolescent health behaviors in a large nationally representative sample of middle-school and high-school students in South Korea (N = 74,698). A generalized ordered logit model was estimated to examine independent associations of self-reported responses to an unspecified future cigarette price increase with smoking rate and time since smoking initiation, after controlling for other individual and family characteristics. Higher smoking rates and longer time since smoking initiation were associated with a greater likelihood to continue smoking despite a future cigarette price increase. When these two factors were accounted for in the model, other individual characteristics were not statistically significant. Among youth smokers in South Korea, higher smoking rates were associated with lower self-reported responsiveness to a future cigarette price increase. Tobacco tax increases help prevent youth smokers from progressing to advanced stages of smoking, while certain subgroups of youth smokers, especially with nicotine dependence, may still need other effective cessation interventions.

Weight Concerns and Use of Cigarettes and E-Cigarettes among Young Adults.

PubMed

Bennett, Brooke L; Pokhrel, Pallav

2018-05-28

Higher weight concerns have been associated with higher cigarette smoking, particularly among women, partly because smoking is perceived to limit appetite for food. E-cigarettes are increasingly used as an alternative to combustible cigarettes and are widely believed to be less harmful than cigarettes. Currently it is not known whether weight concerns are associated with e-cigarette use among young adults. In this study, we tested the association between weight concerns and cigarette and e-cigarette use and use susceptibility among young adults. Cross-sectional data were collected from college students (N = 470; M age = 20.9; SD = 2.1; 65% women). Results indicated that weight concerns were significantly associated with lifetime and current cigarette smoking status, current cigarette smoking frequency and cigarette use susceptibility (among never smokers), adjusting for demographics variables. Weight concerns were not associated with lifetime or current e-cigarette use status or e-cigarette use susceptibility, adjusting for demographics and cigarette use status. However, higher weight concerns were associated with higher frequency of current e-cigarette use, adjusting for demographic variables and current cigarette smoking frequency. These findings imply that even though weight concerns may not motivate e-cigarette use as strongly as cigarette use, weight concerns may influence higher intensity of e-cigarette use among users.

Smoking Status and the Five-Factor Model of Personality: Results of a Cross-Sectional Study Conducted in Poland.

PubMed

Buczkowski, Krzysztof; Basinska, Małgorzata A; Ratajska, Anna; Lewandowska, Katarzyna; Luszkiewicz, Dorota; Sieminska, Alicja

2017-01-27

Tobacco smoking is the single most important modifiable factor in increased morbidity and premature mortality. Numerous factors-including genetics, personality, and environment-affect the development and persistence of tobacco addiction, and knowledge regarding these factors could improve smoking cessation rates. This study compared personality traits between never, former, and current smokers, using the Five-Factor Model of Personality in a country with a turbulent smoking reduction process. : In this cross-sectional study, 909 Polish adults completed the Revised Neuroticism-Extraversion-Openness Personality Inventory. Our results showed that current smokers' scores for extraversion, one of the five global dimensions of personality, were higher relative to never smokers. Neuroticism, openness to experience, agreeableness, and conscientiousness did not differ significantly according to smoking status. Facet analysis, which described each dimension in detail, showed that current smokers' activity and excitement seeking (facets of extraversion) scores were higher relative to those of never and former smokers. In turn, current smokers' dutifulness and deliberation (facets of conscientiousness) scores were lower than those found in former and never smokers. Never smokers scored the highest in self-consciousness (a facet of neuroticism) and compliance (a component of agreeableness). The study conducted among Polish individuals showed variation in personality traits according to their smoking status; however, this variation differed from that reported in countries in which efforts to reduce smoking had begun earlier relative to Poland. Knowledge regarding personality traits could be useful in designing smoking prevention and cessation programs tailored to individuals' needs.

Smoking, alcohol consumption, and risks for biliary tract cancer and intrahepatic bile duct cancer.

PubMed

Makiuchi, Takeshi; Sobue, Tomotaka; Kitamura, Tetsuhisa; Sawada, Norie; Iwasaki, Motoki; Yamaji, Taiki; Shimazu, Taichi; Inoue, Manami; Tsugane, Shoichiro

2018-05-11

Smoking and alcohol are established risk factors for several types of cancer, but the effects on biliary cancers comprising biliary tract cancer (BTC) and intrahepatic bile duct cancer (IHBDC) have been inconclusive. In this population-based prospective cohort study in Japan, we investigated the association of smoking and alcohol consumption with the risks of BTC and its subtypes, and IHBDC incidence in men and women. Furthermore, the association of smoking stratified by drinking status was investigated. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the Cox proportional hazard model. A total of 48,367 men and 54,776 women aged 40-69 years were enrolled between 1990 and 1994 and followed up for 846,417 person-years in men and 1,021,330 person-years in women until 2012, during which 246 BTC and 80 IHBDC male cases and 227 BTC and 60 IHBDC female cases were identified. In men, smoking was significantly associated with an increased risk of IHBDC (HR = 2.25 [95% CI, 1.19-4.25] for current smokers with ≥30 pack-years), and the risk was enhanced among regular drinkers (HR = 3.48 [95% CI, 1.41-8.61]). A non-significant increase of IHBDC risk associated with alcohol was observed. Neither smoking nor alcohol consumption was associated with BTC risk. In women, the association of smoking and alcohol consumption with IHBDC and BTC was unclear because current smokers and regular drinkers were very few. Our findings suggest that smoking increases IHBDC risk in men, especially among regular drinkers.

Smoking, Smoking Cessation, and the Risk of Type 2 Diabetes among Japanese Adults: Japan Epidemiology Collaboration on Occupational Health Study.

PubMed

Akter, Shamima; Okazaki, Hiroko; Kuwahara, Keisuke; Miyamoto, Toshiaki; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Tomita, Kentaro; Nagahama, Satsue; Eguchi, Masafumi; Kochi, Takeshi; Imai, Teppei; Nishihara, Akiko; Sasaki, Naoko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Uehara, Akihiko; Yamamoto, Makoto; Hori, Ai; Sakamoto, Nobuaki; Nishiura, Chihiro; Nishiura, Chiro; Totsuzaki, Takafumi; Kato, Noritada; Fukasawa, Kenji; Pham, Ngoc M; Kurotani, Kayo; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2015-01-01

To examine the association of smoking status, smoking intensity, and smoking cessation with the risk of type 2 diabetes (T2D) using a large database. The present study included 53,930 Japanese employees, aged 15 to 83 years, who received health check-up and did not have diabetes at baseline. Diabetes was defined as fasting plasma glucose ≥126 mg/dl, random plasma glucose ≥200 mg/dl, HbA1c ≥6.5% (≥48 mmol/mol), or receiving medication for diabetes. Cox proportional-hazards regression models were used to investigate the association between smoking and the risk of diabetes. During 3.9 years of median follow-up, 2,441 (4.5%) individuals developed T2D. The multivariable-adjusted hazard ratios (95% CI) for diabetes were 1 (reference), 1.16 (1.04 to 1.30) and 1.34 (1.22 to 1.48) for never smokers, former smokers, and current smokers, respectively. Diabetes risk increased with increasing numbers of cigarette consumption among current smokers (P for trend <0.001). Although the relative risk of diabetes was greater among subjects with lower BMIs (< 23 kg/m2), attributable risk was greater in subjects with higher BMIs (≥ 23 kg/m2). Compared with individuals who had never smoked, former smokers who quit less than 5 years, 5 to 9 years, and 10 years or more exhibited hazards ratios for diabetes of 1.36 (1.14 to 1.62), 1.23 (1.01 to 1.51), and 1.02 (0.85 to 1.23), respectively. Results suggest that cigarette smoking is associated with an increased risk of T2D, which may decrease to the level of a never smoker after 10 years of smoking cessation.

Active smoking and risk of breast cancer in a Danish nurse cohort study.

PubMed

Andersen, Zorana Jovanovic; Jørgensen, Jeanette Therming; Grøn, Randi; Brauner, Elvira Vaclavik; Lynge, Elsebeth

2017-08-22

No scientific consensus has been reached on whether active tobacco smoking causes breast cancer. We examine the association between active smoking and breast cancer risk in Denmark, which has some of the highest smoking and breast cancer rates in women worldwide. We used the data from a nationwide Danish Nurse Cohort on 21,867 female nurses (age > 44 years) who at recruitment in 1993 or 1999 reported information on smoking status, onset, duration, and intensity, as well as breast cancer risk factors. We obtained data on incidence of breast cancer from Danish Cancer Registry until 2013, and used Cox regression models to analyze the association between smoking and breast cancer. Of 21,831 women (mean age 53.2 years) 1162 developed breast cancer during 15.7 years of follow-up. 33.7% of nurses were current and 30.0% former smokers at cohort baseline. Compared to never smokers, we found increased risk of breast cancer of 18% in ever (hazard ratio and 95% confidence interval: 1.18; 1.04-1.34) and 27% in current (1.27; 1.11-1.46) smokers. We detected a dose-response relationship with smoking intensity with the highest breast cancer risk in women smoking >15 g/day (1.31; 1.11-1.56) or >20 pack-years (1.32; 1.12-1.55). Parous women who smoked heavily (>10 pack-years) before first childbirth had the highest risk of breast cancer (1.58; 1.20-2.10). Association between smoking and breast cancer was not modified by menopausal status, obesity, alcohol or hormone therapy use, and seemed to be limited to the estrogen receptor positive breast cancer subtype. Active smoking increases risk of breast cancer, with smoking before first birth being the most relevant exposure window.

Sex differences in negative affect and lapse behavior during acute tobacco abstinence: a laboratory study.

PubMed

Pang, Raina D; Leventhal, Adam M

2013-08-01

Heightened negative affect during acute tobacco abstinence in women relative to men could be an important factor underlying sex differences in smoking motivation. However, little controlled experimental work addresses this hypothesis. The current study investigated sex differences in withdrawal-related negative affect, time to start smoking on a lab analogue smoking lapse task, and the interrelation between sex, withdrawal-related negative affect, and smoking lapse behavior. Following a baseline session, current smokers (women: n = 68, men: n = 131) attended two counterbalanced lab sessions (16 hours smoking abstinence and ad libitum smoking) during which they completed self-report measures of mood and withdrawal symptoms followed by a laboratory analogue smoking lapse task. In this task participants are monetarily rewarded for delaying smoking. Performance on this task serves as an analogue model of smoking lapse behavior by measuring smoker's capability to resist temptation to smoke under conditions where abstinence is advantageous. Females showed greater abstinence induced increases in composite negative affect as well as several particular negative affect states (i.e., POMS Anger, Anxiety, Depression, and Confusion, ps < .05) but no differences in abstinence induced changes in other forms of affect or craving. Females also exhibited marginally greater abstinence induced decreases in their willingness to delay smoking for money (p = .10), which was mediated by abstinence induced increases in anger (p < .05). These results suggest that differential sensitivity to abstinence induced negative affect, particularly anger, could underlie sex specific smoking patterns. Negative affect during tobacco abstinence may be an important factor for understanding and treating nicotine addiction in women. PsycINFO Database Record (c) 2013 APA, all rights reserved

No effect of cigarette smoking dose on oxidized plasma proteins

PubMed Central

Yeh, Chih-Ching; Barr, R. Graham; Powell, Charles A.; Mesia-Vela, Sonia; Wang, Yuanjia; Hamade, Nada K.; Austin, John H.M.; Santella, Regina M.

2008-01-01

Cigarette smoking is a major source of oxidative stress. Protein carbonyls have been used as a biomarker of oxidative stress because of the relative stability of carbonylated proteins and the high protein concentration in blood. Increased levels of carbonyl groups have been found in serum proteins of smokers compared to nonsmokers. However, neither the dose effect of current cigarette smoke nor other predictors of oxidative stress have been studied. Hence, we used an ELISA (Enzyme-Linked Immunosorbent Assay) to evaluate plasma protein carbonyls in smokers recruited in the Early Lung Cancer Action Project (ELCAP) program. The lung cancer screening program enrolled current and former smokers age 60 years and over without a prior cancer diagnosis. A total of 542 participants (282 men and 260 women) completed a baseline questionnaire and provided blood samples for the biomarker study. Protein oxidation was measured by derivatization of the carbonyl groups with 2,4-dinitrophenylhydrazine (DNPH) and ELISA quantitation of the DNPH group. Current smoking status was confirmed with urinary cotinine. The mean (± SD) protein carbonyl level was 17.9 ± 2.9 nmol carbonyls/ml plasma. Protein carbonyls did not differ significantly by gender. Carbonyl levels were higher among current than former smokers, but these differences did not attain statistical significance, nor did differences by urine cotinine levels, pack-years, pack/day among current smokers, and smoking duration. In a multiple regression analysis, higher protein carbonyl levels were independently associated with increasing age (0.59 nmol/ml increase per 10 years, 95% CI 0.14, 1.05, p = 0.01), African-American vs. white race/ethnicity, (1.30 nmol/ml, 95% CI 0.4, 2.19, p =0.008), and lower educational attainment (0.75 nmol/ml, 95% CI 0.12, 1.38, p = 0.02). Although we found no significant difference between current versus past cigarette smoking and protein carbonyls in this older group of smokers, associations were found for age, ethnicity and educational attainment. Our results indicate that the measurement of plasma carbonyls by this ELISA technique is still an easy and suitable method for studies of diseases related to oxidative stress. PMID:17996865

Attitudes of Cairo University medical students toward smoking: the need for tobacco control programs in medical education.

PubMed

Khan, Adeel A M; Dey, Subhojit; Taha, Alaa H; Huq, Farhan S; Moussawi, Ahmad H; Omar, Omar S; Soliman, Amr S

2012-04-01

Tobacco smoking rates are increasing in developing countries and so are tobacco-related chronic diseases. Reported figures from the WHO show rates of smoking in Egypt as high as 20% but limited information is available about smoking specifically among physicians and medical students. Final-year medical students of Cairo University were surveyed regarding their tobacco behavior and attitudes using a modified Global Health Professions Student Survey. We approached 220 students by randomly selecting clinical units into which they were assigned and requested completion of the survey. Ever users of some form of tobacco comprised 46.7% of students sampled, current users of cigarettes comprised 17.4%, and current users of water pipe 'sheesha' comprised 17.6%. The vast majority (87.7%) of students believed that smoking is a public health problem in Cairo and supported restriction of tobacco. Yet, only 58.5% stated that they were taught it is important for physicians to provide tobacco education materials to patients. Among ever users of cigarettes, 54.4% believed health professionals do not serve as health role models for patients, and only a small percentage of all students (34.2%) stated that they had received some form of training on smoking cessation in their medical curriculum to be able to instruct patients. A high rate of smoking was revealed among medical students in Cairo. Overall, approximately 23.4% of students were currently smoking cigarettes and/or sheesha, and 46.7% were ever users of some form of tobacco. A formal antitobacco program for medical students should be incorporated into their medical curriculum to change the attitudes of medical students and overcome the anticipated increase in chronic diseases in Egypt.

Using Self-affirmation to Increase the Effects of Emotive Health Warnings on Smoking: A Randomized Exploratory Trial.

PubMed

Memish, Kate E; Schüz, Natalie; Frandsen, Mai; Ferguson, Stuart G; Schüz, Benjamin

2017-10-01

Emotive health messages are widely used tools in tobacco control. However, under some circumstances, they can be less effective than desired by eliciting defensive responses in smokers. This study tests whether enhancing a currently used emotive graphic smoking health warning with a self-affirmation component reduces cigarette consumption and whether potential effects are stronger in heavier smokers, as suggested by previous research. Participants (n = 265) were randomly allocated to a self-affirmation (reflecting on personal values and positive traits using a questionnaire) or matched control condition before viewing an emotive graphic health message from a current Australian government public health campaign. The primary outcome (cigarettes per day [CPD]) was assessed both before and a week following the intervention. No main effect of self-affirmation on smoking, but as hypothesized, a significant interaction between baseline smoking and self-affirmation was found that showed that heavier smokers (>21 CPD) who self-affirmed significantly reduced CPD compared to nonaffirmed smokers. These findings support the use of self-affirmation to enhance smoking awareness campaigns in heavier smokers. This study shows that enhancing emotive graphic smoking health messages with self-affirmation (the act of reflecting on positive aspects of oneself) increases their effectiveness in heavier smokers. This suggests that self-affirmation might be a particularly useful tool for health promotion targeting heavier smokers. This study adds to previous research in that it is the first to test the add-on effects of self-affirmation to current graphic health messages on smoking rather than smoking-related cognitions. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cigarette smoking is associated with adverse survival among women with ovarian cancer: Results from a pooled analysis of 19 studies.

PubMed

Praestegaard, Camilla; Jensen, Allan; Jensen, Signe M; Nielsen, Thor S S; Webb, Penelope M; Nagle, Christina M; DeFazio, Anna; Høgdall, Estrid; Rossing, Mary Anne; Doherty, Jennifer A; Wicklund, Kristine G; Goodman, Marc T; Modugno, Francesmary; Moysich, Kirsten; Ness, Roberta B; Edwards, Robert; Matsuo, Keitaro; Hosono, Satoyo; Goode, Ellen L; Winham, Stacey J; Fridley, Brooke L; Cramer, Daniel W; Terry, Kathryn L; Schildkraut, Joellen M; Berchuck, Andrew; Bandera, Elisa V; Paddock, Lisa E; Massuger, Leon F; Wentzensen, Nicolas; Pharoah, Paul; Song, Honglin; Whittemore, Alice; McGuire, Valerie; Sieh, Weiva; Rothstein, Joseph; Anton-Culver, Hoda; Ziogas, Argyrios; Menon, Usha; Gayther, Simon A; Ramus, Susan J; Gentry-Maharaj, Alexandra; Wu, Anna H; Pearce, Celeste L; Pike, Malcolm; Lee, Alice W; Sutphen, Rebecca; Chang-Claude, Jenny; Risch, Harvey A; Kjaer, Susanne K

2017-06-01

Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08-1.28) and former smokers (pHR = 1.10, 95% CI: 1.02-1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01-3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00-1.23; former smoking: pHR = 1.12, 95% CI: 1.04-1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis. © 2017 UICC.

Cigarette smoking is associated with adverse survival among women with ovarian cancer: Results from a pooled analysis of 19 studies

PubMed Central

Præstegaard, Camilla; Jensen, Allan; Jensen, Signe M.; Nielsen, Thor S. S.; Webb, Penelope M.; Nagle, Christina M.; DeFazio, Anna; Høgdall, Estrid; Rossing, Mary Anne; Doherty, Jennifer A.; Wicklund, Kristine G.; Goodman, Marc T.; Modugno, Francesmary; Moysich, Kirsten; Ness, Roberta B.; Edwards, Robert; Matsuo, Keitaro; Hosono, Satoyo; Goode, Ellen L.; Winham, Stacey J; Fridley, Brooke L.; Cramer, Daniel W.; Terry, Kathryn L.; Schildkraut, Joellen M.; Berchuck, Andrew; Bandera, Elisa V.; Paddock, Lisa E.; Massuger, Leon F.; Wentzensen, Nicolas; Pharoah, Paul; Song, Honglin; Whittemore, Alice; McGuire, Valerie; Sieh, Weiva; Rothstein, Joseph; Anton-Culver, Hoda; Ziogas, Argyrios; Menon, Usha; Gayther, Simon A.; Ramus, Susan J.; Gentry-Maharaj, Alexandra; Wu, Anna H.; Pearce, Celeste L.; Pike, Malcolm; Lee, Alice W.; Sutphen, Rebecca; Chang-Claude, Jenny; Risch, Harvey A.; Kjaer, Susanne K.

2017-01-01

Cigarette smoking is associated with an increased risk of developing mucinous ovarian tumors but whether it is associated with ovarian cancer survival overall or for the different histotypes is unestablished. Furthermore, it is unknown whether the association between cigarette smoking and survival differs according to strata of ovarian cancer stage at diagnosis. In a large pooled analysis, we evaluated the association between various measures of cigarette smoking and survival among women with epithelial ovarian cancer. We obtained data from 19 case-control studies in the Ovarian Cancer Association Consortium (OCAC), including 9,114 women diagnosed with ovarian cancer. Cox regression models were used to estimate adjusted study-specific hazard ratios (HRs), which were combined into pooled hazard ratios (pHR) with corresponding 95% confidence intervals (CIs) under random effects models. Overall, 5,149 (57%) women died during a median follow-up period of 7.0 years. Among women diagnosed with ovarian cancer, both current (pHR = 1.17, 95% CI: 1.08–1.28) and former smokers (pHR = 1.10, 95% CI: 1.02–1.18) had worse survival compared with never smoking women. In histotype-stratified analyses, associations were observed for mucinous (current smoking: pHR = 1.91, 95% CI: 1.01–3.65) and serous histotypes (current smoking: pHR = 1.11, 95% CI: 1.00–1.23; former smoking: pHR = 1.12, 95% CI: 1.04–1.20). Further, our results suggested that current smoking has a greater impact on survival among women with localized than disseminated disease. The identification of cigarette smoking as a modifiable factor associated with survival has potential clinical importance as a focus area to improve ovarian cancer prognosis. PMID:28063166

Compliance and support for smoke-free school policies.

PubMed

Trinidad, D R; Gilpin, E A; Pierce, J P

2005-08-01

Our objective was to examine factors associated with compliance and support for a smoke-free campus before and after a 1995 campus-wide smoking ban for everyone, including teachers and visitors, in California. Adolescent (12-17 years) data from the 1993, 1996, 1999 and 2002 (N approximately 6000 each year) California Tobacco Surveys (population-based telephone surveys) were analyzed. Trends in compliance with smoke-free school policies and support for smoke-free campuses were examined among students in public and private schools. Perceived compliance with the no-smoking rule by most or all student smokers increased from 43.7 +/- 1.6% in 1993 to 71.5 +/- 1.4% in 2002. While non-smokers have overwhelmingly favored smoke-free school grounds since 1993 (more than 85% each survey year), support among current smokers increased from 55.8 +/- 4.7% in 1996 to 69.1 +/- 6.8% in 2002. Student smokers who saw teachers smoking in school were less likely to favor school smoking bans (odds ratio = 0.25, 95% confidence interval 0.12-0.49). The percentage of private school students seeing teachers smoke on school grounds has been at least twice that of public school students since 1996. Compliance with and support for smoke-free schools increased since smoking was banned on campus for everyone. Perceived compliance by teachers, much lower in private schools, appears to undermine student smokers' support of this policy. Increased efforts are necessary to communicate to teachers the importance of their modeling of policy compliance to students.

Effects of Disasters on Smoking and Relapse: An Exploratory Study of Hurricane Katrina Victims.

PubMed

Lanctot, Jennifer Q; Stockton, Michelle B; Mzayek, Fawaz; Read, Mary; McDevitt-Murphy, Meghan; Ward, Kenneth

2008-01-01

Psychosocial stress maintains cigarette use and precipitates relapse, but little is known about how natural disasters in particular affect smoking. To determine the feasibility of recruiting victims soon after a natural disaster for a survey study, and to assess the types and determinants of changes in smoking behavior resulting from exposure to the disaster. A convenience sample of 35 Hurricane Katrina refugees who had smoked more than 100 cigarettes in their lifetime were surveyed one month after the storm to evaluate changes in smoking behavior. Among a small sample of former smokers, more than half relapsed after Katrina, citing stress, urge, and sadness. Among current smokers, 52% increased their smoking after Katrina by more than half a pack per day on average. Most individuals who increased their smoking or relapsed expressed interest in receiving cessation assistance within the next month. Stress-related increases in smoking and relapse may be common after a natural disaster. Health education professionals have an important role to play in responding to changes in tobacco use in the aftermath of disasters. Educational interventions to discourage tobacco use as a coping strategy may be especially warranted given the high level of interest expressed in smoking cessation.

Plausible Roles for RAGE in Conditions Exacerbated by Direct and Indirect (Secondhand) Smoke Exposure.

PubMed

Lewis, Joshua B; Hirschi, Kelsey M; Arroyo, Juan A; Bikman, Benjamin T; Kooyman, David L; Reynolds, Paul R

2017-03-17

Approximately 1 billion people smoke worldwide, and the burden placed on society by primary and secondhand smokers is expected to increase. Smoking is the leading risk factor for myriad health complications stemming from diverse pathogenic programs. First- and second-hand cigarette smoke contains thousands of constituents, including several carcinogens and cytotoxic chemicals that orchestrate chronic inflammatory responses and destructive remodeling events. In the current review, we outline details related to compromised pulmonary and systemic conditions related to smoke exposure. Specifically, data are discussed relative to impaired lung physiology, cancer mechanisms, maternal-fetal complications, cardiometabolic, and joint disorders in the context of smoke exposure exacerbations. As a general unifying mechanism, the receptor for advanced glycation end-products (RAGE) and its signaling axis is increasingly considered central to smoke-related pathogenesis. RAGE is a multi-ligand cell surface receptor whose expression increases following cigarette smoke exposure. RAGE signaling participates in the underpinning of inflammatory mechanisms mediated by requisite cytokines, chemokines, and remodeling enzymes. Understanding the biological contributions of RAGE during cigarette smoke-induced inflammation may provide critically important insight into the pathology of lung disease and systemic complications that combine during the demise of those exposed.

Plausible Roles for RAGE in Conditions Exacerbated by Direct and Indirect (Secondhand) Smoke Exposure

PubMed Central

Lewis, Joshua B.; Hirschi, Kelsey M.; Arroyo, Juan A.; Bikman, Benjamin T.; Kooyman, David L.; Reynolds, Paul R.

2017-01-01

Approximately 1 billion people smoke worldwide, and the burden placed on society by primary and secondhand smokers is expected to increase. Smoking is the leading risk factor for myriad health complications stemming from diverse pathogenic programs. First- and second-hand cigarette smoke contains thousands of constituents, including several carcinogens and cytotoxic chemicals that orchestrate chronic inflammatory responses and destructive remodeling events. In the current review, we outline details related to compromised pulmonary and systemic conditions related to smoke exposure. Specifically, data are discussed relative to impaired lung physiology, cancer mechanisms, maternal-fetal complications, cardiometabolic, and joint disorders in the context of smoke exposure exacerbations. As a general unifying mechanism, the receptor for advanced glycation end-products (RAGE) and its signaling axis is increasingly considered central to smoke-related pathogenesis. RAGE is a multi-ligand cell surface receptor whose expression increases following cigarette smoke exposure. RAGE signaling participates in the underpinning of inflammatory mechanisms mediated by requisite cytokines, chemokines, and remodeling enzymes. Understanding the biological contributions of RAGE during cigarette smoke-induced inflammation may provide critically important insight into the pathology of lung disease and systemic complications that combine during the demise of those exposed. PMID:28304347

Associations between depression risk, bullying and current smoking among Chinese adolescents: Modulated by gender.

PubMed

Guo, Lan; Hong, Lingyao; Gao, Xue; Zhou, Jinhua; Lu, Ciyong; Zhang, Wei-Hong

2016-03-30

This school-based study aimed to investigate the prevalence of being at risk for depression, bullying behavior, and current smoking among Chinese adolescents in order to explore gender differences in the vulnerability of adolescents with these behaviors to develop a smoking habit. A total of 35,893 high school students sampled from high schools in eighteen cities in China participated in the study from 2011 to 2012. Overall, the prevalence of current smoking was estimated at 6.4%. In total, 1.7% (618) of the participants admitted to bullying others, 5.8% (2071) reported being bullied, 3.5% (1269) were involved in both bullying others and being bullied, and 5.6% (2017) were at high risk for depression. Logistic regression analysis indicated that among girls, with high depression risk, bullying others, being bullied, and both bullying others and being bullied were independently and positively associated with current smoking habits, while the final results among boys showed that bullying others and both bullying others and being bullied were independently associated with an increased risk of current smoking. School-based prevention programs are highly recommended, and we should focus on high-risk students, particularly girls with high risk of depression or involved in school bullying and boys who are involved in school bullying. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse.

PubMed

Pulakka, Anna; Halonen, Jaana I; Kawachi, Ichiro; Pentti, Jaana; Stenholm, Sari; Jokela, Markus; Kaate, Ilkka; Koskenvuo, Markku; Vahtera, Jussi; Kivimäki, Mika

2016-10-01

Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce. To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors. The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n = 53 755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n = 11 924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis. Walking distance from home to the nearest tobacco outlet. Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up. Overall, 20 729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers. These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.

Relationships among Smoking Habits, Airflow Limitations, and Metabolic Abnormalities in School Workers

PubMed Central

Horie, Masafumi; Noguchi, Satoshi; Tanaka, Wakae; Goto, Yasushi; Yoshihara, Hisanao; Kawakami, Masaki; Suzuki, Masaru; Sakamoto, Yoshio

2013-01-01

Background Chronic obstructive pulmonary disease is caused mainly by habitual smoking and is common among elderly individuals. It involves not only airflow limitation but also metabolic disorders, leading to increased cardiovascular morbidity and mortality. Objective We evaluated relationships among smoking habits, airflow limitation, and metabolic abnormalities. Methods Between 2001 and 2008, 15,324 school workers (9700 males, 5624 females; age: ≥30 years) underwent medical checkups, including blood tests and spirometry. They also responded to a questionnaire on smoking habits and medical history. Results Airflow limitation was more prevalent in current smokers than in ex-smokers and never-smokers in men and women. The frequency of hypertriglyceridemia was higher in current smokers in all age groups, and those of low high-density-lipoprotein cholesterolemia and diabetes mellitus were higher in current smokers in age groups ≥ 40 s in men, but not in women. There were significant differences in the frequencies of metabolic abnormalities between subjects with airflow limitations and those without in women, but not in men. Smoking index was an independent factor associated with increased frequencies of hypertriglyceridemia (OR 1.015; 95% CI: 1.012–1.018; p<0.0001) and low high-density-lipoprotein cholesterolemia (1.013; 1.010–1.016; p<0.0001) in men. Length of smoking cessation was an independent factor associated with a decreased frequency of hypertriglyceridemia (0.984; 0.975–0.994; p = 0.007). Conclusions Habitual smoking causes high incidences of airflow limitation and metabolic abnormalities. Women, but not men, with airflow limitation had higher frequencies of metabolic abnormalities. PMID:24312268

Relationships among smoking habits, airflow limitations, and metabolic abnormalities in school workers.

PubMed

Horie, Masafumi; Noguchi, Satoshi; Tanaka, Wakae; Goto, Yasushi; Yoshihara, Hisanao; Kawakami, Masaki; Suzuki, Masaru; Sakamoto, Yoshio

2013-01-01

Chronic obstructive pulmonary disease is caused mainly by habitual smoking and is common among elderly individuals. It involves not only airflow limitation but also metabolic disorders, leading to increased cardiovascular morbidity and mortality. We evaluated relationships among smoking habits, airflow limitation, and metabolic abnormalities. Between 2001 and 2008, 15,324 school workers (9700 males, 5624 females; age: ≥ 30 years) underwent medical checkups, including blood tests and spirometry. They also responded to a questionnaire on smoking habits and medical history. Airflow limitation was more prevalent in current smokers than in ex-smokers and never-smokers in men and women. The frequency of hypertriglyceridemia was higher in current smokers in all age groups, and those of low high-density-lipoprotein cholesterolemia and diabetes mellitus were higher in current smokers in age groups ≥ 40 s in men, but not in women. There were significant differences in the frequencies of metabolic abnormalities between subjects with airflow limitations and those without in women, but not in men. Smoking index was an independent factor associated with increased frequencies of hypertriglyceridemia (OR 1.015; 95% CI: 1.012-1.018; p<0.0001) and low high-density-lipoprotein cholesterolemia (1.013; 1.010-1.016; p<0.0001) in men. Length of smoking cessation was an independent factor associated with a decreased frequency of hypertriglyceridemia (0.984; 0.975-0.994; p = 0.007). Habitual smoking causes high incidences of airflow limitation and metabolic abnormalities. Women, but not men, with airflow limitation had higher frequencies of metabolic abnormalities.

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents.

PubMed

Mejia, Raul; Pérez, Adriana; Peña, Lorena; Kollath-Cattano, Christy; Morello, Paola; Braun, Sandra; Hardin, James W; Thrasher, James F; Sargent, James D

2017-01-01

To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aOR first vs third tertile  1.77, 95% CI 1.30-2.41), of trying smoking (aOR first vs third tertile  1.54, 1.14-2.08), and marginally associated with current smoking (AOR first vs third tertile  1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies. Copyright © 2016 Elsevier Inc. All rights reserved.

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents

PubMed Central

Mejia, Raul; Pérez, Adriana; Peña, Lorena; Kollath-Cattano, Christy; Morello, Paola; Braun, Sandra; Hardin, James W.; Thrasher, James F.; Sargent, James

2016-01-01

Objective To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents. Study design School-based longitudinal study involving 33 secondary schools in Argentina. The sample included 2502 never smokers (average age at entry =12.5y), 1,700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco, and then asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated adjusted odds ratio (AOR) for the following transitions: non-susceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days). Results At follow-up, 34.4% of non-susceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.6% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Higher exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (AOR1st vs 3rd tertile = 1.77, 95% confidence interval 1.30–2.41), of trying smoking (AOR1st vs 3rd tertile = 1.54, 1.14–2.08), and marginally associated with current smoking (AOR1st vs 3rd tertile = 1.54, 0.99–2.40). Exposure to smoking in US- or Argentine-produced films had similar associations. Conclusion In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies. PMID:28029343

Is current smoking still an important environmental factor in inflammatory bowel diseases? Results from a population-based incident cohort.

PubMed

Lakatos, Peter L; Vegh, Zsuzsanna; Lovasz, Barbara D; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Szita, Istvan; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Golovics, Petra A; Mandel, Michael; Horvath, Agnes; Szathmari, Miklos; Kiss, Lajos S; Lakatos, Laszlo

2013-04-01

Previous studies suggest that smoking is an important environmental factor in inflammatory bowel diseases (IBDs), with dichotomous effects in ulcerative colitis (UC) and Crohn's disease (CD). The aim of this study was to analyze the relationship between smoking and IBD risk in a population-based database from Veszprem Province, which included incident cases diagnosed between January 1, 1977, and December 31, 2008. Data from 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 years; CD: 506, age at diagnosis: 31.5 years). Both inpatient and outpatient records were collected and comprehensively reviewed. Overall, smoking frequency in the adult general population was 36.1%. Of patients with CD, 47.2% were current smokers at diagnosis. Smoking was more frequent in male patients (P = 0.002) and was associated with an increased risk of CD (odds ratio, 1.96; 95% confidence interval, 1.63-2.37; P < 0.001). In contrast, current smoking was protective against UC (odds ratio, 0.33; 95% confidence interval, 0.27-0.41). The effect of smoking was linked to gender (in CD, more deleterious in male patients) and age at diagnosis and was most prominent in young adults, with a difference already being seen in 18- to 19-year-olds. In CD, a change in disease behavior (P = 0.02), location from ileal or colonic to ileocolonic (P = 0.003), arthritis/arthropathy (P = 0.002), need for steroids (P = 0.06), or AZA (P = 0.038) was more common in current smokers. Smoking in UC was associated with more extensive disease (P = 0.01) and a tendency for decreased need for colectomy (P = 0.06). Current smoking was associated with the risk of IBD. This effect was linked to gender and age at diagnosis and was most prominent in young adults. No association was observed in pediatric or elderly patients. The deleterious and protective effects of smoking on the course in CD and UC were partially confirmed.

Parental behaviours, but not parental smoking, influence current smoking and smoking susceptibility among 14 and 15 year-old children.

PubMed

Waa, Andrew; Edwards, Richard; Newcombe, Rhiannon; Zhang, Jane; Weerasekera, Deepa; Peace, Jo; McDuff, Ingrid

2011-12-01

To explore whether parental behaviours related to smoking socialisation and parenting are associated with smoking susceptibility and current smoking in 14-15 year old students. Data were sourced from the New Zealand 2006 Year 10 In-depth Survey, a school-based survey of 3,189 students. Outcome measures were susceptibility to smoking and current smoking. Potential determinants were second-hand smoke exposure in the home, parental smoking, parental anti-smoking expectations, anti-smoking rules, pocket money, monitoring of pocket money expenditure, general rule setting and monitoring, and concern about education. Analysis used logistic regression to adjust for potential confounding factors. Exposure to second-hand smoke and lack of parental anti-smoking expectations were independently associated with smoking susceptibility and current smoking. Parental smoking was not independently associated with current smoking or susceptibility. Receiving pocket money and an absence of monitoring of expenditure were associated with smoking susceptibility and current smoking. Lack of parental rule setting was associated with smoking susceptibility. Findings were similar whether or not one or more parents were smokers. Not allowing smoking in the home, communicating non-smoking expectations to children, monitoring pocket money, and setting rules to guide behaviour are strategies which are likely to reduce risk of smoking uptake. The study provides evidence to inform the development of parent-focused interventions to reduce the risk of smoking initiation by children. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Smoking, HIV, and risk of pregnancy loss.

PubMed

Westreich, Daniel; Cates, Jordan; Cohen, Mardge; Weber, Kathleen M; Seidman, Dominika; Cropsey, Karen; Wright, Rodney; Milam, Joel; Young, Mary A; Mehta, C Christina; Gustafson, Deborah R; Golub, Elizabeth T; Fischl, Margaret A; Adimora, Adaora A

2017-02-20

Cigarette smoking during pregnancy increases risks of poor pregnancy outcomes including miscarriage and stillbirth (pregnancy loss), but the effect of smoking on pregnancy loss among HIV-infected women has not been explored. Here, investigated the impact of smoking on risk of pregnancy loss among HIV-positive and HIV-negative women, and estimated the potential impact of realistic smoking cessation interventions on risk of pregnancy loss among HIV-positive women. We analyzed pregnancy outcomes in HIV-positive and HIV-negative participants in the Women's Interagency HIV Study between 1994 and 2014. We estimated effects of current smoking at or immediately before pregnancy on pregnancy loss; we controlled for confounding using regression approaches, and estimated potential impact of realistic smoking cessation interventions using a semiparametric g-formula approach. Analysis examined 1033 pregnancies among 659 women. The effect of smoking on pregnancy loss differed dramatically by HIV status: adjusted for confounding, the risk difference comparing current smokers to current nonsmokers was 19.2% (95% confidence limit 10.9-27.5%) in HIV-positive women and 9.7% (95% confidence limit 0.0-19.4%) in HIV-negative women. These results were robust to sensitivity analyses. We estimated that we would need to offer a realistic smoking cessation intervention to 36 women to prevent one pregnancy loss. Smoking is a highly prevalent exposure with important consequences for pregnancy in HIV-positive pregnant women in the United States, even in the presence of potent highly active antiretroviral therapy. This evidence supports greater efforts to promote smoking cessation interventions among HIV-positive women, especially those who desire to become pregnant.

Smoking frequency among current college student smokers: distinguishing characteristics and factors related to readiness to quit smoking

PubMed Central

Berg, Carla J.; Ling, Pamela M.; Hayes, Rashelle B.; Berg, Erin; Nollen, Nikki; Nehl, Eric; Choi, Won S.; Ahluwalia, Jasjit S.

2012-01-01

Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1–5 days, 10.5% (n = 281) smoked 6–29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (β = 0.63, 95% CI 0.57–0.69) and more frequent other tobacco use (β = 0.04, 95% CI 0.02–0.05), drinking (β = 0.04, 95% CI 0.02–0.07) and binge drinking (β = 0.09, 95% CI 0.06–0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers. PMID:22156071

Effects of expectancies and coping on pain-induced motivation to smoke.

PubMed

Ditre, Joseph W; Heckman, Bryan W; Butts, Emily A; Brandon, Thomas H

2010-08-01

The prevalence of tobacco smoking among persons with recurrent pain is approximately twice that observed in the general population. Smoking has been associated with the development and exacerbation of several chronically painful conditions. Conversely, there is both experimental and cross-sectional evidence that pain is a potent motivator of smoking. A recent study provided the first evidence that laboratory-induced pain could elicit increased craving and produce shorter latencies to smoke (Ditre & Brandon, 2008). To further elucidate interrelations between pain and smoking, and to identify potential targets for intervention, in the current study, we tested whether several constructs derived from social-cognitive theory influence the causal pathway between pain and increased motivation to smoke. Smokers (N = 132) were randomly assigned to 1 of 4 conditions in this 2 x 2 between-subjects experimental design. Results indicated that manipulations designed to (a) challenge smoking-related outcome expectancies for pain reduction and (b) enhance pain-related coping produced decreased urge ratings and increased latencies to smoke, relative to controls. An unexpected interaction effect revealed that although each manipulation was sufficient to reduce smoking urges, the combination was neither additive nor synergistic. These findings were integrated with those of the extant literature to conceptualize and depict a causal pathway between pain and motivation to smoke as moderated by smoking-related outcome expectancies and mediated by the use of pain coping behaviors. Copyright 2010 APA, all rights reserved

The relationship between posttraumatic stress disorder and smoking outcome expectancies among U.S. military veterans who served since September 11, 2001.

PubMed

Calhoun, Patrick S; Levin, Holly F; Dedert, Eric A; Johnson, Yashika; Beckham, Jean C

2011-06-01

Posttraumatic stress disorder (PTSD) is associated with increased rates of smoking although little is known regarding the mechanisms underlying this relationship. The current study examined expectations about smoking outcomes among smokers with and without PTSD. The sample included 96 veterans (mean age of 34 years) and included 17% women and 50% racial minorities. Smoking expectancies were measured with the Smoking Consequences Questionnaire-Adult (Copeland, Brandon, & Quinn, 1995). Consistent with previous work suggesting that smokers with PTSD smoke in an effort to reduce negative affect, unadjusted analyses indicated that smokers with PTSD (n = 38) had higher expectations that smoking reduces negative affect than smokers without PTSD (d = 0.61). Smokers with PTSD also had increased expectancies associated with boredom reduction (d = 0.48), stimulation (d = 0.61), taste/sensorimotor manipulation aspects of smoking (d = 0.73), and social facilitation (d = 0.61). Results of hierarchical linear regression analyses indicated that PTSD symptom severity was uniquely associated with these expectancies beyond the effects of gender and nicotine dependence. More positive beliefs about the consequences of smoking may increase risk of continued smoking among those with PTSD who smoke. Further understanding of smoking expectancies in this group may help in developing interventions tailored for this vulnerable population. Published 2011. This article is a US Government work and is in the public domain in the USA.

The association between smoking and breast cancer characteristics and outcome.

PubMed

Goldvaser, Hadar; Gal, Omer; Rizel, Shulamith; Hendler, Daniel; Neiman, Victoria; Shochat, Tzippy; Sulkes, Aaron; Brenner, Baruch; Yerushalmi, Rinat

2017-09-06

Smoking is associated with an increased incidence of hormone receptor positive breast cancer. Data regarding worse breast cancer outcome in smokers are accumulating. Current literature regarding the impact of smoking on breast cancer characteristics is limited. We evaluated the impact of smoking on breast cancer characteristics and outcome. This was a retrospective single center study. All women diagnosed from 4/2005 through 3/2012 and treated in our institute for early, estrogen receptor positive, human epidermal growth factor receptor 2 (HER2) negative breast cancer, whose tumors were sent for Oncotype DX analysis were included. Medical records were reviewed for demographics, clinico-pathological parameters, treatment and outcome. Data regarding smoking were retrieved according to patients' history at the first visit in the oncology clinic. Patients were grouped and compared according to smoking history (ever smokers vs. never smokers), smoking status (current vs. former and never smokers) and smoking intensity (pack years ≥30 vs. the rest of the cohort). Outcomes were adjusted in multivariate analyses and included age, menopausal status, ethnicity, tumor size, nodal status and grade. A total of 662 women were included. 28.2% had a history of smoking, 16.6% were current smokers and 11.3% were heavy smokers. Smoking had no impact on tumor size, nodal involvement and Oncotype DX recurrence score. Angiolymphatic and perineural invasion rates were higher in current smokers than in the rest of the cohort (10.4% vs. 5.1%, p = 0.045, 8.3% vs. 3.5%, p = 0.031, respectively). Smoking had no other impact on histological characteristics. Five-year disease free survival and overall survival rates were 95.7% and 98.5%, respectively. Smoking had no impact on outcomes. Adjusted disease free survival and overall survival did not influence the results. Smoking had no clinically significant influence on tumor characteristics and outcome among women with estrogen receptor positive, HER2 negative, early breast cancer. As the study was limited to a specific subgroup of the breast cancer population in this heterogeneous disease and since smoking is a modifiable risk factor for the disease, further research is required to clarify the possible impact of smoking on breast cancer.

Smoking cessation programs in occupational settings

PubMed Central

Danaher, Brian G.

1980-01-01

For reasons of health and economics, the business community is displaying a growing interest in providing smoking cessation programs for employees. An examination of the current research on smoking cessation methods has revealed a number of promising directions that smoking cessation programs can take, for example, aversive smoking approaches combined with self-control strategies. A review of current smoking cessation programs in occupational settings revealed some emphasis on physician counseling, but a relatively greater emphasis on use of consultants (especially in proprietary programs) or of contingency programs to encourage nonsmoking. The smoking cessation programs in businesses can move in a number of innovative directions, including (a) increased use of inhouse programs with a variety of smoking cessation strategies; (b) greater emphasis on the training of program participants in nonsmoking behavioral skills, combined with contingency or incentive programs for smoking control; (c) vastly improved research methods, including complete followup assessments of program participants and chemical tests to validate their self-reported abstinence; (d) greater concern about the need for empirically tested procedures for recruitment of participants for the programs; and (e) expanded interchange among behavioral scientists (especially behavioral psychologists), health professionals in occupational health and medicine, union and employee groups, and management. PMID:7360872

Adverse childhood events and current depressive symptoms among women in Hawaii: 2010 BRFSS, Hawaii.

PubMed

Remigio-Baker, Rosemay A; Hayes, Donald K; Reyes-Salvail, Florentina

2014-12-01

Research on the association between adverse childhood events (ACEs) and depression among women in Hawaii is scarce. ACEs have been linked to unfavorable health behaviors such as smoking and binge drinking which are more prevalent in the state compared to the US overall. The concomitant presence of ACEs with smoking or binge drinking may explain the excess depression prevalence in Hawaii compared to the national average. Using data of women residing in the state (2010 Hawaii Behavioral Risk Factor Surveillance System Survey), we examined the association between ACEs count or type (household dysfunction and physical, verbal and sexual abuse) and current depressive symptoms (CDS), in addition to modification by current smoking status (smoked >100 cigarettes in a lifetime and currently smoke) and binge drinking (consumed ≥4 alcoholic beverage within the past month and in ≥1 occasion(s)). Evaluation of ACEs before age 18 consisted of 11 indicators. Eight indicators of the Patient Health Questionnaire (PHQ-8) were used to assess CDS. All analyses utilized logistic regression taking into account sampling design. The odds ratio of having CDS between those with versus without ACEs increased per increasing number of ACEs (1 ACE: OR = 2.11, CI = 1.16-3.81; 2 ACEs: OR = 2.90, CI = 1.51-5.58; 3 or 4 ACEs: OR = 3.94, CI = 2.13-7.32; 5+ ACEs: OR = 4.04, CI = 2.26-7.22). Household dysfunction (OR = 2.10, CI = 1.37-3.23), physical abuse (OR = 1.67, CI = 1.08-2.59), verbal abuse (OR = 3.21, CI = 2.03-5.09) and sexual abuse (OR = 1.68, CI = 1.04-2.71) were all positively associated with CDS. Verbal abuse had the strongest magnitude of association. Neither current smoking status nor binge drinking modified the relationship between ACEs count (or type) and CDS. In conclusion, the presence of ACEs among women in Hawaii was indicative of CDS in adulthood, notably verbal abuse. Further, a dose response existed between the number of ACEs and the odds for CDS. The concomitant exposure to ACEs and current smoking status or binge drinking did not elevate odds for CDS.

Smoking and prevalence of allergic disorders in Japanese pregnant women: baseline data from the Kyushu Okinawa Maternal and Child Health Study.

PubMed

Tanaka, Keiko; Miyake, Yoshihiro; Arakawa, Masashi

2012-03-14

Studies on the associations between smoking and allergic diseases have mostly focused on asthma. Epidemiological studies in adults on the effects of smoking on allergic diseases other than asthma, such as eczema and rhinoconjunctivitis, have been limited, and the information that is available has been inconsistent. The aim of this study was to investigate the association between smoking status and environmental tobacco smoke (ETS) exposure and the prevalence of allergic diseases. Study subjects were 1743 pregnant Japanese women. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age; region of residence; family history of asthma, atopic eczema, and allergic rhinitis; household income; and education. Compared with never smoking, current smoking and ≥ 4 pack-years of smoking were independently positively associated with the prevalence of wheeze. There were no associations between smoking status and the prevalence of asthma, eczema, or rhinoconjunctivitis. When subjects who had never smoked were classified into four categories based on the source of ETS exposure (never, only at home, only at work, and both), exposure occurring both at home and at work was independently associated with an increased prevalence of two outcomes: wheeze and rhinoconjunctivitis. No relationships were observed between exposure to ETS and the prevalence of asthma or eczema. Our results provide evidence that current smoking and ETS exposure may increase the likelihood of wheeze. The possibility of a positive association between ETS exposure and rhinoconjunctivitis was also suggested.

Smoking and prevalence of allergic disorders in Japanese pregnant women: baseline data from the Kyushu Okinawa Maternal and Child Health Study

PubMed Central

2012-01-01

Background Studies on the associations between smoking and allergic diseases have mostly focused on asthma. Epidemiological studies in adults on the effects of smoking on allergic diseases other than asthma, such as eczema and rhinoconjunctivitis, have been limited, and the information that is available has been inconsistent. The aim of this study was to investigate the association between smoking status and environmental tobacco smoke (ETS) exposure and the prevalence of allergic diseases. Methods Study subjects were 1743 pregnant Japanese women. The definitions of wheeze and asthma were based on criteria from the European Community Respiratory Health Survey whereas those of eczema and rhinoconjunctivitis were based on criteria from the International Study of Asthma and Allergies in Childhood. Adjustment was made for age; region of residence; family history of asthma, atopic eczema, and allergic rhinitis; household income; and education. Results Compared with never smoking, current smoking and ≥ 4 pack-years of smoking were independently positively associated with the prevalence of wheeze. There were no associations between smoking status and the prevalence of asthma, eczema, or rhinoconjunctivitis. When subjects who had never smoked were classified into four categories based on the source of ETS exposure (never, only at home, only at work, and both), exposure occurring both at home and at work was independently associated with an increased prevalence of two outcomes: wheeze and rhinoconjunctivitis. No relationships were observed between exposure to ETS and the prevalence of asthma or eczema. Conclusions Our results provide evidence that current smoking and ETS exposure may increase the likelihood of wheeze. The possibility of a positive association between ETS exposure and rhinoconjunctivitis was also suggested. PMID:22413964

Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey.

PubMed

Merom, D; Rissel, C

2001-08-01

To examine the sociodemographic characteristics associated with smoke-free homes (SFHs) in NSW and specify high-risk groups with a low prevalence of household smoking restrictions. Data were drawn from the 1998 NSW Health Survey, a computer-assisted telephone interview survey of 17,494 randomly selected respondents aged > or = 16 years across NSW (response rate = 70%). Logistic regression analyses, stratified by smoking status, were used. Overall, 72% of adults reported having a SFH; 87% of never-smokers, 81% of ex- and 35% of current smokers. The highest percentages of SFHs were reported in households with young children (78%) and with older children (72%) or with adults only (72%). For smokers, SFHs were independently associated with the presence of young children (OR=3.8, 95% CI 3.1-4.7) compared with those who lived alone, but the odds of living in a SFH were only slightly increased for smokers living with older children (aged 6-15) and for those living with adults only (OR=1.9, OR=1.8 respectively). Speaking a language other than English at home, having more than 10 years' education, and being <35 years old were independently and positively associated with SFH. Being employed in smoke-free workplaces increased the likelihood of SFHs for both current and past smokers (OR=1.6, OR=1.2 respectively). Most NSW homes have restrictions on smoking inside, but more than half the households with children and at least one smoker adult are not smoke free. Interventions to shape parents' smoking behaviour around older children are warranted. Strategies need to address never-smokers in communities with high prevalence of smoking and adults with lower levels of education. A continued commitment to workplace smoking bans is important as they may affect household smoking restrictions.

Smoking among Hispanic/Latino nationality groups and Whites, comparisons between California and the United States.

PubMed

Felicitas-Perkins, Jamie Q; Sakuma, Kari-Lyn K; Blanco, Lyzette; Fagan, Pebbles; Pérez-Stable, Eliseo J; Bostean, Georgiana; Xie, Bin; Trinidad, Dennis R

2017-08-30

Although California is home to the largest Hispanic/Latino population, few studies have compared smoking behavior trends of Hispanic/Latino nationality groups in California to the remaining United States (US), which may identify the impact of the state's anti-tobacco efforts on these groups. This study compared smoking status, frequency, and intensity among Mexican Americans, Central/South Americans, and non-Hispanic Whites in California to the remaining US in the 1990s and 2000s. Data were analyzed using the 1992-2011 Current Population Survey Tobacco Use Supplement to report the estimated prevalence of smoking status, frequency, and intensity by decade, race/ethnicity, and state residence. Weighted logistic regression explored sociodemographic factors associated with never and heavy smoking (≥ 20 cigarettes per day). Results showed absolute overall increases from 6.8% to 9.6% in never smoking across all groups. Compared to the remaining US, there was a greater decrease in heavy smoking among Mexican American current smokers in California (5.1%) and a greater increase in light and intermittent smokers among Central/South American current smokers in California (9.3%) between decades. Compared to those living in the remaining US, smokers living in California had lower odds of heavy smoking (1990s: OR=0.64, 95% CI=0.62, 0.66; 2000s: 0.54, 95% CI= 0.52, 0.55). California state residence significantly impacted smoking behaviors as indicated by significant differences in smoking intensity between California and the remaining US among Hispanic/Latino nationality groups. Understanding smoking behaviors across Hispanic/Latino nationality groups in California and the US can inform tobacco control and smoking prevention strategies for these groups. The present study explored the differences in smoking behaviors between Whites, Mexican Americans, and Central South/Americans living in California versus the rest of the US in the 1990s and the 2000s. The results contribute to our current knowledge as there have been minimal efforts to provide disaggregated cigarette consumption information among Hispanic/Latino nationality groups. Additionally, by comparing cigarette consumption between those in California and the remaining US, our data may provide insight into the impact of California's anti-tobacco efforts in reaching Hispanic/Latino subpopulations relative to the remaining US states, many of which have had less tobacco control policy implementation. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A social–contextual investigation of smoking among rural women: multi-level factors associated with smoking status and considerations for cessation.

PubMed

Nemeth, Julianna M; Thomson, Tiffany L; Lu, Bo; Peng, Juan; Krebs, Valdis; Doogan, Nathan J; Ferketich, Amy K; Post, Douglas M; Browning, Christopher R; Paskett, Electra D; Wewers, Mary E

2018-03-01

The social-contextual model of tobacco control and the potential mechanisms of the maintenance or cessation of smoking behavior among disadvantaged women, including rural residents, have yet to be comprehensively studied. The purpose of this study was to determine the association between selected individual, interpersonal, workplace, and neighborhood characteristics and smoking status among women in Appalachia, a US region whose residents experience a disproportionate prevalence of tobacco-related health disparities. These findings may assist in efforts to design and test scientifically valid tobacco control interventions for this and other disadvantaged populations. Women, 18 years of age and older, residing in three rural Ohio Appalachian counties, were recruited using a two-phase address-based sampling methodology for a cross-sectional interview-administered survey between August 2012 and October 2013 (N=408). Multinomial logistic regression was employed to determine associations between select multilevel factors (independent variables) and smoking status (dependent variable). The sample included 82 (20.1%) current smokers, 92 (22.5%) former smokers, and 234 (57.4%) women reporting never smoking (mean age 51.7 years). In the final multivariable multinomial logistic regression model, controlling for all other significant associations, constructs at multiple social-contextual levels were associated with current versus either former or never smoking. At the individual level, for every additional year in age, the odds of being a former or never smoker increased by 7% and 6% (odds ratio (OR) (95% confidence interval(CI)): 1.07 (1.0-1.11) and 1.06 (1.02-1.09)), respectively, as compared to the odds of being a current smoker. With regard to depression, for each one unit increase in the Center for Epidemiologic Studies Depression Scale score, the odds of being a former or never smoker were 5% and 7% lower (OR(95%CI): 0.95(0.91-0.999) and 0.93(0.88-0.98)), respectively. Five interpersonal factors were associated with smoking status. As the social influence injunctive norm score increased by one unit, indicating perception of smoking to be more acceptable, the odds of being a former or never smoker decreased by 23% and 30%, respectively. For every one unit increase in the social participation score, indicating past-year engagement in one additional activity type, the odds of being a former or never smoker increased by 17% and 36%, respectively. For every 10% increase in the percentage of social ties in the participant's advice network who smoked, the odds of being a former or never smoker were 24% and 28% less, respectively. For every 0.1 unit increase in the E/I index, indicating increasing homophily on smoking in one's social network, the odds of being a former or never smoker were 20% and 24% less, respectively, in the time network, and 18% and 20% less, respectively, in the advice network. At the neighborhood level, for every one unit increase in neighborhood cohesion score, indicating increasing cohesion, the odds of being a former smoker or never smoker were 12% and 14% less, respectively. These findings indicate that a social-contextual approach to tobacco control may be useful for narrowing a widening trajectory of smoking disparity for rural women. Interpersonal context, in particular, must be considered in the development of culturally targeted cessation interventions for Ohio Appalachian women.

What Do Mothers Think about Concurrent Breastfeeding and Smoking?

PubMed Central

Bogen, Debra L.; Davies, Erin D.; Barnhart, Wesley C.; Lucero, Cynthia A.; Moss, Deborah R.

2008-01-01

Background According to newer AAP policies, smoking is not contraindicated with breastfeeding, yet smokers initiate and maintain breastfeeding less than non-smokers. Objectives 1) Describe maternal knowledge and 2) attitudes regarding concurrent breastfeeding and smoking or nicotine replacement therapy (NRT) and 3) evaluate the association between maternal smoking and infant feeding practices. Methods Mothers bringing children <13 months old for an appointment completed a 24-item, anonymous survey which addressed knowledge, attitudes and practices about concurrent breastfeeding and smoking/NRT. Results Among 204 survey completers, 63% were African American, 52% had never breastfed and 54% had never smoked. Knowledge: Regardless of smoking status, 19% were aware of the recommendation to smoke after breastfeeding; most did not know that nicotine gum (42%) or patch (40%) transfers less or about the same amount of nicotine into breast milk than smoking a pack per day. Attitudes: Most mothers (80%) believe that women should not smoke any cigarettes if breastfeeding; current smokers (25%) were more likely than former (10%) or never smokers (11%) to find it acceptable to smoke one or more cigarettes per day (p=.03). Only 2% found it acceptable to use NRT while breastfeeding. Practice: Among ever breastfeeders, 10% stopped breastfeeding because of smoking. Over half of recent or current smokers reported that smoking impacted their infant feeding decision. Conclusions Mothers in this sample believe that women who smoke or take NRT should not breastfeed. Smoking status impacted women’s infant feeding practices. Correction of misinformation could increase breastfeeding rates. PMID:18501868

Can Smoke-Free Policies Reduce Tobacco Use Disparities of Sexual and Gender Minorities in Missouri?

PubMed

Wintemberg, Jenna; McElroy, Jane A; Ge, Bin; Everett, Kevin D

2017-11-01

The purpose of this study is to explore the associations between smoke-free policies, current and former smoking status, personal smoking restrictions, and intention to quit among sexual and gender minority (SGM) and non-SGM individuals in Missouri. The current analysis derives from the Out, Proud and Healthy project. Chi-squares examined differences between SGM (N = 2210) and non-SGM (N = 586) respondents and former (N = 836) and current (N = 1960) smokers on smoking-related variables. Odds ratios and 95% confidence intervals from logistic regression identified variables associated with former (vs. current) smoking. SGM current smokers (25%) were significantly more likely than SGM former smokers (19%) to live in a community without a smoke-free policy. Among SGM current smokers, significantly greater intention to quit was seen in those living in a smoke-free community with a smoke-free policy of two or more years (94%) compared with those living in a community without a smoke-free policy (76%). Living in an area with smoke-free policies is related to greater intention to quit among SGM current smokers, greater support for smoke-free policies, and lower smoking prevalence for this community. The SGM community may collectively accrue greater public health benefits from the adoption of smoke-free policies than the non-SGM community. Prior to this study, no data are available regarding current and former smoking status among SGM individuals following the implementation of a local smoke-free policy. The purpose of this study was to explore the relationship between smoke-free policies, current and former smoking status, and intention to quit among SGM and non-SGM individuals in Missouri. This study finds evidence of lower current smoking prevalence and greater intentions to quit among SGM current smokers who live in communities with smoke-free policies. The SGM community may collectively accrue greater public health benefits from the adoption of smoke-free policies than the non-SGM community. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Smoking-related morbidity and mortality in the cardiovascular setting.

PubMed

White, William B

2007-01-01

It is estimated that during the 20th century, 100 million people died of tobacco-related illnesses worldwide. The outlook for the future is grim as this number is expected to increase 10-fold during the 21st century. Many of these deaths will occur in middle-aged adults and, while most tobacco-related deaths currently occur in men, female mortality is expected to increase markedly due to increased rates of smoking in women, especially in developing countries. The risk of coronary heart disease is strongly associated with smoking in both developed and undeveloped countries. In addition, other forms of tobacco exposure (chewing, inhalation through water, and secondhand smoke) have also been documented to be important causes of coronary disease worldwide. Fortunately, the news is not all bad. Recent large-scale studies show that much of the excess risk associated with smoking is attenuated 1 to 2 years after quitting, depending on the level of smoking during an individual's lifetime. These latest findings should stimulate efforts of health care workers to become more aggressive toward cessation of smoking in our practices.

Examining the association of smoking with work productivity and associated costs in Japan.

PubMed

Suwa, Kiyomi; Flores, Natalia M; Yoshikawa, Reiko; Goto, Rei; Vietri, Jeffrey; Igarashi, Ataru

2017-09-01

Smoking is associated with significant health and economic burden globally, including an increased risk of many leading causes of mortality and significant impairments in work productivity. This burden is attenuated by successful tobacco cessation, including reduced risk of disease and improved productivity. The current study aimed to show the benefits of smoking cessation for workplace productivity and decreased costs associated with loss of work impairment. The data source was the 2011 Japan National Health and Wellness Survey (n = 30,000). Respondents aged 20-64 were used in the analyses (n = 23,738) and were categorized into: current smokers, former smokers, and never smokers. Generalized linear models controlling for demographics and health characteristics examined the relationship of smoking status with the Work Productivity and Activity Impairment questionnaire (WPAI-GH) endpoints, as well as estimated indirect costs. Current smokers reported the greatest overall work impairment, including absenteeism (i.e. work time missed) and presenteeism (i.e. impairment while at work); however, after controlling for covariates, there were no significant differences between former smokers and never smokers on overall work impairment. Current smokers and former smokers had greater activity impairment (i.e. impairment in daily activities) than never smokers. Current smokers reported the highest indirect costs (i.e. costs associated with work impairment); however, after controlling for covariates, there were no significant differences between former smokers and never smokers on indirect costs. Smoking exerts a large health and economic burden; however, smoking cessation attenuates this burden. The current study provides important further evidence of this association, with former smokers appearing statistically indistinguishable from never smokers in terms of work productivity loss and associated indirect costs among a large representative sample of Japanese workers. This report highlights the workplace benefits of smoking cessation across productivity markers and cost-savings.

Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey

PubMed Central

Elton-Marshall, Tara; Leatherdale, Scott T.; Burkhalter, Robin

2011-01-01

Background Despite the high prevalence of smoking among Aboriginal youth, there is a paucity of research related to tobacco use and other risk behaviours among Aboriginal youth living off-reserve in Canada. We used data from the national Youth Smoking Survey to characterize non-traditional tobacco use, exposure to second-hand smoke, and alcohol and drug use among Aboriginal youth living off-reserve. We examined whether these youth were at increased health risk compared with non-Aboriginal youth. Methods We examined cigarette smoking behaviour, use of other tobacco products, use of alcohol and other drugs, and exposure to second-hand smoke among 2620 Aboriginal youth living off-reserve and 26 223 non-Aboriginal youth in grades 9 to 12 who participated in the 2008/09 Youth Smoking Survey. Results The prevalence of current smoking among the Aboriginal youth was more than double that among non-Aboriginal youth (24.9% v. 10.4%). Aboriginal youth also had a higher prevalence of regular exposure to second-hand smoke at home (37.3% v. 19.7%) and in cars (51.0% v. 30.3%). Aboriginal youth were more likely than non-Aboriginal youth to be current smokers, to be regularly exposed to second-hand smoke, to have tried marijuana and other illicit drugs, and to engage in binge drinking. They were less likely than non-Aboriginal youth to have tried to quit smoking. Interpretation Current national estimates of smoking, and alcohol and illicit drug use among youth underestimate the prevalence of these behaviours among Aboriginal youth living off-reserve. Our findings highlight the need for culturally appropriate prevention and cessation policies and programs for this at-risk population. PMID:21555383

Tobacco, alcohol and illicit drug use among Aboriginal youth living off-reserve: results from the Youth Smoking Survey.

PubMed

Elton-Marshall, Tara; Leatherdale, Scott T; Burkhalter, Robin

2011-05-17

Despite the high prevalence of smoking among Aboriginal youth, there is a paucity of research related to tobacco use and other risk behaviours among Aboriginal youth living off-reserve in Canada. We used data from the national Youth Smoking Survey to characterize non-traditional tobacco use, exposure to second-hand smoke, and alcohol and drug use among Aboriginal youth living off-reserve. We examined whether these youth were at increased health risk compared with non-Aboriginal youth. We examined cigarette smoking behaviour, use of other tobacco products, use of alcohol and other drugs, and exposure to second-hand smoke among 2620 Aboriginal youth living off-reserve and 26,223 non-Aboriginal youth in grades 9 to 12 who participated in the 2008/09 Youth Smoking Survey. The prevalence of current smoking among the Aboriginal youth was more than double that among non-Aboriginal youth (24.9% v. 10.4%). Aboriginal youth also had a higher prevalence of regular exposure to second-hand smoke at home (37.3% v. 19.7%) and in cars (51.0% v. 30.3%). Aboriginal youth were more likely than non-Aboriginal youth to be current smokers, to be regularly exposed to second-hand smoke, to have tried marijuana and other illicit drugs, and to engage in binge drinking. They were less likely than non-Aboriginal youth to have tried to quit smoking. Current national estimates of smoking, and alcohol and illicit drug use among youth underestimate the prevalence of these behaviours among Aboriginal youth living off-reserve. Our findings highlight the need for culturally appropriate prevention and cessation policies and programs for this at-risk population.

Bone density loss on computed tomography at 3-year follow-up in current compared to former male smokers.

PubMed

Pompe, E; Bartstra, J; Verhaar, H J; de Koning, H J; van der Aalst, C M; Oudkerk, M; Vliegenthart, R; Lammers, J-W J; de Jong, P A; Mohamed Hoesein, F A A

2017-04-01

Cigarette smoking negatively affects bone quality and increases fracture risk. Little is known on the effect of smoking cessation and computed tomography (CT)-derived bone mineral density (BMD) decline in the spine. We evaluated the association of current and former smoking with BMD decline after 3-year follow-up. Male current and former smokers participating in a lung cancer screening trial who underwent baseline and 3-year follow-up CT were included. BMD was measured by manual placement of a region of interest in the first lumbar vertebra and expressed in Hounsfield Unit (HU). Multiple linear regression analysis was used to evaluate the association between pack years smoked and smoking status with BMD decline. 408 participants were included with median (25th-75th percentile) age of 59.4 (55.9-63.5) years. At the start of the study, 197 (48.3%) participants were current smokers and 211 (51.7%) were former smokers and had a similar amount of pack years. Current smokers had quit smoking for 6 (4-8) years prior to inclusion. There was no difference in BMD between current and former smokers at baseline (109±34 HU vs. 108±32 HU, p=0.96). At 3-year follow-up, current smokers had a mean BMD decline of -3±13 HU (p=0.001), while BMD in former smokers did not change as compared to baseline (1±13 HU, p=0.34). After adjustment for BMD at baseline and body mass index, current smoking was independently associated with BMD decline (-3.8 HU, p=0.003). Age, pack years, and the presence of a fracture at baseline did not associate with BMD decline. Current smokers showed a more rapid BMD decline over a 3-year period compared to former smokers. This information might be important to identify subjects at risk for osteoporosis and emphasizes the importance of smoking cessation in light of BMD decline. Copyright © 2017 Elsevier B.V. All rights reserved.

Smoking and mortality in stroke survivors: can we eliminate the paradox?

PubMed

Levine, Deborah A; Walter, James M; Karve, Sudeep J; Skolarus, Lesli E; Levine, Steven R; Mulhorn, Kristine A

2014-07-01

Many studies have suggested that smoking does not increase mortality in stroke survivors. Index event bias, a sample selection bias, potentially explains this paradoxical finding. Therefore, we compared all-cause, cardiovascular disease (CVD), and cancer mortality by cigarette smoking status among stroke survivors using methods to account for index event bias. Among 5797 stroke survivors of 45 years or older who responded to the National Health Interview Survey years 1997-2004, an annual, population-based survey of community-dwelling US adults, linked to the National Death Index, we estimated all-cause, CVD, and cancer mortality by smoking status using Cox proportional regression and propensity score analysis to account for demographic, socioeconomic, and clinical factors. Mean follow-up was 4.5 years. From 1997 to 2004, 18.7% of stroke survivors smoked. There were 1988 deaths in this stroke survivor cohort, with 50% of deaths because of CVD and 15% because of cancer. Current smokers had an increased risk of all-cause mortality (hazard ratio [HR], 1.36; 95% confidence interval [CI], 1.14-1.63) and cancer mortality (HR, 3.83; 95% CI, 2.48-5.91) compared with never smokers, after controlling for demographic, socioeconomic, and clinical factors. Current smokers had an increased risk of CVD mortality controlling for age and sex (HR, 1.29; 95% CI, 1.01-1.64), but this risk did not persist after controlling for socioeconomic and clinical factors (HR, 1.15; 95% CI, .88-1.50). Stroke survivors who smoke have an increased risk of all-cause mortality, which is largely because of cancer mortality. Socioeconomic and clinical factors explain stroke survivors' higher risk of CVD mortality associated with smoking. Published by Elsevier Inc.

Estimating benefits of past, current, and future reductions in smoking rates using a comprehensive model with competing causes of death.

PubMed

van Meijgaard, Jeroen; Fielding, Jonathan E

2012-01-01

Despite years of declining smoking prevalence, tobacco use is still the leading preventable contributor to illness and death in the United States, and the effect of past tobacco-use control efforts has not fully translated into improvements in health outcomes. The objective of this study was to use a life course model with multiple competing causes of death to elucidate the ongoing benefits of tobacco-use control efforts on US death rates. We used a continuous-time life course simulation model for the US population. We modeled smoking initiation and cessation and 20 leading causes of death as competing risks over the life span, with the risk of death for each cause dependent on past and current smoking status. Risk parameters were estimated using data from the National Health Interview Survey that were linked to follow-up mortality data. Up to 14% (9% for men, 14% for women) of the total gain in life expectancy since 1960 was due to tobacco-use control efforts. Past efforts are expected to further increase life expectancy by 0.9 years for women and 1.3 years for men. Additional reduction in smoking prevalence may eventually yield an average 3.4-year increase in life expectancy in the United States. Coronary heart disease is expected to increase as a share of total deaths. A dynamic individual-level model with multiple causes of death supports assessment of the delayed benefits of improved tobacco-use control efforts. We show that past smoking reduction efforts will translate into further increases in life expectancy in the coming years. Smoking will remain a major contributor to preventable illness and death, worthy of continued interventions.

Effects of cigarette smoking on cortical thickness in major depressive disorder.

PubMed

Zorlu, Nabi; Cropley, Vanessa Louise; Zorlu, Pelin Kurtgoz; Delibas, Dursun Hakan; Adibelli, Zehra Hilal; Baskin, Emel Pasa; Esen, Özgür Sipahi; Bora, Emre; Pantelis, Christos

2017-01-01

Findings of surface-based morphometry studies in major depressive disorder (MDD) are still inconsistent. Given that cigarette smoking is highly prevalent in MDD and has documented negative effects on the brain, it is possible that some of the inconsistencies may be partly explained by cigarette use. The aim of the current study was to examine the influence of cigarette smoking on brain structure in MDD. 50 MDD patients (25 smokers and 25 non-smokers) and 22 age, education, gender and BMI matched non-smoker healthy controls underwent structural magnetic resonance imaging. Thickness and area of the cortex were measured using surface-based morphometry implemented with Freesurfer (v5.3.0). The non-smoker MDD patients had significantly increased cortical thickness, including in the left temporal cortex (p < 0.001), right insular cortex (p = 0.033) and left pre- and postcentral gyrus (p = 0.045), compared to healthy controls. We also found decreased cortical thickness in MDD patients who smoked compared to non-smoking patients in regions that overlapped with the regions found to be increased in non-smoking patients in comparison to controls. Non-smoker MDD patients had increased surface area in the right lateral occipital cortex (p = 0.009). We did not find any region where cortical thickness or surface area significantly differed between controls and either smoker MDD patients or all MDD patients. The findings of the current study suggest that cigarette smoking is associated with cortical thinning in regions found to be increased in patients with MDD. However, these results should be considered preliminary due to methodological limitations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Associations of smoking and alcohol consumption with impaired β-cell function in Chinese men.

PubMed

Xu, Min; Zhou, Yulin; Xu, Baihui; Sun, Jichao; Wang, Tiange; Lu, Jieli; Lai, Shenghan; Bi, Yufang; Wang, Weiqing; Ning, Guang

2016-05-01

The aims of the present study were to examine the association of cigarette smoking and alcohol consumption with impaired β-cell function in Chinese men, particularly the interaction of smoking and alcohol consumption on impaired insulin secretion. A population-based cross-sectional study was performed in 3957 Chinese men aged ≥40 years. The homeostatic model assessment of β-cell function (HOMA-β) was calculated, and impaired β-cell function was defined as less than the lowest quartile HOMA-βcut-off point. The prevalence of impaired β-cell function in current smokers and heavy drinkers (≥200 g/week) was significantly higher than in non-smokers and non-drinkers, respectively. Compared with non-smoking, current smoking had an exacerbating relationship with impaired β-cell function (odds ratio [OR] 1.78; 95% confidence interval [CI] 1.47-2.15; P < 0.001). No significant association was found between impaired β-cell function and former smoking (P = 0.21), although low and heavy drinking were associated with an increased risk of impaired β-cell function (OR 1.40 [95% CI 1.07-1.81] and 2.14 [95% CI 1.77-2.58], respectively) compared with non-drinking. The combination of current smoking and heavy drinking was associated with the highest risk of impaired β-cell function (OR 3.16; 95% CI 2.43-4.12; P < 0.0001) after adjustment for confounders. We did not detect an additive interaction between current smoking and heavy drinking on the association with impaired β-cell function. Cigarette smoking and alcohol consumption were significantly and independently associated with impaired β-cell function in Chinese men. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Patterns of global tobacco use in young people and implications for future chronic disease burden in adults.

PubMed

Warren, C W; Jones, N R; Eriksen, M P; Asma, S

2006-03-04

Tobacco use is a leading preventable risk factor for many chronic disorders, which are expected to account for an increasing share of the global disease burden. As part of the Global Youth Tobacco Survey (GYTS), we aimed to assess the effect of tobacco use by young people on global mortality. GYTS is a school-based survey of students aged 13-15 years. The survey was undertaken at 395 sites in 131 countries and the Gaza Strip and West Bank. We questioned students about current tobacco use, susceptibility to smoking among non-smokers, and exposure to secondhand smoke at home and in public places. The difference in current cigarette smoking between boys and girls is narrower than expected in many regions of the world. Use of tobacco products other than cigarettes by students is as high as cigarette smoking in many regions. Almost one in five never-smokers reported they were susceptible to smoking in the next year. Student exposure to secondhand smoke was high both at home (more than four in ten) and in public places (more than five in ten). Never-smokers were significantly less likely than current smokers to be exposed to secondhand smoke at home (prevalence 39.1% [95% CI 36.6-41.6] vs 72.8% [64.0-81.6]) and in public places (49.5% [46.7-52.3] vs 81.2% [74.2-88.2]). Our findings are troubling for the future of chronic disease and tobacco-related mortality. Reduction of tobacco consumption will require a redoubling of efforts to prevent initiation and promote cessation among the large proportion of young people who currently use tobacco. High exposure to secondhand smoke suggests a need for countries to pass strong and effective smoke-free policies.

Do the smoking intensity and duration, the years since quitting, the methodological quality and the year of publication of the studies affect the results of the meta-analysis on cigarette smoking and Acute Myeloid Leukemia (AML) in adults?

PubMed

Colamesta, Vittoria; D'Aguanno, Silvia; Breccia, Massimo; Bruffa, Sara; Cartoni, Claudio; La Torre, Giuseppe

2016-03-01

The aim was to perform a systematic review and meta-analysis on the relationship between tobacco smoking and the onset of acute myeloid leukemia (AML) in adults. PubMed and Scopus databases were systematically searched. In the meta-analysis, random or fixed effects models were used according to the presence of heterogeneity. Study quality was assessed using the Newcastle-Ottawa Scale. Twenty-seven articles were included. Case-control and cohort meta-analyses show that current, ever and former smokers have a significant increased risk to develop AML compared to never smokers [current: OR=1.36 (1.11-1.66) and RR=1.52 (1.10-2.14); ever: OR=1.25 (1.14-1.38) and RR=1.45 (1.10-1.90); former: OR=1.21 (1.03-1.41) and RR=1.45 (1.08-1.94)]. Moreover, increasing smoking intensity and duration is associated with an increase of the risk, OR shift from 1.14 (1-20 pack/years) to 2.36 (>40 pack/years). Smoking may have a significant role in AML onset in a multistep pathogenesis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Population Support Before and After the Implementation of Smoke-Free Laws in the United States: Trends From 1992–2007

PubMed Central

Nagelhout, Gera E.; Wolfson, Tanya; Zhuang, Yue-Lin; Gamst, Anthony; Willemsen, Marc C.

2015-01-01

Introduction: Several states implemented comprehensive smoke-free laws in workplaces (14 states), restaurants (17 states), and bars (13 states) between 2002 and 2007. We tested the hypothesis that public support for smoke-free laws increases at a higher rate in states that implemented smoke-free laws between 2002 and 2007 (group A) than in states that implemented smoke-free laws after that time or not at all (group B). The period before the implementation (1992–2001) was also considered. Methods: Data was used from the Current Population Survey (CPS) Tobacco Use Supplements (TUS), which is representative for the U.S. adult population. Respondents were asked whether they thought smoking should not be allowed in indoor work areas, restaurants, and bars and cocktail lounges. Differences in trends were analyzed with binomial mixed effects models. Results: Population support for smoke-free restaurants and bars was higher among group A than among group B before 2002. After 2002, support for smoke-free restaurants and bars increased at a higher rate among group A than among group B. Population support for smoke-free workplaces did not differ between group A and B, and the increase in support for smoke-free workplaces also did not differ between these groups. Conclusions: The positive association between the implementation of smoke-free restaurant and bar laws and the rate of increase in support for these laws partly supported the hypothesis. The implementation of the laws may have caused support to increase, but also states that have higher support may have been more likely to implement smoke-free laws. PMID:25143293

E-cigarette use among women of reproductive age: Impulsivity, cigarette smoking status, and other risk factors.

PubMed

Chivers, Laura L; Hand, Dennis J; Priest, Jeff S; Higgins, Stephen T

2016-11-01

The study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant. Survey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24-44years from the US. Half (n=400) reported current, daily smoking and half (n=400) reported smoking <100 cigarettes lifetime. Participants completed questionnaires regarding sociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression. Daily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products. E-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs. Copyright © 2016 Elsevier Inc. All rights reserved.

Smoking Status and the Five-Factor Model of Personality: Results of a Cross-Sectional Study Conducted in Poland

PubMed Central

Buczkowski, Krzysztof; Basinska, Małgorzata A.; Ratajska, Anna; Lewandowska, Katarzyna; Luszkiewicz, Dorota; Sieminska, Alicja

2017-01-01

Tobacco smoking is the single most important modifiable factor in increased morbidity and premature mortality. Numerous factors—including genetics, personality, and environment—affect the development and persistence of tobacco addiction, and knowledge regarding these factors could improve smoking cessation rates. This study compared personality traits between never, former, and current smokers, using the Five-Factor Model of Personality in a country with a turbulent smoking reduction process.: In this cross-sectional study, 909 Polish adults completed the Revised Neuroticism-Extraversion-Openness Personality Inventory. Our results showed that current smokers’ scores for extraversion, one of the five global dimensions of personality, were higher relative to never smokers. Neuroticism, openness to experience, agreeableness, and conscientiousness did not differ significantly according to smoking status. Facet analysis, which described each dimension in detail, showed that current smokers’ activity and excitement seeking (facets of extraversion) scores were higher relative to those of never and former smokers. In turn, current smokers’ dutifulness and deliberation (facets of conscientiousness) scores were lower than those found in former and never smokers. Never smokers scored the highest in self-consciousness (a facet of neuroticism) and compliance (a component of agreeableness). The study conducted among Polish individuals showed variation in personality traits according to their smoking status; however, this variation differed from that reported in countries in which efforts to reduce smoking had begun earlier relative to Poland. Knowledge regarding personality traits could be useful in designing smoking prevention and cessation programs tailored to individuals’ needs. PMID:28134805

E-cigarette Use Among Women of Reproductive Age: Impulsivity, Cigarette Smoking Status, and Other Risk Factors

PubMed Central

Chivers, Laura L.; Hand, Dennis J.; Priest, Jeff S.; Higgins, Stephen T.

2016-01-01

Introduction The study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant. Method Survey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24–44 years from the US. Half (n = 400) reported current, daily smoking and half (n = 400) reported smoking less than 100 cigarettes lifetime. Participants completed questionnaires regarding sociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression. Results Daily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products. Conclusions E-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs. PMID:27492277

Perception of Lung Cancer Risk: Impact of Smoking Status and Nicotine Dependence.

PubMed

Greillier, Laurent; Cortot, Alexis B; Viguier, Jérôme; Brignoli-Guibaudet, Lysel; Lhomel, Christine; Eisinger, François; Morère, Jean-François; Couraud, Sébastien

2018-03-05

The general population is nowadays well aware that tobacco smoking dramatically increases the risk of developing lung cancer. We hypothesized that a personal history of smoking and the level of nicotine dependence in current smokers may affect the perception of this risk among healthy individuals. The fourth French nationwide observational survey, EDIFICE 4, was conducted by telephone among a representative sample of individuals (N = 1602) aged between 40 and 75 years. Interviewees were asked about their smoking habits, perception of the risk of lung cancer, and nicotine dependence (Fagerström test). Regardless of their smoking status or level of nicotine dependence, the majority (96%) of our study population (N = 1463) acknowledged that tobacco smoking is a major risk factor for lung cancer. For 34% of all respondents, smoking ≤ 10 cigarettes per day does not carry any risk of lung cancer. Only half the current smokers considered themselves to be at higher risk of lung cancer than the average-risk population. The majority of current cigarette smokers with a nicotine dependence considered themselves to be at higher risk for lung cancer while only 37% of non-nicotine-dependent individuals had the same perception (P < 0.01). Current smokers were more likely to consider a screening examination than former smokers and never-smokers. However, the intention to undergo screening was not significantly affected by the level of nicotine dependence. Awareness campaigns may first have to overcome misconceptions about light smoking and, secondly, to target specific populations (heavy smokers, those with a long history, highly dependent smokers).

Trends in use of electronic nicotine delivery systems by adolescents.

PubMed

Camenga, Deepa R; Delmerico, Jennifer; Kong, Grace; Cavallo, Dana; Hyland, Andrew; Cummings, K Michael; Krishnan-Sarin, Suchitra

2014-01-01

Electronic nicotine delivery systems (ENDS) have been gaining in popularity. The few prevalence studies in adults have found that most ENDS users are current or former smokers. The objectives of this study were to estimate the prevalence of ENDS usage in adolescents, and examine the correlates of use. Self-administered written surveys assessing tobacco use behaviors were conducted in multiple waves as part of a larger intervention study in two large suburban high schools. The prevalence of past-30 day ENDS use increased from 0.9% in February 2010 to 2.3% in June 2011 (p=0.009). Current cigarette smokers had increased odds of past-30 day ENDS use in all study waves. When adjusted for school, grade, sex, race and smoking status, students in October 2010 (Adjusted OR 2.12; 95% confidence interval (CI): 1.12-4.02) and June 2011 (Adjusted OR 2.51; 95% CI: 1.17-4.71) had increased odds past-30 day ENDS use compared to February 2010. The prevalence of ENDS use doubled in this sample of high school students, and current cigarette smoking is the strongest predictor of current use. Continued monitoring of ENDS is needed to determine whether it increases the likelihood of cigarette smoking initiation and maintenance in youth. © 2013.

Smoking and psychopathology increasingly associated in recent birth cohorts.

PubMed

Talati, Ardesheer; Wickramaratne, Priya J; Keyes, Katherine M; Hasin, Deborah S; Levin, Frances R; Weissman, Myrna M

2013-12-01

In recent decades, smoking has become an increasingly non-normative behavior. Because deviant behaviors are associated with greater clinical and genetic risks, current-generation smokers may have greater concentrations of psychiatric comorbidity than previous generations. We examined this question empirically by testing whether associations between measures of smoking, psychiatric diagnoses, and risk-associated personality traits, increased across seven birth-cohorts of the 20th century. 4326 subjects from a cross-sectional NIMH control sample were categorized into one of seven groups based on birth (born before 1930, and 1930s-80s) and one of three smoking levels (lifetime dependent smoker, never dependent smoker, never smoker). Smoking and ND were assessed using the Fagerstrom Test for Nicotine Dependence; psychiatric diagnoses (drug and alcohol dependence, major depression, and generalized anxiety disorder) using the Composite International Diagnostic Interview-Short Form, and personality traits (neuroticism and extraversion) with the Eysenck Personality Questionnaire. Lifetime prevalence of smoking decreased across the seven cohorts. Associations between smoking and drug dependence, generalized anxiety, and neuroticism, as well as total psychiatric comorbidity, were greater in more recent cohorts [smoking-by-cohort interaction: p<0.01], with greatest increases contributed by nicotine-dependent smokers. Smoking was also independently associated with alcohol dependence and depression, but these associations did not significantly vary across cohorts. More recent generations included fewer persons who smoked, but their smoking was associated with greater psychiatric morbidity. Failure to account for systematic variation in comorbidity across smoking cohorts may lead to unwanted heterogeneity in clinical, and possibly genetic, studies of nicotine dependence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The association between tobacco and the risk of asthma, rhinoconjunctivitis and eczema in children and adolescents: analyses from Phase Three of the ISAAC programme.

PubMed

Mitchell, Edwin A; Beasley, Richard; Keil, Ulrich; Montefort, Stephen; Odhiambo, Joseph

2012-11-01

Exposure to parental smoking is associated with wheeze in early childhood, but in 2006 the US Surgeon General stated that the evidence is insufficient to infer a causal relationship between exposure and asthma in childhood and adolescents. To examine the association between maternal and paternal smoking and symptoms of asthma, eczema and rhinoconjunctivitis. Parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including maternal smoking in the child's first year of life, current maternal smoking (and amount) and paternal smoking. Adolescents aged 13-14 years self completed the questionnaires on these symptoms and whether their parents currently smoked. In the 6-7-year age group there were 220 407 children from 75 centres in 32 countries. In the 13-14-year age group there were 350 654 adolescents from 118 centres in 53 countries. Maternal and paternal smoking was associated with an increased risk of symptoms of asthma, eczema and rhinoconjunctivitis in both age groups, although the magnitude of the OR is higher for symptoms of asthma than the other outcomes. Maternal smoking is associated with higher ORs than paternal smoking. For asthma symptoms there is a clear dose relationship (1-9 cigarettes/day, OR 1.27; 10-19 cigarettes/day, OR 1.35; and 20+ cigarettes/day, OR 1.56). When maternal smoking in the child's first year of life and current maternal smoking are considered, the main effect is due to maternal smoking in the child's first year of life. There was no interaction between maternal and paternal smoking. This study has confirmed the importance of maternal smoking, and the separate and additional effect of paternal smoking. The presence of a dose-response effect relationship with asthma symptoms suggests that the relationship is causal, however for eczema and rhinoconjunctivitis causality is less certain.

Associations Between Excessive Sodium Intake and Smoking and Alcohol Intake Among Korean Men: KNHANES V.

PubMed

Choi, Kyung-Hwa; Park, Myung-Sook; Kim, Jung Ae; Lim, Ji-Ae

2015-12-08

In this study, we evaluated the associations of smoking and alcohol intake, both independently and collectively, with sodium intake in Korean men. Subjects (6340 men) were from the fifth Korean National Health Examination Survey (2010-2012). Smoking-related factors included smoking status, urinary cotinine level, and pack-years of smoking. Food intake was assessed using a 24-h recall. The odds of excessive sodium intake were estimated using survey logistic regression analysis. The smoking rate was 44.1%. The geometric mean of the urinary cotinine level was 0.05 µg/mL, and the median (min-max) pack-years of smoking was 13.2 (0-180). When adjusted for related factors, the odds (95% confidence interval) of excessive sodium intake were 1.54 (1.00, 2.37), 1.55 (1.23, 1.94), 1.44 (1.07, 1.95), and 1.37 (1.11, 1.68) times higher in the group exposed to smoking and drinking than in the group that never smoked nor drank, the group that never smoked and drank <5 times per month, the group that did not currently smoke and never drank, and the group that did not currently smoke or drink <5 times per month, respectively. There was an interaction effect between smoking and alcohol intake (p-interaction = 0.02). The results suggest that simultaneous exposure to smoking and alcohol intake is associated with increased odds of excessive sodium intake.

Associations Between Excessive Sodium Intake and Smoking and Alcohol Intake Among Korean Men: KNHANES V

PubMed Central

Choi, Kyung-Hwa; Park, Myung-Sook; Kim, Jung Ae; Lim, Ji-Ae

2015-01-01

In this study, we evaluated the associations of smoking and alcohol intake, both independently and collectively, with sodium intake in Korean men. Subjects (6340 men) were from the fifth Korean National Health Examination Survey (2010–2012). Smoking-related factors included smoking status, urinary cotinine level, and pack-years of smoking. Food intake was assessed using a 24-h recall. The odds of excessive sodium intake were estimated using survey logistic regression analysis. The smoking rate was 44.1%. The geometric mean of the urinary cotinine level was 0.05 µg/mL, and the median (min–max) pack-years of smoking was 13.2 (0–180). When adjusted for related factors, the odds (95% confidence interval) of excessive sodium intake were 1.54 (1.00, 2.37), 1.55 (1.23, 1.94), 1.44 (1.07, 1.95), and 1.37 (1.11, 1.68) times higher in the group exposed to smoking and drinking than in the group that never smoked nor drank, the group that never smoked and drank <5 times per month, the group that did not currently smoke and never drank, and the group that did not currently smoke or drink <5 times per month, respectively. There was an interaction effect between smoking and alcohol intake (p-interaction = 0.02). The results suggest that simultaneous exposure to smoking and alcohol intake is associated with increased odds of excessive sodium intake. PMID:26670236

Exemptions for hookah bars in clean indoor air legislation: a public health concern.

PubMed

Noonan, Devon

2010-01-01

Popularity of waterpipe smoking or hookah smoking in the United States has been growing for some time now among youth and young adults. Currently, many cities and states have exemptions that allow hookah bars to remain in operation despite the passage of clean indoor air legislation. From a public health perspective this is concerning for many reasons. One public health concern with the increase in popularity of this type of tobacco use is the associated health effects. Another concern is that hookah smoke produces a sweet smelling aroma making it less obvious that patrons and employees of hookah bars are inhaling noxious fumes from mainstream smoke, as well as the toxins from the charcoal that is used to heat the tobacco. The purpose of this paper is to discuss smoke-free air legislation in relation to hookah use, the public health implications of exempting hookah bars from current smoke-free legislation, and implications for the public health nurse in protecting the public from the dangers of second-hand smoke, and limiting this new form of tobacco use.

Association of parent and best friend smoking with stage of adolescent tobacco smoking.

PubMed

Scragg, Robert; Glover, Marewa; Paynter, Janine; Wong, Grace; McCool, Judith

2010-11-26

Compare the effect of parental and best friend smoking across the stages of adolescent smoking, from being a never smoker susceptible to smoking, to being a daily smoker National cross-sectional annual survey (2002-2006 combined) of 157,637 Year 10 students aged 14 and 15 years who answered an anonymous self-administered questionnaire. The effects of smoking by parents and best friend varied with stage of adolescent tobacco smoking. Attributable risk calculations showed that parental and best friend smoking explained only 6.3% of susceptibility to smoking among never smokers, and 21.7% of non-smoking students who had ever experimented with cigarettes. The attributable risk for parental and best friend smoking progressively increased with smoking frequency, up to 78.7% for daily smoking. The effect of best friend smoking was stronger than parental smoking, although there was a synergistic effect of both variables on the risk of daily smoking. Smoking by best friend and parents are strongly associated with current smoking by adolescents, but unrelated to susceptibility to smoke among those who are non-smokers.

Social Acceptance of Smoking Restrictions During 10 Years of Policy Implementation, Reversal, and Reenactment in the Netherlands: Findings From a National Population Survey.

PubMed

Hummel, Karin; Willemsen, Marc C; de Vries, Hein; Monshouwer, Karin; Nagelhout, Gera E

2017-02-01

Little is known about the extent to which smoking restrictions are socially accepted in a country such as the Netherlands where smoking restrictions have been implemented and reversed several times. The current study assessed trends as well as factors associated with two indicators of social acceptance of smoking restrictions in the Netherlands: acceptance of smoking in public places and implementation of home smoking bans. We used data from the Dutch Continuous Survey of Smoking Habits (DCSSH) between 2005 and 2014 (n = 182826). The DCSSH is a national population survey with a cross-sectional design in which respondents aged 15 years and older are surveyed weekly. Acceptance of smoking in public places decreased for six out of eight included venues, with the largest decrease for smoking in restaurants. The decrease in acceptance was larger among younger respondents and smokers. Smoking on terraces was an exception: decrease in acceptance there was larger among older respondents and ex-smokers. Implementation of home smoking bans increased over time. Having implemented a home smoking ban was associated with being male, being younger, having a high socioeconomic status, and being ex- or never smoker. Social acceptance of smoking restrictions has increased in the Netherlands, despite a suboptimal implementation process of smoking restrictions. However, there is still potential for improvement as acceptance of smoking is still quite high for some public venues like bars. It is important to strengthen smoking restrictions in order to further denormalize smoking in the Netherlands. We examined the extent to which smoking restrictions are socially accepted in the Netherlands where smoking restrictions have been implemented and reversed several times. Acceptance of smoking in public places decreased and implementation of home smoking bans increased between 2005 and 2014. Social acceptance of smoking restrictions increased in the Netherlands despite a suboptimal implementation process of smoking restrictions. However, acceptance of smoking in bars remains relatively high. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Collaboration in Action: Office of Research and Development ...

EPA Pesticide Factsheets

The "Collaboration in Action: US EPA's Office of Research and Develop - Current Wildfire Research Program" was invited by the USDA's US Forest Service's Scientific Executive Committee to provide USFS scientific leadership active and potential future opportunities for cooperation/collaboration. Health impacts of wildfire smoke merit the attention and action of the US EPA and current research is supported in the ACE and SHC Research Programs. Wildland fire smoke research has taken on greater importance because the 1) contribution of wildland fire PM emissions relative to total US PM emissions is increasing, 2) the population health impacts are measurable and costly, 3) vulnerable and sensitive populations at-risk are increasing attendant to our aging U.S. population and the increasing area of the wildland-urban interface, and 4) health impacts of smoke could be minimized by identifying at-risk individuals and reducing their exposures. Examples are provided. The "Collaboration in Action: US EPA's Office of Research and Develop - Current Wildfire Research Program" was invited by the USDA's US Forest Service's Scientific Executive Committee to provide USFS scientific leadership active and potential future opportunities for cooperation/collaboration.

Fire and smoke retardants

NASA Astrophysics Data System (ADS)

Drews, M. J.

Despite a reduction in Federal regulatory activity, research concerned with flame retardancy and smoke suppression in the private sector appears to be increasing. This trend seem related to the increased utilization of plastics for end uses which traditionally have employed metal or wood products. As a result, new markets have appeared for thermally stable and fire resistance thermoplastic materials, and this in turn has spurred research and development activity. In addition, public awareness of the dangers associated with fire has increased as a result of several highly publicized hotel and restaurant fires within the past two years. The consumers recognition of flammability characteristics as important materials property considerations has increased. The current status of fire and smoke retardant chemistry and research are summarized.

Is there a link between motor vehicle collisions and being a cigarette smoker in Canada? Analysis of survey data from Ontario from 2002 to 2014.

PubMed

Vingilis, Evelyn; Pederson, Linda L; Seeley, Jane; Ialomiteanu, Anca R; Wickens, Christine M; Ferrence, Roberta; Mann, Robert E

2018-05-19

Although most research on drugs and driving has focused on the use of alcohol and cannabis, research that has been conducted on cigarette smoking and collisions has found that smokers have an increased collision involvement. Studies dating from 1967 through 2013 have shown a crude relative risk of about 1.5 among smokers compared to nonsmokers. In Canada, the association between smoking and collisions has not been recently investigated. Studies that have examined the association between smoking and collisions often did not control for all confounding factors, such as alcohol use and driving exposure, which have been associated with increased collision rates. Additionally, a number of these studies were examined in countries and at times when prevalence of smoking was much higher than is currently the case in Canada. The purpose of this research is to examine the association between self-reported current smoking and past-year collision involvement, controlling for confounding factors, in a large representative sample of adult drivers in Ontario, Canada, from 2002 and 2014. Data are based on the Centre for Addiction and Mental Health (CAMH) Monitor, an ongoing, rolling telephone survey of Ontario adults that provides epidemiological surveillance of indicators related to alcohol, tobacco, and other drug use, as well as physical and mental health. The survey uses random-digit-dialing methods via Computer-Assisted Telephone Interview, with response rates over 50%. Prevalence of self-reported collision involvement within the past year for 2002-2014 was 8.6% among those who currently smoke compared to 6.5% of nonsmokers. Logistic regression analysis, controlling for the potential confounding effects of sociodemographics, driving exposure measures, drinking frequency, and hazardous alcohol use, found that the overall odds for collision involvement in the preceding year among current smokers for 2002-2014 was 1.27 (95% confidence interval [CI], 1.06-1.53) times that of nonsmokers. These findings indicate that despite a substantial reduction in overall prevalence of smoking in Canada, smokers still have a significantly increased odds of collision involvement, even when controlling for alcohol and exposure. Additionally, the results are consistent with the increased odds/risks of motor vehicle collisions found in other countries.

Depressive symptoms, depression proneness, and outcome expectancies for cigarette smoking.

PubMed

Friedman-Wheeler, Dara G; Ahrens, Anthony H; Haaga, David A F; McIntosh, Elizabeth; Thorndike, Frances P

2007-08-01

The high rates of cigarette smoking among depressed persons may be partially explained by increased positive expectancies for cigarette smoking among this population. In view of theoretical and empirical work on depressed people's negative views of the future, though, it would be expected that depressed smokers would hold particularly negative expectancies about the effects of cigarette smoking. The two current studies examined the relations between depression and smoking outcome expectancies in (a) a general population of adult regular smokers and (b) adult smokers seeking to quit smoking. Depressive symptoms and depression proneness both showed significant positive correlations with positive expectancies for cigarette smoking. Several positive correlations with negative expectancies also emerged. Thus, experiencing depressive symptoms may serve to amplify both favorable and unfavorable expectancies about the effects of smoking.

Effects of tobacco smoke exposure on asthma prevalence and medical care use in North Carolina middle school children.

PubMed

Sturm, Jesse J; Yeatts, Karin; Loomis, Dana

2004-02-01

We sought to determine the effects of exposure to environmental tobacco smoke (ETS) and childhood cigarette smoking on asthma symptoms among middle school children in North Carolina. During 1999-2000, information was collected from a survey completed by the children. Outcomes of asthma symptom reporting were regressed on tobacco smoke exposures. Children who currently smoked or reported any exposure to ETS were at increased risk of reporting active asthma symptoms. Exposure to ETS and childhood cigarette smoking was responsible for 15% of the asthma cases observed in the study population and $1.34 million in excess medical expenditures. Even at low levels of exposure, childhood cigarette smoking and ETS are independently associated with asthmatic symptoms.

Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema

PubMed Central

2011-01-01

Background Smoking is a known cause of the outcomes COPD, chronic bronchitis (CB) and emphysema, but no previous systematic review exists. We summarize evidence for various smoking indices. Methods Based on MEDLINE searches and other sources we obtained papers published to 2006 describing epidemiological studies relating incidence or prevalence of these outcomes to smoking. Studies in children or adolescents, or in populations at high respiratory disease risk or with co-existing diseases were excluded. Study-specific data were extracted on design, exposures and outcomes considered, and confounder adjustment. For each outcome RRs/ORs and 95% CIs were extracted for ever, current and ex smoking and various dose response indices, and meta-analyses and meta-regressions conducted to determine how relationships were modified by various study and RR characteristics. Results Of 218 studies identified, 133 provide data for COPD, 101 for CB and 28 for emphysema. RR estimates are markedly heterogeneous. Based on random-effects meta-analyses of most-adjusted RR/ORs, estimates are elevated for ever smoking (COPD 2.89, CI 2.63-3.17, n = 129 RRs; CB 2.69, 2.50-2.90, n = 114; emphysema 4.51, 3.38-6.02, n = 28), current smoking (COPD 3.51, 3.08-3.99; CB 3.41, 3.13-3.72; emphysema 4.87, 2.83-8.41) and ex smoking (COPD 2.35, 2.11-2.63; CB 1.63, 1.50-1.78; emphysema 3.52, 2.51-4.94). For COPD, RRs are higher for males, for studies conducted in North America, for cigarette smoking rather than any product smoking, and where the unexposed base is never smoking any product, and are markedly lower when asthma is included in the COPD definition. Variations by sex, continent, smoking product and unexposed group are in the same direction for CB, but less clearly demonstrated. For all outcomes RRs are higher when based on mortality, and for COPD are markedly lower when based on lung function. For all outcomes, risk increases with amount smoked and pack-years. Limited data show risk decreases with increasing starting age for COPD and CB and with increasing quitting duration for COPD. No clear relationship is seen with duration of smoking. Conclusions The results confirm and quantify the causal relationships with smoking. PMID:21672193

Effects of Disasters on Smoking and Relapse: An Exploratory Study of Hurricane Katrina Victims

PubMed Central

Lanctot, Jennifer Q.; Stockton, Michelle B.; Mzayek, Fawaz; Read, Mary; McDevitt-Murphy, Meghan; Ward, Kenneth

2016-01-01

Background Psychosocial stress maintains cigarette use and precipitates relapse, but little is known about how natural disasters in particular affect smoking. Purpose To determine the feasibility of recruiting victims soon after a natural disaster for a survey study, and to assess the types and determinants of changes in smoking behavior resulting from exposure to the disaster. Methods A convenience sample of 35 Hurricane Katrina refugees who had smoked more than 100 cigarettes in their lifetime were surveyed one month after the storm to evaluate changes in smoking behavior. Results Among a small sample of former smokers, more than half relapsed after Katrina, citing stress, urge, and sadness. Among current smokers, 52% increased their smoking after Katrina by more than half a pack per day on average. Most individuals who increased their smoking or relapsed expressed interest in receiving cessation assistance within the next month. Discussion Stress-related increases in smoking and relapse may be common after a natural disaster. Translation to Health Education Practice Health education professionals have an important role to play in responding to changes in tobacco use in the aftermath of disasters. Educational interventions to discourage tobacco use as a coping strategy may be especially warranted given the high level of interest expressed in smoking cessation. PMID:28496561

Smoking of parents and best friend--independent and combined effects on adolescent smoking and intention to initiate and quit smoking.

PubMed

Mak, Kwok-Kei; Ho, Sai-Yin; Day, Jeffrey R

2012-09-01

This study investigates the independent and combined effects of smoking of parents and best friend on smoking and the intention to initiate or quit smoking in adolescents. In this school-based survey, 6,553 Hong Kong students aged 13-18 reported their demographic characteristics, smoking status of themselves, parents, and best friend; and intention to smoke (initiation among never-smokers and reinitiation among ex-smokers) or quit smoking among current smokers. Logistic regression yielded adjusted odds ratios (AORs) of student smoking (current/ever) and intention to smoke or quit smoking for parental (paternal/maternal/both parents vs. none) and best friend (yes vs. no) smoking. Parental smoking and having a smoking best friend were associated with adolescent current smoking, ever smoking, and intention to initiate smoking. Having a smoking best friend was also associated with reinitiating and quitting smoking. The AORs (95% CI) of current smoking for having a smoking best friend, in addition to smoking father, mother, or both were 19.14 (14.36-25.51), 20.38 (12.42-33.43), and 24.18 (15.89-36.77). The respective AORs of ever smoking were 8.30 (6.74-10.22), 8.92 (5.63-14.12), and 11.99 (8.05-17.87). Parental smoking and best friend smoking have independent effects on adolescent smoking behaviors. Their combined effects on current and ever smoking were particularly large. Smoking prevention programs should pay special attention to adolescents with both best friend and parents who smoke.

Parental Smoking Exposure and Adolescent Smoking Trajectories

PubMed Central

Gilman, Stephen E.; Rende, Richard; Luta, George; Tercyak, Kenneth P.; Niaura, Raymond S.

2014-01-01

OBJECTIVE: In a multigenerational study of smoking risk, the objective was to investigate the intergenerational transmission of smoking by examining if exposure to parental smoking and nicotine dependence predicts prospective smoking trajectories among adolescent offspring. METHODS: Adolescents (n = 406) ages 12 to 17 and a parent completed baseline interviews (2001–2004), and adolescents completed up to 2 follow-up interviews 1 and 5 years later. Baseline interviews gathered detailed information on parental smoking history, including timing and duration, current smoking, and nicotine dependence. Adolescent smoking and nicotine dependence were assessed at each time point. Latent Class Growth Analysis identified prospective smoking trajectory classes from adolescence into young adulthood. Logistic regression was used to examine relationships between parental smoking and adolescent smoking trajectories. RESULTS: Four adolescent smoking trajectory classes were identified: early regular smokers (6%), early experimenters (23%), late experimenters (41%), and nonsmokers (30%). Adolescents with parents who were nicotine-dependent smokers at baseline were more likely to be early regular smokers (odds ratio 1.18, 95% confidence interval 1.05–1.33) and early experimenters (odds ratio 1.04, 95% confidence interval 1.04–1.25) with each additional year of previous exposure to parental smoking. Parents’ current non-nicotine–dependent and former smoking were not associated with adolescent smoking trajectories. CONCLUSIONS: Exposure to parental nicotine dependence is a critical factor influencing intergenerational transmission of smoking. Adolescents with nicotine-dependent parents are susceptible to more intense smoking patterns and this risk increases with longer duration of exposure. Research is needed to optimize interventions to help nicotine-dependent parents quit smoking early in their children’s lifetime to reduce these risks. PMID:24819567

Examining the association between adverse childhood experiences and smoking-exacerbated illnesses.

PubMed

Crouch, E; Radcliff, E; Strompolis, M; Wilson, A

2018-04-01

Adults who smoke increase their likelihood of death from smoking-exacerbated illnesses. The presence of illnesses exacerbated by smoking can be a powerful incentive to quit smoking. However, having a smoking-exacerbated illness does not stop all patients from smoking. Understanding that smoking may be a coping mechanism for stress, this study examined the association between the experiences of adverse events in childhood with continued smoking in adulthood among individuals and a smoking-exacerbated illness. This retrospective observational study used 2014-2015 data from the South Carolina Behavioral Risk Factor Surveillance System survey. We used multivariable logistic regression to examine the impact of adverse childhood experience (ACE) exposure on current smoking status. A total of 6321 respondents reported having a smoking-exacerbated illness. The most frequently reported categories of smoking-exacerbated illnesses were current asthma (63.9%), previous asthma (13.0%), and diabetes (12.3%). Overall, 62.4% of respondents had at least one ACE, with 20.3% of respondents having four or more ACEs. Respondents with one to three ACEs (adjusted odds ratio [aOR] 1.38; 95% confidence interval [CI] 1.37-1.40) and four or more ACEs (aOR 2.89; CI 2.86-2.92) were both significantly more likely to smoke than respondents with no ACEs, even in the presence of illnesses exacerbated by smoking. Results suggest that ACE exposure may influence risky health behaviors in adulthood, such as continued smoking even in the presence of illnesses that are exacerbated by smoking. Given that smoking has been found to be a coping mechanism for adversity, anti-smoking efforts might benefit from designing interventions and treatment plans that address ACE exposure. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Trends in recall and appraisal of anti-smoking advertising among American youth: national survey results, 1997-2001.

PubMed

Johnston, Lloyd D; Terry-McEllrath, Yvonne M; O'Malley, Patrick M; Wakefield, Melanie

2005-03-01

Public health efforts to reduce the harms related to tobacco use currently include a significant emphasis on anti-smoking media campaigns. This paper provides (a) data on the overall extent of exposure to anti-smoking media among American youth from 1997 to 2001, (b) an appraisal of general youth reactions to such advertising, and (c) an examination of how exposure levels and reactions vary by socio-demographic characteristics. Data were obtained from the Monitoring the Future study, an ongoing nationwide study of youth. Data were collected each year from nationally representative separate and nonoverlapping school samples of 8th, 10th, and 12th grade students (N = 29,724; 24,639; and 12,138, respectively). Self-reported levels of recalled exposure to both electronic and print anti-smoking advertising were measured, as well as the judged impact and perceived exaggeration of such advertising. Data indicate that significant increases in overall exposure to anti-smoking advertising occurred over the study time period. These increases were associated with (a) increases in the self-reported likelihood that anti-smoking advertising diminished the probability of individual smoking behaviors, and (b) increases in the perceived level to which anti-smoking advertising exaggerates the risks associated with smoking. Further, these trends were significantly associated with various characteristics-most notably, ethnicity, smoking behaviors, and residence in a state with an ongoing tobacco-control program having a media component.

Laboratory studies of refractory metal oxide smokes

NASA Technical Reports Server (NTRS)

Nuth, Joseph A.; Nelson, R. N.; Donn, Bertram

1989-01-01

Studies of the properties of refractory metal oxide smokes condensed from a gas containing various combinations of SiH4, Fe(CO)5, Al(CH3)3, TiCl4, O2 and N2O in a hydrogen carrier stream at 500 K greater than T greater than 1500 K were performed. Ultraviolet, visible and infrared spectra of pure, amorphous SiO(x), FeO(x), AlO(x) and TiO(x) smokes are discussed, as well as the spectra of various co-condensed amorphous oxides, such as FE(x)SiO(y) or Fe(x)AlO(y). Preliminary studies of the changes induced in the infrared spectra of iron-containing oxide smokes by vacuum thermal annealing suggest that such materials become increasingly opaque in the near infrared with increased processing: hydration may have the opposite effect. More work on the processing of these materials is required to confirm such a trend: this work is currently in progress. Preliminary studies of the ultraviolet spectra of amorphous Si2O3 and MgSiO(x) smokes revealed no interesting features in the region from 200 to 300 nm. Studies of the ultraviolet spectra of both amorphous, hydrated and annealed SiO(x), TiO(x), AlO(x) and FeO(x) smokes are currently in progress. Finally, data on the oxygen isotopic composition of the smokes produced in the experiments are presented, which indicate that the oxygen becomes isotopically fractionated during grain condensation. Oxygen in the grains is as much as 3 percent per amu lighter than the oxygen in the original gas stream. The authors are currently conducting experiments to understand the mechanism by which fractionation occurs.

Alcohol consumption, cigarette smoking and incidence of aortic valve stenosis.

PubMed

Larsson, S C; Wolk, A; Bäck, M

2017-10-01

Alcohol consumption and cigarette smoking are modifiable lifestyle factors with important impact on public health. It is unclear whether these factors influence the risk of aortic valve stenosis (AVS). To investigate the associations of alcohol consumption and smoking, including smoking intensity and time since cessation, with AVS incidence in two prospective cohorts. This analysis was based on data from the Swedish Mammography Cohort and the Cohort of Swedish Men, comprising 69 365 adults without cardiovascular disease at baseline. Participants were followed for AVS incidence and death by linkage to the Swedish National Patient and Causes of Death Registers. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated by Cox proportional hazards regression. Over a mean follow-up of 15.3 years, 1249 cases of AVS (494 in women and 755 in men) were recorded. Compared with never drinkers of alcohol (lifelong abstainers), the risk of AVS was significantly lower in current light drinkers (1-6 drinks per week [1 drink = 12 g alcohol]; multivariable HR 0.82; 95% CI: 0.68-0.99). The risk of AVS increased with increasing smoking intensity. Compared with never smokers, the HR was 1.46 (95% CI: 1.16-1.85) in current smokers of ≥30 pack-years. Former smokers who had quit smoking 10 or more years previously had similar risk for AVS as never smokers. This study suggests that current light alcohol consumption is associated with a lower risk of AVS, and indicates that the association between smoking and AVS risk is reversible. © 2017 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

Risk Perception and Correlates of Tobacco Use among Young People Outside of Formal School Settings in Lagos State, Nigeria.

PubMed

Odukoya, O O; Dada, M R; Olubodun, T; Igwilo, U A; Ayo-Yusuf, O A

2016-01-01

Tobacco use among youth is a major public health problem. Youth outside of formal school settings are often understudied but may be at increased risk. A descriptive cross- sectional study was carried out among 326 young people aged 15-24 years in four randomly selected motor parks in Lagos state. Interviewer-administered questionnaires were used to collect data. The mean age of the respondents was 21.0±2.3yrs. Many 252 (77.3%) dropped out before the end of the third year of secondary schooling. The majority were aware that active (78.2%), and passive smoking (77.3%) are harmful to health. Nearly two-thirds of the respondents disagreed with an outright ban of cigarettes (63.2%) and restriction of cigarette sales to persons below 18 years (67.9%) while 254 (66.8%) supported a ban on tobacco smoking in enclosed public places. One hundred and fifty (46.0%) respondents had experimented with smoking of which 106 (32.5%) had progressed to become current smokers. Half of the current smokers, 54 (50.9%), felt the need for a cigarette first thing in the morning. A multivariate analysis for smoking initiation, showed that for every increasing year of age, respondents were 1.08 times more likely to have initiated cigarette smoking; males and respondents who lived alone or with peers were 2.34 times and 1.77 times more likely to have initiated smoking respectively; those who consume alcohol and marijuana were 7.27 and 1.89 times respectively more likely to have initiated smoking while those who consumed alcohol were 6.17 times more likely to be current smokers.

Long-term health and medical cost impact of smoking prevention in adolescence.

PubMed

Wang, Li Yan; Michael, Shannon L

2015-02-01

To estimate smoking progression probabilities from adolescence to young adulthood and to estimate long-term health and medical cost impacts of preventing smoking in today's adolescents. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we first estimated smoking progression probabilities from adolescence to young adulthood. Then, using the predicted probabilities, we estimated the number of adolescents who were prevented from becoming adult daily smokers as a result of a hypothetical 1 percentage point reduction in the prevalence of ever smoking in today's adolescents. We further estimated lifetime medical costs saved and quality-adjusted life years (QALYs) gained as a result of preventing adolescents from becoming adult daily smokers. All costs were in 2010 dollars. Compared with never smokers, those who had tried smoking at baseline had higher probabilities of becoming current or former daily smokers at follow-up regardless of baseline grade or sex. A hypothetical 1 percentage point reduction in the prevalence of ever smoking in 24.5 million students in 7th-12th grades today could prevent 35,962 individuals from becoming a former daily smoker and 44,318 individuals from becoming a current daily smoker at ages 24-32 years. As a result, lifetime medical care costs are estimated to decrease by $1.2 billion and lifetime QALYs is estimated to increase by 98,590. Effective smoking prevention programs for adolescents go beyond reducing smoking prevalence in adolescence; they also reduce daily smokers in young adulthood, increase QALYs, and reduce medical costs substantially in later life. This finding indicates the importance of continued investment in effective youth smoking prevention programs. Published by Elsevier Inc.

Tobacco-specific nitrosamine exposures in smokers and nonsmokers exposed to cigarette or waterpipe tobacco smoke.

PubMed

Radwan, Ghada; Hecht, Stephen S; Carmella, Steven G; Loffredo, Christopher A

2013-01-01

The causal relationship between tobacco smoking and a variety of cancers is attributable to the carcinogens that smokers inhale, including tobacco-specific nitrosamines (TSNAs). We aimed to assess the exposure to TSNAs in waterpipe smokers (WPS), cigarette smokers (CS), and nonsmoking females exposed to tobacco smoke. We measured 2 metabolites, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronides (NNAl-Gluc) in the urine of males who were either current CS or WPS, and their wives exposed to either cigarette or waterpipe smoke in a sample of 46 subjects from rural Egypt. Of the 24 current male smokers, 54.2% were exclusive CS and 45.8% were exclusive WPS. Among wives, 59.1% reported exposure to cigarette smoke and 40.9% to waterpipe smoke. The geometric mean of urinary NNAL was 0.19 ± 0.60 pmol/ml urine (range 0.005-2.58) in the total sample. Significantly higher levels of NNAL were observed among male smokers of either cigarettes or waterpipe (0.89 ± 0.53 pmol/ml, range 0.78-2.58 in CS and 0.21-1.71 in WPS) compared with nonsmoking wives (0.04 ± 0.18 pmol/ml, range 0.01-0.60 in CS wives, 0.05-0.23 in WPS wives, p = .000). Among males, CS had significantly higher levels of NNAL compared with WPS (1.22 vs. 0.62; p = .007). However, no significant difference was detected in NNAL levels between wives exposed to cigarette smoke or waterpipe smoke. Cigarette smokers levels of NNAL were higher than WPS levels in males. Exposure to tobacco smoke was evident in wives of both CS and WPS. Among WPS, NNAL tended to increase with increasing numbers of hagars smoked/day.

Longitudinal changes in prevalence of respiratory symptoms among Canadian grain elevator workers.

PubMed

Pahwa, Punam; McDuffie, Helen H; Dosman, James A

2006-06-01

To determine longitudinal changes in the prevalence of chronic respiratory symptoms among Canadian grain workers. Data on respiratory symptoms, smoking status, and pulmonary function were obtained approximately every 3 years (termed cycle) over 15 years beginning in 1978 from five regions of Canada. The number of grain workers participating in each cycle were as follows: cycle 1 (n = 5,702); cycle 2 (n = 5,491); cycle 3 (n = 3,713); cycle 4 (n = 2,847); and cycle 5 (n = 3,079). A procedure based on generalized estimating equations (PROC GENMOD; SAS Institute; Cary, NC) was used to fit marginal models to determine risk factors influencing the prevalence of chronic respiratory symptoms (wheeze, dyspnea, sputum, and cough). The prevalence (predicted probability based on the final model) of chronic respiratory symptoms had an increasing trend with increasing number of years in the grain industry from cycle 1 to cycle 3 (before dust control) for all three smoking categories (current smokers, ex-smokers, and nonsmokers). For cycle 4 and cycle 5 (after dust control), there was a reduction in the prevalence of these respiratory symptoms. For example, in cycle 1, the prevalence of chronic wheeze among current smoking grain workers increased from 12% (for those in the industry for < 5 years) to 44% (for those in the industry for > 35 years); in cycle 5, the prevalence of chronic wheeze among current smoking grain workers increased from 9% (for those in the industry for < 5 years) to 28% (for those in the industry for > 35 years). Similar trends were observed for ex-smokers and nonsmokers and for other chronic respiratory symptoms. Our results indicate that grain dust control was effective in reducing the prevalence of chronic respiratory symptoms among grain workers in all smoking and exposure categories.

Prediagnostic Smoking Is Associated with Binary and Quantitative Measures of ER Protein and ESR1 mRNA Expression in Breast Tumors.

PubMed

Butler, Eboneé N; Bensen, Jeannette T; Chen, Mengjie; Conway, Kathleen; Richardson, David B; Sun, Xuezheng; Geradts, Joseph; Olshan, Andrew F; Troester, Melissa A

2018-01-01

Background: Smoking is a possible risk factor for breast cancer and has been linked to increased risk of estrogen receptor-positive (ER + ) disease in some epidemiologic studies. It is unknown whether smoking has quantitative effects on ER expression. Methods: We examined relationships between smoking and ER expression from tumors of 1,888 women diagnosed with invasive breast cancer from a population-based study in North Carolina. ER expression was characterized using binary (±) and continuous measures for ER protein, ESR1 mRNA, and a multigene luminal score (LS) that serves as a measure of estrogen signaling in breast tumors. We used logistic and linear regression models to estimate temporal and dose-dependent associations between smoking and ER measures. Results: The odds of ER + , ESR1 + , and LS + tumors among current smokers (at the time of diagnosis), those who smoked 20 or more years, and those who smoked within 5 years of diagnosis were nearly double those of nonsmokers. Quantitative levels of ESR1 were highest among current smokers compared with never smokers overall [mean (log 2 ) = 9.2 vs. 8.7, P < 0.05] and among ER + cases; however, we did not observe associations between smoking measures and continuous ER protein expression. Conclusions: In relationship to breast cancer diagnosis, recent smoking was associated with higher odds of the ER + , ESR1 + , and LS + subtype. Current smoking was associated with elevated ESR1 mRNA levels and an elevated LS, but not with altered ER protein. Impact: A multigene LS and single-gene ESR1 mRNA may capture tumor changes associated with smoking. Cancer Epidemiol Biomarkers Prev; 27(1); 67-74. ©2017 AACR . ©2017 American Association for Cancer Research.

Electronic cigarette use and its association with smoking in Hong Kong Chinese adolescents.

PubMed

Wang, Man Ping; Ho, Sai Yin; Leung, Lok Tung; Lam, Tai Hing

2015-11-01

Electronic cigarettes (e-cigarettes) are increasingly used in adolescents with unknown impacts on conventional cigarette smoking. We examined the associations of e-cigarette use with smoking intention, nicotine addiction and smoking cessation in Chinese adolescents. A total of 45,128 students (age 14.6 ± 1.9; boys 51.4%) from 75 randomly selected schools in Hong Kong reported e-cigarette use (in the past 30 days), conventional cigarette use and socio-demographic characteristics in an anonymous questionnaire survey. Adjusted odds ratios (AORs) of intention to smoke, morning smoking urge, intention to quit and quit attempts; and beta-coefficient (β) of cigarette consumption per day were calculated in relation to e-cigarette use. E-cigarette use was associated with intention to smoke with an AOR (95% CI) of 1.74 (1.30-2.31) in all students, 2.18 (1.12-4.23) in never and 2.79 (2.05-3.79) in ever smokers (non-significant interaction by smoking status). The associations were also significant in experimental and former smokers but not in current smokers. In current smokers, e-cigarette use was significantly associated with heavier smoking (β 2.54, 95% CI 1.28-3.81) and morning smoking urge (AOR 2.54, 95% CI 1.50-3.11), and non-significantly associated with lower quit intention (0.76, 0.52-1.09) and attempts (0.80, 0.56-1.23). E-cigarette use was associated with smoking intention in never, experimental and former smokers in Hong Kong Chinese adolescents. In current smokers, e-cigarette use was associated with nicotine addiction but not quit intention and attempts. Prospective studies with detailed measurements on e-cigarette use are warranted for further studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Heavier smoking increases coffee consumption: findings from a Mendelian randomization analysis.

PubMed

Bjørngaard, Johan H; Nordestgaard, Ask Tybjærg; Taylor, Amy E; Treur, Jorien L; Gabrielsen, Maiken E; Munafò, Marcus R; Nordestgaard, Børge Grønne; Åsvold, Bjørn Olav; Romundstad, Pål; Davey Smith, George

2017-12-01

There is evidence for a positive relationship between cigarette and coffee consumption in smokers. Cigarette smoke increases metabolism of caffeine, so this may represent a causal effect of smoking on caffeine intake. We performed Mendelian randomization analyses in the UK Biobank (N = 114 029), the Norwegian HUNT study (N = 56 664) and the Copenhagen General Population Study (CGPS) (N = 78 650). We used the rs16969968 genetic variant as a proxy for smoking heaviness in all studies and rs4410790 and rs2472297 as proxies for coffee consumption in UK Biobank and CGPS. Analyses were conducted using linear regression and meta-analysed across studies. Each additional cigarette per day consumed by current smokers was associated with higher coffee consumption (0.10 cups per day, 95% CI: 0.03, 0.17). There was weak evidence for an increase in tea consumption per additional cigarette smoked per day (0.04 cups per day, 95% CI: -0.002, 0.07). There was strong evidence that each additional copy of the minor allele of rs16969968 (which increases daily cigarette consumption) in current smokers was associated with higher coffee consumption (0.16 cups per day, 95% CI: 0.11, 0.20), but only weak evidence for an association with tea consumption (0.04 cups per day, 95% CI: -0.01, 0.09). There was no clear evidence that rs16969968 was associated with coffee or tea consumption in never or former smokers or that the coffee-related variants were associated with cigarette consumption. Higher cigarette consumption causally increases coffee intake. This is consistent with faster metabolism of caffeine by smokers, but could also reflect a behavioural effect of smoking on coffee drinking. © The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association.

Heavier smoking increases coffee consumption: findings from a Mendelian randomization analysis

PubMed Central

Bjørngaard, Johan H; Nordestgaard, Ask Tybjærg; Taylor, Amy E; Treur, Jorien L; Gabrielsen, Maiken E; Munafò, Marcus R; Nordestgaard, Børge Grønne; Åsvold, Bjørn Olav; Romundstad, Pål; Davey Smith, George

2017-01-01

Abstract Background There is evidence for a positive relationship between cigarette and coffee consumption in smokers. Cigarette smoke increases metabolism of caffeine, so this may represent a causal effect of smoking on caffeine intake. Methods We performed Mendelian randomization analyses in the UK Biobank (N = 114 029), the Norwegian HUNT study (N = 56 664) and the Copenhagen General Population Study (CGPS) (N = 78 650). We used the rs16969968 genetic variant as a proxy for smoking heaviness in all studies and rs4410790 and rs2472297 as proxies for coffee consumption in UK Biobank and CGPS. Analyses were conducted using linear regression and meta-analysed across studies. Results Each additional cigarette per day consumed by current smokers was associated with higher coffee consumption (0.10 cups per day, 95% CI: 0.03, 0.17). There was weak evidence for an increase in tea consumption per additional cigarette smoked per day (0.04 cups per day, 95% CI: −0.002, 0.07). There was strong evidence that each additional copy of the minor allele of rs16969968 (which increases daily cigarette consumption) in current smokers was associated with higher coffee consumption (0.16 cups per day, 95% CI: 0.11, 0.20), but only weak evidence for an association with tea consumption (0.04 cups per day, 95% CI: -0.01, 0.09). There was no clear evidence that rs16969968 was associated with coffee or tea consumption in never or former smokers or that the coffee-related variants were associated with cigarette consumption. Conclusions Higher cigarette consumption causally increases coffee intake. This is consistent with faster metabolism of caffeine by smokers, but could also reflect a behavioural effect of smoking on coffee drinking. PMID:29025033

Exploring Scenarios to Dramatically Reduce Smoking Prevalence: A Simulation Model of the Three-Part Cessation Process

PubMed Central

Mabry, Patricia L.; Graham, Amanda L.; Orleans, C. Tracy; Abrams, David B.

2010-01-01

Objectives. We used a simulation model to analyze whether the Healthy People 2010 goal of reducing smoking prevalence from the current 19.8% rate to 12% by 2010 could be accomplished by increasing quit attempts, increasing the use of treatments, or increasing the effectiveness of treatment. Methods. We expanded on previous versions of the tobacco control simulation model SimSmoke to assess the effects of an increase in quit attempts, treatment use, and treatment effectiveness to reduce smoking prevalence. In the model, we considered increases in each of these parameters individually and in combination. Results. Individually, 100% increases in quit attempts, treatment use, and treatment effectiveness reduced the projected 2020 prevalence to 13.9%, 16.7%, and 15.9%, respectively. With a combined 100% increase in all components, the goal of a 12% adult smoking prevalence could be reached by 2012. Conclusions. If we are to come close to reaching Healthy People 2010 goals in the foreseeable future, we must not only induce quit attempts but also increase treatment use and effectiveness. Simulation models provide a useful tool for evaluating the potential to reach public health targets. PMID:20466969

Predictors of Smoking among Saudi Dental Students in Jeddah.

PubMed

Mansour, Ameerah Y

2017-05-01

The objective of this study was to assess tobacco use, secondhand smoke exposure, knowledge of health risks, and smoking predictors among dental students attending King Abdulaziz University, Jeddah, Saudi Arabia. A cross-sectional study was conducted and 420 dental students were invited to participate. Binary logistic regression analyses assessed the predictors of smoking. A total of 336 dental students completed the questionnaires with 25% reporting current or previous tobacco use and 96% reporting secondhand smoke exposure. Nearly half of all smokers initiated smoking during the dental program. The logistic regression results revealed that being a male (OR = 7.1, p < .0001; 95%CI = 3.7-13.4) and having a smoker in the family (OR = 2.6, p = .005; 95%CI = 1.3-5.0) increased the likelihood of smoking. In contrast, knowledge of health risks decreased the likelihood of smoking (OR = 0.90, p = .014; 95%CI = 0.82-0.98). Despite possessing knowledge about the health risks of smoking, high numbers of dental students continue to smoke and were exposed to secondhand smoke. Sex and family influence were the main pro-smoking risk factors, whereas increased knowledge of health risks was a protective factor. Tobacco control programs to reduce and/or prevent tobacco use among future dentists are needed.

Smoking cessation and bone healing: optimal cessation timing.

PubMed

Truntzer, Jeremy; Vopat, Bryan; Feldstein, Michael; Matityahu, Amir

2015-02-01

Smoking is a worldwide epidemic. Complications related to smoking behavior generate an economic loss around $193 billion annually. In addition to impacting chronic health conditions, smoking is linked to increased perioperative complications in those with current or previous smoking history. Numerous studies have demonstrated more frequent surgical complications including higher rates of infection, poor wound healing, heightened pain complaints, and increased pulmonary morbidities in patients with a smoking history. Longer preoperative cessation periods also seem to correlate with reduced rates. At roughly 4 weeks of cessation prior to surgery, complication rates more closely reflect individuals without a smoking history in comparison with those that smoke within 4 weeks of surgery. In the musculoskeletal system, a similar trend has been observed in smokers with higher rates of fractures, nonunions, malunions, infections, osteomyelitis, and lower functional scores compared to non-smoking patients. Unfortunately, the present literature lacks robust data suggesting a temporal relationship between smoking cessation and bone healing. In our review, we analyze pseudoarthrosis rates following spinal fusion to suggest that bone healing in the context of smoking behavior follows a similar time sequence as observed in wound healing. We also discuss the implications for further clarity on bone healing and smoking cessation within orthopedics including improved risk stratification and better identification of circumstances where adjunct therapy is appropriate.

Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions

PubMed Central

Torres, L. D.; Barrera, A. Z.; Delucchi, K.; Penilla, C.; Pérez-Stable, E. J.; Muñoz, R. F.

2011-01-01

Background Limited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation. Method Spanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history. Results Continued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04–1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77–1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29–2.27, p<0.001) and afterwards (history 21.7% v. no history 8.3%, OR 3.87, 95% CI 2.25–6.65, p<0.001), although the interaction between history and abstinence did not. Conclusions Quitting smoking was not associated with increased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs. PMID:19627638

Quitting smoking does not increase the risk of major depressive episodes among users of Internet smoking cessation interventions.

PubMed

Torres, L D; Barrera, A Z; Delucchi, K; Penilla, C; Pérez-Stable, E J; Muñoz, R F

2010-03-01

Limited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation. Spanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history. Continued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04-1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77-1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29-2.27, p<0.001) and afterwards (history 21.7% v. no history 8.3%, OR 3.87, 95% CI 2.25-6.65, p<0.001), although the interaction between history and abstinence did not. Quitting smoking was not associated with increased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs.

The tobacco endgame in Hong Kong: public support for a total ban on tobacco sales.

PubMed

Wang, Man Ping; Wang, Xin; Lam, Tai Hing; Viswanath, Kasisomayajula; Chan, Sophia S

2015-03-01

Tobacco endgame policies are increasingly advocated to end tobacco use. This study investigated public support for a total ban on tobacco sales, use and possession in Hong Kong. A telephone survey was conducted among 1537 randomly selected residents in 2012 to assess their support for a total ban on tobacco sales, usage and possession. Information on sociodemographic characteristics, smoking, and second hand smoke exposure were collected. Logistic regression was used to investigate factors associated with support for a total ban. Most of the never smokers (75.3%), ex-smokers (63.9%), and nearly half of current smokers (48.9%) backed some form of a total ban on tobacco. A total ban on tobacco sales was the most popular option among the three groups, with over half (64.8%) of all respondents supporting a ban within 10 years. Current smoking and higher educational attainment were associated with less support for a total ban on tobacco sales. Among current smokers, having quit intentions and attempts to quit were associated with support for a total ban. A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Youth tobacco surveillance--United States, 2000.

PubMed

2001-11-02

Tobacco use is the single leading preventable cause of death in the United States, accounting for approximately 430,000 deaths each year. The prevalence of cigarette smoking nationwide among high school students increased during the 1990s, peaking during 1996-1997, then began a gradual decline. Approximately 80% of tobacco users initiate use before age 18 years. If the trend in early initiation of cigarette smoking continues, approximately 5 million children aged <18 years who are living today will die prematurely because they began to smoke cigarettes during adolescence. The economic costs associated with tobacco use ranges from $53 billion to $73 billion per year in medical expenses and $47 billion in lost productivity. Because of these health and economic consequences, CDC has recommended that states establish and maintain comprehensive tobacco-control programs to reduce tobacco use among youth. January 2000 through December 2000. To assist states in developing and maintaining their state-based comprehensive tobacco prevention and control programs, CDC developed the Youth Tobacco Surveillance and Evaluation System, which includes international, national, and state school-based surveys of middle school and high school students. Two components of this system are discussed in this report--the National Youth Tobacco Survey and the state Youth Tobacco Surveys. The national survey is representative of students in the 50 states and the District of Columbia; 35,828 students in 324 schools completed questionnaires in the spring of 2000. Twenty-nine state surveys were conducted in the spring and fall of 2000; state sample sizes ranged from 583 to 33,586 students. This report summarizes data from the 2000 national survey and state surveys. Findings from the National Youth Tobacco Survey indicate that current tobacco use ranges from 15.1% among middle school students to 34.5% among high school students. Cigarette smoking is the most prevalent form of tobacco use, followed by cigar smoking and smokeless tobacco use. Approximately one half of current cigarette smokers in middle school and high school report that they usually smoke Marlboro cigarettes. Black students are more likely to smoke Newport cigarettes than any other brand. More than one half of current cigarette smokers in middle school and high school report that they want to stop smoking. Nearly one fourth of middle school and high school students who have never smoked cigarettes are susceptible to initiating cigarette smoking in the next year. Exposure to secondhand smoke (e.g., environmental tobacco smoke) is substantially higher among both middle school and high school students. During the week before the survey, approximately 9 out of 10 current cigarette smokers and one half of never cigarette smokers were in the same room with someone who was smoking cigarettes; and 8 out of 10 current cigarette smokers and 3 out of 10 never cigarette smokers rode in a car with someone who was smoking cigarettes. Approximately 70% of middle school and 57% of high school students who currently smoke cigarettes live in a home where someone smokes cigarettes. Among never cigarette smokers, approximately 3 out of 10 live in a home where someone smokes cigarettes. Approximately 69% of middle school and 58% of high school students aged <18 years who currently smoke cigarettes were not asked to show proof of age when they bought or tried to buy cigarettes. Approximately 8 out of 10 middle school and high school students have seen antismoking commercials. Eight out of 10 middle school students report having seen actors using tobacco on television or in the movies, and approximately 11% of middle school and 16% of high school students who had never used tobacco would wear or use something with a tobacco company name or picture on it. This rate increases to nearly 60% for current tobacco users. Youth Tobacco Survey data are used by health and education officials to improve national and state programs to prevent and control youth tobacco use. Several states use the data in presentations to their state legislators to demonstrate the need for funding smoking cessation and prevention programs for youth.

What do mothers think about concurrent breast-feeding and smoking?

PubMed

Bogen, Debra L; Davies, Erin D; Barnhart, Wesley C; Lucero, Cynthia A; Moss, Deborah R

2008-01-01

According to newer policies of the American Academy of Pediatrics, smoking is not contraindicated with breast-feeding, yet smokers initiate and maintain breast-feeding less often than nonsmokers. We sought to describe maternal knowledge and attitudes regarding concurrent breast-feeding and smoking or nicotine replacement therapy (NRT) and to evaluate the association between maternal smoking and infant feeding practices. Mothers bringing children <13 months old for an appointment completed a 24-item anonymous survey that addressed knowledge, attitudes, and practices about concurrent breast-feeding and smoking/NRT. Among 204 survey completers, 63% were African American, 52% had never breast-fed, and 54% had never smoked. Regardless of smoking status, 19% were aware of the recommendation to smoke after breast-feeding; most did not know that nicotine gum (42%) or patch (40%) transfers less or about the same amount of nicotine into breast milk than smoking a pack per day. Most mothers (80%) believed that women should not smoke any cigarettes if breast-feeding; current smokers (25%) were more likely than former (10%) or never smokers (11%) to find it acceptable to smoke one or more cigarettes per day (P = .03). Only 2% found it acceptable to use NRT while breast-feeding. Among ever breast-feeders, 10% stopped breast-feeding because of smoking. Over half of recent or current smokers reported that smoking affected their infant feeding decision. Mothers in this sample believe that women who smoke or take NRT should not breast-feed. Smoking status affected women's infant feeding practices. Correction of misinformation could increase breast-feeding rates.

Reward-related frontostriatal activity and smoking behavior among adolescents in treatment for smoking cessation.

PubMed

Garrison, Kathleen A; Yip, Sarah W; Balodis, Iris M; Carroll, Kathleen M; Potenza, Marc N; Krishnan-Sarin, Suchitra

2017-08-01

Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking. The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n=14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n=28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales. Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment. These findings suggest that reduced smoking during smoking cessation treatment is associated with a "recovery of function" in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence and sociodemographic determinants of tobacco use among adults in Pakistan: findings of a nationwide survey conducted in 2012

PubMed Central

2013-01-01

Background Smoking is one of the leading causes of preventable mortality. The World Health Organization recommends that countries should monitor tobacco use regularly. In Pakistan, the last national study on smoking in the general population was conducted in 2002 to 2003. Methods We conducted a cross-sectional survey of a nationally representative sample of men and women living in rural and urban areas of four main provinces of Pakistan from March through April 2012. Face-to-face in-house interviews were undertaken using a pre-tested structured questionnaire that asked about smoking and other forms of tobacco use. Multistage stratified random area probability sampling was used. To determine the national prevalence of tobacco use, the sample was weighted to correspond to rural–urban population proportions in each of the four provinces as in the 1998 census conducted by Pakistan’s Population Census Organization. Associations between sociodemographic variables and tobacco use were investigated using multivariable robust regression. Results Out of 2,644 respondents (1,354 men and 1,290 women), 354 men and 4 women reported being current cigarette smokers. The weighted prevalence of current cigarette smoking was 15.2% (95% confidence interval [CI]; 11.2, 19.3) overall, 26.6% (95% CI: 19.1, 34.1) among males, and 0.4% (95% CI: -0.2, 1.0) among females. Among females, 1.8% (95% CI: 0.4, 3.1) used any smoked tobacco and 4.6% (95% CI: 1.8, 7.4) used any smokeless tobacco daily or on some days of the week. Among males, odds of current cigarette smoking decreased with increasing level of education (OR = 0.75; 95% CI: 0.68, 0.84) and increased with having a father who used tobacco (OR = 2.11; 95% CI: 1.39, 3.22) after adjusting for other sociodemographic characteristics. Lower household income was associated with current cigarette smoking among rural males only (odds ratio [OR] = 0.67; 95% CI: 0.48, 0.92 per category increase in monthly household income). Conclusion A large proportion of males smoked cigarettes. Cigarette use was negligible among females, but they used other forms of tobacco. Low education was a determinant of cigarette smoking among males irrespective of socioeconomic status and area of residence. Tobacco control campaigns should target uneducated and rural poor men and monitor all forms of tobacco used by the population. PMID:24004968

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections

PubMed Central

2012-01-01

Background Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. Methods The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Results Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Conclusions Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy. PMID:22784412

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections.

PubMed

McLellan, Deborah L; Hodgkin, Dominic; Fagan, Pebbles; Reif, Sharon; Horgan, Constance M

2012-07-11

Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy.

Youth tobacco surveillance--United States, 1998-1999.

PubMed

2000-10-13

Tobacco use is the single leading preventable cause of death in the United States, accounting for approximately, 430,000 deaths each year. The prevalence of cigarette smoking nationwide among high school students increased during the 1990s, peaking in 1996-1997, then began a gradual decline. Approximately 80% of tobacco users initiate use before the age of 18 years. If the trend in early initiation of cigarette smoking continues, approximately 5 million children aged <18 years who are living today will die prematurely as adults because they began to smoke cigarettes during adolescence. The economic liability associated with tobacco use ranges from $50 billion to $73 billion per year in medical expenses alone. Because of these health and economic consequences, CDC has recommended that states establish and maintain comprehensive tobacco control programs to reduce tobacco use among youth. February 1998 through December 1999. To assist states in developing and maintaining their state-based comprehensive tobacco prevention and control programs, CDC developed the Youth Tobacco Surveillance and Evaluation System, which includes international, national, and state school-based surveys of middle school and high school students. Two components of this system are discussed--the National Youth Tobacco Survey and the state Youth Tobacco Surveys. The national survey is representative of students in the 50 states and the District of Columbia; 15,061 students in 131 schools completed questionnaires in 1999. The state surveys were first conducted in 1998, when three states participated, and in 1999, when 13 states participated (13 states conducted middle school surveys and 10 states conducted high school surveys); state sample sizes ranged from 452 to 15,478 students. This report summarizes data from the 1999 national survey and the 1998 and 1999 state surveys. Findings from the National Youth Tobacco Survey show current tobacco use ranges from 12.8% among middle school students to 34.8% among high school students. Cigarette smoking is the most prevalent form of tobacco used, followed by cigars and smokeless tobacco. Young people have strong cigarette brand preferences. Almost half of current smokers in both middle school and high school report that they usually smoke Marlboro cigarettes. Black students are more likely to smoke Newport cigarettes than any other brand. Half of current smokers in middle school and high school report that they want to completely stop smoking. Nearly one fourth of middle school and high school students who have never smoked cigarettes indicate that they are susceptible to initiating smoking in the next year. Environmental tobacco smoke exposure is very high among both middle school and high school students. During the week before the survey, approximately 9 out of 10 current smokers and half of never smokers were in the same room with someone who was smoking; 8 out of 10 current smokers and 3 out of 10 never smokers rode in a car with someone who was smoking. Six out of 10 current smokers and 3 out of 10 never smokers live in a home where someone else smokes cigarettes. Approximately 70% of middle school and 60% of high school students who currently smoke and are aged <18 years were not asked to show proof of age when they purchased cigarettes. Approximately three fourths of middle school and high school students have seen antismoking commercials; however, 90% report having seen actors smoking on television or in the movies. Approximately 2% of middle school and high school students who had never used tobacco would wear or use something with a tobacco company name or picture on it. This rate increases to approximately 20% for current tobacco users. Youth Tobacco Survey data are used by health and education officials to improve national and state programs to prevent and control youth tobacco use. (ABSTRACT TRUN

Heterogeneous relationships of squamous and basal cell carcinomas of the skin with smoking: the UK Million Women Study and meta-analysis of prospective studies.

PubMed

Pirie, Kirstin; Beral, Valerie; Heath, Alicia K; Green, Jane; Reeves, Gillian K; Peto, Richard; McBride, Penelope; Olsen, Catherine M; Green, Adèle C

2018-06-14

Published findings on the associations between smoking and the incidence of cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are inconsistent. We aimed to generate prospective evidence on these relationships overall and by anatomical site. We followed 1,223,626 women without prior cancer by electronic linkage to national cancer registration data. Questionnaire information about smoking and other factors was recorded at recruitment (1996-2001) and every 3-5 years subsequently. Cox regression yielded adjusted relative risks (RRs) comparing smokers versus never-smokers. After 14 (SD4) years follow-up per woman, 6699 had a first registered cutaneous SCC and 48,666 a first BCC. In current versus never-smokers, SCC incidence was increased (RR = 1.22, 95% CI 1.15-1.31) but BCC incidence was decreased (RR = 0.80, 0.78-0.82). RRs varied substantially by anatomical site; for the limbs, current smoking was associated with an increased incidence of SCC (1.55, 1.41-1.71) and a decreased incidence of BCC (0.72, 0.66-0.79), but for facial lesions there was little association of current smoking with either SCC (0.93, 0.82-1.06) or BCC (0.92, 0.88-0.96). Findings in meta-analyses of results from this and seven other prospective studies were largely dominated by the findings in this study. Smoking-associated risks for cutaneous SCC and BCC are in the opposite direction to each other and appear to vary by anatomical site.

Passive smoking reduces and vitamin C increases exercise-induced oxidative stress: does this make passive smoking an anti-oxidant and vitamin C a pro-oxidant stimulus?

PubMed

Theodorou, Anastasios A; Paschalis, Vassilis; Kyparos, Antonios; Panayiotou, George; Nikolaidis, Michalis G

2014-11-07

The current interpretative framework states that, for a certain experimental treatment (usually a chemical substance) to be classified as "anti-oxidant", it must possess the property of reducing (or even nullifying) exercise-induced oxidative stress. The aim of the study was to compare side by side, in the same experimental setup, redox biomarkers responses to an identical acute eccentric exercise session, before and after chronic passive smoking (considered a pro-oxidant stimulus) or vitamin C supplementation (considered an anti-oxidant stimulus). Twenty men were randomly assigned into either passive smoking or vitamin C group. All participants performed two acute eccentric exercise sessions, one before and one after either exposure to passive smoking or vitamin C supplementation for 12 days. Vitamin C, oxidant biomarkers (F2-isoprostanes and protein carbonyls) and the non-enzymatic antioxidant (glutathione) were measured, before and after passive smoking, vitamin C supplementation or exercise. It was found that chronic exposure to passive smoking increased the level of F2-isoprostanes and decreased the level of glutathione at rest, resulting in minimal increase or absence of oxidative stress after exercise. Conversely, chronic supplementation with vitamin C decreased the level of F2-isoprostanes and increased the level of glutathione at rest, resulting in marked exercise-induced oxidative stress. Contrary to the current scientific consensus, our results show that, when a pro-oxidant stimulus is chronically delivered, it is more likely that oxidative stress induced by subsequent exercise is decreased and not increased. Reversely, it is more likely to find greater exercise-induced oxidative stress after previous exposure to an anti-oxidant stimulus. We believe that the proposed framework will be a useful tool to reach more pragmatic explanations of redox biology phenomena. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of smoke exposure and other lifestyle factors on pain response to electrical stimulation in women.

PubMed

Wee, J Y; Hopman, W M

2008-01-01

A relationship between smoking and development of pain syndromes has been suggested in the literature. The present study examined associations between smoke exposure and other related variables, and pain response to suprathreshold electrical stimulation. Subjects were prospectively recruited from a population referred to an electrodiagnostic clinic. Information about age, smoke exposure, caffeine and alcohol consumption was obtained, as well as documented objective signs of stress through physical assessment. One investigator applied two standardized 0.1 ms electrical stimulations (50 mA followed by 100 mA) to asymptomatic extremities at the beginning of each electrodiagnostic session, using consistent technique. Subjects used a visual analogue scale to indicate the level of pain felt after each stimulation. Two hundred fifteen women were included. Current smokers and those currently exposed to second-hand smoke had significantly higher pain ratings (P=0.003 for 50 mA, P=0.005 for 100 mA) than those not currently exposed to smoke. Time since exposure was negatively associated with pain ratings. Those with objective signs of stress reported higher levels of pain, which was significant for the 100 mA stimulation (P=0.046). Linear regression modelling indicated that current smoke exposure and alcohol use were associated with higher pain ratings at both 50 mA and 100 mA, while stress was associated with higher pain ratings and older age was associated with lower pain ratings at 100 mA only. Exposure to cigarette smoke is significantly related to higher reported levels of pain experienced in response to electrical stimulation in this study population. Exposure to smoke can add 10 points to the 100-point visual analogue scale compared with subjects without exposure, with alcohol use adding another eight points. Reported pain decreases as length of time since previous exposure to smoke increases.

Self-reported smoking, serum cotinine, and blood DNA methylation.

PubMed

Zhang, Yan; Florath, Ines; Saum, Kai-Uwe; Brenner, Hermann

2016-04-01

Epigenome-wide profiling of DNA methylation pattern with respect to tobacco smoking has given rise to a new measure of smoking exposure. We investigated the relationships of methylation markers with both cotinine, an established marker of internal smoking exposure, and self-reported smoking. Blood DNA methylation levels across the genome and serum cotinine were measured in 1000 older adults aged 50-75 years. Epigenome-wide scans were performed to identify methylation markers associated with cotinine. The inter-dose-response relationships between the number of cigarettes smoked per day, cotinine concentration, and DNA methylation were modeled by restricted cubic spline regression. Of 61 CpGs that passed the genome-wide significance threshold (p<1.13×10(-7)), 40 CpGs in 25 chromosomal regions were successfully replicated, showing 0.2-3% demethylation per 10ng/ml increases in cotinine. The strongest associations were observed for several loci at AHRR, F2RL3, 2q37.1, 6p21.33, and GFI1 that were previously identified to be related to self-reported smoking. One locus at RAB34 was newly discovered. Both cotinine and methylation markers exhibited non-linear relationships with the number of cigarettes smoked per day, where the highest rates of increase in cotinine and decreases in methylation were observed at low smoking intensity (1-15 cigarettes/day) and plateaued at high smoking intensity (>15-20 cigarettes/day). A clear linear relationship was observed between cotinine concentration and methylation level. Both cotinine and methylation markers showed similar accuracy in distinguishing current from never smoker, but only methylation markers distinguished former from never smoker with high accuracy. Our study corroborates and expands the list of smoking-associated DNA methylation markers. Methylation levels were linearly related to cotinine concentration and provided accurate measures for both current and past smoking exposure. Copyright © 2016 Elsevier Inc. All rights reserved.

Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population

PubMed Central

Perkett, Mackenzie; Robson, Shannon M.; Kripalu, Varsha; Wysota, Christina; McGarry, Charlotte; Weddle, David; Papas, Mia A.

2017-01-01

Food assistance recipients are at higher risk for poor cardiovascular health given their propensity to poor dietary intake and tobacco use. This study sought to evaluate the cardiovascular health status, and determine the impact of a low-intensity smoking cessation education intervention that connected mobile food pantry participants to state quit-smoking resources. A pre-post design with a 6-week follow-up was used to evaluate the impact of a 10–12 min smoking cessation education session implemented in five food pantries in Delaware. Baseline cardiovascular health, smoking behaviors and food security status were assessed. Smoking cessation knowledge, intention to quit and use of the state quit line were also assessed at follow-up. Of the 144 participants 72.3% reported having hypertension, 34.3% had diabetes, 13.9% had had a stroke. 50.0% were current smokers. The low-intensity intervention significantly increased smoking cessation knowledge but not intention to quit at follow-up. Seven percent of current smokers reported calling the quit line. Current tobacco use was five times more likely in food insecure versus food secure adults (OR 4.98; p=0.006), even after adjustment for demographic factors. Systems based approaches to address tobacco use and cardiovascular health in low-income populations are needed. The extent to which smoking cessation could reduce food insecurity and risk for cardiovascular disease in this population warrants investigation. PMID:27837357

Smoking increased the risk of prostate cancer with grade group ≥ 4 and intraductal carcinoma in a prospective biopsy cohort.

PubMed

Tang, Bo; Han, Cheng-Tao; Gan, Hua-Lei; Zhang, Gui-Ming; Zhang, Cui-Zhu; Yang, Wei-Yi; Shen, Ying; Zhu, Yao; Ye, Ding-Wei

2017-06-01

To investigate the association between smoking and different prostate cancer (PCa) pathological subtypes incidence in Chinese men. We prospectively included 1795 patients who underwent prostate biopsies in one tertiary center between March 2013 and April 2016. Clinical data and biopsy outcomes were collected. Logistic regression was used to evaluate the association between cigarette smoking and PCa incidence. A total of 737 men, 480 men and 58 men were diagnosed with PCa, high-grade PCa (HGPCa, grade group ≥ 4 as accepted by the 2014 ISUP) and intraductal carcinoma of the prostate (IDC-P), respectively. Current smokers had a significantly higher risk of HGPCa than never smokers (OR = 1.89, 95%CI: 1.44-2.48). No such association was observed for low-grade disease and cigarette smoking (OR = 0.84, 95%CI: 0.61-1.16). In a sub-analysis, men who had smoked longer than 30 years had a higher risk of HGPCa, compared with men who had smoked fewer than 30 years (OR = 1.50, 95%CI: 1.09-2.06). Current smokers were more likely to develop IDC-P than never smokers (OR = 2.29, 95%CI: 1.14-4.59). Among men in this Chinese biopsy cohort, current smoking was associated with highly malignant PCa incidence, such as HGPCa and IDC-P. The duration of smoking may be associated with HGPCa. © 2017 Wiley Periodicals, Inc.

Deniers and Admitters: Examining Smoker Identities in a Changing Tobacco Landscape.

PubMed

Kingsbury, John H; Parks, Michael J; Amato, Michael S; Boyle, Raymond G

2016-11-01

Smoking prevalence has declined considerably over the past 30 years. This decline has coincided with a growing stigma against smokers and a trend toward nondaily or occasional smoking. Some individuals now deny being a smoker despite current cigarette use-i.e., "deniers"; conversely, occasional smokers who admit to being a smoker are defined as "admitters." Although the "denier" phenomenon has been the focus of recent research, no studies have examined smoker identity in the context of emerging tobacco products and ongoing, statewide tobacco control programs. Recent data from the 2014 Minnesota Adult Tobacco Survey provided an opportunity to address these research gaps. Using the Minnesota Adult Tobacco Survey, participants were 242 adults who reported smoking 100 cigarettes lifetime, currently smoking "some days," and past 30-day smoking. Questions also assessed smoker identity, emerging product use and perceptions, and changes in smoking behavior in response to a recent statewide tobacco tax increase. Regression models revealed no difference in e-cigarette or hookah use between deniers and admitters, but deniers were more likely to perceive that hookah use was less harmful than smoking cigarettes. In response to the tax increase, we found that admitters were more likely than deniers to report thinking about quitting, reducing cigarette amount, and making a quit attempt. Findings suggest that deniers perceive lower harm from using tobacco products. Tax increases may be less effective at motivating quit attempts in deniers compared to admitters, implying that cessation programs tailored to specific smoking identities could usefully complement tax increases. Findings from this study suggest that tobacco tax increases should be coordinated with health promotion interventions to address occasional and social smoking. The denier phenomenon in particular is an important identity-based construct that population-level public health practice should consider in order to design effective tobacco control interventions. In addition, findings from our study and previous research suggest that occasional or social smokers who deny the smoker identity may be slowing progress in reducing smoking rates. Interventions targeting occasional smokers, and in particular, deniers, are needed to accelerate cessation efforts. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Secondhand smoke in New Zealand homes and cars: exposure, attitudes, and behaviours in 2004.

PubMed

Gillespie, Julie; Milne, Kiri; Wilson, Nick

2005-12-16

To assess exposure to secondhand smoke (SHS) in New Zealand homes and cars and to describe attitudes and behaviours that relate to establishing smokefree settings. In 2004, a nationwide telephone survey randomly selected and interviewed 2731 respondents. This sample was weighted to represent the national population and was comprised of a general adult population sample (n=1507), a sample selected from the Maori electoral roll (n=924), and a sample of current smokers and people who had recently quit smoking (n=300). 19.6% of the general population and 42.7% of the Maori sample reported current smoking. Of all current smokers, 47.2% smoked indoors at home and 70.8% smoked in their cars. Maori participants were significantly more likely to be exposed to SHS in their homes than non-Maori participants. There was also some evidence for lower socioeconomic status being related to higher SHS exposure. Extrapolating from the adult exposure data in households with children, it was estimated that 18.9% of children were potentially exposed to SHS indoors at home. However, most respondents (73.6%) lived in homes with total smoking bans. SHS exposure remains a significant problem especially for Maori and low-income New Zealanders. There is a need for further public health campaigns to increase the prevalence of smokefree homes and cars.

Cigarette smoking in a Middle Eastern country and its association with hospitalisation use: a nationwide cross-sectional study

PubMed Central

Sibai, Abla Mehio; Iskandarani, Mohamad; Darzi, Andrea; Nakkash, Rima; Saleh, Shadi; Fares, Souha; Hwalla, Nahla

2016-01-01

Objectives Little is known about the distribution of cigarette smoking by place and persons at the national level or its burden on healthcare expenditure in countries of the Middle East. We examine in this study the pattern of cigarette smoking by age, gender and geography and assess its association with hospitalisation use in Lebanon, a small middle-income country in the Middle East. Design Population-based cross-sectional study. Setting The study draws on data collected as part of the nationwide multistage cluster sample Nutrition and Non-Communicable Disease Risk Factor survey conducted in Lebanon in 2009. Participants A total of 2836 Lebanese adults 18 years and over. Measures Hospitalisation, the outcome variable, was measured using one item and recoded as a dichotomous variable. Cigarette smoking, the main exposure variable, was assessed by examining smoking status and pack-years, capturing intensity, frequency and duration of exposure. Results The overall prevalence rate of current smoking in this study was 34.7%, with significantly higher rates in males than females (42.9% and 27.5%, respectively). Close to two-thirds of the study population reported ever being hospitalised (62.8%). Compared to non-smokers, past and current smokers were significantly more likely to be hospitalised, after controlling for sociodemographic and health-related characteristics (OR=2.9, 95% CI 1.26 to 3.34, and OR=1.35, 95% CI 1.12 to 1.63, respectively). Hospitalisation use increased significantly in a dose–response manner with increasing pack-years. Conclusions When compared to regional and international estimates, the prevalence rates of smoking in Lebanon are considerably high, with percentages among women being among the highest in the region. Our findings of increased odds of hospitalisation among ever smokers, net of the effect of comorbidity, underscore the additional burden of smoking on the healthcare bill cost. Continued monitoring of smoking rates and disease surveillance frameworks are warranted in developing countries for policy development and evaluation. PMID:27059466

Smoking, Smoking Cessation, and the Risk of Type 2 Diabetes among Japanese Adults: Japan Epidemiology Collaboration on Occupational Health Study

PubMed Central

Akter, Shamima; Okazaki, Hiroko; Kuwahara, Keisuke; Miyamoto, Toshiaki; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Tomita, Kentaro; Nagahama, Satsue; Eguchi, Masafumi; Kochi, Takeshi; Imai, Teppei; Nishihara, Akiko; Sasaki, Naoko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Uehara, Akihiko; Yamamoto, Makoto; Hori, Ai; Sakamoto, Nobuaki; Nishiura, Chiro; Totsuzaki, Takafumi; Kato, Noritada; Fukasawa, Kenji; Pham, Ngoc M.; Kurotani, Kayo; Nanri, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2015-01-01

Aims To examine the association of smoking status, smoking intensity, and smoking cessation with the risk of type 2 diabetes (T2D) using a large database. Methods The present study included 53,930 Japanese employees, aged 15 to 83 years, who received health check-up and did not have diabetes at baseline. Diabetes was defined as fasting plasma glucose ≥126 mg/dl, random plasma glucose ≥200 mg/dl, HbA1c ≥6.5% (≥48 mmol/mol), or receiving medication for diabetes. Cox proportional-hazards regression models were used to investigate the association between smoking and the risk of diabetes. Results During 3.9 years of median follow-up, 2,441 (4.5%) individuals developed T2D. The multivariable-adjusted hazard ratios (95% CI) for diabetes were 1 (reference), 1.16 (1.04 to 1.30) and 1.34 (1.22 to 1.48) for never smokers, former smokers, and current smokers, respectively. Diabetes risk increased with increasing numbers of cigarette consumption among current smokers (P for trend <0.001). Although the relative risk of diabetes was greater among subjects with lower BMIs (< 23 kg/m2), attributable risk was greater in subjects with higher BMIs (≥ 23 kg/m2). Compared with individuals who had never smoked, former smokers who quit less than 5 years, 5 to 9 years, and 10 years or more exhibited hazards ratios for diabetes of 1.36 (1.14 to 1.62), 1.23 (1.01 to 1.51), and 1.02 (0.85 to 1.23), respectively. Conclusions Results suggest that cigarette smoking is associated with an increased risk of T2D, which may decrease to the level of a never smoker after 10 years of smoking cessation. PMID:26200457

A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery.

PubMed

Prochaska, Judith J; Delucchi, Kevin; Hall, Sharon M

2004-12-01

This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (> or = 6 months) were summarized with random effects models. Intervention effects for smoking cessation were significant at posttreatment and comparable for participants in addictions treatment and recovery; however, intervention effects for smoking cessation were nonsignificant at long-term follow-up. Smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Short-term smoking cessation effects look promising, but innovative strategies are needed for long-term cessation. Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety. Copyright 2004 APA.

Correlates of current and heavy smoking among U.S. soldiers returning from combat.

PubMed

Lopez, Alexa A; Toblin, Robin L; Riviere, Lyndon A; Lee, James D; Adler, Amy B

2018-06-01

Smoking rates are higher in U.S. soldiers than civilians, with combat-experienced soldiers particularly at risk for heavy smoking (≥20 cigarettes/day). While heavy smoking is correlated with mental health symptoms in civilian samples, the extent to which these symptoms, background variables, and unit climate (self-reported assessments of cohesion, organizational support, and leadership) are linked to smoking in at-risk soldiers remains unclear. The present study examines a range of correlates of smoking-related behavior. Cross-sectional, anonymous surveys were collected from 3,380 soldiers following a deployment in 2008-2009. Measures included demographics, combat exposures, unit climate (e.g., unit cohesion, perceived organizational support, leadership), short sleep duration, and behavioral health variables (e.g., posttraumatic stress disorder, depression, anxiety, alcohol misuse, aggression, adverse childhood experiences [ACEs]). Logistic regression modeled the effects of these variables on two outcome variables: daily smoking and heavy smoking. In the current sample, nearly half (47%) of soldiers reported smoking daily, with 35% of all smokers reporting heavy smoking (17% of the entire sample). Daily smoking was associated with demographic (age, gender, education, rank), behavioral health (ACE, alcohol misuse, sleep duration, aggression), and unit characteristics (unit cohesion); only increased combat exposures and aggression were specifically associated with heavy smoking. Interventions focused on the postdeployment period could incorporate messages about alternatives to smoking as a coping strategy while unit interventions or individual counseling addressing aggression could also address smoking as a negative coping strategy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The effect of the internet on teen and young adult tobacco use: a literature review.

PubMed

Forsyth, Susan R; Kennedy, Christine; Malone, Ruth E

2013-01-01

Research has shown that a positive association exists between exposure to smoking imagery, such as that found in movies and print advertising, and the subsequent uptake of cigarette smoking. Children appear to be especially vulnerable to advertising messaging and other positive portrayals of smoking, given that most adult smokers develop the habit before age 18 years. Although many traditional types of media have been studied, the current generation of youth is growing up as digital natives, with young people increasingly using the Internet for entertainment and to obtain information. Currently the Internet is an essentially unregulated marketplace of ideas and images. However, the effect of the Internet on teen smoking initiation has received little attention in studies. In this literature review, we summarize and critique the existing work, identify current knowledge gaps, and offer suggestions to health care providers about how to address this issue. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Cigarette smoke–induced induction of antioxidant enzyme activities in airway leukocytes is absent in active smokers with COPD

PubMed Central

Dove, Rosamund E.; Leong-Smith, Pheneatia; Roos-Engstrand, Ester; Pourazar, Jamshid; Shah, Mittal; Behndig, Annelie F.; Mudway, Ian S.; Blomberg, Anders

2015-01-01

Background Oxidative injury to the airway has been proposed as an important underlying mechanism in the pathogenesis of chronic obstructive pulmonary disease (COPD). As the extent of oxidant-mediated damage is dependent on the endogenous antioxidant defences within the airways, we examined whether COPD was associated with deficiencies in the antioxidant network within the respiratory tract lining fluids (RTLFs) and resident airway leukocytes. We hypothesised that COPD would be associated with both basal depression of antioxidant defences and impaired adaptive antioxidant responses to cigarette smoke. Methods Low molecular weight and enzymatic antioxidants together with metal-handling proteins were quantified in bronchoalveolar lavage fluid and airway leukocytes, derived from current (n=9) and ex-smoking COPD patients (n=15), as well as from smokers with normal lung function (n=16) and healthy never smokers (n=13). Results Current cigarette smoking was associated with an increase in ascorbate and glutathione within peripheral RTLFs in both smokers with normal lung function compared with healthy never smokers and in COPD smokers compared with COPD ex-smokers. In contrast, intra-cellular antioxidant enzyme activities (glutathione peroxidase, glutathione reductase, and catalase) were only up-regulated in smokers with normal lung function compared with healthy never smokers and not in actively smoking COPD patients relative to COPD ex-smokers. Conclusions We found no evidence of impaired basal antioxidant defences, within either the RTLFs or airway leukocytes in stable ex-smoking COPD patients compared with healthy never smoking controls. Current cigarette smoking induced an up-regulation of low molecular weight antioxidants in the RTLFs of both control subjects with normal lung function and patients with COPD. Importantly, the present data demonstrated a cigarette smoke–induced increase in intra-cellular antioxidant enzyme activities only within the smokers with normal lung function, implying that patients with COPD who continue to smoke will experience enhanced oxidative stress, prompting disease progression. PMID:26557249

Tobacco use and outcome in radical prostatectomy patients.

PubMed

Curtis, Alexandra; Ondracek, Rochelle Payne; Murekeyisoni, Christine; Kauffman, Eric; Mohler, James; Marshall, James

2017-04-01

Cigarette smoking has been consistently associated with increased risk of overall mortality, but the importance of smoking for patients with prostate cancer (CaP) who are candidates for curative radical prostatectomy (RP) has received less attention. This retrospectively designed cohort study investigated the association of smoking history at RP with subsequent CaP treatment outcomes and overall mortality. A total of 1981 patients who underwent RP at Roswell Park Cancer Institute (RPCI) between 1993 and 2014 were studied. Smoking history was considered as a risk factor for overall mortality as well as for currently accepted CaP treatment outcomes (biochemical failure, treatment failure, distant metastasis, and disease-specific mortality). The associations of smoking status with these outcomes were tested by Cox proportional hazard analyses. A total of 153 (8%) patients died during follow-up. Current smoking at diagnosis was a statistically significant predictor of overall mortality after RP (current smokers vs. former and never smokers, hazards ratio 2.07, 95% confidence interval [CI]: 1.36-3.14). This association persisted for overall mortality at 3, 5, and 10 years (odds ratios 2.07 [95% CI: 1.36-3.15], 2.05 [95% CI: 1.35-3.12], and 1.8 [95% CI: 1.18-2.74], respectively). Smoking was not associated with biochemical failure, treatment failure, distant metastasis, or CaP-specific mortality, and the association of smoking with overall mortality did not appear to be functionally related to treatment or biochemical failure, or to distant metastasis. Smoking is a non-negligible risk factor for death among CaP patients who undergo RP; patients who smoke are far more likely to die of causes other than CaP. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Opinions About Electronic Cigarette Use in Smoke-Free Areas Among U.S. Adults, 2012

PubMed Central

Dube, Shanta R.; Sterling, Kymberle; Whitney, Carrie; Eriksen, Michael P.

2015-01-01

Introduction: In the United States, electronic cigarettes (e-cigarettes) are currently unregulated, extensively marketed, and experiencing a rapid increase in use. The purpose of this study was to examine the opinions of U.S. adults about e-cigarette use in smoke-free public areas. Methods: Data were obtained from the online HealthStyle survey administered to a probability sample of a nationally representative online panel. The study included 4,043U.S. adults, aged 18 years or older who responded to this question, “Do you think e-cigarette should be allowed to be used in public areas where tobacco smoking is prohibited?” Multinomial logistic regression analyses were used to examine opinions on e-cigarette use in smoke-free areas by sex, age, race/ethnicity, household income, education, census region, and cigarette smoking status and e-cigarette awareness and ever use. Results: Overall, about 40% of adults were uncertain whether e-cigarettes should be allowed in smoke-free areas, 37% opposed, while 23% favored their use in smoke-free public places. Multinomial logistic regression analyses showed that adults who were aware, ever used e-cigarettes, and current cigarette smokers were more likely to express an “in favor” opinion than adults who expressed an uncertain opinion (don’t know). Conclusion: Over 75% of U.S. adults reported uncertainty or disapproval of the use of e-cigarettes in smoke-free areas. Current cigarette smokers, adults aware or have ever used e-cigarettes were more supportive to exempting e-cigarettes from smoking restrictions. With impending regulation and the changing e-cigarette landscape, continued monitoring and research on public opinions about e-cigarette use in smoke-free places are needed. PMID:25358659

Impact of Smoke Exposure on Digital Instrumentation and Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, Tina J.; Nowlen, Steven P.; Korsah, Kofi

2003-08-15

Smoke can cause interruptions and upsets in active electronics. Because nuclear power plants are replacing analog with digital instrumentation and control systems, qualification guidelines for new systems are being reviewed for severe environments such as smoke and electromagnetic interference. Active digital systems, individual components, and active circuits have been exposed to smoke in a program sponsored by the U.S. Nuclear Regulatory Commission. The circuits and systems were all monitored during the smoke exposure, indicating any immediate effects of the smoke. The results of previous smoke exposure studies have been reported in various publications. The major immediate effect of smoke hasmore » been to increase leakage currents and to cause momentary upsets and failures in digital systems. This paper presents new results from conformal coatings, memory chips, and hard drive tests.The best conformal coatings were found to be polyurethane, parylene, and acrylic (when applied by dipping). Conformal coatings can reduce smoke-induced leakage currents and protect against metal loss through corrosion. However conformal coatings are typically flammable, so they do increase material flammability. Some of the low-voltage biased memory chips failed during a combination of high smoke and high humidity. Typically, smoke along with heat and humidity is expected during fire, rather than smoke alone. Thus, due to high sensitivity of digital circuits to heat and humidity, it is hypothesized that the impact of smoke may be secondary.Low-voltage (3.3-V) static random-access memory (SRAMs) were found to be the most vulnerable to smoke. Higher bias voltages decrease the likelihood of failure. Erasable programmable read-only memory (EPROMs) and nonvolatile SRAMs were very smoke tolerant. Failures of the SRAMs occurred when two conditions were present: high density of smoke and high humidity. As the high humidity was present for only part of the test, the failures were intermittent. All of the chips that failed during the test recovered after enough venting.Hard disks were tested in severe environments but did not fail during the 2 h of monitoring.While the results of the tests documented in this report confirm that digital circuits can indeed be vulnerable to smoke, there is currently no practical, repeatable testing methodology, so it is not feasible to assess smoke susceptibility as part of environmental qualification. As a result, the most reasonable approach to minimizing smoke susceptibility is to employ design, implementation, and procedural practices that can reduce the possibility of smoke exposure and enhance smoke tolerance. Traditional approaches to mitigate its effects in digital safety instrumentation and control, such as redundancy, separation, defense in depth, as well as adherence to standards (e.g., the Institute of Electrical and Electronics Engineers' IEEE 384) and the Code of Federal Regulations Appendix R of 10 CFR 50, should continue to be applied.« less

Results from the Albanian Adult Tobacco Survey.

PubMed

Ross, Hana; Zaloshnja, Eduard; Levy, David T; Tole, Dhimiter

2008-12-01

Tobacco use prevalence in Europe is characterized by large disparities, with Western nations reporting smoking rates generally below 25%, while Eastern nations have smoking rates usually above 30%. Albania provides a distressing case study for Eastern Europe in which the exposure to the West after the fall of the communist regime dramatically increased the availability of Western-type cigarettes, while adoption of counterbalancing tobacco control measures lagged far behind. Results based on the representative Albanian Adult Tobacco Survey (AATS) conducted in 2007 suggest that smoking is a major problem, with a 64% smoking prevalence among Albanian men. It is becoming an increasingly greater concern among women, whose smoking prevalence more than doubled since 1990, reaching 19% in 2007. Young women living in urban areas are particularly susceptible to tobacco use; about one-third of them reported that they smoke. About 85% of current smokers smoke daily and with very high intensity, which further increases their risk of dying of smoking-attributable diseases. Smoking and secondhand exposure kill about 3,800 Albanians per year, about one-fifth of all deaths in the country. In addition, tobacco use imposes opportunity costs on Albanian households, which spent $358.6 million on cigarettes in 2007, or about 6% of the gross domestic product (GDP). To reduce the health and economic burden caused by tobacco use, the Albanian government should implement and enforce evidence-based tobacco control policies such increasing cigarette taxes; promoting cessation, particularly via the health care system; and enacting stricter clean indoor air laws.

Comparison of subjective, pharmacokinetic, and physiologic effects of marijuana smoked as joints and blunts

PubMed Central

Cooper, Ziva D.; Haney, Margaret

2009-01-01

Recent increases in marijuana smoking among the young adult population have been accompanied by the popularization of smoking marijuana as blunts instead of as joints. Blunts consist of marijuana wrapped in tobacco leaves, whereas joints consist of marijuana wrapped in cigarette paper. To date, the effects of marijuana smoked as joints and blunts have not been systematically compared. The current within-subject, randomized, double-blind, placebo-controlled study sought to directly compare the subjective, physiologic, and pharmacokinetic effects of marijuana smoked by these two methods. Marijuana blunt smokers (12 women; 12 men) were recruited and participated in a 6-session outpatient study. Participants were blindfolded and smoked three puffs from either a blunt or a joint containing marijuana with varying delta-9-tetrahydrocannabinol (THC) concentrations (0.0, 1.8, and 3.6%). Subjective, physiological (heart rate, blood pressure, carbon monoxide levels) and pharmacokinetic effects (plasma THC concentration) were monitored before and at specified time points for three hours after smoking. Joints produced greater increases in plasma THC and subjective ratings of marijuana intoxication, strength, and quality compared to blunts, and these effects were more pronounced in women compared to men. However, blunts produced equivalent increases in heart rate and higher carbon monoxide levels than joints, despite producing lower levels of plasma THC. These findings demonstrate that smoking marijuana in a tobacco leaf may increase the risks of marijuana use by enhancing carbon monoxide exposure and increasing heart rate compared to joints. PMID:19443132

Cigarette, Water-pipe, and Medwakh Smoking Prevalence Among Applicants to Abu Dhabi's Pre-marital Screening Program, 2011

PubMed Central

Aden, Bashir; Karrar, Sara; Shafey, Omar; Al Hosni, Farida

2013-01-01

Background: This study assesses self-reported tobacco use prevalence (cigarette, water-pipe, and medwakh) among applicants to Abu Dhabi's Premarital Screening program during 2011. Methods: Premarital Screening data reported to the Health Authority – Abu Dhabi from April to December 2011 were utilized to estimate tobacco use prevalence among applicants. Smoking prevalence was examined by nationality, age group and gender. Results: Overall, 24.7% of Premarital Screening Program applicants were current smokers; 11.5% smoked cigarettes, 5.9% smoked medwakh (hand-held pipe), 4.8% smoked water-pipe and 2.5% smoked a combination (more than one type). Men (19.2%) were more likely than women (3.5%) to be current cigarette smokers. Women were much less likely to smoke medwakh (0.1%) than men (11.5%), with male UAE Nationals having the highest medwakh smoking prevalence (16.1%). The overall prevalence of water-pipe smoking was 6.8% among men and 2.8% for women with the highest water-pipe smoking prevalence (10.2%) among Arab expatriate men. Conclusions: Variations in tobacco use prevalence among Premarital Screening Program applicants reflect preferences for different modes of tobacco consumption by nationality, age group and gender. Enforcement of tobacco control laws, including implementation of clean indoor air laws and tobacco tax increases, and targeted health education programs are required to reduce tobacco consumption and concomitant tobacco-related morbidity and mortality. PMID:24404364

Prevalence and determinants of cigarette smoking among adolescents in Blantyre City, Malawi.

PubMed

Muula, A S

2007-01-01

Tobacco smoking is a major risk factor for non-communicable diseases such as ischaemic heart disease, stroke, chronic obstructive airways disease and several cancers. There is little data about the prevalence and determinants of smoking among adolescents in southern Africa. This study aimed to determine the prevalence and determinants of cigarette smoking among adolescents in Blantyre City, Malawi. Cross-sectional data were obtained from school-going adolescents in Blantyre in 2001 using the Global Youth Tobacco Survey data collection instrument. Data were analysed to determine prevalence of current and ever cigarette smoking, and predictors of smoking. The prevalence of current smoking and ever smoking were 3.0% and 15.6%, respectively. Predictors of current tobacco smoking included male gender, having friends or parents who smoked, having been exposed to advertisements about tobacco brands on television and having seen a lot of advertisements in newspapers and magazines. School programmes that included being taught about smoking in class and a class discussion on the dangers of tobacco were not associated with reduced current smoking. Intervention programmes aiming to curb tobacco smoking among adolescents should focus on dealing also with parental smoking, peer influence and pay special attention toward male gender. School-based programmes to prevent smoking should be evaluated as some may have little impact in influencing current smoking status.

Social Determinants of Health and Tobacco Use in Five Low and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012.

PubMed

Tee, Guat Hiong; Aris, Tahir; Rarick, James; Irimie, Sorina

2016-01-01

Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

Predictors of medication adherence and smoking cessation among smokers under community corrections supervision.

PubMed

Cropsey, Karen L; Clark, C Brendan; Stevens, Erin N; Schiavon, Samantha; Lahti, Adrienne C; Hendricks, Peter S

2017-02-01

Individuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community. Five hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence. The strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence. These results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cigarette Smoking among Adolescents aged 13-15 in Viet Nam and Correlates of Current Cigarette Smoking: Results from GYTS 2014 Data.

PubMed

Huong, Le Thi; Vu, Nga Thi Thu; Dung, Nguyen Ngoc; Xuan, Le Thi Thanh; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Minh, Hoang Van; Nga, Pham Thi Quynh

2016-01-01

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%- 3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.

Smoking-Related Behaviors and Effectiveness of Smoking Cessation Therapy Among Prisoners and Prison Staff.

PubMed

Turan, Onur; Turan, Pakize Ayse

2016-04-01

Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. This study includes four visits to a prison in Bolvadin-Afyon, Turkey. Pharmacologic options for tobacco cessation were offered to the participants who wanted to quit smoking. One hundred seventy-nine subjects (109 prisoners and 70 prison staff) with 68.7% current smokers were included. There was an increase of cigarette smoking in 41.8% (the most common reason was stress) and decrease in 18.7% (the most common reason was health problems) of the participants after incarceration. Fifty-nine participants accepted the offered tobacco cessation treatment. Only 2 participants started their planned medications, but they could not quit smoking. The most common reason for failed attempts to quit was the high prices of cessation therapies. Factors like stress and being in prison may provoke smoking. A smoking ban does not seem to be a total solution for preventing tobacco use in prisons. Tobacco cessation programs may be a better option. Cost-free cessation medications may increase quitting rates among prisoners and prison staff. Copyright © 2016 by Daedalus Enterprises.

The Effectiveness of Cigarette Price and Smoke-Free Homes on Low-Income Smokers in the United States

PubMed Central

Vijayaraghavan, Maya; Messer, Karen; White, Martha M.

2013-01-01

Objectives. We examined the effectiveness of state cigarette price and smoke-free homes on smoking behaviors of low-income and high-income populations in the United States. Methods. We used the 2006–2007 Tobacco Use Supplement to the Current Population Survey. The primary outcomes were average daily cigarette consumption and successful quitting. We used multivariable regression to examine the association of cigarette price and smoke-free home policies on these outcomes. Results. High state cigarette price (pack price ≥ $4.50) was associated with lower consumption across all income levels. Although low-income individuals were least likely to adopt smoke-free homes, those who adopted them had consumption levels and successful quit rates that were similar to those among higher-income individuals. In multivariable analysis, both policies were independently associated with lower consumption, but only smoke-free homes were associated with sustained cessation at 90 days. Conclusions. High cigarette prices and especially smoke-free homes have the potential to reduce smoking behaviors among low-income individuals. Interventions are needed to increase adoption of smoke-free homes among low-income populations to increase cessation rates and prevent relapse. PMID:24134354

Dual use of electronic nicotine delivery systems (ENDS) and smoked tobacco: a qualitative analysis.

PubMed

Robertson, Lindsay; Hoek, Janet; Blank, Mei-Ling; Richards, Rosalina; Ling, Pamela; Popova, Lucy

2018-02-01

Electronic nicotine delivery systems (ENDS) arguably pose fewer health risks than smoking, yet many smokers adopt ENDS without fully relinquishing smoking. Known as 'dual use', this practice is widespread and compromises the health benefits that ENDS may offer. To date, few studies have explored how dual use practices arise and manifest. We conducted in-depth, semi-structured interviews with 20 current ENDS users from New Zealand who reported smoking tobacco at least once a month. We explored participants' smoking history, their recent and current smoking, trial, uptake and patterns of ENDS use, and future smoking and vaping intentions. We managed the data using NVivo V.11 and used a thematic analysis approach to interpret the transcripts. Dual use practices among participants evolved in four ways. First, as an attempt to manage the 'inauthenticity' of vaping relative to smoking and to retain meaningful rituals. Second, as complex rationalisations that framed decreased tobacco use, rather than smoking cessation, as 'success'. Third, as a means of alleviating the financial burden smoking imposed and to circumvent smoke-free policies. Lastly, dual use reflected attempts to comply with social group norms and manage stigma. Dual use reflects both social and physical cues. It assisted participants to navigate smoking restrictions and allowed them to manage divergent norms. Policies that discourage smoking, particularly excise tax increases on smoked tobacco and smoke-free space restrictions, appear important in prompting ENDS use. Future research could explore whether these policies also help foster complete transition from smoking to exclusive ENDS use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Cost-Effectiveness Analysis of Smoking Cessation Interventions in Japan Using a Discrete-Event Simulation.

PubMed

Igarashi, Ataru; Goto, Rei; Suwa, Kiyomi; Yoshikawa, Reiko; Ward, Alexandra J; Moller, Jörgen

2016-02-01

Smoking cessation medications have been shown to yield higher success rates and sustained abstinence than unassisted quit attempts. In Japan, the treatments available include nicotine replacement therapy (NRT) and varenicline; however, unassisted attempts to quit smoking remain common. The objective of this study was to compare the health and economic consequences in Japan of using pharmacotherapy to support smoking cessation with unassisted attempts and the current mix of strategies used. A discrete-event simulation that models lifetime quitting behaviour and includes multiple quit attempts (MQAs) and relapses was adapted for these analyses. The risk of developing smoking-related diseases is estimated based on the duration of abstinence. Data collected from a survey conducted in Japan were used to determine the interventions selected by smokers initiating a quit attempt and the time between MQAs. Direct and indirect costs are assessed (expressed in 2014 Japanese Yen). Using pharmacotherapy (NRT or varenicline) to support quit attempts proved to be dominant when compared with unassisted attempts or the current mix of strategies (most are unassisted). The results of stratified analyses by age imply that smoking cessation improves health outcomes across all generations. Indirect costs due to premature death leading to lost wages are an important component of the total costs, exceeding the direct medical cost estimates. Increased utilisation of smoking cessation pharmacotherapy to support quit attempts is predicted to lead to an increase in the number of smokers achieving abstinence, and provide improvements in health outcomes over a lifetime with no additional costs.

Examining the impact of changes in school tobacco control policies and programs on current smoking and susceptibility to future smoking among youth in the first two years of the COMPASS study: looking back to move forward.

PubMed

Leatherdale, Scott T; Cole, Adam

2015-01-01

School-based prevention activities continue to be an important tobacco control resource, however there is little guidance for school-based tobacco control programming within Ontario. The objective of this study is to identify real-world changes in school-based tobacco control programs or policies in the COMPASS study and examine of those interventions (natural experiments) had any impact on the school-level prevalence of smoking susceptibility and current smoking over time. This paper uses longitudinal school-level smoking behaviour data from Year 1 (Y1: 2012-13) and Year 2 (Y2: 2013-14) of the COMPASS study. Changes to school-level tobacco control programs and policies were measured using the COMPASS School Programs and Policies Questionnaire and knowledge broker follow-up interviews. Quasi-experimental tests of proportion and difference-in-difference models were used to evaluate the impact of the interventions identified between Y1 and Y2 on school-level prevalence of smoking susceptibility among never smokers and current smoking. Between Y1 and Y2, 17 schools reported a change in their tobacco control programming or policies. In four of the intervention schools, the increase in the within-school prevalence of susceptible never smokers between Y1 and Y2 was significantly greater than the natural change observed in the control schools. In five of the intervention schools, the decrease in the within-school prevalence of current smokers between Y1 and Y2 was significantly greater than the natural change observed in the control schools. Only two of the new interventions evaluated (both focused on policies of progressive punishment for students caught smoking on school property), were associated with significant desirable changes in both smoking susceptibility and current smoking between Y1 and Y2. Interventions specific to effective and enforced tobacco control were the most common and consistently had the desired impact on the school-level prevalence of smoking susceptibility and current smoking. Due to the variation in the types of interventions implemented and their effectiveness, additional evaluation evidence is necessary to determine the most successful activities and contexts among individual students. The results presented here highlight which of these real-world promising interventions should be further evaluated using the longitudinal individual-level data in COMPASS over time.

Changes in circulating peptide YY and ghrelin are associated with early smoking relapse.

PubMed

Lemieux, Andrine M; al'Absi, Mustafa

2018-01-01

Ghrelin and peptide YY (PYY) during ad libitum smoking have been associated with decreased reported craving (ghrelin) and increased positive affect (PYY), and higher baseline ghrelin levels predicted subsequent increased risk of smoking relapse. The current study assessed PYY and ghrelin during ad libitum smoking and again after the initial 48h of a smoking cessation attempt. The data compared smokers who abstained for 28days (n=37), smokers who relapsed (n=54), and nonsmokers (n=37). Plasma samples and subjective measures assessing craving and mood were collected at the beginning of each session. Results showed that relapsers experienced greater levels of distress (ps <0.01). While nonsmokers and abstainers showed no change in ghrelin across the initial 48h, relapsers declined (p <0.01). With PYY, relapsers increased (p <0.05) across the early abstinent phase. PYY and ghrelin may be useful predictors of relapse, specifically in reference to early withdrawal. Copyright © 2017. Published by Elsevier B.V.

Comparison of Cigarette and Water-Pipe Smoking By Arab and Non–Arab-American Youth

PubMed Central

Weglicki, Linda S.; Templin, Thomas N.; Rice, Virginia Hill; Jamil, Hikmet; Hammad, Adnan

2008-01-01

Background Water-pipe smoking is a rapidly growing form of tobacco use worldwide. Building on an earlier report of experimentation with cigarette and water-pipe smoking in a U.S. community sample of Arab-American youth aged 14–18 years, this article examines water-pipe smoking in more detail (e.g., smoking history, belief in harmfulness compared to cigarettes, family members in home who smoke water pipes) and compares the water-pipe–smoking behaviors of Arab-American youth with non–Arab-American youth in the same community. Methods A convenience sample of 1872 Arab-American and non–Arab-American high school students from the Midwest completed a 24-item tobacco survey. Data were collected in 2004–2005 and analyzed in 2007–2008. Results Arab-American youth reported lower percentages of ever cigarette smoking (20% vs 39%); current cigarette smoking (7% vs 22%); and regular cigarette smoking (3% vs 15%) than non–Arab-American youth. In contrast, Arab-American youth reported significantly higher percentages of ever water-pipe smoking (38% vs 21%) and current water-pipe smoking (17% vs 11%) than non–Arab-American youth. Seventy-seven percent perceived water-pipe smoking to be as harmful as or more harmful than cigarette smoking. Logistic regression showed that youth were 11.0 times more likely to be currently smoking cigarettes if they currently smoked water pipes. Youth were also 11.0 times more likely to be current water-pipe smokers if they currently smoked cigarettes. If one or more family members smoked water pipes in the home, youth were 6.3 times more likely to be current water-pipe smokers. The effects of ethnicity were reduced as a result of the explanatory value of family smoking. Conclusions Further research is needed to determine the percentages, patterns, and health risks of water-pipe smoking and its relationship to cigarette smoking among all youth. Additionally, youth tobacco prevention/cessation programs need to focus attention on water-pipe smoking in order to further dispel the myth that water-pipe smoking is a safe alternative to cigarette smoking. PMID:18675529

Cigarette smoking and the association with serous ovarian cancer in African American women: African American Cancer Epidemiology Study (AACES).

PubMed

Kelemen, Linda E; Abbott, Sarah; Qin, Bo; Peres, Lauren Cole; Moorman, Patricia G; Wallace, Kristin; Bandera, Elisa V; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cartmell, Kathleen; Cote, Michele L; Funkhouser, Ellen; Paddock, Lisa E; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Alberg, Anthony J; Schildkraut, Joellen M

2017-07-01

Smoking is a risk factor for mucinous ovarian cancer (OvCa) in Caucasians. Whether a similar association exists in African Americans (AA) is unknown. We conducted a population-based case-control study of incident OvCa in AA women across 11 geographic locations in the US. A structured telephone interview asked about smoking, demographic, health, and lifestyle factors. Odds ratios and 95% confidence intervals (OR, 95% CI) were estimated from 613 cases and 752 controls using unconditional logistic regression in multivariable adjusted models. Associations were greater in magnitude for serous OvCa than for all OvCa combined. Compared to never smokers, increased risk for serous OvCa was observed for lifetime ever smokers (1.46, 1.11-1.92), former smokers who quit within 0-2 years of diagnosis (5.48, 3.04-9.86), and for total pack-years smoked among lifetime ever smokers (0-5 pack-years: 1.79, 1.23-2.59; >5-20 pack-years: 1.52, 1.05-2.18; >20 pack-years: 0.98, 0.61-1.56); however, we observed no dose-response relationship with increasing duration or consumption and no significant associations among current smokers. Smoking was not significantly associated with mucinous OvCa. Associations for all OvCa combined were consistently elevated among former smokers. The proportion of ever smokers who quit within 0-2 years was greater among cases (23%) than controls (7%). Cigarette smoking may be associated with serous OvCa among AA, which differs from associations reported among Caucasians. Exposure misclassification or reverse causality may partially explain the absence of increased risk among current smokers and lack of dose-response associations. Better characterization of smoking patterns is needed in this understudied population.

Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

PubMed

Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

2017-12-01

Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers.

PubMed

Tomko, Rachel L; Saladin, Michael E; McClure, Erin A; Squeglia, Lindsay M; Carpenter, Matthew J; Tiffany, Stephen T; Baker, Nathaniel L; Gray, Kevin M

2017-02-01

The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse. The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants' daily lives. Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493-5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were re-assessed following cue exposure. Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving. Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues.

Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers

PubMed Central

Tomko, Rachel L.; Saladin, Michael E.; McClure, Erin A.; Squeglia, Lindsay M.; Carpenter, Matthew J.; Tiffany, Stephen T.; Baker, Nathaniel L.; Gray, Kevin M.

2017-01-01

Background and rationale The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse. Objective The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants’ daily lives. Methods Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493–5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were reassessed following cue exposure. Results Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving. Conclusions Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues. PMID:27838746

Does Motivation Matter? Analysis of a Randomized Trial of Proactive Outreach to VA Smokers.

PubMed

Danan, Elisheva R; Joseph, Anne M; Sherman, Scott E; Burgess, Diana J; Noorbaloochi, Siamak; Clothier, Barbara; Japuntich, Sandra J; Taylor, Brent C; Fu, Steven S

2016-08-01

Current guidelines advise providers to assess smokers' readiness to quit, then offer cessation therapies to smokers planning to quit and motivational interventions to smokers not planning to quit. We examined the relationship between baseline stage of change (SOC), treatment utilization, and smoking cessation to determine whether the effect of a proactive smoking cessation intervention was dependent on smokers' level of motivation to quit. Secondary analysis of a multicenter randomized controlled trial. A total of 3006 current smokers, aged 18-80 years, at four Veterans Affairs (VA) medical centers. Proactive care included proactive outreach (mailed invitation followed by telephone outreach), offer of smoking cessation services (telephone or face-to-face), and access to pharmacotherapy. Usual care participants had access to VA smoking cessation services and state telephone quitlines. Baseline SOC measured with Readiness to Quit Ladder, and 6-month prolonged abstinence self-reported at 1 year. At baseline, 35.8 % of smokers were in preparation, 38.2 % in contemplation, and 26.0 % in precontemplation. The overall interaction between SOC and treatment arm was not statistically significant (p = 0.30). Among smokers in preparation, 21.1 % of proactive care participants achieved 6-month prolonged abstinence, compared to 13.1 % of usual care participants (OR, 1.8 [95 % CI, 1.2-2.6]). Similarly, proactive care increased abstinence among smokers in contemplation (11.0 % vs. 6.5 %; OR, 1.8 [95 % CI, 1.1-2.8]). Smokers in precontemplation quit smoking at similar rates (5.3 % vs. 5.6 %; OR, 0.9 [95 % CI, 0.5-1.9]). Within each stage, uptake of smoking cessation treatments increased with higher SOC and with proactive care as compared with usual care. Mostly male participants limits generalizability. Randomization was not stratified by SOC. Proactive care increased treatment uptake compared to usual care across all SOC. Proactive care increased smoking cessation among smokers in preparation and contemplation but not in precontemplation. Proactively offering cessation therapies to smokers at all SOC will increase treatment utilization and population-level smoking cessation.

Perceptions of risk among childhood and young adult cancer survivors who smoke.

PubMed

Ford, Jennifer S; Puleo, Elaine; Sprunck-Harrild, Kim; deMoor, Janet; Emmons, Karen M

2014-08-01

Despite the fact that childhood and young adult cancer survivors are at increased risk for chronic health problems as a result of their cancer treatment, many use tobacco, thereby increasing their risks. Perceptions of risk related to tobacco use can be targeted for interventions aimed at improving health behaviors for childhood, adolescent, and young adult cancer survivors. Understanding the covariates of perceptions of health risks among young adult survivors who smoke will help to determine targets for intervention. Three hundred seventy-four participants who were diagnosed with cancer prior to age 35, currently between 18 and 55 years of age, and current smokers were recruited as part of a larger smoking cessation study, Partnership for Health-2 (PFH-2). Data were collected by telephone survey. Overall, women had the highest perception of risk for serious health problems, a second cancer, and heart problems. Additionally, those participants who were dependent on nicotine endorsed that they were at higher risk of serious health problems and second cancers, but not heart problems. Finally, Hodgkin lymphoma survivors reported that they were at increased risk for second cancers and heart problems compared to their “healthy” peers. Young adult cancer survivors who smoke correctly perceived some of their increased health risks. Additional motivation and education is needed for those young adult cancer survivors who perceive their increased health risks yet continue to smoke. Further education is needed for young survivors so they have a fully appropriate sense of risk, especially as it relates to their tobacco use.

Prevention of deaths and injuries caused by house fires: survey of local authority smoke alarm policies.

PubMed

Rowland, Diane; Afolabi, Elizabeth; Roberts, Ian

2002-09-01

Despite an increased risk of fire in disadvantaged households, smoke alarm ownership is considerably lower than in the general population. The government currently recommends that local authorities install battery-operated smoke alarms in all public sector properties regardless of tenure. However, the extent to which local authorities comply is currently not known. We conducted a survey of local authorities to establish the extent of their smoke alarm provision to public sector households. A telephone survey of all 405 local authorities within England and Wales was carried out. We obtained responses from 390 (97 per cent) local authorities, 266 of which had responsibility for housing. Over half of all public-sector households are offered smoke alarms by the local authorities. The majority of local authorities offer ionization and/or optical sensor alarm types (78 per cent), with many local authorities providing battery-operated alarms alone (17 per cent) or in combination with hardwired alarms (31 per cent). Many local authorities offer smoke alarm provision to their public-sector households. Whether this represents an effective and cost-effective use of resources requires further investigation.

Smoking increases risk for cognitive decline among community-dwelling older Mexican Americans

PubMed Central

Collins, Nicole; Sachs-Ericsson, Natalie; Preacher, Kristopher J.; Sheffield, Kristin M.; Markides, Kyriakos

2011-01-01

Objectives Few studies have investigated smoking and cognitive decline among older Mexican Americans. In the current study we explore the relationship between smoking status and cognitive changes over time in a large sample of community-dwelling older adults of Mexican descent. Design Latent growth curve analyses were used to examine the decreasing growth in the number of correct responses on a test of cognitive functioning with increasing age (7 years with 4 data collection points). Setting In-home interviews were obtained from participants residing in the Southwest United States. Participants Participants were community-dwelling older Mexican Americans. Measurements Cognitive functioning was assessed at each of the 4 data collection points with the Mini-Mental Status Examination. Participants’ self-reports of health functioning and smoking status were obtained at baseline. Results With the inclusion of health variables and other control variables, the effect of smoking status on cognitive functioning was significant such that the decrease in the number of correct responses over time was greater for smokers than for non-smokers. Conclusions Smoking increases risk for cognitive decline among community-dwelling older Mexican Americans. There are numerous health benefits in quitting smoking, even for older adults who have been smoking for many years. Further efforts to ensure that smoking cessation and prevention programs are targeted toward Hispanics are necessary. PMID:20104052

Adolescent same-sex and both-sex romantic attractions and relationships: implications for smoking.

PubMed

Easton, Alyssa; Jackson, Kat; Mowery, Paul; Comeau, Dawn; Sell, Randall

2008-03-01

We examined cross-sectional and longitudinal associations between smoking and romantic attractions and relationships. We used data from the National Longitudinal Study of Adolescent Health to assess associations of smoking at Waves I and II with same-sex, both-sex, and opposite-sex romantic attractions or relationships as determined at Wave I. We used logistic regression to predict smoking at Wave II by sexual orientation. Both adolescent boys and adolescent girls with both-sex attractions or relationships were significantly more likely than those with opposite-sex attractions or relationships to be current smokers. Adolescent boys and girls with both-sex attractions or relationships who were nonsmokers at Wave I were more likely to be current smokers at Wave II than those with opposite-sex attractions or relationships. Our findings support previous research on smoking among youths who report same-sex or both-sex romantic attractions or relationships and demonstrate the increased risk bisexual youths have for smoking initiation and smoking prevalence. Tobacco use prevention programs targeting gay and bisexual youths are warranted, particularly among adolescent girls and boys who have had both-sex romantic attractions or relationships.

Adolescent Same-Sex and Both-Sex Romantic Attractions and Relationships: Implications for Smoking

PubMed Central

Easton, Alyssa; Jackson, Kat; Mowery, Paul; Comeau, Dawn; Sell, Randall

2008-01-01

Objectives. We examined cross-sectional and longitudinal associations between smoking and romantic attractions and relationships. Methods. We used data from the National Longitudinal Study of Adolescent Health to assess associations of smoking at Waves I and II with same-sex, both-sex, and opposite-sex romantic attractions or relationships as determined at Wave I. We used logistic regression to predict smoking at Wave II by sexual orientation. Results. Both adolescent boys and adolescent girls with both-sex attractions or relationships were significantly more likely than those with opposite-sex attractions or relationships to be current smokers. Adolescent boys and girls with both-sex attractions or relationships who were nonsmokers at Wave I were more likely to be current smokers at Wave II than those with opposite-sex attractions or relationships. Conclusions. Our findings support previous research on smoking among youths who report same-sex or both-sex romantic attractions or relationships and demonstrate the increased risk bisexual youths have for smoking initiation and smoking prevalence. Tobacco use prevention programs targeting gay and bisexual youths are warranted, particularly among adolescent girls and boys who have had both-sex romantic attractions or relationships. PMID:18235075

Parental smoking, rejection of parental smoking, and smoking susceptibility and behaviors in Hong Kong adolescents.

PubMed

Chen, Jianjiu; Ho, Sai Yin; Wang, Man Ping; Lam, Tai Hing

2018-07-01

We explored the role of rejection of parental smoking in the association between parental smoking and smoking in adolescents. In 2010-11 cross-sectional survey, 61,810 Hong Kong secondary school students (mean age 14.6 years, 50.5% boys) reported their smoking (never, not susceptible; never, susceptible; ever, not current; current), paternal and maternal smoking, and whether they accepted paternal and maternal smoking (acceptance/rejection). We used multinomial logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of students' smoking in relation to acceptance and rejection of parental smoking, compared with no parental smoking. The OR (95% CI) of "never, susceptible", "ever, not current", and "current", compared with "never, not susceptible", in relation to acceptance of paternal smoking was 1.81 (1.67-1.96), 2.46 (2.25-2.69), and 2.79 (2.51-3.10), respectively. The corresponding ORs for rejection were 0.70 (0.64-0.76), 1.23 (1.13-1.35), and 0.47 (0.40-0.56). The OR (95% CI) of "never, susceptible", "ever, not current", and "current", compared with "never, not susceptible", in relation to acceptance of maternal smoking was 2.05 (1.80-2.33), 2.57 (2.29-2.88), and 6.33 (5.39-7.44), respectively. The corresponding ORs for rejection were 0.85 (0.69-1.05), 1.59 (1.39-1.81), and 2.14 (1.71-2.68). No overlapping was observed between the 95% CIs for acceptance and rejection of paternal or maternal smoking. While adolescent smoking was associated with parental smoking, especially in those who accepted parental smoking, the association was attenuated or reversed in those who rejected parental smoking. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Burden of smoking-related disease and potential impact of cigarette price increase in Peru].

PubMed

Bardach, Ariel E; Caporale, Joaquín E; Alcaraz, Andrea; Augustovski, Federico; Huayanay-Falconí, Leandro; Loza-Munarriz, Cesar; Hernández-Vásquez, Akram; Pichon-Riviere, Andrés

2016-01-01

. To calculate the burden of smoking-related disease and evaluate the potential economic and health impact of tax-induced cigarette price increase in Peru. A microsimulation model was used to estimate smoking-attributable impact on mortality, quality of life, and costs associated with heart and cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, lung cancer, and another nine cancers. Three scenarios, involving increased taxes, were evaluated. . A yearly total of 16,719 deaths, 6,926 cancer diagnoses, 7,936 strokes, and 7,548 hospital admissions due to cardiovascular disease can be attributed to smoking in Peru. Similarly, 396,069 years of life are lost each year from premature death and disability, and the cost of treating smoking-attributable health issues rises to 2,500 million soles (PEN 2015). Currently, taxes on tobacco cover only 9.1% of this expense. If cigarette prices were to increase by 50% over the next 10 years, 13,391 deaths, 6,210 cardiovascular events, and 5,361 new cancers could be prevented, representing an economic benefit of 3,145 million (PEN) in savings in health costs and increases in tax revenues. . Smoking-attributable burden of disease and costs to the health system are very high in Peru. Higher cigarette taxes could have substantial health and economic benefits for the country.

The impact of cigarette excise taxes on smoking cessation rates from 1994 to 2010 in Poland, Russia, and Ukraine.

PubMed

Ross, Hana; Kostova, Deliana; Stoklosa, Michal; Leon, Maria

2014-01-01

We studied the impact of cigarette excise taxes on the rates of smoking cessation with data from 3 neighboring Eastern European countries (Russia, Poland, and Ukraine) during the post-transitional period of the 1990s and 2000s. Using Global Adult Tobacco Survey data from 11,106 former and current smokers, we estimated the impact of cigarette taxes on the smokers' likelihood of quitting over time. We first transformed the survey's cross-sectional data into a pseudo-longitudinal format in which the average observation period for individual subjects was 12 years and then employed duration analysis. We estimated that a 10% increase in cigarette taxes during the observation period increased the probability of smoking cessation among smokers in these countries by 1.6% to 2.3%. Cigarette tax increases have played a significant role in driving smoking cessation in Poland, Russia, and Ukraine. Further increases in cigarette excise taxes are likely to encourage further cessation and thus impact the prevalence of smoking in the region.

Smoking and Diet: Impact on Disease Course?

PubMed

Cosnes, Jacques

2016-01-01

The impact of current smoking on inflammatory bowel disease (IBD) course has been studied extensively; smoking is deleterious in Crohn's disease (CD), and beneficial in ulcerative colitis (UC). Except for enteral nutrition, there are only limited data regarding the impact of diet on disease course. Current smoking worsens the course of CD, increasing the incidence of flares, the need for steroids, immunosuppressants and re-operations. Conversely, smoking cessation has a rapid beneficial effect on disease course, decreasing the risk of flares and of post-operative recurrences. From 3 months after the quit date, quitters have a disease course similar to that of never smokers. Achieving smoking cessation in CD is thus an important goal of therapy. On the contrary, smoking improves the course of UC and in particular, is associated with a decreased need for colectomy. Smoking cessation increases the risk of flare and the need for steroids or immunosuppressants. However, patients with UC should not be discouraged to quit, because the beneficial effect of smoking for their disease is counterbalanced by the deleterious systemic effects of tobacco. Among dietary interventions, only exclusive enteral nutrition was shown to induce remission and achieve mucosal healing in some patients with CD. The beneficial effect of liquid-defined diet is observed whatever be the type of administration (orally or by tube), the type of diet regarding protein and fat content and resulting alterations in the gut microbiota. In UC, enteral nutrition has no effect. Finally, popularized restrictive diets in IBD as the specific-carbohydrate diet and the gluten-free diet have not been rigorously tested. In a small trial, a semi-vegetarian diet was shown to be effective in maintaining remission over 2 years in CD. Patients with IBD should not smoke and avoid passive smoking. Aside from the defined liquid diets, there is no rationale for advising particular diets. © 2016 S. Karger AG, Basel.

Positive smoking cessation-related interactions with HIV care providers increase the likelihood of interest in cessation among HIV-positive cigarette smokers.

PubMed

Pacek, Lauren R; Rass, Olga; Johnson, Matthew W

2017-10-01

Smoking cessation has proven to be a challenge for HIV-positive smokers. Patient and provider characteristics may provide barriers to smoking cessation. We aimed to identify characteristics associated with interest in cessation as well as characterize use of, current interest in, and provider recommendations for smoking cessation modalities. Data came from 275 HIV-positive smokers recruited online. Half (49.1%) of the sample was interested in quitting; daily smoking was associated with decreased likelihood of interest in cessation, whereas making a lifetime quit attempt, receiving encouragement to quit from an HIV care provider, and greater frequency of discussions regarding cessation with HIV care providers were associated with increased likelihood of interest in cessation. Nicotine replacement therapy was the most commonly used (42.9%), generated the most interest (59.1%), and was the most commonly clinician-recommended (70.7%) cessation modality. Findings emphasize the importance of the healthcare provider-patient relationship for smoking cessation promotion in HIV-positive smokers.

Current perspective of the impact of smoking on the progression and treatment of periodontitis.

PubMed

Nociti, Francisco H; Casati, Marcio Z; Duarte, Poliana Mendes

2015-02-01

This literature review provides an overview of the current scenario regarding the impact of smoking on the progression and treatment of periodontitis; clinical, microbiological and immunological data from studies from our and other groups are presented. In general, preclinical and clinical data are unanimous in demonstrating that smokers present increased susceptibility, greater severity and faster progression of periodontal disease compared with nonsmokers. The evidence further demonstrates that smokers lose more teeth and have a less favorable response to therapy than do nonsmokers. Although it is well established that smoking significantly impacts on the onset, progression and outcome of periodontal disease, the mechanisms involved remain unclear. More importantly, some of the reported deleterious effects of smoking on periodontal tissues have been reported to be reversible upon participation in smoking-cessation programs. Therefore, clinicians should strongly advise smokers to enroll in cessation strategies, even temporarily, in order to improve the overall outcome. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pathophysiology, management and treatment of smoke inhalation injury

PubMed Central

Rehberg, Sebastian; Maybauer, Marc O; Enkhbaatar, Perenlei; Maybauer, Dirk M; Yamamoto, Yusuke; Traber, Daniel L

2009-01-01

Smoke inhalation injury continues to increase morbidity and mortality in burn patients in both the third world and industrialized countries. The lack of uniform criteria for the diagnosis and definition of smoke inhalation injury contributes to the fact that, despite extensive research, mortality rates have changed little in recent decades. The formation of reactive oxygen and nitrogen species, as well as the procoagulant and antifibrinolytic imbalance of alveolar homeostasis, all play a central role in the pathogenesis of smoke inhalation injury. Further hallmarks include massive airway obstruction owing to cast formation, bronchospasm, the increase in bronchial circulation and transvascular fluid flux. Therefore, anticoagulants, antioxidants and bronchodilators, especially when administered as an aerosol, represent the most promising treatment strategies. The purpose of this review article is to provide an overview of the pathophysiological changes, management and treatment options of smoke inhalation injury based on the current literature. PMID:20161170

Tobacco and the developing world.

PubMed

Mackay, J; Crofton, J

1996-01-01

Tobacco consumption is increasing in developing countries, which will bear the brunt of the tobacco epidemic in the 21st century. If current smoking patterns continue, 7 of the world's 10 million annual deaths from tobacco in 2025 will occur in developing countries. Compared with developed countries, more men and fewer women currently smoke in developing countries, but smoking among girls and women is increasing. While indigenous tobacco production and consumption remain a major problem, of particular concern is the penetration by the transnational tobacco companies, bringing with them denial of the health evidence, sophisticated advertising and promotion, threats of trade sanctions based on tobacco trade, and opposition to tobacco control measures, in particular promotional bans and tobacco tax policy. Developing countries must urgently devise and implement national tobacco control policies, but many governments have little experience in the new noncommunicable disease epidemic or in countering the transnational tobacco companies.

Smoking and risk of treatment-induced neutralizing antibodies to interferon β-1a.

PubMed

Hedström, Anna Karin; Ryner, Malin; Fink, Katarina; Fogdell-Hahn, Anna; Alfredsson, Lars; Olsson, Tomas; Hillert, Jan

2014-04-01

Neutralizing antibodies (NAbs) to interferon β (IFNβ) products that develop during treatment are associated with a loss of clinical efficacy. The aim of this study was to investigate the influence of smoking habits on the risk of developing NAbs to IFNβ, in the treatment of multiple sclerosis (MS). This report is based on 695 MS patients treated with IFNβ-1a, included in two Swedish case-control studies that collected information on smoking habits. Using logistic regression, the development of NAbs to IFNβ-1a among current smokers was compared with that of non-smokers, by calculating the odds ratio (OR) with a 95% confidence interval (CI). Current smokers showed an increased risk of developing NAbs to IFNβ-1a, compared with non-smokers (OR 1.9; 95% CI 1.3-2.8; p = 0.002). There were no gender differences. We observed no association between past smoking and the risk of developing NAbs to IFNβ-1a. The finding that current smokers have an increased risk of developing NAbs to IFNβ-1a has implications, both for the practical care and the treatment of MS; it also provides an interesting perspective of the lungs as an immune-reactive organ, reacting upon irritation.

Is There an Association Between Smoking Status and Prosthetic Joint Infection After Primary Total Joint Arthroplasty?

PubMed

Gonzalez, Amanda I; Luime, Jolanda J; Uçkay, Ilker; Hannouche, Didier; Hoffmeyer, Pierre; Lübbeke, Anne

2018-02-23

Recent reports highlighted the association between smoking and higher risk of postsurgical infections. The aim was to compare the incidence of prosthetic joint infection after primary total joint arthroplasty (TJA) according to smoking status. A prospective hospital registry-based cohort study was performed including all primary knee and hip TJAs performed between March 1996 and December 2013. Smoking status preoperatively was classified into never, former, and current smoker. Incidence rates and hazard ratios (HRs) for prosthetic joint infection according to smoking status were assessed within the first year and beyond. We included 8559 primary TJAs (mean age 69.5 years), and median follow-up was 67 months. There were 5722 never, 1315 former, and 1522 current smokers. Incidence rates of infection within the first year for never, former, and current smokers were, respectively, 4.7, 10.1, and 10.9 cases/1000 person-years, comparing ever vs never smokers, crude and adjusted HRs were 2.35 (95% confidence interval [CI] 1.39-3.98) and 1.8 (95% CI 1.04-3.2). Beyond the first year, crude and adjusted HRs were 1.37 (95% CI 0.78-2.39) and 1.12 (95% CI 0.61-2.04). Smoking increased the infection risk about 1.8 times after primary hip or knee TJA in both current and former smokers. Beyond the first year, the infection risk was similar to never smokers. Copyright © 2018 Elsevier Inc. All rights reserved.

Smoking is associated with increased resting energy expenditure in the general population: The NEO study.

PubMed

Blauw, Lisanne L; Boon, Mariëtte R; Rosendaal, Frits R; de Mutsert, Renée; Gast, Karin B; van Dijk, Ko Willems; Rensen, Patrick C N; Dekkers, Olaf M

2015-11-01

Animal studies and human studies in small selected populations have shown a positive association between nicotine smoking and resting energy expenditure (REE), but data in large cohorts are lacking. We aimed to investigate the association between smoking behavior and REE in a large, population-based study. Population-based cross-sectional study. In this cross-sectional analysis of baseline measurements from the Netherlands Epidemiology of Obesity (NEO) study (n=6673), we included participants with REE measurement by indirect calorimetry who were not using lipid or glucose lowering drugs (n=1189). We used linear regression analysis to examine the association of smoking status (never, former, occasional, current smoker) and smoking quantity (pack years) with REE per kilogram (kg) fat free mass (FFM) and with REE adjusted for FFM. Models were adjusted for age, sex, ethnicity, educational level, physical activity, energy intake and body mass index (BMI). Mean (standard deviation, SD) age was 55.2 (5.9) years and BMI was 26.3 (4.4) kg/m(2). 60% of the participants were women. Mean (SD) REE/FFM (kcal/day/kg FFM) was for male never smokers 25.1 (2.0), male current smokers 26.4 (2.8), female never smokers 28.9 (2.5) and female current smokers 30.1 (3.7). After adjustment, only current smokers had a higher REE/FFM (mean difference 1.28, 95% CI 0.64, 1.92), and a higher REE adjusted for FFM (mean difference 60.3 kcal/day, 95% CI 29.1, 91.5), compared with never smokers. There was no association between pack years and REE/FFM (mean difference -0.01, 95% CI -0.06, 0.04) or REE adjusted for FFM (mean difference 0.2, 95% CI -2.4, 2.8) in current smokers. Current smoking is associated with a higher resting energy expenditure compared with never smoking in a large population-based cohort. Copyright © 2015 Elsevier Inc. All rights reserved.

Trends in smoking rates among urban civil servants in Japan according to occupational categories.

PubMed

Higashibata, Takahiro; Nakagawa, Hiroko; Okada, Rieko; Wakai, Kenji; Hamajima, Nobuyuki

2015-08-01

Occupation could affect the distribution of smoking status of workers, and the success of smoking cessation among workers depends partly on worksite conditions. Blue collar workers have been identified as a high-risk group for smoking. The aim of the present study was to examine trends in smoking rates among urban civil servants in Japan according to occupational categories. Subjects were urban civil servants aged 30-59 years. They annually reported smoking status in a questionnaire in a worksite health check-up each year from 2004 to 2011. Urban civil servants reported substantially lower current smoking rates than national smoking rates in Japan (20.2%, 23.8%, and 27.0% for males in their 30s, 40s, and 50s and 2.4%, 6.3%, and 9.5% for females, respectively, in 2011). In analysis by occupational categories, current smoking rates declined among all groups except female white collar workers in their 50s. The current and persistent smoking rates (number of current smokers/[number of ex-smokers and current smokers]) among blue collar workers were higher than those among white collar workers at almost all time points in all age and gender groups. This study found relatively lower current smoking rates among urban civil servants than the national average and higher current and persistent smoking rates in blue collar workers than in white collar workers among them. These results would help to make suitable worksite smoking cessation policies for each occupational category.

Cigarette smoking and poverty in China.

PubMed

Liu, Yuanli; Rao, Keqin; Hu, Teh-Wei; Sun, Qi; Mao, Zhenzhong

2006-12-01

Drawing on the 1998 China national health services survey data, this study estimated the poverty impact of two smoking-related expenses: excessive medical spending attributable to smoking and direct spending on cigarettes. The excessive medical spending attributable to smoking is estimated using a regression model of medical expenditure with smoking status (current smoker, former smoker, never smoker) as part of the explanatory variables, controlling for people's demographic and socioeconomic characteristics. The poverty impact is measured by the changes in the poverty head count, after smoking-related expenses are subtracted from income. We found that the excessive medical spending attributable to smoking may have caused the poverty rate to increase by 1.5% for the urban population and by 0.7% for the rural population. To a greater magnitude, the poverty headcount in urban and rural areas increased by 6.4% and 1.9%, respectively, due to the direct household spending on cigarettes. Combined, the excessive medical spending attributable to smoking and consumption spending on cigarettes are estimated to be responsible for impoverishing 30.5 million urban residents and 23.7 million rural residents in China. Smoking related expenses pushed a significant proportion of low-income families into poverty in China. Therefore, reducing the smoking rate appears to be not only a public health strategy, but also a poverty reduction strategy.

The relationship between smoking and exercise among physical education teachers in Turkey.

PubMed

Gundogdu, Cemal; Oguzoncul, A Ferdane

2013-07-04

We studied the relationship between smoking and exercise among physical education teachers in Turkey. An online questionnaire was used to collect data. The responses of 1,995 teachers who completed the questionnaire were evaluated. The mean age of the participants was 31.0 +/- 4.7 years; 67.4% of the participants were male. The smoking rate was 65.2%. The mean age of onset of smoking was 16.6 +/- 2.6 years. The age of starting smoking increased with higher parental education level. There were no differences between smokers and nonsmokers with respect to gender. Of smokers, 51.2% were married; 52.4% were in the 30-39 year old age group. The most common reasons for starting smoking were the influence of friends and emulation. The most common reason for trying to quit smoking among men was future health concerns and among women was current health concerns. We found smoking was less common among participants who exercised regularly. The level of nicotine dependence was significantly lower among participants who exercised regularly compared to those who did not. This study suggests physical education teachers, who are role models for their students, have a high smoking rate. We believe urgent action is needed to reduce the smoking rate and increase the quit rate among physical education teachers.

Nursing Students’ Smoking Behaviors and Smoking-Related Self-Concept

DTIC Science & Technology

2003-04-01

The purposes of this pilot study were to describe: (a) the relationships between baccalaureate (BSN) nursing students’ smoking-related current self ...instruments used to describe nursing students’ self -concept, including current smoking-related self -concept and possible selves. A schema model of smoking...collected to gather data on demographics, smoking history, and current self and possible future selves. Nonparametric tests were used to describe group

Association Between Smoking and Serum GlycA and High-Sensitivity C-Reactive Protein Levels: The Multi-Ethnic Study of Atherosclerosis (MESA) and Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

PubMed

Kianoush, Sina; Bittencourt, Marcio S; Lotufo, Paulo A; Bensenor, Isabela M; Jones, Steven R; DeFilippis, Andrew P; Toth, Peter P; Otvos, James D; Tibuakuu, Martin; Hall, Michael E; Harada, Paulo H N; Blaha, Michael J

2017-08-23

Inflammation is suggested to be a central feature of atherosclerosis, particularly among smokers. We studied whether inflammatory biomarkers GlycA and high-sensitivity C-reactive protein are associated with cigarette smoking. A total of 11 509 participants, 6774 from the MESA (Multi-Ethnic Study of Atherosclerosis) and 4735 from ELSA-Brasil (The Brazilian Longitudinal Study of Adult Health) were included. We evaluated the cross-sectional association between multiple measures of smoking behavior and the inflammatory biomarkers, GlycA and high-sensitivity C-reactive protein, using regression models adjusted for demographic, anthropometric, and clinical characteristics. Participants were 57.7±11.1 years old and 46.4% were men. Never, former, and current smokers comprised 51.7%, 34.0%, and 14.3% of the population, respectively. Multivariable-adjusted mean absolute difference in GlycA levels (μmol/L) with 95% confidence interval (CI) were higher for former (4.1, 95% CI, 1.7-6.6 μmol/L) and current smokers (19.9, 95% CI, 16.6-23.2 μmol/L), compared with never smokers. Each 5-unit increase in pack-years of smoking was associated with higher GlycA levels among former (0.7, 95% CI, 0.3-1.1 μmol/L) and current smokers (1.6, 95% CI, 0.8-2.4 μmol/L). Among former smokers, each 5-year increase in time since quitting smoking was associated with lower GlycA levels (-1.6, 95% CI, -2.4 to -0.8 μmol/L) and each 10-unit increase in number of cigarettes/day was associated with higher GlycA among current smokers (2.8, 95% CI, 0.5-5.2 μmol/L). There were similar significant associations between all measures of smoking behavior, and both log-transformed GlycA and high-sensitivity C-reactive protein. Acute and chronic exposure to tobacco smoking is associated with inflammation, as quantified by both GlycA and high-sensitivity C-reactive protein. These biomarkers may have utility for the study and regulation of novel and traditional tobacco products. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Awareness and impact of New York City's graphic point-of-sale tobacco health warning signs.

PubMed

Coady, Micaela H; Chan, Christina A; Auer, Kari; Farley, Shannon M; Kilgore, Elizabeth A; Kansagra, Susan M

2013-05-01

To increase knowledge of smoking-related health risks and provide smoking cessation information at the point of sale, in 2009, New York City required the posting of graphic point-of-sale tobacco health warnings in tobacco retailers. This study is the first to evaluate the impact of such a policy in the USA. Cross-sectional street-intercept surveys conducted among adult current smokers and recent quitters before and after signage implementation assessed the awareness and impact of the signs. Approximately 10 street-intercept surveys were conducted at each of 50 tobacco retailers in New York City before and after policy implementation. A total of 1007 adults who were either current smokers or recent quitters were surveyed about the awareness and impact of tobacco health warning signs. Multivariate risk ratios (RR) were calculated to estimate awareness and impact of the signs. Most participants (86%) were current smokers, and the sample was 28% African-American, 32% Hispanic/Latino and 27% non-Hispanic white. Awareness of tobacco health warning signs more than doubled after the policy implementation (adjusted RR =2.01, 95% CI 1.74 to 2.33). Signage posting was associated with an 11% increase in the extent to which signs made respondents think about quitting smoking (adjusted RR =1.11, 95% CI 1.01 to 1.22). A policy requiring tobacco retailers to display graphic health warning signs increased awareness of health risks of smoking and stimulated thoughts about quitting smoking. Additional research aimed at evaluating the effect of tobacco control measures in the retail environment is necessary to provide further rationale for implementing these changes.

Relationship between negative affect and smoking topography in heavy drinking smokers.

PubMed

Green, ReJoyce; Bujarski, Spencer; Roche, Daniel J O; Ray, Lara A

2016-10-01

Heavy drinking smokers represent a sizeable subgroup of smokers for whom nicotine deprivation and alcohol use increases the urge to smoke in the laboratory and predicts lapses during smoking cessation. The manner in which individuals smoke a cigarette (i.e. smoking topography) provides a reliable index of smoking intensity and reinforcement, yet the effects of affect on smoking topography have not been thoroughly examined in heavy drinking smokers. The current study examined how affect and nicotine deprivation predict smoking behavior as participants (N=27) smoked one cigarette using a smoking topography device after 12-h of nicotine abstinence and after a priming dose of alcohol (target BrAC=0.06g/dl). Primary smoking topography measures were puff volume, velocity, duration, and inter-puff interval (IPI). The effect of nicotine deprivation was measured by the Minnesota Nicotine Withdrawal Scale (MNWS) and the Profile of Mood States (POMS). Measures were obtained at baseline (i.e. 12-h of nicotine abstinence and pre-alcohol) and 30-minutes after alcohol administration (i.e. peak BrAC). Results revealed post-priming negative affect significantly moderated the trajectories of puff volume, puff duration and IPI (p's<0.05) over the course of the cigarette, such that those with greater negative affect had flatter slopes for volume and duration and increasingly infrequent puffs. Our results suggest that baseline and post-priming negative affect following nicotine deprivation alters smoking patterns and increases nicotine exposure throughout a single cigarette. Future studies need to examine differential amounts of nicotine deprivation on response to alcohol and smoking in heavy drinking smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

To quit or not: Vulnerability of women to smoking tobacco.

PubMed

Park, Se-Jung; Yi, Bitna; Lee, Ho-Sun; Oh, Woo-Yeon; Na, Hyun-Kyung; Lee, Minjeong; Yang, Mihi

2016-01-01

Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among women, we focused on the vulnerability of women to smoking behaviors--smoking cessation or tobacco addiction--and performed a systematic review of the socioeconomic and intrinsic factors as well as tobacco ingredients that affect women's susceptibility to smoking tobacco. We observed that nicotine and other tobacco components including cocoa-relatives, licorice products, and menthol aggravate tobacco addiction in women rather than in men. Various genetic and epigenetic alterations in dopamine pathway and the pharmaco-kinetics and -dynamic factors of nicotine also showed potential evidences for high susceptibility to tobacco addiction in women. Therefore, we suggest systemic approaches to prevent tobacco smoking-related health risks, considering gene-environment-gender interaction.

Asymmetric peer effects in the analysis of cigarette smoking among young people in the United States, 1992-1999.

PubMed

Harris, Jeffrey E; González López-Valcárcel, Beatriz

2008-03-01

We extend the recent literature on peer effects to test the possible role of asymmetric social influences in the determination of youth smoking. We analyzed cigarette smoking among people aged 15-24 in approximately 90,000 households in the 1992-1999 U.S. Current Population Surveys. The presence of additional smoking sibling in a household, we estimated, raised a young person's probability of smoking by 7.6%, while each non-smoking sibling lowered the probability by an estimated 3.5%. Moreover, the overall deterrent effect of an increase in cigarette price on the probability of smoking was approximately 60% greater than the estimated effect when peer influences were held constant. The concept of asymmetric social influence may have applications in other fields, including labor economics, education, crime prevention, and group dynamics.

What Is the Impact of Smoking on Revision Total Knee Arthroplasty?

PubMed

Bedard, Nicholas A; Dowdle, S Blake; Wilkinson, Brandon G; Duchman, Kyle R; Gao, Yubo; Callaghan, John J

2018-07-01

There is a paucity of literature evaluating the impact of smoking on revision arthroplasty procedures. The purpose of this study was to identify the effect of smoking on complications after revision total knee arthroplasty (rTKA). We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patients who underwent rTKA between 2006 and 2014. Patients were divided into current smokers and nonsmokers according to the NSQIP definitions. Each cohort was compared in terms of demographic data, preoperative comorbidities, and operative time. Infection end points were created from composite surgical site infection variables defined by the NSQIP database. Multivariate logistic regression analysis was utilized to adjust for confounding variables and calculate adjusted odds ratios (ORs) and associated 95% confidence intervals (95% CIs). In total, 8776 patients underwent rTKA. Of these patients, 11.6% were current smokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (3.8% vs 1.8%, P < .0001), deep infection (2.5% vs 1.0%, P < .0001), pneumonia (1.3% vs 0.4%, P < .0001), and reoperation (5.0% vs 3.1%, P = .001) compared to nonsmokers undergoing revision total knee arthroplasty. Multivariate analysis identified current smokers as being at a significantly increased risk of any wound complication (OR 2.1; 95% CI 1.4-3.1) and deep infection (OR 2.1, 95% CI 1.2-3.6) after rTKA. This study demonstrates that smoking significantly increases the risk of infection, wound complications, and reoperation after rTKA. The results are even more magnified for revision procedures compared to published effects of smoking on primary total knee arthroplasty complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks. Copyright © 2018 Elsevier Inc. All rights reserved.

Racial/Ethnic Workplace Discrimination

PubMed Central

Chavez, Laura J.; Ornelas, India J.; Lyles, Courtney R.; Williams, Emily C.

2014-01-01

Background Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity. Purpose To examine the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surveillance System survey Reactions to Race Module (2004–2010). Methods Multivariable logistic regression analyses evaluated cross-sectional associations between self-reported workplace discrimination and tobacco (current and daily smoking) and alcohol use (any and heavy use, and binge drinking) among all participants and stratified by race/ethnicity, adjusting for relevant covariates. Data were analyzed in 2013. Results Among respondents, 70,080 completed the workplace discrimination measure. Discrimination was more common among black non-Hispanic (21%), Hispanic (12%), and other race respondents (11%) than white non-Hispanics (4%) (p<0.001). In the total sample, discrimination was associated with current smoking (risk ratio [RR]=1.32, 95% CI=1.19, 1.47), daily smoking (RR=1.41, 95% CI=1.24, 1.61), and heavy drinking (RR=1.11, 95% CI=1.01, 1.22), but not binge or any drinking. Among Hispanics, workplace discrimination was associated with increased heavy and binge drinking, but not any alcohol use or smoking. Workplace discrimination among black non-Hispanics and white Non-Hispanics was associated with increased current and daily smoking, but not alcohol outcomes. Conclusions Workplace discrimination is common, associated with smoking and alcohol use, and merits further policy attention given the impact of these behaviors on morbidity and mortality. PMID:25441232

Racial/ethnic workplace discrimination: association with tobacco and alcohol use.

PubMed

Chavez, Laura J; Ornelas, India J; Lyles, Courtney R; Williams, Emily C

2015-01-01

Experiences of discrimination are associated with tobacco and alcohol use, and work is a common setting where individuals experience racial/ethnic discrimination. Few studies have evaluated the association between workplace discrimination and these behaviors, and none have described associations across race/ethnicity. To examine the association between workplace discrimination and tobacco and alcohol use in a large, multistate sample of U.S. adult respondents to the Behavioral Risk Factor Surveillance System survey Reactions to Race Module (2004-2010). Multivariable logistic regression analyses evaluated cross-sectional associations between self-reported workplace discrimination and tobacco (current and daily smoking) and alcohol use (any and heavy use, and binge drinking) among all participants and stratified by race/ethnicity, adjusting for relevant covariates. Data were analyzed in 2013. Among respondents, 70,080 completed the workplace discrimination measure. Discrimination was more common among black non-Hispanic (21%), Hispanic (12%), and other race respondents (11%) than white non-Hispanics (4%) (p<0.001). In the total sample, discrimination was associated with current smoking (risk ratio [RR]=1.32, 95% CI=1.19, 1.47), daily smoking (RR=1.41, 95% CI=1.24, 1.61), and heavy drinking (RR=1.11, 95% CI=1.01, 1.22), but not binge or any drinking. Among Hispanics, workplace discrimination was associated with increased heavy and binge drinking, but not any alcohol use or smoking. Workplace discrimination among black non-Hispanics and white Non-Hispanics was associated with increased current and daily smoking, but not alcohol outcomes. Workplace discrimination is common, associated with smoking and alcohol use, and merits further policy attention, given the impact of these behaviors on morbidity and mortality. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

Factors associated with smoking frequency among current waterpipe smokers in the United States: Findings from the National College Health Assessment II.

PubMed

Haider, M Rifat; Salloum, Ramzi G; Islam, Farahnaz; Ortiz, Kasim S; Kates, Frederick R; Maziak, Wasim

2015-08-01

Some waterpipe smokers exhibit nicotine dependent behaviors such as increased use over time and inability to quit, placing them at high risk of adverse health outcomes. This study examines the determinants of dependence by measuring frequency of use among current waterpipe smokers using a large national U.S. Data were drawn from four waves (Spring/Fall 2009 and Spring/Fall 2010) of the American College Health Association-National College Health Assessment datasets. The sample was restricted to students who smoked a waterpipe at least once in the past 30 days (N=19,323). Ordered logistic regression modeled the factors associated with higher frequency of waterpipe smoking. Among current waterpipe smokers, 6% used a waterpipe daily or almost daily (20-29 days). Daily cigarette smokers were at higher odds of smoking a waterpipe at higher frequencies compared with non-smokers of cigarettes (OR=1.81; 95% CI=1.61-2.04). There was a strong association between daily cigar smoking and higher frequency of waterpipe smoking (OR=7.77; 95% CI=5.49-11.02). Similarly, students who used marijuana had higher odds of smoking a waterpipe at higher frequencies (OR=1.57; 95% CI=1.37-1.81). Daily consumers of other addictive substances are at a higher risk of intensive waterpipe smoking and thus higher risk of waterpipe dependence. Intervention programs must incorporate methods to reduce waterpipe dependence and subsequently prevent its deleterious health effects. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Smoking prevalence and beliefs on smoking cessation among members of the Japanese Cancer Association in 2006 and 2010.

PubMed

Kumiko, Saika; Tomotaka, Sobue; Masakazu, Nakamura; Akira, Oshima; Keiji, Wakabayashi; Nobuyuki, Hamajima; Yumiko, Mochizuki; Rie, Yamaguchi; Kazuo, Tajima

2012-08-01

Smoking is a significant contributing factor to disease-related deaths worldwide. Members of the Japanese Cancer Association (JCA) can play a leading role in helping people to live tobacco-free through social action. In 2010, this study assessed smoking prevalence among JCA members and their attitudes toward smoking, smoking cessation, and their responsibilities. Results of the 2010 survey were compared with those of a 2006 survey. Final response rates were 60.8% in the 2006 survey and 47.4% in the 2010 survey, and the current smoking rates were 9.0% and 5.3%, respectively. Regarding concern by current smokers over smoking cessation, the percentage of smokers who were ready to quit smoking within the next month increased from 4.9% to 6.3% between 2006 and 2010. Most JCA members agreed with antismoking actions such as smoking bans in all workplaces, public places, or while walking in the street, regulation restricting the sale and distribution of tobacco to children, tobacco education at school, use of tobacco tax for health, provision of information on tobacco, and smoking cessation support. Approximately 30% of responders disagreed on actions to raise the price of tobacco, regulations restricting the sale of tobacco, health warnings on tobacco packaging, bans on tobacco advertisement, and antismoking campaigns. Barriers to smoking cessation interventions identified were physician's time required to provide interventions, resistance of patients to smoking cessation advice, and lack of education on tobacco control. Not only antismoking actions but also support of smokers by health professionals through adequate education on smoking cessation treatment is needed in the future. © 2012 Japanese Cancer Association.

The effect of tobacco control policies on smoking prevalence and smoking-attributable deaths. Findings from the Netherlands SimSmoke Tobacco Control Policy Simulation Model.

PubMed

Nagelhout, Gera E; Levy, David T; Blackman, Kenneth; Currie, Laura; Clancy, Luke; Willemsen, Marc C

2012-02-01

To develop a simulation model projecting the effect of tobacco control policies in the Netherlands on smoking prevalence and smoking-attributable deaths. Netherlands SimSmoke-an adapted version of the SimSmoke simulation model of tobacco control policy-uses population, smoking rates and tobacco control policy data for the Netherlands to predict the effect of seven types of policies: taxes, smoke-free legislation, mass media, advertising bans, health warnings, cessation treatment and youth access policies. Outcome measures were smoking prevalence and smoking-attributable deaths. With a comprehensive set of policies, as recommended by MPOWER, smoking prevalence can be decreased by as much as 21% in the first year, increasing to a 35% reduction in the next 20 years and almost 40% by 30 years. By 2040, 7706 deaths can be averted in that year alone with the stronger set of policies. Without effective tobacco control policies, almost a million lives will be lost to tobacco-related diseases between 2011 and 2040. Of those, 145,000 can be saved with a comprehensive tobacco control package. Smoking prevalence and smoking-attributable deaths in the Netherlands can be reduced substantially through tax increases, smoke-free legislation, high-intensity media campaigns, stronger advertising bans and health warnings, comprehensive cessation treatment and youth access laws. The implementation of these FCTC/MPOWER recommended policies could be expected to show similar or even larger relative reductions in smoking prevalence in other countries which currently have weak policies. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Psychological, pharmacological, and combined smoking cessation interventions for smokers with current depression: A systematic review and meta-analysis.

PubMed

Secades-Villa, Roberto; González-Roz, Alba; García-Pérez, Ángel; Becoña, Elisardo

2017-01-01

We conducted a systematic literature review and meta-analysis (ID: CRD42016051017) of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP). Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%), pharmacological (6/30%) or combined (8/40%). Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base.

Psychological, pharmacological, and combined smoking cessation interventions for smokers with current depression: A systematic review and meta-analysis

PubMed Central

González-Roz, Alba; García-Pérez, Ángel; Becoña, Elisardo

2017-01-01

We conducted a systematic literature review and meta-analysis (ID: CRD42016051017) of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP). Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%), pharmacological (6/30%) or combined (8/40%). Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base. PMID:29206852

Factors Associated with American Indian Cigarette Smoking in Rural Settings

PubMed Central

Hodge, Felicia; Nandy, Karabi

2011-01-01

Introduction: This paper reports on the prevalence, factors and patterns of cigarette smoking among rural California American Indian (AI) adults. Methods: Thirteen Indian health clinic registries formed the random household survey sampling frame (N = 457). Measures included socio-demographics, age at smoking initiation, intention to quit, smoking usage, smoking during pregnancy, health effects of smoking, suicide attempts or ideation, history of physical abuse, neglect and the role of the environment (smoking at home and at work). Statistical tests included Chi Square and Fisher’s Exact test, as well as multiple logistic regression analysis among never, former, and current smokers. Results: Findings confirm high smoking prevalence among male and female participants (44% and 37% respectively). American Indians begin smoking in early adolescence (age 14.7). Also, 65% of current smokers are less than 50% Indian blood and 76% of current smokers have no intention to quit smoking. Current and former smokers are statistically more likely to report having suicidal ideation than those who never smoked. Current smokers also report being neglected and physically abused in childhood and adolescence, are statistically more likely to smoke ½ pack or less (39% vs. 10% who smoke 1+ pack), smoke during pregnancy, and have others who smoke in the house compared with former and never smokers. Conclusion: Understanding the factors associated with smoking will help to bring about policy changes and more effective programs to address the problem of high smoking rates among American Indians. PMID:21695023

Smoking among Hong Kong Chinese women: behavior, attitudes and experience.

PubMed

Li, Ho Cheung William; Chan, Sophia Sc; Lam, Tai Hing

2015-02-25

The numbers of women smoking have risen 72.5% since 1990 with the increasing population - from 56,100 to 96,800 in 2012, reflecting an alarming situation in Hong Kong. The study aimed to describe the smoking behaviour, attitudes and associated factors among women in Hong Kong. A qualitative cross-sectional study involving semi-structured interview was conducted with Chinese women from five community centres in different districts in Hong Kong in 2010. A purposive sample of 73 female participants (24 current smokers, 20 ex-smokers and 29 never-smokers) were recruited. The 73 women were classified by their smoking status and age to form 15 focus groups. Most informants knew about the general health hazards of smoking, such as cancer and heart or respiratory diseases, but not about the female-specific health consequences of smoking. A few smokers considered smoking to be a weight control strategy, fearing a gain in weight if they gave up. Moreover, a few relied on smoking as a coping strategy to relieve negative emotions and stress. Additionally, a few smokers had misconceptions about giving up: that a loss of concentration would result, that continued smoking would not further affect their health as they had become desensitised to the chemicals in tobacco smoke or that quitting would harm their health. This study generates new knowledge about the behavior, attitudes, and experiences related to smoking of current female smokers, ex-smokers and non-smokers in Hong Kong, which is unique as a Chinese but highly westernized community but with a very low female smoking prevalence.

Pattern and prevalence of smoking among students at King Faisal University, Al Hassa, Saudi Arabia.

PubMed

Al-Mohamed, H I; Amin, T T

2010-01-01

The study describes the prevalence of different forms of smoking, and the correlates of current smoking, by male students of King Faisal University, Saudi Arabia. A random sample of 1382 students at 9 colleges answered a self-administered questionnaire based on the Global Youth Tobacco Survey plus the modified Fagerström Test for Nicotine Dependence. The prevalence of current smoking was 28.1% (21.6% for cigarettes, 14.6% for waterpipe). Of current smokers, 41.4% were living in homes where others smoke and 17.0% initiated smoking below age 12 years. In logistic regression analysis older age, living away from home, smoking by family and close friends and exposure to tobacco promotion were predictors of current smoking status.

Active and Passive Smoking and Risk of Nasopharyngeal Carcinoma: A Population-Based Case-Control Study in Southern China

PubMed Central

Chang, Ellen T.; Liu, Zhiwei; Hildesheim, Allan; Liu, Qing; Cai, Yonglin; Zhang, Zhe; Chen, Guomin; Xie, Shang-Hang; Cao, Su-Mei; Shao, Jian-Yong; Jia, Wei-Hua; Zheng, Yuming; Liao, Jian; Chen, Yufeng; Lin, Longde; Ernberg, Ingemar; Vaughan, Thomas L.; Adami, Hans-Olov; Huang, Guangwu; Zeng, Yi; Zeng, Yi-Xin; Ye, Weimin

2017-01-01

Abstract The magnitude and patterns of associations between smoking and risk of nasopharyngeal carcinoma (NPC) in high-incidence regions remain uncertain. Associations with active and passive tobacco smoking were estimated using multivariate logistic regression in a population-based case-control study of 2,530 NPC cases and 2,595 controls in Guangdong and Guangxi, southern China, in 2010–2014. Among men, risk of NPC was significantly higher in current smokers compared with never smokers (odds ratio (OR) = 1.32, 95% confidence interval (CI): 1.14, 1.53) but not in former smokers (OR = 0.92, 95% CI: 0.73, 1.17). Risk increased with smoking intensity (per 10 cigarettes/day, OR = 1.09, 95% CI: 1.03, 1.16), smoking duration (per 10 years, OR = 1.11, 95% CI: 1.06, 1.16), and cumulative smoking (per 10 pack-years, OR = 1.08, 95% CI: 1.04, 1.12). Risk decreased with later age at smoking initiation (per year, OR = 0.97, 95% CI: 0.96, 0.98) but not greater time since smoking cessation. Exposures to passive smoking during childhood (OR = 1.24, 95% CI: 1.03, 1.48) and from a spouse during adulthood (OR = 1.30, 95% CI: 1.03, 1.63) were independently associated with increased NPC risk in never-smoking men and women, but exposure-response trends were not observed. In conclusion, active and passive tobacco smoking are associated with modestly increased risk of NPC in southern China; risk is highest among long-term smokers. PMID:28459936

The Effect of Body Image Threat on Smoking Motivation Among College Women: Mediation by Negative Affect

PubMed Central

Lopez Khoury, Elena N.; Litvin, Erika B.; Brandon, Thomas H.

2014-01-01

Previous descriptive, correlational, and quasi-experimental research has established that weight concerns and negative body image are associated with tobacco smoking, cessation, and relapse among young women. A recent experimental study found that activation of negative body image cognitions produced urges to smoke (Lopez, Drobes, Thompson, & Brandon, 2008). The current study intended to replicate and extend these experimental findings by examining the role of negative affect as a mediator of the relationship between body dissatisfaction and smoking urges. Female college smokers (N = 133) were randomly assigned to a body image challenge (trying on a bathing suit) or a control condition (evaluating a purse). State levels of urge to smoke, mood, and body dissatisfaction were assessed both pre- and post-manipulation. Trying on a bathing suit increased body dissatisfaction and reported urges to smoke, particularly those urges related to reducing negative affect. Additionally, state negative affect mediated the relationship between the body image manipulation and smoking urge. This study provides additional support, through an experimental design, that situational challenges to body image influence smoking motivation, and that this effect occurs, at least in part, via increases in negative affect. Theoretical and applied implications are discussed. PMID:19586144

Mortality risk in former smokers with breast cancer: pack-years vs. smoking status.

PubMed

Saquib, Nazmus; Stefanick, Marcia L; Natarajan, Loki; Pierce, John P

2013-11-15

It is unclear why successful quitting at time of breast cancer diagnosis should remove risk from a significant lifetime of smoking. Studies concluding this may be biased by how smoking is measured in many epidemiological cohorts. In the late 1990s, a randomized trial of diet and breast cancer outcomes enrolled early-stage female breast cancer survivors diagnosed within the previous 4 years. Smoking history and key covariate measures were available at study entry for 2,953 participants. Participants were followed for an average of 7.3 years (96% response rate). There were 10.1% deaths (83% from breast cancer). At enrollment, 55.2% were never smokers, 41.2% former smokers and 4.6% current smokers. Using current smoking status in a Cox regression, there was no increased risk for former smokers for either all-cause mortality [hazard ratio (HR) = 1.11; 95% confidence interval (CI) = 0.87-1.41; p-value = 0.42) or breast cancer mortality. However, when we categorized on extensive lifetime exposure, former smokers with 20+ pack-years of smoking (25.8%) had a significantly higher risk of both all-cause (HR = 1.77; 95% CI = 1.17-2.48; p-value = 0.0007) and breast cancer-specific mortality (HR = 1.62; 95% CI = 1.11-2.37; p-value = 0.01). Lifetime smoking exposure, not current status, should be used to assess mortality risk among former smokers. Copyright © 2013 UICC.

Neighborhood social cohesion and smoking among legal and unauthorized Brazilian migrants in metropolitan Boston.

PubMed

Holmes, Louisa M; Marcelli, Enrico A

2014-12-01

Tobacco smoking is estimated to be the largest preventable cause of mortality in the USA, but little is known about the relationship between neighborhood social environment and current smoking behavior or how this may differ by population and geography. We investigate how neighborhood social cohesion and disorder are associated with smoking behavior among legal and unauthorized Brazilian migrant adults using data from the 2007 Harvard-UMASS Boston Metropolitan Immigrant Health and Legal Status Survey (BM-IHLSS), a probabilistic household survey of adult Brazilian migrants. We employ logistic regression to estimate associations between neighborhood social cohesion, neighborhood disorder, and current smoking. We find that neighborhood-level social cohesion is associated with lower likelihood of being a current smoker (O.R. = .836; p < .05), and neighborhood disorder, measured as crime experienced in the neighborhood, is not associated with current smoking. Neighborhood population density, age, being male, and residing with someone who smokes are each positively associated with current smoking (p < .10). The health of participants' parents at the age of 35, being married, and individual earnings are associated with a reduction in the probability of being a current smoker (p < .05). Migrant legal status and length of residence in the USA are not associated with current smoking. Our findings suggest that neighborhood social cohesion may be protective against smoking. Alternatively, neighborhood disorder does not appear to be related to current smoking among Brazilian migrants.

Smoking-attributable medical expenditures by age, sex, and smoking status estimated using a relative risk approach☆

PubMed Central

Maciosek, Michael V.; Xu, Xin; Butani, Amy L.; Pechacek, Terry F.

2015-01-01

Objective To accurately assess the benefits of tobacco control interventions and to better inform decision makers, knowledge of medical expenditures by age, gender, and smoking status is essential. Method We propose an approach to distribute smoking-attributable expenditures by age, gender, and cigarette smoking status to reflect the known risks of smoking. We distribute hospitalization days for smoking-attributable diseases according to relative risks of smoking-attributable mortality, and use the method to determine national estimates of smoking-attributable expenditures by age, sex, and cigarette smoking status. Sensitivity analyses explored assumptions of the method. Results Both current and former smokers ages 75 and over have about 12 times the smoking-attributable expenditures of their current and former smoker counterparts 35–54 years of age. Within each age group, the expenditures of formers smokers are about 70% lower than current smokers. In sensitivity analysis, these results were not robust to large changes to the relative risks of smoking-attributable mortality which were used in the calculations. Conclusion Sex- and age-group-specific smoking expenditures reflect observed disease risk differences between current and former cigarette smokers and indicate that about 70% of current smokers’ excess medical care costs is preventable by quitting. PMID:26051203

The density of tobacco retailers in home and school environments and relationship with adolescent smoking behaviours in Scotland.

PubMed

Shortt, N K; Tisch, C; Pearce, J; Richardson, E A; Mitchell, R

2016-01-01

Neighbourhood retailing of tobacco products has been implicated in affecting smoking prevalence rates. Long-term smoking usually begins in adolescence and tobacco control strategies have often focused on regulating 'child spaces', such as areas in proximity to schools. This cross-sectional study examines the association between adolescent smoking behaviour and tobacco retail outlet density around home and school environments in Scotland. Data detailing the geographic location of every outlet registered to sell tobacco products in Scotland were acquired from the Scottish Tobacco Retailers Register and used to create a retail outlet density measure for every postcode. This measure was joined to individual responses of the Scottish Schools Adolescent Lifestyle and Substance Use Survey (n=20 446). Using logistic regression models, we explored the association between the density of retailers, around both home and school address, and smoking behaviours. Those living in the areas of highest density of retailers around the home environment had 53% higher odds of reporting having ever smoked (95% CI 1.27 to 1.85, p<0.001) and 47% higher odds of reporting current smoking (95% CI 1.13 to 1.91 p<0.01). Conversely, those attending schools in areas of highest retail density had lower odds of having ever smoked (OR 0.66, 95% CI 0.50 to 0.86 p<0.01) and lower odds of current smoking (OR 0.75, 95% CI 0.59 to 0.95, p<0.05). The density of tobacco retail outlets in residential neighbourhoods is associated with increased odds of both ever smoked and current smoking among adolescents in Scotland. Policymakers may be advised to focus on reducing the overall density of tobacco outlets, rather than concentrating on 'child spaces'. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Rapid fall in lung density following smoking cessation in COPD.

PubMed

Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian; Stoel, Berend C; Dirksen, Asger

2011-02-01

Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD. Thirty-six patients quit smoking out of 254 current smokers with COPD who were followed with annual CT and lung function tests (LFT) for 2?4 years as part of a randomised placebo-controlled trial of the effect of inhaled budesonide on CT-lung density. Lung density was expressed as the 15th percentile density (PD15) and relative area of emphysema below -910 HU (RA-910). From the time-trends in the budesonide and placebo groups the expected CT-lung densities at the first visit after smoking cessation were calculated by linear regression and compared to the observed densities. Following smoking cessation RA-910 increased by 2.6% (p = 0.003) and PD15 decreased by -4.9 HU (p = 0.0002). Furthermore, changes were larger in the budesonide group than the placebo group (PD15: -7.1 vs -2.8 HU. RA-910 3.7% vs 1.7%). These differences were, however, not statistically significant. The LFT parameters (FEV(1) and diffusion capacity) were not significantly influenced by smoking cessation. Inflammation partly masks the presence of emphysema on CT and smoking cessation results in a paradoxical fall in lung density, which resembles rapid progression of emphysema. This fall in density is probably due to an anti-inflammatory effect of smoking cessation.

Educational inequalities in smoking among men and women aged 16 years and older in 11 European countries.

PubMed

Huisman, M; Kunst, A E; Mackenbach, J P

2005-04-01

To determine those groups who are at increased risk of smoking related diseases, we assessed in which male and female generations smoking was more prevalent among lower educated groups than among the higher educated, in 11 European countries. Cross sectional analysis of data on smoking, covering the year 1998, from a social survey designed for all member states of the European Union. Higher and lower educated men and women aged 16 years and older from 11 member states of the European Union. Age standardised prevalence rates by education and prevalence odds ratios of current and ever daily smoking comparing lower educated groups with higher educated groups. A north-south gradient in educational inequalities in current and ever daily smoking was observed for women older than 24 years, showing larger inequalities in the northern countries. Such a gradient was not observed for men. A disadvantage for the lower educated in terms of smoking generally occurred later among women than among men. Indications of inequalities in smoking in the age group 16-24 years were observed for all countries, with the exception of women from Greece and Portugal. Preventing and reducing smoking among lower educated subgroups should be a priority of policies aiming to reduce inequalities in health in Europe. If steps are not taken to control tobacco use among the lower educated groups specifically, inequalities in lung cancer and other smoking related diseases should be anticipated in all populations of the European Union, and both sexes.

Smoking-Associated Site-Specific Differential Methylation in Buccal Mucosa in the COPDGene Study

PubMed Central

Qiu, Weiliang; Carey, Vincent J.; Morrow, Jarrett; Bacherman, Helene; Foreman, Marilyn G.; Hokanson, John E.; Bowler, Russell P.; Crapo, James D.; DeMeo, Dawn L.

2015-01-01

DNA methylation is a complex, tissue-specific phenomenon that can reflect both endogenous factors and exogenous exposures. Buccal brushings represent an easily accessible source of DNA, which may be an appropriate surrogate tissue in the study of environmental exposures and chronic respiratory diseases. Buccal brushings were obtained from a subset of current and former smokers from the COPDGene study. Genome-wide DNA methylation data were obtained in the discovery cohort (n = 82) using the Illumina HumanMethylation450K array. Empirical Bayes methods were used to test for differential methylation by current smoking status at 468,219 autosomal CpG sites using linear models adjusted for age, sex, and race. Pyrosequencing was performed in a nonoverlapping replication cohort (n = 130). Current smokers were significantly younger than former smokers in both the discovery and replication cohorts. Seven CpG sites were associated with current smoking at a false discovery rate less than 0.05 in the discovery cohort. Six of the seven significant sites were pyrosequenced in the replication cohort; five CpG sites, including sites annotated to CYP1B1 and PARVA, were replicated. Correlations between cumulative smoke exposure and time since smoking cessation were observed in a subset of the significantly associated CpG sites. A significant correlation between reduced lung function and increased radiographic emphysema with methylation at cg02162897 (CYP1B1) was observed among female subjects. Site-specific methylation of DNA isolated from buccal mucosa is associated with exposure to cigarette smoke, and may provide insights into the mechanisms underlying differential susceptibility toward the development of smoking-related chronic respiratory diseases. PMID:25517428

Quantifying the effect of changes in state-level adult smoking rates on youth smoking.

PubMed

Farrelly, Matthew C; Arnold, Kristin Y; Juster, Harlan R; Allen, Jane A

2014-01-01

Quantify the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence. Analysis of data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected from 1995 to 2006 and the National Youth Tobacco Survey (NYTS) collected from 1999 to 2006. Adults 25 years or older who completed the TUS-CPS and youth in middle and high school who completed the NYTS. Current smoking among middle and high school students as a function of the change in state-level adult smoking, controlling for individual-level sociodemographic characteristics and state-level tobacco control policy variables. Among middle school students, declines in state-level adult smoking rates are associated with lower odds of current smoking (P < .05), and each doubling of the decline in adult smoking rates is associated with a 6.0% decrease in youth smoking. Among high school students, declines in state-level adult smoking rates are not associated with current smoking. Higher cigarette prices were associated with lower odds of smoking among middle and high school students. Greater population coverage by smoke-free air laws and greater funding for tobacco control programs were associated with lower odds of current smoking among high school students but not middle school students. Compliance with youth access laws was not associated with middle or high school smoking. By quantifying the effect of changes in state-level adult smoking rates on youth smoking, this study enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.

Effect of a smoking ban and school-based prevention and control policies on adolescent smoking in Spain: a multilevel analysis.

PubMed

Galán, Iñaki; Díez-Gañán, Lucía; Gandarillas, Ana; Mata, Nelva; Cantero, Jose Luis; Durbán, María

2012-12-01

We evaluated the impact of a smoking ban in schools and of school-based smoking prevention and control policies on adolescent smoking. Annual surveys carried out between 2001 and 2005 that were representative of students in the 4th year of secondary education in the Madrid region, with 203 schools and 9127 students participating. The student questionnaire gathered information about personal and family variables. The contextual factors were: the periods before (years 2001-2002) and after the law; and through a survey of school management boards: compliance with the law, policy reflected in the school regulations, existence of complaints against smoking, and undertaking of educational activities regarding smoking. Multilevel logistic regression models were constructed with two dependent variables: current smoking and the proportion giving up smoking. Smoking declined in 2003, the first year after the law came into force (Odds ratio: 0.80; CI 95%: 0.66-0.96), and this decline was maintained in 2005. By contrast, smoking increased in those schools that did not undertake educational programmes regarding smoking (Odds ratio: 1.34; CI 95%: 1.13-1.59), and in those that received complaints about smoking (Odds ratio: 1.12; CI 95%: 0.96-1.29). This association is partly due to the effect of the increase in giving up smoking. The inclusion of contextual variables into the model with the individual factors reduces the variability of smoking between schools by 32.6%. In summary, the coming into force of a law banning smoking in schools, and the implementing of educational policies for the prevention and control of smoking are related to a lower risk of adolescent smoking.

Cigarette smoking, androgen levels, and hot flushes in midlife women.

PubMed

Cochran, Chrissy J; Gallicchio, Lisa; Miller, Susan R; Zacur, Howard; Flaws, Jodi A

2008-11-01

To test the hypothesis that cigarette smoking is associated with hot flushes through a mechanism involving androgen levels, progesterone levels, sex hormone-binding globulin levels, or the ratio of androgens to estrogens. Women with and without hot flushes were recruited from Baltimore, Maryland, and the surrounding counties. Women were between 45 and 54 years of age, with at least three menstrual periods in the previous 12 months, and were not postmenopausal. Study participants completed a questionnaire and gave a blood sample for hormone measurements. Current smokers had significantly higher androstenedione levels and a higher androgen-to-estrogen ratio than never smokers. Current smokers had significantly lower progesterone levels compared with never smokers. Former and current cigarette smokers had increased odds of experiencing hot flushes compared with never smokers (former: odds ratio [OR] 1.41, 95% confidence interval [CI] 0.99-2.01; current: OR 2.43, 95% CI 1.28-4.62). This association, however, was not attenuated by the addition of hormones to the smoking and hot-flush model. Cigarette smoking is associated with hot flushes through a mechanism that may not involve alterations in hormone levels or their ratios. II.

Lifetime Smoking History and Cause-Specific Mortality in a Cohort Study with 43 Years of Follow-Up

PubMed Central

Taghizadeh, Niloofar; Vonk, Judith M.; Boezen, H. Marike

2016-01-01

Background In general, smoking increases the risk of mortality. However, it is less clear how the relative risk varies by cause of death. The exact impact of changes in smoking habits throughout life on different mortality risks is less studied. Methods We studied the impact of baseline and lifetime smoking habits, and duration of smoking on the risk of all-cause mortality, mortality of cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), any cancer and of the four most common types of cancer (lung, colorectal, prostate, and breast cancer) in a cohort study (Vlagtwedde-Vlaardingen 1965–1990, with a follow-up on mortality status until 2009, n = 8,645). We used Cox regression models adjusted for age, BMI, sex, and place of residence. Since previous studies suggested a potential effect modification of sex, we additionally stratified by sex and tested for interactions. In addition, to determine which cause of death carried the highest risk we performed competing-risk analyses on mortality due to CVD, cancer, COPD and other causes. Results Current smoking (light, moderate, and heavy cigarette smoking) and lifetime persistent smoking were associated with an increased risk of all-cause, CVD, COPD, any cancer, and lung cancer mortality. Higher numbers of pack years at baseline were associated with an increased risk of all-cause, CVD, COPD, any cancer, lung, colorectal, and prostate cancer mortality. Males who were lifetime persistent pipe/cigar smokers had a higher risk of lung cancer [HR (95% CI) = 7.72 (1.72–34.75)] as well as all-cause and any cancer mortality. A longer duration of smoking was associated with a higher risk of COPD, any and lung cancer [HR (95% CI) = 1.06 (1.00–1.12), 1.03 (1.00–1.06) and 1.10 (1.03–1.17) respectively], but not with other mortality causes. The competing risk analyses showed that ex- and current smokers had a higher risk of cancer, CVD, and COPD mortality compared to all other mortality causes. In addition, heavy smokers had a higher risk for COPD mortality compared to cancer, and CVD mortality. Conclusion Our study indicates that lifetime numbers of cigarettes smoked and the duration of smoking have different impacts for different causes of mortality. Moreover, our findings emphasize the importance of smoking-related competing risks when studying the smoking-related cancer mortality in a general population and that smoking cessation immediately effectively reduces the risk of all-cause and any cancer mortality. PMID:27055053

[Changes in hospitality workers' expectations and attitudes after the implementation of the Spanish smoking law].

PubMed

Martínez-Sánchez, Jose M; Fenández, Esteve; Fu, Marcela; Pérez-Ríos, Mónica; Schiaffino, Anna; López, María J; Alonso, Begoña; Saltó, Esteve; Nebot, Manel; Borràs, Josep M

2010-01-01

To assess changes in hospitality workers' expectations and attitudes towards the Spanish smoking law before and 2 years after the smoking ban. We performed a longitudinal study of a cohort (n=431) of hospitality workers in five regions in Spain before the law came into effect and 24 months later. Expectations and attitudes towards the ban and knowledge about the effect of second-hand smoke on health were compared before and after the ban. We recruited 431 hospitality workers in the baseline survey and 219 were followed-up 24 months later (overall follow-up rate of 50.8%). The percentage of hospitality workers who knew the law was 79.0% before it was passed and was 94.1% 24 months later (p<0.05). We observed an increase in support to the smoke-free ban in all public places, including bars and restaurants (54.1% to 65.8%; p<0.05). The percentages of support for the current ban, perception of compliance with the ban by employees and customers, and knowledge of the effect of second-hand smoke on health also increased. Knowledge and support to the Spanish smoking law among hospitality workers increased 2 years after the implementation of the ban. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

Trends and timing of cigarette smoking uptake among US young adults: survival analysis using annual national cohorts from 1976 to 2005.

PubMed

Terry-McElrath, Yvonne M; O'Malley, Patrick M

2015-07-01

To measure changes over time in cigarette smoking uptake prevalence and timing during young adulthood (ages 19-26 years), and associations between time-invariant/-varying characteristics and uptake prevalence/timing. Discrete-time survival modeling of data collected from United States high school seniors (modal age 17/18) enrolled in successive graduating classes from 1976 to 2005 and participating in four follow-up surveys (to modal age 25/26). The longitudinal component of the Monitoring the Future study. A total of 10 758 individuals reporting no life-time smoking when first surveyed as high school seniors. Smoking uptake (any, experimental, occasional and regular); socio-demographic variables; marital, college and work status; time spent socializing. The percentage of young adults moving from non-smoker to experimental smoking [slope estimate 0.11, standard error (SE) = 0.04, P = 0.005] or occasional smoking (slope estimate 0.17, SE = 0.03, P < 0.001) increased significantly across graduating classes; the percentage moving from non-smoker to regular smoker remained stable. All forms of smoking uptake were most likely to occur at age 19/20, but uptake prevalence at older ages increased over time [e.g. cohort year predicting occasional uptake at modal age 25/26 adjusted hazard odds ratio (AHOR) = 1.05, P = 0.002]. Time-invariant/-varying characteristics had unique associations with the timing of various forms of smoking uptake (e.g. at modal age 21/22, currently attending college increased occasional uptake risk (AHOR = 2.11, P < 0.001) but decreased regular uptake risk (AHOR = 0.69, P = 0.026). Young adult occasional and experimental smoking uptake increased in the United States for non-smoking high school seniors graduating from 1976 to 2005. Smoking uptake for these cohorts remained most likely to occur at age 19/20, but prevalence of uptake at older ages increased. © 2015 Society for the Study of Addiction.

Impact of removing point-of-sale tobacco displays: data from a New Zealand youth survey.

PubMed

Edwards, Richard; Ajmal, Ali; Healey, Benjamin; Hoek, Janet

2017-07-01

The tobacco industry increasingly invests in point-of-sale (POS) marketing. In July 2012, New Zealand required the removal of POS tobacco displays concurrently with increased enforcement and penalties for selling tobacco to minors, and additional restrictions on tobacco sponsorship. We evaluated the impact of these measures using a before-after study. We analysed data from annual surveys of more than 25 000 year 10 (14-15 years) students from 2007 and 2011 to 2014. Measures included prevalence of smoking-related behaviours and strength of association between visiting tobacco-retailing stores and smoking behaviours. Between 2011 and 2014, smoking experimentation (had smoked ever but smoked less than monthly currently) decreased from 23% in 2011 to 17% in 2014 (adjusted odds ratio (aOR) 0.73, 95% CI 0.69 to 0.78); current smoking (at least monthly) prevalence from 9% to 7% (aOR 0.71, 0.64 to 0.79) and initiation in the last year from 13% to 11% (aOR 0.91, 0.84 to 0.98). Attempted purchase of cigarettes in the past 30 days among smokers decreased from 30% in 2012 to 26% in 2013 (aOR 0.77, 0.63 to 0.91). Positive associations between frequency of visiting tobacco-retailing stores and smoking-related behaviours weakened post-implementation. The introduction of a POS display ban and concurrent measures was followed by significant reductions in initiation, experimental and regular smoking, attempted purchase of cigarettes, and reduced association between visiting tobacco-retailing stores and smoking behaviours. The findings suggest that POS display bans are important components of strategies to reduce smoking initiation among youth and young people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Public smoking ban and socioeconomic inequalities in smoking prevalence and cessation: a cross-sectional population-based study in Geneva, Switzerland (1995-2014).

PubMed

Sandoval, José Luis; Leão, Teresa; Cullati, Stéphane; Theler, Jean-Marc; Joost, Stéphane; Humair, Jean-Paul; Gaspoz, Jean-Michel; Guessous, Idris

2018-01-26

Smoking bans were suggested to reduce smoking prevalence and increase quit ratio but their equity impact remains unclear. We aimed to characterise the socioeconomic status (SES)-related inequalities in smoking prevalence and quit ratio before and after the implementation of a public smoking ban. We included data from 17 544 participants in the population-based cross-sectional Bus Santé study in Geneva, Switzerland, between 1995 and 2014. We considered educational attainment (primary, secondary and tertiary) as a SES indicator. Outcomes were smoking prevalence (proportion of current smokers) and quit ratio (ex-smokers to ever-smokers ratio). We used segmented linear regression to assess the overall impact of smoking ban on outcome trends. We calculated the relative (RII) and slope (SII, absolute difference) indexes of inequality, quantifying disparities between educational groups in outcomes overall (1995-2014), before and after ban implementation (November 2009). Least educated participants displayed higher smoking prevalence (RII=2.04, P<0.001; SII=0.15, P<0.001) and lower quit ratio (RII=0.73, P<0.001; SII=-0.18, P<0.001). As in other studies, smoking ban implementation coincided with a temporary reduction of smoking prevalence (P=0.003) and increase in quit ratio (P=0.02), with a progressive return to preban levels. Inequalities increased (P<0.05) in relative terms for smoking prevalence (RII before =1.84, P<0.001 and RII after =3.01, P<0.001) and absolute terms for both outcomes (smoking prevalence: SII before =0.14, P<0.001 and SII after =0.19, P<0.001; quit ratio: SII before =-0.15, P<0.001 and SII after =-0.27, P<0.001). Implementation of a public smoking ban coincided with a short-lived decrease in smoking prevalence and increase in quit ratio but also with a widening in SES inequalities in smoking-related outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoking, physical activity, nutrition and lifestyle: environmental factors and their impact on IBD.

PubMed

Cosnes, Jacques

2010-01-01

Current smoking increases the risk of developing Crohn's disease and worsens its course, increasing the need for steroids, immunosuppressants, and re-operations. On the contrary, smoking protects against ulcerative colitis and after disease onset improves its course, decreasing the need for colectomy. Smoking cessation improves Crohn's disease and worsens ulcerative colitis. Achieving smoking cessation in Crohn's disease is thus an important goal of therapy, whereas patients with ulcerative colitis should not be discouraged to quit, because the beneficial effect of smoking for their disease is counterbalanced by the deleterious respiratory and cardiovascular effects of tobacco. Physical activity improves quality of life without detrimental effect on disease activity, and may contribute to increase muscle mass and to prevent osteoporosis. Regarding nutrition, a Western diet may be associated with an increased risk of IBD, and a case-control study revealed an increased consumption of linoleic acid before diagnosis of ulcerative colitis. Liquid diets may improve Crohn's disease flares and decrease the need for steroids; however, there are no defined diets able to improve the disease course, and in Crohn's disease, supplementation with omega-3 fatty acids did not show a significant benefit. Obesity is becoming more prevalent in IBD and may be associated with higher disease activity. In total, adhering to four simple lifestyle factors - never smoking, physical activity, prudent diet and body mass index <25 - may have a strong impact both on the prevention of major chronic diseases and on the course of IBD. Copyright © 2010 S. Karger AG, Basel.

The Relationship of Dysthymia, Minor Depression, and Gender to Changes in Smoking for Current and Former Smokers: Longitudinal Evaluation in the U.S. Population

PubMed Central

Weinberger, Andrea H.; Pilver, Corey E.; Desai, Rani A.; Mazure, Carolyn M.; McKee, Sherry A.

2012-01-01

BACKGROUND Although data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over three years for current and former smokers with and without dysthymia and minor depression. METHODS Participants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n=11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers. RESULTS Wave 1 current daily smokers with current dysthymia (OR=2.13, 95% CI=1.23, 3.70) or minor depression (OR=1.53, 95% CI=1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR=0.44, 95% CI=0.20, 0.96) and lifetime dysthymia (OR=0.37, 95% CI=0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women. CONCLUSIONS Current dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence. PMID:22809897

The relationship of dysthymia, minor depression, and gender to changes in smoking for current and former smokers: longitudinal evaluation in the U.S. population.

PubMed

Weinberger, Andrea H; Pilver, Corey E; Desai, Rani A; Mazure, Carolyn M; McKee, Sherry A

2013-01-01

Although data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over 3 years for current and former smokers with and without dysthymia and minor depression. Participants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n=11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and/or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers. Wave 1 current daily smokers with current dysthymia (OR=2.13, 95% CI=1.23, 3.70) or minor depression (OR=1.53, 95% CI=1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR=0.44, 95% CI=0.20, 0.96) and lifetime dysthymia (OR=0.37, 95% CI=0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women. Current dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Reactivity to smoking- and food-related cues in currently dieting and non-dieting young women smokers.

PubMed

Jenks, Rebecca A; Higgs, Suzanne

2011-04-01

There is some evidence to suggest that young women dieters who smoke experience greater cigarette cravings in the presence of food-related related cues. The aim of this experiment was to examine reactivity to both smoking-related and water cues by dieting and non-dieting women smokers in the presence or absence of food cues. Eighteen female undergraduates attended two sessions (food present and food absent). At each session, participants were presented with a cigarette and water cue in a counterbalanced order. Pre- and post-cue measures included the brief version of the Questionnaire for Smoking Urges, heart rate and self-reported mood. All smokers showed enhanced reactivity (increased craving and heart rate) to smoking versus water cues. For dieters there was a larger increase in cigarette craving and heart rate in response to the smoking-related cues in the presence of food compared with the absence of food, whereas for non-dieters there was a smaller increase in cigarette craving and heart rate in response to the smoking-related cues in the presence of food compared with the absence of food. Mood and appetite ratings were not significantly affected by either cue type or session. The results suggest that cue reactivity to smoking-related cues is modulated by the presence of incentive stimuli relevant to the individual.

Testing the influence of external and internal cues on smoking motivation using a community sample.

PubMed

Litvin, Erika B; Brandon, Thomas H

2010-02-01

Exposing smokers to either external cues (e.g., pictures of cigarettes) or internal cues (e.g., negative affect induction) can induce urge to smoke and other behavioral and physiological responses. However, little is known about whether the two types of cues interact when presented in close proximity, as is likely the case in the real word. Additionally, potential moderators of cue reactivity have rarely been examined. Finally, few cue-reactivity studies have used representative samples of smokers. In a randomized 2 x 2 crossed factorial between-subjects design, the current study tested the effects of a negative affect cue intended to produce anxiety (speech preparation task) and an external smoking cue on urge and behavioral reactivity in a community sample of adult smokers (N = 175), and whether trait impulsivity moderated the effects. Both types of cues produced main effects on urges to smoke, despite the speech task failing to increase anxiety significantly. The speech task increased smoking urge related to anticipation of negative affect relief, whereas the external smoking cues increased urges related to anticipation of pleasure; however, the cues did not interact. Impulsivity measures predicted urge and other smoking-related variables, but did not moderate cue-reactivity. Results suggest independent rather than synergistic effects of these contributors to smoking motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Perceived acceptability of female smoking in China.

PubMed

Sansone, Natalie; Yong, Hua-Hie; Li, Lin; Jiang, Yuan; Fong, Geoffrey T

2015-11-01

Female smoking prevalence in China is very low but may rise with increased tobacco marketing towards women and changing norms. However, little is known about current perceptions of women smoking in China. This study sought to examine smokers' and non-smokers' perceived acceptability of female smoking and how it changed over time in China. Data come from Waves 1 to 3 (2006-2009) of the International Tobacco Control China Survey, a face-to-face cohort survey of approximately 800 adult smokers and 200 non-smokers in each of seven cities in mainland China. At Wave 3 (2009), about 38% of smokers and 9% of non-smokers agreed that female smoking is acceptable with women being almost twice as likely to do so as men (67% vs 36% and 11% vs 6%, respectively). In addition to women, smokers who were younger and had more positive perceptions of smoking in general were more likely to say that female smoking is acceptable. This perception significantly increased from Wave 1 (2006) to Wave 3 (2009), as did the perception that smoking is a sign of sophistication, but other general perceptions of smoking did not significantly change between 2006 and 2009. Norms against female smoking appear to remain strong in China, but female smoking may be becoming more acceptable. It is important to monitor these perceptions to prevent a rise in female smoking prevalence along with an increase in tobacco-related death and disease among women in China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Use of Interrupted Time-Series Method to Evaluate the Impact of Cigarette Excise Tax Increases in Pennsylvania, 2000–2009

PubMed Central

Kuller, Lewis H.; Fisher, Monica A.; Ostroff, Stephen M.

2013-01-01

Introduction Scientific evidence shows that cigarette price increases can significantly reduce smoking prevalence and smoking initiation among adolescents and young adults. However, data are lacking regarding the effectiveness of increasing Pennsylvania’s cigarette tax to reduce smoking and/or adverse health effects of smoking. The objective of our study was to assess the impact of cigarette tax increases and resulting price increases on smoking prevalence, acute myocardial infarction (AMI) and asthma hospitalization rates, and sudden cardiac death (SCD) rates in Pennsylvania. Methods We used segmented regression analyses of interrupted time series to evaluate the level and trend changes in Pennsylvania adults’ current smoking prevalence, age-adjusted AMI and asthma hospitalization rates, age-specific asthma hospitalization rates, and age-adjusted SCD rates following 2 cigarette excise tax increases. Results After the first excise tax increase, no beneficial effects were noted on the outcomes of interest. The second tax increase was associated with significant declines in smoking prevalence for people aged 18 to 39, age-adjusted AMI hospitalization rates for men, age-adjusted asthma hospitalizations rates, and SCD rates among men. Overall smoking prevalence declined by 5.2% (P = .01), with a quarterly decrease of 1.4% (P = .01) for people aged 18 to 39 years. The age-adjusted AMI hospitalization rate for men showed a decline of 3.87/100,000 population (P = .04). The rate of age-adjusted asthma hospitalizations decreased by 10.05/100,000 population (P < .001), and the quarterly trend decreased by 3.21/100,000 population (P < .001). Quarterly SCD rates for men decreased by 1.34/100,000 population (P < .001). Conclusion An increase in the price of cigarettes to more than $4 per 20-cigarette pack was associated with a significant decrease in smoking among younger people (aged 18–39). Decreases were also seen in asthma hospitalizations and men’s age-adjusted AMI hospitalization and SCD rates. Further research and policy development regarding the effect of cigarette taxes on tobacco consumption should be cognizant of the psychological tipping points at which overall price affects smoking patterns. PMID:24135393

Posttraumatic Symptom Reporting and Reported Cigarette Smoking During Pregnancy.

PubMed

Kornfield, Sara L; Moseley, Marian; Appleby, Dina; McMickens, Courtney L; Sammel, Mary D; Epperson, C Neill

2017-06-01

Increased prevalence of nicotine dependence among individuals suffering from posttraumatic stress disorder (PTSD) is well established. However, there are limited studies on the prevalence of smoking during pregnancy in relation to prepregnancy history of trauma exposures and active PTSD symptoms during pregnancy. Prenatal smoking has been implicated in a host of negative outcomes for mother and baby. Given maternal and fetal risk, it is critical to define predictors of continued cigarette smoking during pregnancy. Pregnant women from an urban perinatal clinic completed an anonymous survey of trauma history using a modified Traumatic Life Events Questionnaire (TLEQ), PTSD symptoms using the PTSD Symptom Checklist-Civilian Version (PCL-C) and current and past smoking behavior. Those who smoked any number of cigarettes per day after pregnancy confirmation were considered to be "pregnant smokers." Of 218 women who completed the survey, 34 (15.6%) reported smoking cigarettes after confirmation of pregnancy. In unadjusted models, trauma exposure that resulted in fear, helplessness, or horror (FHH), as well as current PTSD symptom severity and probable PTSD diagnosis showed statistical significance as predictors of smoking during pregnancy. After adjusting for age only, PTSD symptoms retained their significant association with smoking during pregnancy. When history of smoking at least five cigarettes per day was added to our models, none of the associations remained significant. These findings emphasize the importance of the behavioral response to past traumatic exposures in influencing cigarette smoking behavior before pregnancy. Given such behaviors enhance risk for continued tobacco use during pregnancy, a trauma-informed approach to smoking cessation in preconception care may ultimately reduce the likelihood of smoking during pregnancy and requires further study.

Ulcerative colitis in smokers, non-smokers and ex-smokers

PubMed Central

Bastida, Guillermo; Beltrán, Belén

2011-01-01

Smoking is a major environmental factor that interferes in the establishment and clinical course of ulcerative colitis (UC). Firstly, the risk of smoking status impact in the development of UC is reviewed, showing that current smoking has a protective association with UC. Similarly, being a former smoker is associated with an increased risk of UC. The concept that smoking could have a role in determining the inflammatory bowel disease phenotype is also discussed. Gender may also be considered, as current smoking delays disease onset in men but not in women. No clear conclusions can be driven from the studies trying to clarify whether childhood passive smoking or prenatal smoke exposure have an influence on the development of UC, mainly due to methodology flaws. The influence of smoking on disease course is the second aspect analysed. Some studies show a disease course more benign in smokers that in non-smokers, with lower hospitalizations rates, less flare-ups, lower use of oral steroids and even less risk of proximal extension. This is not verified by some other studies. Similarly, the rate of colectomy does not seem to be determined by the smoking status of the patient. The third issue reviewed is the use of nicotine as a therapeutic agent. The place of nicotine in the treatment of UC is unclear, although it could be useful in selected cases, particularly in recent ex-smokers with moderate but refractory attacks of UC. Finally, the effect of smoking cessation in UC patients is summarised. Given that smoking represents a major worldwide cause of death, for inpatients with UC the risks of smoking far outweigh any possible benefit. Thus, physicians should advise, encourage and assist UC patients who smoke to quit. PMID:21734782

The prevalence of smoking, second-hand smoke exposure, and knowledge of the health hazards of smoking among internal migrants in 12 provinces in China: a cross-sectional analysis.

PubMed

Zheng, Yunting; Ji, Ying; Dong, Hongbo; Chang, Chun

2018-05-24

Previous studies have provided inconsistent findings on smoking among migrants, and very limited data exist on their second-hand smoke exposure. This study aims to investigate internal migrants' smoking prevalence, second-hand smoke exposure among non-smokers, and knowledge of the health hazards of smoking in 12 major migrant provinces in China in 2013. Data from the 2013 Migrant Dynamics Monitoring Survey in China published by the National Commission of Health and Family Planning was used in this study. Descriptive analysis, Chi-square analysis, and sex-stratified multivariate logistic regression analysis were used to explore the determinants of current smoking and second-hand smoke exposure. Among 7200 migrants, 34.1% (55% male, 4% female) were current smokers. For males, factors associated with current smoking were education year (aOR = 0.95, 95% CI: 0.93-0.98), duration of stay (aOR = 1.01, 95% CI: 1.00-1.03) and occupation (aOR = 1.25, 95% CI: 1.03-1.53). For females, household registration status (aOR = 1.70, 95% CI: 1.04-2.80) was the most important factor associated with current smoking. Sixty five percent of non-smokers were exposed to second-hand smoke. Factors associated with exposure to second-hand smoke were duration of stay (aOR = 1.01, 95% CI: 1.00-1.02), divorced/widowed marital status (aOR = 0.48, 95% CI: 0.25-0.91), occupation (aOR = 1.29, 95% CI: 1.05-1.58) and the nature of employer (aOR = 0.77, 95% CI: 0.60-0.97). About 95% of participants were aware that lung cancer is one of the hazards of smoking. Non-current smokers had a better knowledge of fertility reduction and accelerated aging as hazards of smoking than current smokers (p < 0.01). Knowledge of the impact of smoking on cardiovascular diseases was relatively low compared with knowledge of other smoking-related hazards (26.1-44.3%). Current smoking and exposure to second-hand smoke among internal migrants in China is high. Socio-demographic characteristics and migration status were strongly associated with current smoking and second-hand smoke exposure. We recommend specifically targeted tobacco control interventions to help to address these risk factors, such as focusing on divorced/widowed women.

Cigarette smoking among Korean adolescents: prevalence and correlates.

PubMed

Juon, H S; Shin, Y; Nam, J J

1995-01-01

The purpose of this study was to examine the prevalence of cigarette smoking and to explore its relationship with individual, family, school, and psychological factors among Korean adolescents. As part of the Korean Institute for Health and Social Affairs' Adolescent Health Survey, 5,209 eighth graders and 4,677 eleventh graders from 70 junior and senior high schools completed a self-administered questionnaire during school hours in 1989. Current prevalence of cigarette smoking was 8.45% (15.43% of boys and 1.28% of girls). Smoking prevalence increased with age among boys. Based on logistic regression analyses, perceived peer use was most strongly associated with smoking status (OR = 9.97 for boys; and 68.27 for girls). Academic stress, grade, and type of school were also associated with smoking status for both boys and girls. In addition, mother's smoking, birth order, and urbanity were associated with smoking status for boys. Implications of the results for prevention efforts to inhibit the onset of cigarette smoking among Korean adolescents are discussed.

Exercise-based smoking cessation interventions among women

PubMed Central

Linke, Sarah E; Ciccolo, Joseph T; Ussher, Michael; Marcus, Bess H

2017-01-01

Although smoking rates are lower among women than men, women are less likely to quit smoking in cessation trials. This is in part due to their tendency to smoke to help prevent or mitigate negative mood/affect, depression and/or postcessation weight gain. Exercise helps to alleviate women’s fear of postcessation weight gain and reduces their cessation-related mood symptoms, making it a theoretically ideal smoking cessation intervention for women. In addition, short bouts of exercise decrease cigarette cravings and withdrawal symptoms among temporarily abstinent smokers. However, results from exercise-based smoking cessation interventions to date have been mostly nonsignificant. This paper describes the theoretical mechanisms (psychological, behavioral, physiological and neurobiological) and practical reasons underlying our belief that exercise-based smoking cessation interventions should not yet be abandoned despite their current paucity of supporting evidence. It also presents ideas for modifying future exercise-based smoking cessation interventions to increase adherence and, as a result, more accurately evaluate the effect of exercise on smoking cessation. PMID:23241156

Exercise-based smoking cessation interventions among women.

PubMed

Linke, Sarah E; Ciccolo, Joseph T; Ussher, Michael; Marcus, Bess H

2013-01-01

Although smoking rates are lower among women than men, women are less likely to quit smoking in cessation trials. This is in part due to their tendency to smoke to help prevent or mitigate negative mood/affect, depression and/or postcessation weight gain. Exercise helps to alleviate women's fear of postcessation weight gain and reduces their cessation-related mood symptoms, making it a theoretically ideal smoking cessation intervention for women. In addition, short bouts of exercise decrease cigarette cravings and withdrawal symptoms among temporarily abstinent smokers. However, results from exercise-based smoking cessation interventions to date have been mostly nonsignificant. This paper describes the theoretical mechanisms (psychological, behavioral, physiological and neurobiological) and practical reasons underlying our belief that exercise-based smoking cessation interventions should not yet be abandoned despite their current paucity of supporting evidence. It also presents ideas for modifying future exercise-based smoking cessation interventions to increase adherence and, as a result, more accurately evaluate the effect of exercise on smoking cessation.

Adolescent smoking behaviour and cigarette brand preference in Japan.

PubMed

Osaki, Y; Tanihata, T; Ohida, T; Minowa, M; Wada, K; Suzuki, K; Kaetsu, A; Okamoto, M; Kishimoto, T

2006-06-01

As part of efforts to develop a smoking control strategy for Japanese adolescents, the results of two nationwide surveys on adolescent smoking behaviour were compared. Descriptive study on smoking behaviour among high school students was conducted. Self-reporting anonymous questionnaires were administered to 115,814 students in 1996 and 106,297 in 2000 through randomly sampled junior and senior high schools throughout Japan. Smoking prevalence, proportion of smokers by usual sources of cigarettes, national estimated cigarettes consumed by minors, share of cigarette brands smoked by high school students. The experiment rate among junior high school boys decreased in 2000 compared with that in 1996, whereas current and daily smoking rates did not. Although prevalence among Japanese girls was much lower than that among boys, prevalence among girls increased in 2000. The main source of cigarettes among high school smokers was vending machines. The proportion of smokers who usually purchased cigarettes from vending machines increased in 2000, in spite of the 1998 introduction of restrictions on night-time operations. Japanese adolescents were more likely than adults to smoke American cigarette brands, and the adolescent market share of American brands has increased rapidly, especially for menthol brands. This survey revealed the seriousness of the problem of smoking behaviour among Japanese high school students, and suggested that this behaviour may be influenced by social environmental factors, including the marketing strategies of the tobacco industry. Action should be taken to reduce the prevalence and impact of pro-tobacco marketing messages and to abolish cigarette vending machines.

Impact of the 2005 smoke-free policy in Italy on prevalence, cessation and intensity of smoking in the overall population and by educational group.

PubMed

Federico, Bruno; Mackenbach, Johan P; Eikemo, Terje A; Kunst, Anton E

2012-09-01

To estimate the immediate as well as the longer-term impact of the 2005 smoke-free law on smoking prevalence, cessation and intensity both in the overall population and separately by educational level. Interrupted time-series analyses of 11 cross-sectional nationally representative surveys. Italy, 1999-2010. Adults aged 20-64 years. For each year we computed the prevalence of current smoking, the quit ratio and the mean number of cigarettes smoked per day. All measures were standardized by age. Segmented linear regression analyses were performed for each smoking variable separately by sex. Among males, smoking prevalence decreased by 2.6% (P = 0.002) and smoking cessation increased by 3.3% (P = 0.006) shortly after the ban, but both measures tended to return to pre-ban values in the following years. This occurred among both highly and low-educated males. Among low-educated females, the ban was followed by a 1.6% decrease (P = 0.120) in smoking prevalence and a 4.5% increase in quit ratios (P < 0.001). However, these favourable trends reversed over the following years. Among highly educated females, trends in smoking prevalence and cessation were not altered by the ban. Among both males and females, long-term trends in the daily number of cigarettes, which were already declining well before the implementation of the policy, changed to a minor extent. The impact of the Italian smoke-free policy on smoking and inequalities in smoking was short-term. Smoke-free policies may not achieve the secondary effect of reducing smoking prevalence in the long term, and they may have limited effects on inequalities in smoking. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

Systematic review with meta-analysis of the epidemiological evidence in the 1900s relating smoking to lung cancer

PubMed Central

2012-01-01

Background Smoking is a known lung cancer cause, but no detailed quantitative systematic review exists. We summarize evidence for various indices. Methods Papers published before 2000 describing epidemiological studies involving 100+ lung cancer cases were obtained from Medline and other sources. Studies were classified as principal, or subsidiary where cases overlapped with principal studies. Data were extracted on design, exposures, histological types and confounder adjustment. RRs/ORs and 95% CIs were extracted for ever, current and ex smoking of cigarettes, pipes and cigars and indices of cigarette type and dose–response. Meta-analyses and meta-regressions investigated how relationships varied by study and RR characteristics, mainly for outcomes exactly or closely equivalent to all lung cancer, squamous cell carcinoma (“squamous”) and adenocarcinoma (“adeno”). Results 287 studies (20 subsidiary) were identified. Although RR estimates were markedly heterogeneous, the meta-analyses demonstrated a relationship of smoking with lung cancer risk, clearly seen for ever smoking (random-effects RR 5.50, CI 5.07-5.96) current smoking (8.43, 7.63-9.31), ex smoking (4.30, 3.93-4.71) and pipe/cigar only smoking (2.92, 2.38-3.57). It was stronger for squamous (current smoking RR 16.91, 13.14-21.76) than adeno (4.21, 3.32-5.34), and evident in both sexes (RRs somewhat higher in males), all continents (RRs highest for North America and lowest for Asia, particularly China), and both study types (RRs higher for prospective studies). Relationships were somewhat stronger in later starting and larger studies. RR estimates were similar in cigarette only and mixed smokers, and similar in smokers of pipes/cigars only, pipes only and cigars only. Exceptionally no increase in adeno risk was seen for pipe/cigar only smokers (0.93, 0.62-1.40). RRs were unrelated to mentholation, and higher for non-filter and handrolled cigarettes. RRs increased with amount smoked, duration, earlier starting age, tar level and fraction smoked and decreased with time quit. Relationships were strongest for small and squamous cell, intermediate for large cell and weakest for adenocarcinoma. Covariate-adjustment little affected RR estimates. Conclusions The association of lung cancer with smoking is strong, evident for all lung cancer types, dose-related and insensitive to covariate-adjustment. This emphasises the causal nature of the relationship. Our results quantify the relationships more precisely than previously. PMID:22943444

Educational inequalities in smoking among Japanese adults aged 25-94 years: Nationally representative sex- and age-specific statistics.

PubMed

Tabuchi, Takahiro; Kondo, Naoki

2017-04-01

Few studies have investigated differences in age- and gender-specific educational gradients in tobacco smoking among the whole range of adult age groups. We examined educational inequality in smoking among Japanese adults aged 25-94 years. Using a large nationally representative sample (167,925 men and 186,588 women) in 2010, prevalence of current smoking and heavy smoking among daily smokers and their inequalities attributable to educational attainment were analyzed according to sex and age groups. Among men aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 68.4% (95% confidence interval [CI], 66.0%-70.6%), and graduate school graduates had the lowest at 19.4% (95% CI, 17.2%-21.9%). High school graduates had the second highest current smoking prevalence (e.g., 55.9%; 95% CI, 54.9%-56.8% in men aged 25-34 years). Among men aged 75-94 years, the difference in current smoking across educational categories was small. A similar but steeper educational gradient in current smoking was observed among women. Among women aged 25-34 years, junior high school graduates had the highest current smoking prevalence at 49.3% (95% CI, 46.3%-52.3%), and graduate school graduates had the lowest at 4.8% (95% CI, 2.9%-7.4%). Compared with older age groups, such as 65-94 years, younger age groups, such as 25-54 years, had higher estimates of inequality indicators for educational inequality in both current and heavy smoking in both sexes. Educational inequalities in current and heavy smoking were apparent and large in the young population compared with older generations. The current study provides basic data on educational inequalities in smoking among Japanese adults. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Smoking Trends among U.S. Latinos, 1998–2013: The Impact of Immigrant Arrival Cohort

PubMed Central

Bostean, Georgiana; Ro, Annie; Fleischer, Nancy L.

2017-01-01

Few studies examine nativity disparities in smoking in the U.S., thus a major gap remains in understanding whether immigrant Latinos’ smoking prevalence is stable, converging, or diverging, compared with U.S.-born Latinos. This study aimed to disentangle the roles of period changes, duration of U.S. residence, and immigrant arrival cohort in explaining the gap in smoking prevalence between foreign-born and U.S.-born Latinos. Using repeated cross-sectional data spanning 1998–2013 (U.S. National Health Interview Survey), regressions predicted current smoking among foreign-born and U.S.-born Latino men and women (n = 12,492). We contrasted findings from conventional regression analyses that simply include period and duration of residence effects, to two methods of assessing arrival cohort effects: the first accounted for baseline differences in smoking among arrival cohorts, while the second examined smoking probabilities by tracking foreign-born arrival cohorts as they increase their duration of U.S. residence. Findings showed that Latino immigrants maintained lower prevalence of current smoking compared with U.S.-born Latinos over the period 1998–2013, and that longer duration of U.S. residence is associated with lower odds of smoking among men. Two findings are particularly novel: (1) accounting for immigrant arrival cohort dampens the overall protective effect of duration of residence among men; and (2) the earliest arrival cohort of Latino immigrant men experienced the steepest decline in smoking over duration of U.S. residence. Results have methodological and theoretical implications for smoking studies and the Latino mortality paradox. PMID:28257125

Smoking Cessation Counseling Beliefs and Behaviors of Outpatient Oncology Providers

PubMed Central

Danhauer, Suzanne C.; Tooze, Janet A.; Blackstock, A. William; Spangler, John; Thomas, Leslie; Sutfin, Erin L.

2012-01-01

Purpose. Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the “teachable moment” of cancer diagnosis to provide smoking cessation assistance. Providers and Methods. Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices. Results. Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for both current smokers and recent quitters. Rates of advising patients to quit smoking were also high (86.5% frequently or always), but <30% of providers reported frequently or always providing intervention to smoking patients (e.g., nicotine replacement therapy or other medications, self-help materials, and/or referrals). Only 30% of providers reported that they frequently or always followed up with patients to assess progress with quitting. Few providers (18.1%) reported high levels of confidence in their ability to counsel smoking patients. Patients' lack of motivation was identified as the most important barrier to smoking cessation. Conclusions. Although beliefs about providing cessation services to smoking patients were generally positive, few providers reported commonly providing interventions beyond advice to quit. Additional training and clinic-based interventions may improve adherence to tobacco cessation practice guidelines in the outpatient oncology setting. PMID:22334454

Patient engagement during medical visits and smoking cessation counseling.

PubMed

Cunningham, Peter

2014-08-01

Increased patient engagement with health and health care is considered crucial to increasing the quality of health care and patient self-management of health. To examine whether patients with high levels of engagement during medical encounters are more likely to receive advice and counseling about smoking compared with less engaged patients. Cross-sectional survey using multivariate regression analysis of 8656 current and retired autoworkers and their spouses younger than 65 years who are or were employed by the 3 major US auto companies. Clinician advice and counseling about smoking; patients who tried to quit smoking. Among 1904 current smokers, 58.5% of those who were more highly engaged during medical encounters were counseled by clinicians about specific strategies and methods to stop smoking, compared with 45.4% of patients who were less engaged. Patient engagement and being advised by clinicians to stop smoking had independent effects on smoking cessation efforts by patients. Accounting for differences in other patient characteristics, patients with high engagement levels were more likely to try to stop smoking compared with patients with lower engagement (odds ratio, 1.62; P < .01). Patients who were both highly engaged and had received counseling from clinicians were the most likely to try to stop smoking (74.6%) while patients with low engagement who did not receive counseling were the least likely (46.0%). Nevertheless, counseling is still effective among even less engaged patients; 60.4% of smokers with low engagement who received counseling tried to quit smoking in the past year compared with 46.0% who did not receive counseling. The study results provide evidence that clinicians respond differently to patients who are highly engaged during medical encounters than they do to less engaged patients in terms of smoking cessation advice. Clinicians should not assume that low patient engagement and greater passivity during medical encounters is evidence of unwillingness to quit. The results show that smoking cessation counseling is associated with a higher likelihood of quit attempts even for patients who are less engaged during medical encounters.

Perceived Deterrence of Cigarette Use and Smoking Status Among Active Duty Military Personnel.

PubMed

Ulanday, Kathleene T; Jeffery, Diana D; Nebeling, Linda; Srinivasan, Shobha

2017-05-01

Tobacco use in the military adversely affects fitness, readiness and performance levels, and increases health care costs. In 2011, cigarette use in the military was higher than in the civilian population (24.0% vs. 21.2%). We examined the perceptions of active duty service members with respect to supervisory and military installation determent of cigarette smoking. Using the Department of Defense's 2011 Health-Related Behaviors Survey (HRBS) of active duty military personnel (N = 39,877) data, a multivariate logistic regression estimated the association of personnel's perception of leadership discouraging cigarette use with smoking status, controlling for covariates (n = 23,354). Those who perceived their supervisor as "Somewhat" (adjusted odds ratio [AOR] 1.41, 95% confidence interval [CI] [1.29, 1.54]) or "Strongly" (AOR 1.22, 95% CI [1.09, 1.37]) discouraging of cigarette use had higher odds of smoking compared to those who perceived supervisors "Not at all" discouraging use. Odds of currently smoking increased with perceptions of increasing discouragement by installation, from "Somewhat" (AOR 1.64, 95% CI [1.49, 1.80]) to "Strongly discourages" cigarette use (AOR 1.71, 95% CI [1.50, 1.95]). As expected, the strongest correlate of current smoking was having friends who smoke (AOR 13.62, 95% CI [11.53, 16.07]). Other significant covariates in the model focused on current smokers included high risk for alcohol problems, specifically hazardous drinking (AOR 2.57, 95% CI [2.25, 2.93]), harmful drinking (AOR 5.46, 95% CI [3.57, 8.35]), and possible alcohol dependence (AOR 1.43, 95% CI [1.07, 1.91]); being underweight (AOR 1.72, 95% CI [1.19, 2.53]); high anxiety (AOR 1.31, 95% CI [1.18, 1.46]); high anger (AOR 1.20, 95% CI [1.03, 1.39]); and high overall stress (AOR 1.17, 95% CI [1.07, 1.27]). Among the demographic covariates, higher rates of smoking were found in all levels of enlisted military rank, most notably among E1-E4 (AOR 7.22, 95% CI [5.64, 9.21]) and E4-E% (AOR 8.60, 95% CI [6.79, 10.91]); non-Air Force affiliation; longer length of combat experience; males; non-Hispanic whites; married personnel without a spouse present; job classifications in combat, administration, maintenance, or food service; and duty station in the continental United States. Additional analyses found that personnel with high overall stress were less likely to perceive their supervisor (odds ratio 0.67, 95% CI [0.62, 0.73]) and installation (odds ratio 0.69, 95% CI [0.63, 0.76]) as strongly discouraging smoking compared to those with low overall stress. Perceived influence of tobacco deterrence by military leadership is associated with smoking behaviors of active duty personnel. Paradoxically, those who perceived the strongest discouragement by military leadership had the highest rates of smoking. We hypothesize that current smokers may have a heightened awareness of antismoking messages and policies, and are more sensitive to threats that impinge upon freedom to smoke or aim to restrict a substance used for stress reduction. Results support military tobacco control efforts extending beyond individual-level approaches. A focus on multilevel influences of health behavior, emphasizing effective leadership, social and environmental changes, is needed to address military smoking behaviors. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Victimization, Smoking, and Chronic Physical Health Problems Among Sexual Minority Women

PubMed Central

Simoni, Jane M.

2014-01-01

Background Sexual minority women (SMW) have been shown to be at increased risk for abuse, smoking, and chronic physical health problems compared with heterosexual women. In the general population, abuse and smoking are associated with physical health problems. However, there has been little research on their associations among SMW. Purpose The current study examined a mediational model of abuse, smoking, and self-reported physical health conditions in a national sample of SMW. Methods Participants (N=1,224) were recruited via the Internet and completed measures of childhood trauma, adult sexual assault, smoking, body mass index, and chronic medical conditions. Results Structural equation modeling demonstrated that childhood abuse was associated with adult sexual assault, smoking, and physical health problems, but smoking was not a significant mediator. Conclusions The results highlight the impact of childhood abuse on physical health problems among SMW and the need to examine other health behaviors that may mediate this relation. PMID:21735343

Transmission of Smoking across Three Generations in Finland

PubMed Central

El-Amin, Salma E. T.; Kinnunen, Jaana M.; Ollila, Hanna; Helminen, Mika; Alves, Joana; Lindfors, Pirjo; Rimpelä, Arja H.

2015-01-01

The influence of parents’ smoking on children’s smoking is well known, but few studies have examined the association between grandparents’ and grandchildren’s smoking. We studied the association between paternal and maternal grandparents’ smoking and their grandchildren’s tobacco use and assessed whether parents’ smoking is a mediator in this process. Data were obtained from a national survey of 12–18-year-old Finns in 2013 (N = 3535, response rate 38%). Logistic regression and mediation analyses were used. Both boys and girls had higher odds for smoking experimentation, daily smoking and other tobacco or tobacco-like product use if their mother, father or any of the four grandparents were current or former smokers. When parents’ and grandparents’ smoking status were included in the same model, grandparents’ smoking generally lost statistical significance. In the mediation analysis, 73% of the total effect of grandparents’ smoking on grandchildren’s daily smoking was mediated through parents’ smoking, 64% on smoking experimentation and 63% on other tobacco or tobacco-like product use. The indirect effect of a mother’s smoking was higher than that of a father’s. To conclude, paternal and maternal grandparents’ smoking increases grandchildren’s tobacco use. The influence is mainly, but not completely, mediated through parents’ smoking. PMID:26712771

Similarities in food cravings and mood states between obese women and women who smoke tobacco.

PubMed

Pepino, M Yanina; Finkbeiner, Susana; Mennella, Julie A

2009-06-01

The present study assessed food cravings in a cohort of 229 women who differed in smoking history (i.e., never smoker, former smoker, and current smoker) and body weight (i.e., normal weight, overweight, and obese). Each subject completed the Food Craving Inventory (FCI), which measures cravings for sweets, high fats, carbohydrates/starches, and fast-food fats, and the Profile of Mood States (POMS), which measures psychological distress. Smoking and obesity were independently associated with specific food cravings and mood states. Current smokers craved high fats more frequently than former and never smokers. They also craved starches more frequently and felt more depressed and angry than never smokers, but not former smokers. Whereas cravings for starchy foods and some mood states may be characteristic of women who are likely to smoke, more frequent cravings for fat among smokers is related to smoking per se. Similarly, obese women craved high fats more frequently than nonobese women and depression symptoms were intensified with increasing body weights. We hypothesize that the overlapping neuroendocrine alterations associated with obesity and smoking and the remarkable similarities in food cravings and mood states between women who smoke and women who are obese suggest that common biological mechanisms modulate cravings for fat in these women.

The development of tobacco use in adolescence among "snus starters" and "cigarette starters": an analysis of the Swedish "BROMS" cohort.

PubMed

Galanti, Maria Rosaria; Rosendahl, Ingvar; Wickholm, Seppo

2008-02-01

Whether the use of smokeless tobacco can facilitate the transition to cigarette smoking and/or to prolonged tobacco use in adolescence is unclear. We analyzed data from a cohort of 2,938 Swedish adolescents, with six follow-up assessments of tobacco use between the ages of 11 and 18 years. The majority of tobacco users (70%) started by smoking cigarettes, 11% took up snus before smoking, and 19% used both tobacco types close in time. Ever users of tobacco at baseline had a higher risk of being current smokers and/or smokeless tobacco users at the end of follow-up compared with never users, with the highest excess relative risk for "mixed users." Adolescents who initiated tobacco use with cigarettes had a non-significantly increased probability to end up as current smokers compared with snus starters (adjusted OR=1.42; 95% CI 0.98-2.10) The OR of smoking for "mixed starters" was 2.54 (95% CI 1.68-3.91). The risk of becoming current user of any tobacco was also significantly enhanced for "mixed starters." Marked sex differences were observed in these associations, as initiation with cigarettes rather than with snus predicted current smoking or tobacco use only among females. Progression of tobacco use in adolescence is not predicted by onset with snus or cigarettes, but rather by initiation with both tobacco types close in time and/or at young age. The proportion of adolescent smoking prevalence attributable to a potential induction effect of snus is likely small.

A Paradox: α-Klotho Levels and Smoking Intensity.

PubMed

Verde, Zoraida; González-Moro, Jose M Rodríguez; Chicharro, Luis M; Reinoso-Barbero, Luis; Bandrés, Fernando; Gómez-Gallego, Félix; Santiago, Catalina

2017-02-01

Reports regarding smoking differences in α-klotho expression have provided conflicting results. In the current study we focused on the influence of smoking intensity to serum levels of the aging molecule α-klotho in healthy smokers. 40 middle aged healthy smokers without airway obstruction or restriction were selected for the analysis. Serum levels of soluble α-klotho were significantly higher in heavy smokers (P < 0.001). These results are in agreement with the possibility that α-klotho acts as anti-inflammatory molecule and strengthen the hypothesis that an increase of serum levels of α-klotho might be a compensatory response to smoking stress in healthy population.

Understanding factors that influence smoking uptake

PubMed Central

Buller, D; Borland, R; Woodall, W; Hall, J; Burris-Woodall, P; Voeks, J

2003-01-01

Objective:To explore relationships between patterns of smoking uptake and social context and attitudinal variables. Design:Cross sectional survey. Setting:Public schools in Tucson, Arizona and Albuquerque, New Mexico. Participants:982 children in grades 6–9 (ages 11–15 years). Main outcome measures:Items measuring smoking history, nicotine dependence and quit attempts, susceptibility to smoking in the future, smoking norms, use of other tobacco products, attitudes toward smoking, and demographic characteristics. Results:Overall, 43% of children had smoked a cigarette and 57% had never used them. Ever smokers lived in social contexts with more smoking and where smoking was normative. Among never users, 25% are susceptible to smoking; these children have positive attitudes toward smoking, do not feel social pressure to stay off cigarettes, and had more friends who smoked. Among ever users, 36% were currently smoking in the past 30 days. Current users also lived in social context with more smoking and had positive attitudes toward smoking. Most users had tried to stop smoking. Only 9% of current users smoked daily; 29% had not smoked a whole cigarette. Greater cigarette consumption was associated with more favourable attitudes toward smoking. Most of past users were in early uptake: 95% had smoked less than 100 cigarettes but 49% were susceptible to smoking again. Conclusions:There is promise in differentiating subgroups among the never, past and current use of cigarettes. Susceptibility within each of these groups was associated with similar patterns of attitudes and social context. These patterns in smoking uptake need to be confirmed prospectively. PMID:14645936

MEDIATORS OF THE RELATIONSHIP BETWEEN NICOTINE REPLACEMENT THERAPY AND SMOKING ABSTINENCE AMONG PEOPLE LIVING WITH HIV/AIDS

PubMed Central

Stanton, Cassandra A.; Lloyd-Richardson, Elizabeth E.; Papandonatos, George D.; de Dios, Marcel A.; Niaura, Raymond

2012-01-01

Cigarette smoking is highly prevalent among people living with HIV/AIDS and poses unique health risks. Smoking cessation programs tailored to this population have documented improved smoking outcomes with nicotine replacement therapy (NRT). The current study examined 6-month abstinence rates from a randomized clinical trial targeting 412 HIV-positive adult current smokers (51% European American, 19% African American, and 17% Hispanic American) and tested whether psychosocial variables, such as self-efficacy and decisional balance, mediated the relationship between NRT and long-term abstinence. Meeting criteria for complete mediation, 6-month smoking abstinence rates improved significantly with increases in these mediators, and the association of NRT and smoking abstinence was no longer significant once changes in self-efficacy and decisional balance were taken into account. Failure to translate gains in self-efficacy among African Americans into improved abstinence rates accounted for racial/ ethnic differences among participants. Specific psychosocial factors, such as self-efficacy, may be particularly amenable to change in cessation interventions and should be addressed with greater awareness of how cultural and social contextual factors impact treatment response among people living with HIV/AIDS. PMID:19537955

Smoking and Cognition.

PubMed

Campos, Marcela Waisman; Serebrisky, Debora; Castaldelli-Maia, Joao Mauricio

2016-01-01

Given the large availability of nicotinic acetylcholine receptors (nAChRs) throughout the brain, and the wide range of neurotransmitter systems affected (norepinephrine, serotonin and dopamine), nicotine influences a wide variety of cognitive domains such as sensorial, motor, attention, executive function, learning and memory. This article reviews current state of the art research on the effects of nicotine upon cognition. There are different neurobiological mechanisms involved in acute/chronic smoking and nicotine abstinence. Smoking reinforcement could be due to the initial cognitive improvement, that is, individuals can learn that smoking temporarily increases cognitive functioning (improving some components of attention and memory). These acute nicotine effects improve (i) cognitive performance above smokers' normal levels, and (ii) cognitive disruption resulting from nicotine abstinence. Both neurobiological effects act as reinforcers to nicotine use, greatly contributing to the development of nicotine dependence. However, heavy smoking is associated with cognitive impairment and cognitive decline in middle age. Future clinical research should investigate the role of positive and negative cognitive effects of nicotine in smoking cessation treatment. This is clearly an important scientific issue, with insufficient current data from which to draw definitive conclusions. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults

PubMed Central

Minh An, Dao Thi; Van Minh, Hoang; Huong, Le Thi; Giang, Kim Bao; Xuan, Le Thi Thanh; Thi Hai, Phan; Quynh Nga, Pham; Hsia, Jason

2013-01-01

Background Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. Results General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population. PMID:23374702

Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults.

PubMed

Minh An, Dao Thi; Van Minh, Hoang; Huong, Le Thi; Giang, Kim Bao; Xuan, Le Thi Thanh; Hai, Phan Thi; Quynh Nga, Pham; Hsia, Jason

2013-01-31

Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population.

Treatment non-response: Associations with smoking expectancies among treatment-seeking smokers.

PubMed

Garey, Lorra; Taha, Samar A; Kauffman, Brooke Y; Manning, Kara F; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

2017-10-01

Despite the high rate of smoking cessation treatment non-response, relatively little empirical work has examined predictors of treatment non-response. The present study sought to explore the effect of smoking outcome expectancies on treatment response in a sample of treatment-seeking adult daily smokers (N=182; 53.3% female; M age =40.67; SD=13.63). Results indicated that expectancies for smoking to reduce negative affect were related to an increased likelihood of treatment non-response (OR=0.73, CI: 0.54, 0.98). These findings remained significant after controlling for sex, presence of Axis I disorder, tobacco-related health problems, tobacco dependence, anxiety sensitivity, and condition assignment as well as other smoking expectancy dimensions. Post hoc analyses revealed that this relation was stronger for smokers in the integrated care condition vs. the standard care condition (Interaction: OR=1.69, CI: 1.05, 2.73). Additionally, expectancies for smoking to enhance positive affect and provide sensory satisfaction were associated with an increased likelihood of treatment response in the standard care condition. The current findings suggest expectancies that smoking will alleviate negative affect may be a risk factor of smoking cessation treatment non-response. Additionally, findings provide evidence that the relation between smoking expectancies and treatment non-response may differ by smoking cessation treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Demographic and migration-related risk factors for low-level smoking in a farm working sample of Latinos (the MICASA study)

PubMed Central

Rodriquez, Erik J.; Stoecklin-Marois, Maria T.; Hennessy-Burt, Tamara E.; Tancredi, Daniel J.; Schenker, Marc B.

2018-01-01

Cigarette smoking is the most preventable cause of death in the U.S. Research regarding the phenomenon of low-level smoking, defined as smoking one to five cigarettes per day (CPD) on average, is increasing as its high prevalence is better recognized. The Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study is a prospective cohort study of Latino hired farm worker families that assesses respiratory health, including patterns and behaviors of cigarette smoking. The purpose of the present analysis was to establish demographic, migration-related, and psychosocial characteristics and risk factors for low-level smoking. Seven percent of participants were current smokers, 61% of them being low-level smokers. Low-level smokers did not smoke as many days during the past month as those who smoke 6+ CPD (p=0.04). Low-level smokers were more likely than never and former smokers combined not to be married and to experience frequent mental distress. Those who smoke 6+ CPD were also more likely than never and former smokers combined to experience frequent mental distress and to be more acculturated. Low-level smokers have characteristics and risk factors that set them apart from other types of smokers. This increased understanding of low-level smokers can enhance public health education and smoking cessation programs targeted at Latinos. PMID:29643941

Acute effects of electronic and tobacco cigarette smoking on complete blood count.

PubMed

Flouris, Andreas D; Poulianiti, Konstantina P; Chorti, Maria S; Jamurtas, Athanasios Z; Kouretas, Dimitrios; Owolabi, Emmanuel O; Tzatzarakis, Manolis N; Tsatsakis, Aristidis M; Koutedakis, Yiannis

2012-10-01

The World Health Organisation called for research assessing the safety of electronic cigarette (e-cigarette). We evaluated the acute effect of active and passive e-cigarette and tobacco cigarette smoking on complete blood count (CBC) markers in 15 smokers and 15 never-smokers, respectively. Smokers underwent a control session, an active tobacco cigarette smoking session, and an active e-cigarette smoking session. Never-smokers underwent a control session, a passive tobacco cigarette smoking session, and a passive e-cigarette smoking session. The results demonstrated that CBC indices remained unchanged during the control session and the active and passive e-cigarette smoking sessions (P>0.05). Active and passive tobacco cigarette smoking increased white blood cell, lymphocyte, and granulocyte counts for at least one hour in smokers and never smokers (P<0.05). It is concluded that acute active and passive smoking using the e-cigarettes tested in the current study does not influence CBC indices in smokers and never smokers, respectively. In contrast, acute active and passive tobacco cigarette smoking increase the secondary proteins of acute inflammatory load for at least one hour. More research is needed to evaluate chemical safety issues and other areas of consumer product safety of e-cigarettes, because the nicotine content in the liquids used may vary considerably. Copyright © 2012 Elsevier Ltd. All rights reserved.

Negative affect in at-risk youth: Outcome expectancies mediate relations with both regular and electronic cigarette use.

PubMed

Miller, Stephen; Pike, James; Stacy, Alan W; Xie, Bin; Ames, Susan L

2017-06-01

Despite the general trend of declining use of traditional cigarettes among young adults in the United States, alternative high school students continue to smoke cigarettes and electronic cigarettes at rates much higher than do students attending regular high schools. Challenging life circumstances leading to elevated levels of negative affect may account for increased smoking behavior in this population. Further, a belief in the negative affect-reducing qualities of nicotine may mediate this effect. The current study tested the hypothesis that negative reinforcing outcome expectancies mediate the relationship between negative affect on smoking susceptibility in nonusers, smoking frequency in users, and smoking experimentation in the overall sample. Results support the hypothesis that negative affect in alternative high school students is correlated with smoking experimentation, smoking willingness, and smoking frequency and that the relationship between negative affect and smoking behavior outcomes is mediated by negative reinforcing outcome expectancies (i.e., beliefs in the negative affect-reducing effects of smoking). This finding was supported for both cigarettes and electronic cigarettes and coincides with a rapid increase in the number of high school students nationally who have experimented with electronic cigarettes. Future antismoking initiatives directed at at-risk youth should consider integrating healthier negative affect reduction techniques to counter the use of nicotine products. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Carbon Monoxide Alarm and Smoke Alarm Use Among Parents Recruited From a Pediatric Emergency Department.

PubMed

Roberts, Kristin J; Fowler, Erica; Comstock, R Dawn; Fernandez, Soledad; Abdel-Rasoul, Mahmoud; Mihalov, Leslie; Casavant, Marcel J; McKenzie, Lara B

2018-02-01

Although the proper installation and maintenance of carbon monoxide (CO) and smoke alarms can protect individuals from residential CO-related and fire-related injuries, these devices are underutilized. We describe characteristics associated with self-reported CO and smoke alarm use of parents recruited from a pediatric emergency department to improve CO alarm use. Parents of children ≤ 18 years (N = 299) reported socio-demographic characteristics and CO and smoke alarm ownership and practices. We assigned participants to a behavioral profile and a Precaution Adoption Process Model stage based on their self-reported CO and smoke alarm use. Most participants (71%) did not have CO alarms in their homes, but reported owning at least one working smoke alarm (98%). Participants who reported "perfect" CO alarm behavior (defined as having a working CO alarm, one near a sleeping area, with batteries replaced every 6 months; 9%) were more likely to earn a higher income, own their home, and have lived at their current residence for at least 2 years. Participants who reported "perfect" smoke alarm behavior (defined as having a working smoke alarm on every level, with batteries replaced every 6 months; 49%) were more likely to rent their home, receive federal assistance, and have lived at their current residence for at least 2 years. Interventions to increase correct CO alarm use are necessary.

Exercise Decreases and Smoking Increases Bladder Cancer Mortality.

PubMed

Liss, Michael A; White, Martha; Natarajan, Loki; Parsons, J Kellogg

2017-06-01

The aim of this study was to investigate modifiable lifestyle factors of smoking, exercise, and obesity with bladder cancer mortality. We used mortality-linked data from the National Health Information Survey from 1998 through 2006. The primary outcome was bladder cancer-specific mortality. The primary exposures were self-reported smoking status (never- vs. former vs. current smoker), self-reported exercise (dichotomized as "did no exercise" vs. "light, moderate, or vigorous exercise in ≥ 10-minute bouts"), and body mass index. We utilized multivariable adjusted Cox proportional hazards regression models, with delayed entry to account for age at survey interview. Complete data were available on 222,163 participants, of whom 96,715 (44%) were men and 146,014 (66%) were non-Hispanic whites, and among whom we identified 83 bladder cancer-specific deaths. In multivariate analyses, individuals who reported any exercise were 47% less likely (adjusted hazard ratio [HR adj ], 0.53; 95% confidence interval [CI], 0.29-0.96; P = .038) to die of bladder cancer than "no exercise". Compared with never-smokers, current (HR adj , 4.24; 95% CI, 1.89-9.65; P = .001) and former (HR adj , 2.95; 95% CI, 1.50-5.79; P = .002) smokers were 4 and 3 times more likely, respectively, to die of bladder cancer. There were no significant associations of body mass index with bladder cancer mortality. Exercise decreases and current smoking increases the risk of bladder cancer-specific mortality. These data suggest that exercise and smoking cessation interventions may reduce bladder cancer death. Published by Elsevier Inc.

Hospital Smoke-Free Policy: Compliance, Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals in Australia.

PubMed

McCrabb, Sam; Baker, Amanda L; Attia, John; Balogh, Zsolt J; Lott, Natalie; Palazzi, Kerrin; Naylor, Justine; Harris, Ian A; Doran, Christopher M; George, Johnson; Wolfenden, Luke; Skelton, Eliza; Bonevski, Billie

2017-11-08

Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of staff most likely to report provision of care to patients. Methods: An online cross-sectional survey of medical, nursing, and allied staff from two Australian public hospitals was conducted. Staff report of: patient and staff compliance with smoke-free policy; perceived policy enforcement; the provision of the 5As for smoking cessation (Ask, Assess, Advise, Assist, and Arrange follow-up); and the provision of stop-smoking medication are described. Logistic regressions were used to determine respondent characteristics related to the provision of the 5As and stop-smoking medication use during hospital admission. Results: A total of 805 respondents participated. Self-reported enforcement of smoke-free policy was low (60.9%), together with compliance for both patients (12.9%) and staff (23.6%). The provision of smoking cessation care was variable, with the delivery of the 5As ranging from 74.7% (ask) to 18.1% (arrange follow-up). Medical staff (odds ratio (OR) = 2.09, CI = 1.13, 3.85, p = 0.018) and full time employees (OR = 2.03, CI = 1.06, 3.89, p = 0.033) were more likely to provide smoking cessation care always/most of the time. Stop-smoking medication provision decreased with increasing age of staff (OR = 0.98, CI = 0.96, 0.99, p = 0.008). Conclusions: Smoke-free policy enforcement and compliance and the provision of smoking cessation care remains low in hospitals. Efforts to improve smoking cessation delivery by clinical staff are warranted.

Genetic and Environmental Influences on Smoking Behavior across Adolescence and Young Adulthood in the Virginia Twin Study of Adolescent Behavioral Development and the Transitions to Substance Abuse Follow-Up

PubMed Central

Do, Elizabeth K.; Prom-Wormley, Elizabeth C.; Eaves, Lindon J.; Silberg, Judy L.; Miles, Donna R.; Maes, Hermine H.

2016-01-01

Little is known regarding the underlying relationship between smoking initiation and current quantity smoked during adolescence into young adulthood. It is possible that the influences of genetic and environmental factors on this relationship vary across sex and age. To investigate this further, the current study applied a common causal contingency model to data from a Virginia-based twin study to determine: (1) if the same genetic and environmental factors are contributing to smoking initiation and current quantity smoked; (2) whether the magnitude of genetic and environmental factor contributions are the same across adolescence and young adulthood; and (3) if qualitative and quantitative differences in the sources of variance between males and females exist. Study results found no qualitative or quantitative sex differences in the relationship between smoking initiation and current quantity smoked, though relative contributions of genetic and environmental factors changed across adolescence and young adulthood. More specifically, smoking initiation and current quantity smoked remain separate constructs until young adulthood, when liabilities are correlated. Smoking initiation is explained by genetic, shared, and unique environmental factors in early adolescence and by genetic and unique environmental factors in young adulthood; while current quantity smoked is explained by shared environmental and unique environmental factors until young adulthood, when genetic and unique environmental factors play a larger role. PMID:25662421

Genetic and Environmental Influences on Smoking Behavior across Adolescence and Young Adulthood in the Virginia Twin Study of Adolescent Behavioral Development and the Transitions to Substance Abuse Follow-Up.

PubMed

Do, Elizabeth K; Prom-Wormley, Elizabeth C; Eaves, Lindon J; Silberg, Judy L; Miles, Donna R; Maes, Hermine H

2015-02-01

Little is known regarding the underlying relationship between smoking initiation and current quantity smoked during adolescence into young adulthood. It is possible that the influences of genetic and environmental factors on this relationship vary across sex and age. To investigate this further, the current study applied a common causal contingency model to data from a Virginia-based twin study to determine: (1) if the same genetic and environmental factors are contributing to smoking initiation and current quantity smoked; (2) whether the magnitude of genetic and environmental factor contributions are the same across adolescence and young adulthood; and (3) if qualitative and quantitative differences in the sources of variance between males and females exist. Study results found no qualitative or quantitative sex differences in the relationship between smoking initiation and current quantity smoked, though relative contributions of genetic and environmental factors changed across adolescence and young adulthood. More specifically, smoking initiation and current quantity smoked remain separate constructs until young adulthood, when liabilities are correlated. Smoking initiation is explained by genetic, shared, and unique environmental factors in early adolescence and by genetic and unique environmental factors in young adulthood; while current quantity smoked is explained by shared environmental and unique environmental factors until young adulthood, when genetic and unique environmental factors play a larger role.

Electronic Cigarette Use Among High School Students and Its Association With Cigarette Use And Smoking Cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013

PubMed Central

Kowitt, Sarah D.; Sutfin, Erin L.; Patel, Tanha; Ranney, Leah M.; Goldstein, Adam O.

2016-01-01

Introduction Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina. Methods Data came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students’ current and past use of e‑cigarettes in 2013. Results The prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%–2.2%) in 2011 to 7.7% (95% CI, 5.9%–10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29–0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49–0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21–0.82) or 1 year (RRR = 0.21; 95% CI, 0.09–0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29–0.74). Conclusion Public health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users. PMID:27490368

Electronic Cigarette Use Among High School Students and Its Association With Cigarette Use And Smoking Cessation, North Carolina Youth Tobacco Surveys, 2011 and 2013.

PubMed

Huang, Li-Ling; Kowitt, Sarah D; Sutfin, Erin L; Patel, Tanha; Ranney, Leah M; Goldstein, Adam O

2016-08-04

Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina. Data came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students' current and past use of e‑cigarettes in 2013. The prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%-2.2%) in 2011 to 7.7% (95% CI, 5.9%-10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29-0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49-0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21-0.82) or 1 year (RRR = 0.21; 95% CI, 0.09-0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29-0.74). Public health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users.

Psychological problems and psychosocial predictors of cigarette smoking behavior among undergraduate students in Malaysia.

PubMed

Saravanan, Coumaravelou; Heidhy, Imran

2014-01-01

Cigarette smokers have their own motivation and justification to smoke. For example, smoking reduces their stress or enhances their pleasure. This study aimed to identify the (a) prevalence of cigarette smokers among undergraduates in Malaysia, (b) gender differences in nicotine dependence among current smokers, (c) differences in psychological problems (depression, anxiety and stress) based on the status of smoking cigarettes (current, former and non-smokers) and (d) extent to which precipitating factors (tension reduction, addiction, automatism, handling, social interaction, pleasure, and stimulation) predict the smoking behavior among current smokers. In this study 780 undergraduate students participated from a private university in Kuala Lumpur and Selangor state in Malaysia. The Depression, Stress and Anxiety Scale, Modified Reason for Smoking Scale and Fagerstrom Nicotine Dependence Test were used to measure psychological problems, predictors of smoking behavior and nicotine dependency among current smokers. The results showed that 14.7%(n=106) of the students were smokers. Current smokers exhibited more psychological problems (depression, anxiety and stress) compared to former and non-smokers. Addiction, tension reduction, pleasure and automatism were predictors of smoking behavior among the current smoking students. Step wise regression analysis showed that smoking behavior was highly predicted by nicotine dependency or addiction. Smoking students were motivated to smoke cigarettes as they believed that it reduced their tension and enhance pleasure. Hence, there is a need for health promotion and anti-tobacco prevention as cigarette smokers experience more psychological problems. Nicotine dependency or addition was one of the major causes for smoking behavior among the student population in Malaysia.

Tobacco smoking and the risk of sudden cardiac death: a systematic review and meta-analysis of prospective studies.

PubMed

Aune, Dagfinn; Schlesinger, Sabrina; Norat, Teresa; Riboli, Elio

2018-06-01

Smoking is an established risk factor for cardiovascular disease including coronary heart disease and stroke, however, data regarding smoking and sudden cardiac death have not been summarized in a meta-analysis previously. We therefore conducted a systematic review and meta-analysis to clarify this association. We searched the PubMed and Embase databases for studies of smoking and sudden cardiac death up to July 20th 2017. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for smoking and sudden cardiac death. Summary RRs were estimated by use of a random effects model. Twelve prospective studies were included. The summary RR was 3.06 (95% CI 2.46-3.82, I 2  = 41%, p heterogeneity  = 0.12, n = 7) for current smokers and 1.38 (95% CI 1.20-1.60, I 2  = 0%, p heterogeneity  = 0.55, n = 7) for former smokers compared to never smokers. For four studies using non-current (never + former) smokers as the reference category the summary RR among current smokers was 2.08 (95% CI 1.70-2.53, I 2  = 18%, p heterogeneity  = 0.30). The results persisted in most of the subgroup analyses. There was no evidence of publication bias. These results confirm that smoking increases the risk of sudden cardiac death. Any further studies should investigate in more detail the effects of duration of smoking, number of cigarettes per day, pack-years, and time since quitting smoking and sudden cardiac death.

Cigarette smoking, health status, socio-economic status and access to health care in diabetes mellitus: a cross-sectional survey

PubMed Central

Gulliford, MC; Sedgwick, JEC; Pearce, AJ

2003-01-01

Background In diabetes mellitus, cigarette smoking is associated with increased risk of cardiovascular mortality and microvascular complications. We evaluated cigarette smoking in people with diabetes mellitus in a socio-economically deprived area. Methods We carried out a cross-sectional survey of people registered with diabetes mellitus at 29 general practices in inner London. Responses were analysed for 1,899 (64%) respondents out of 2,983 eligible. Results There were 1,899 respondents of whom 968 (51%) had never smoked, 296 (16%) were current smokers and 582 (31%) were ex-smokers. Smoking was more frequent in white Europeans (men 22%, women 20%), than in African Caribbeans (men 15%, women 10%) or Africans (men 8%, women 2%). Smoking prevalence decreased with age. Smokers were more likely to be living in rented accommodation (odds ratio, OR 2.02, 95% confidence interval 1.48 to 2.74). After adjusting for confounding, current smokers had lower SF-36 scores than subjects who had never smoked (mean difference in physical functioning score -5.6, 95% confidence interval -10.0 to -1.2; general health -6.1, -9.7 to -2.5). Current smokers were less likely to have attended a hospital diabetic clinic in the last year (OR 0.59, 0.44 to 0.79), and their hypertension was less likely to be treated (OR 0.47, 0.30 to 0.74). Conclusions Compared with non-smokers, smokers had lower socio-economic status and worse health status, but were less likely to be referred to hospital or treated for their hypertension. People with diabetes who smoke can be regarded as a vulnerable group who need more intensive support and treatment. PMID:12589709

Cigarette smoking, health status, socio-economic status and access to health care in diabetes mellitus: a cross-sectional survey.

PubMed

Gulliford, M C; Sedgwick, J E C; Pearce, A J

2003-02-11

In diabetes mellitus, cigarette smoking is associated with increased risk of cardiovascular mortality and microvascular complications. We evaluated cigarette smoking in people with diabetes mellitus in a socio-economically deprived area. We carried out a cross-sectional survey of people registered with diabetes mellitus at 29 general practices in inner London. Responses were analysed for 1,899 (64%) respondents out of 2,983 eligible. There were 1,899 respondents of whom 968 (51%) had never smoked, 296 (16%) were current smokers and 582 (31%) were ex-smokers. Smoking was more frequent in white Europeans (men 22%, women 20%), than in African Caribbeans (men 15%, women 10%) or Africans (men 8%, women 2%). Smoking prevalence decreased with age. Smokers were more likely to be living in rented accommodation (odds ratio, OR 2.02, 95% confidence interval 1.48 to 2.74). After adjusting for confounding, current smokers had lower SF-36 scores than subjects who had never smoked (mean difference in physical functioning score -5.6, 95% confidence interval -10.0 to -1.2; general health -6.1, -9.7 to -2.5). Current smokers were less likely to have attended a hospital diabetic clinic in the last year (OR 0.59, 0.44 to 0.79), and their hypertension was less likely to be treated (OR 0.47, 0.30 to 0.74). Compared with non-smokers, smokers had lower socio-economic status and worse health status, but were less likely to be referred to hospital or treated for their hypertension. People with diabetes who smoke can be regarded as a vulnerable group who need more intensive support and treatment.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

PubMed

Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

How do Indonesian youth perceive cigarette advertising? A cross-sectional study among Indonesian high school students

PubMed Central

Prabandari, Yayi Suryo; Dewi, Arika

2016-01-01

Background Previous studies have reported an association between cigarette advertising and smoking behavior. Although this has been reported extensively in the West, it has been reported less in Southeast Asian countries that have not completely banned tobacco advertising promotion and sponsorship (TAPS). Indonesia is the only ASEAN country that has not ratified the Framework Convention on Tobacco Control, so TAPS regulation is limited. This study aimed to assess the association between youths’ perceptions of cigarette ads and smoking initiation. Design We conducted a cross-sectional survey among 2,115 high school students aged 13–18 years in Yogyakarta, Indonesia. A self-administered questionnaire was distributed to gauge the perception of cigarette ads and initiation to smoking. We calculated the odds ratio (OR) between the perception of cigarette ads and smoking initiation, adjusting for sociodemographic and psychosocial variables. The sociodemographic variables included in the final model were age and sex. Results The final multivariate model showed an association between perception of tobacco ads encouraging youths to smoke and smoking initiation (OR 2.70) and current smoking (OR 7.63). Attitude toward TAPS was associated with smoking initiation (OR 1.51) and current smoking (OR 3.32). Exposure to cigarette ads had an association with smoking initiation only (OR 1.27) and did not have an association with current smoking. Having friends and family who smoked was associated with smoking initiation and current smoking in the final multivariate model. Smoking initiation and current smoking were also related to the susceptibility to smoke. Conclusions This study revealed that cigarette ads were perceived as encouraging youths to smoke and that smoking status was consistently associated with perception of cigarette ads targeted at youths, attitude toward TAPS, and susceptibility as well as smoking friends and family. Regulations to ban TAPS, particularly cigarette ads for preventing youths from smoking, should be adopted rapidly in Indonesia, where tobacco control remains limited. PMID:27578600

Current Cigarette Smoking Among Adults - United States, 2016.

PubMed

Jamal, Ahmed; Phillips, Elyse; Gentzke, Andrea S; Homa, David M; Babb, Stephen D; King, Brian A; Neff, Linda J

2018-01-19

The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products (1). Cigarettes are the most commonly used tobacco product among U.S. adults, and about 480,000 U.S. deaths per year are caused by cigarette smoking and secondhand smoke exposure (1). To assess progress toward the Healthy People 2020 target of reducing the proportion of U.S. adults aged ≥18 years who smoke cigarettes to ≤12.0% (objective TU-1.1),* CDC analyzed data from the 2016 National Health Interview Survey (NHIS). In 2016, the prevalence of current cigarette smoking among adults was 15.5%, which was a significant decline from 2005 (20.9%); however, no significant change has occurred since 2015 (15.1%). In 2016, the prevalence of cigarette smoking was higher among adults who were male, aged 25-64 years, American Indian/Alaska Native or multiracial, had a General Education Development (GED) certificate, lived below the federal poverty level, lived in the Midwest or South, were uninsured or insured through Medicaid, had a disability/limitation, were lesbian, gay, or bisexual (LGB), or had serious psychological distress. During 2005-2016, the percentage of ever smokers who quit smoking increased from 50.8% to 59.0%. Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.S. adults, particularly among subpopulations with the highest smoking prevalences (1,2).

Cigarette smoking and risk of pancreatic cancer: a clinic-based case-control study in the San Francisco Bay Area.

PubMed

Lea, C Suzanne; Holly, Elizabeth A; Bracci, Paige M

2015-11-01

Cigarette smoking is an established risk factor for pancreatic cancer (PC). We examined the association between cigarette smoking and PC in a San Francisco Bay Area clinic-based, case-control study. A total of 536 cases and sex and age frequency-matched controls (n = 869) were recruited predominately from the University of California San Francisco (UCSF) medical clinics between 2006 and 2011. Participants were interviewed in-person using structured questionnaires. Adjusted odds ratios (ORs) were computed. Forty-eight percent of cases and controls reported never having smoked cigarettes; 39% of cases and 40% of controls were former smokers; 13% of cases and 12% of controls were current smokers. No association was found for either former (OR = 0.85, 95% confidence interval [CI] = 0.66-1.1) or current cigarette smoking (men: OR = 1.0, 95% CI = 0.60-1.7; women: OR = 1.2, 95% CI = 0.73-2.1). No dose-response relationships were detected with number of cigarettes/day, smoking intensity, duration, or years since last smoked. Comparisons with a 1995-1999 population-based UCSF study demonstrated a significantly increased proportion of never smokers in this study (P < .001). This study revealed no significant associations between cigarette smoking and PC in the San Francisco Bay Area during 2006-2011. Data suggest a reduction in the duration of smoking within the referral population. Copyright © 2015 Elsevier Inc. All rights reserved.

A structural equation modeling approach to understanding pathways that connect socioeconomic status and smoking.

PubMed

Martinez, Sydney A; Beebe, Laura A; Thompson, David M; Wagener, Theodore L; Terrell, Deirdra R; Campbell, Janis E

2018-01-01

The inverse association between socioeconomic status and smoking is well established, yet the mechanisms that drive this relationship are unclear. We developed and tested four theoretical models of the pathways that link socioeconomic status to current smoking prevalence using a structural equation modeling (SEM) approach. Using data from the 2013 National Health Interview Survey, we selected four indicator variables (poverty ratio, personal earnings, educational attainment, and employment status) that we hypothesize underlie a latent variable, socioeconomic status. We measured direct, indirect, and total effects of socioeconomic status on smoking on four pathways through four latent variables representing social cohesion, financial strain, sleep disturbance, and psychological distress. Results of the model indicated that the probability of being a smoker decreased by 26% of a standard deviation for every one standard deviation increase in socioeconomic status. The direct effects of socioeconomic status on smoking accounted for the majority of the total effects, but the overall model also included significant indirect effects. Of the four mediators, sleep disturbance and psychological distress had the largest total effects on current smoking. We explored the use of structural equation modeling in epidemiology to quantify effects of socioeconomic status on smoking through four social and psychological factors to identify potential targets for interventions. A better understanding of the complex relationship between socioeconomic status and smoking is critical as we continue to reduce the burden of tobacco and eliminate health disparities related to smoking.

A structural equation modeling approach to understanding pathways that connect socioeconomic status and smoking

PubMed Central

Beebe, Laura A.; Thompson, David M.; Wagener, Theodore L.; Terrell, Deirdra R.; Campbell, Janis E.

2018-01-01

The inverse association between socioeconomic status and smoking is well established, yet the mechanisms that drive this relationship are unclear. We developed and tested four theoretical models of the pathways that link socioeconomic status to current smoking prevalence using a structural equation modeling (SEM) approach. Using data from the 2013 National Health Interview Survey, we selected four indicator variables (poverty ratio, personal earnings, educational attainment, and employment status) that we hypothesize underlie a latent variable, socioeconomic status. We measured direct, indirect, and total effects of socioeconomic status on smoking on four pathways through four latent variables representing social cohesion, financial strain, sleep disturbance, and psychological distress. Results of the model indicated that the probability of being a smoker decreased by 26% of a standard deviation for every one standard deviation increase in socioeconomic status. The direct effects of socioeconomic status on smoking accounted for the majority of the total effects, but the overall model also included significant indirect effects. Of the four mediators, sleep disturbance and psychological distress had the largest total effects on current smoking. We explored the use of structural equation modeling in epidemiology to quantify effects of socioeconomic status on smoking through four social and psychological factors to identify potential targets for interventions. A better understanding of the complex relationship between socioeconomic status and smoking is critical as we continue to reduce the burden of tobacco and eliminate health disparities related to smoking. PMID:29408939

The association between self-reported versus nicotine metabolite-confirmed smoking status and coronary artery calcification.

PubMed

Kim, Byung Jin; Han, Ji Min; Kang, Jung Gyu; Kim, Bum Soo; Kang, Jin Ho

2018-05-01

There are no data comparing the relationship between coronary artery calcification and self-reported and cotinine-verified smoking. This study was carried out to evaluate the relationship between coronary artery calcium (CAC) and urinary cotinine or self-reported smoking status in Korean adults. Study participants included 22 797 individuals (19 181 men; mean age±SD 39.2±7.1 years) who were enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013, and who had urinary cotinine and CAC measurements. Cotinine-verified current smokers were defined as having a urinary cotinine level of above 50 ng/ml. The prevalence of never smokers, former smokers, and current smokers according to the self-reported questionnaires was 44.6, 24.2, and 31.2%, respectively, and that of cotinine-verified current smokers was 30.2%. The prevalence of the presence of CAC in self-reported current smokers was higher than that in self-reported never/former smokers (13.7 vs. 10.2%, P<0.001), and that in cotinine-verified current smokers was higher than that in cotinine-verified never smokers (14.0 vs. 10.2%, P<0.001). A multivariate logistic regression model adjusted for the variables with univariate relationships showed that self-reported former smokers and current smokers had significantly increased odds ratio (OR) for the presence of CAC compared with self-reported never smokers [OR (95% confidence interval): 1.20 (1.03-1.40) in former smokers and 1.29 (1.11-1.50) in current smokers]. Cotinine-verified current smokers also showed a significant association with the presence of CAC [1.23 (1.12-1.35)]. Furthermore, log-transformed cotinine levels increased the OR for the presence of CAC [1.03 (1.01-1.05)]. This study is the first large cohort study to show that both self-reported and cotinine-verified smoking is associated independently with the presence of CAC in Korean adults.

Smoking and the risk of type 2 diabetes in Japan: A systematic review and meta-analysis.

PubMed

Akter, Shamima; Goto, Atsushi; Mizoue, Tetsuya

2017-12-01

Cigarette smoking is the leading avoidable cause of disease burden. Observational studies have suggested an association between smoking and risk of type 2 diabetes mellitus (T2DM). We conducted a meta-analysis of prospective observational studies to investigate the association of smoking status, smoking intensity, and smoking cessation with the risk of T2DM in Japan, where the prevalence of smoking has been decreasing but remains high. We systematically searched MEDLINE and the Ichushi database to December 2015 and identified 22 eligible articles, representing 343,573 subjects and 16,383 patients with T2DM. We estimated pooled relative risks (RRs) using a random-effects model and conducted subgroup analyses by participant and study characteristics. Compared with nonsmoking, the pooled RR of T2DM was 1.38 (95% confidence interval [CI], 1.28-1.49) for current smoking (19 studies) and 1.19 (95% CI, 1.09-1.31) for former smoking (15 studies). These associations persisted in all subgroup and sensitivity analyses. We found a linear dose-response relationship between cigarette consumption and T2DM risk; the risk of T2DM increased by 16% for each increment of 10 cigarettes smoked per day. The risk of T2DM remained high among those who quit during the preceding 5 years but decreased steadily with increasing duration of cessation, reaching a risk level comparable to that of never smokers after 10 years of smoking cessation. We estimated that 18.8% of T2DM cases in men and 5.4% of T2DM cases in women were attributable to smoking. The present findings suggest that cigarette smoking is associated with an increased risk of T2DM, so tobacco control programs to reduce smoking could have a substantial effect to decrease the burden of T2DM in Japan. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Development of targeted messages to promote smoking cessation among construction trade workers

PubMed Central

Strickland, J. R.; Smock, N.; Casey, C.; Poor, T.; Kreuter, M. W.; Evanoff, B. A.

2015-01-01

Blue-collar workers, particularly those in the construction trades, are more likely to smoke and have less success in quitting when compared with white-collar workers. Little is known about health communication strategies that might influence this priority population. This article describes our formative work to develop targeted messages to increase participation in an existing smoking cessation program among construction workers. Using an iterative and sequential mixed-methods approach, we explored the culture, health attitudes and smoking behaviors of unionized construction workers. We used focus group and survey data to inform message development, and applied audience segmentation methods to identify potential subgroups. Among 144 current smokers, 65% reported wanting to quit smoking in the next 6 months and only 15% had heard of a union-sponsored smoking cessation program, despite widespread advertising. We tested 12 message concepts and 26 images with the target audience to evaluate perceived relevance and effectiveness. Participants responded most favorably to messages and images that emphasized family and work, although responses varied by audience segments based on age and parental status. This study is an important step towards integrating the culture of a high-risk group into targeted messages to increase participation in smoking cessation activities. PMID:25231165

Is restricting tobacco sales the answer to adolescent smoking?

PubMed

Staff, M; Bennett, C M; Angel, P

2003-11-01

Enforcement of legislation restricting retail access to tobacco is increasingly relied on to reduce adolescent smoking rates. In 1996, health authorities in the Northern Sydney Health Area began monitoring tobacco retailer compliance (PROOF program) with staged purchase attempts by adolescents below the legal age (18 years). Repeat cross-sectional surveys before (1995) and after (2000) the introduction of PROOF monitored changes in adolescent smoking behaviour. Students aged 12 to 17 years from 11 Northern Sydney metropolitan public secondary schools were surveyed for self-reported smoking and tobacco purchasing behavior in 1995 (n = 5,206) and 2000 (n = 4,120). Between 1996 and 2000, 545 retailer compliance checks found 34% unlawfully sold cigarettes to minors and 28% of these repeated the offence. Nine prosecutions resulted. Modelling revealed a significant association between the intervention and never having smoked (adjusted OR = 1.16, 95% CI = 1.01-1.33) although there was no significant association with being a current smoker. The odds of being a smoker were greater for students from coeducational schools, with this effect being modified by gender. There was no reduction in adolescent smoking with active enforcement of tobacco access laws despite an apparent increase in students who reported never to have smoked.

Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey.

PubMed

Ryan, Christopher; Leatherdale, Scott; Cooke, Martin

2017-04-01

First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic factors when developing interventions aimed at reducing the prevalence of smoking among First Nations and Métis youth.

Surface Modified TiO2 Obscurants for Increased Safety and Performance

DTIC Science & Technology

2012-11-01

based obscurant devices in performance. 15. SUBJECT TERMS Obscurant, visible, IR , smoke, TiO2, aerosol, particle, surface modification...hexamethyldimethoxysilane IR Infrared wavelength LabRAM Lab scale Resonant Acoustic Mixer from Resodyn Corporation LPM Liters Per Minute M106 Currently fielded (Army...trinitrophloroglucinol UV-Vis Ultraviolet-visible wavelengths KEYWORDS Obscurant, visible, IR , smoke, TiO2, aerosol, particle, surface modification

Perceived price sensitivity by ethnicity and smoking frequency among California Hispanic and non-Hispanic white smokers.

PubMed

Myers, Mark G; Edland, Steven D; Hofstetter, C Richard; Al-Delaimy, Wael K

2013-06-01

Little is currently known about price sensitivity across ethnic groups as well as for non-daily smokers. To address this issue, this study compared perceived price sensitivity across smoking status (daily and non-daily) and within ethnicity (Hispanic and non-Hispanic White) in a recent representative population survey of California smokers. This study employed data from the 2008 California Tobacco Survey (CTS), a large population-based random-digit-dialed telephone survey. Participants were 1,777 non-Hispanic White and 450 Hispanic respondents who had smoked at least 100 cigarettes and currently smoked daily or on some days. Differences in perceived price sensitivity were found by ethnicity when controlling for age, gender, and cigarette consumption. Comparisons across ethnic groups indicated that Hispanic smokers, in general, have more price-sensitive perceptions than non-Hispanic White smokers. However, daily versus non-daily status had no effect on price sensitivity when controlling for cigarette quantity. These findings indicate that pricing increases may be differentially influential for Hispanic compared with non-Hispanic White smokers across smoking status categories.

The impact of neighborhood violence and social cohesion on smoking behaviors among a cohort of smokers in Mexico

PubMed Central

Fleischer, Nancy L.; Lozano, Paula; Santillán, Edna Arillo; Shigematsu, Luz Myriam Reynales; Thrasher, James F.

2016-01-01

Background Recent increases in violent crime may impact a variety of health outcomes in Mexico. We examined relationships between neighborhood-level violence and smoking behaviors in a cohort of Mexican smokers from 2011–2012, and whether neighborhood-level social cohesion modified these relationships. Methods Data were analyzed from adult smokers and recent ex-smokers who participated in Waves 5–6 of the International Tobacco Control Mexico Survey. Self-reported neighborhood violence and social cohesion were asked of Wave 6 survey participants (n=2129 current and former smokers, n=150 neighborhoods). Neighborhood-level averages for violence and social cohesion (range 4–14 and 10–25, respectively) were assigned to individuals. We used generalized estimating equations to determine associations between neighborhood indicators and individual-level smoking intensity, quit behaviors, and relapse. Results Higher neighborhood violence was associated with higher smoking intensity (Risk Ratio (RR)=1.17, 95% Confidence Interval (CI) 1.02–1.33), and fewer quit attempts (RR=0.72, 95% CI 0.61–0.85). Neighborhood violence was not associated with successful quitting or relapse. Higher neighborhood social cohesion was associated with more quit attempts and more successful quitting. Neighborhood social cohesion modified the association between neighborhood violence and smoking intensity: in neighborhoods with higher social cohesion, as violence increased, smoking intensity decreased and in neighborhoods with lower social cohesion, as violence increased, so did smoking intensity. Conclusion In the context of recent increased violence in Mexico, smokers living in neighborhoods with more violence may smoke more cigarettes per day and make fewer quit attempts than their counterparts in less violent neighborhoods. Neighborhood social cohesion may buffer the impact of violence on smoking intensity. PMID:26043898

Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking?

PubMed

Sznitman, Sharon R; Zlotnick, Cheryl; Harel-Fisch, Yossi

2016-07-01

The multiple risk model postulates that accumulating risk factors increase adolescent drunkenness and smoking. The normalisation theory adds to this by arguing that the relation between accumulative risk and drunkenness and smoking is dependent on the distribution of these behaviours in the larger population. More concretely, normalisation theory predicts that: (i) when population level use increases, low risk adolescents will be more likely to use alcohol and cigarettes; and (ii) adolescents facing multiple risk factors will be equally likely to use alcohol and cigarettes, regardless of trends in population level use. The current study empirically tests these assumptions on five waves of nationally representative samples of Israeli Jewish youth. Five cross-sectional waves of data from the Israeli Health Behaviour in School-aged Children survey for Jewish 10th graders were used. Logistic regression models measured the impact of changes in population level use across waves on drunkenness and smoking, and their association with differing levels of risk factors. Between zero and two risk factors, the risk of drunkenness and smoking increases for each additional risk factor. When reaching two risk factors, added risk does not significantly increase the likelihood of smoking and drunkenness. Changes in population level drunkenness and smoking did not systematically relate to changes in the individual level relationship between risk factors and smoking and drunkenness. The pattern of results in this study provides strong evidence for the multiple risk factor model and inconsistent evidence for the normalisation theory. [Sznitman SR, Zlotnick C, Harel-Fisch Y. Normalisation theory: Does it accurately describe temporal changes in adolescent drunkenness and smoking? Drug Alcohol Rev 2016;35:424-432]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Smoking, exposure to secondhand smoke, and smoking restrictions in Tijuana, Mexico.

PubMed

Martínez-Donate, Ana P; Hovell, Melbourne F; Hofstetter, C Richard; González-Pérez, Guillermo J; Adams, Marc A; Sánchez, José de Jesús; Guzmán-Cerda, Gabriela

2005-12-01

To estimate the prevalence of tobacco use, exposure to secondhand smoke, and smoking restrictions in the home and workplace among residents of Tijuana, one of Mexico's largest cities. This cross-sectional household survey was conducted in Tijuana, Baja California, Mexico, during 2003 and 2004. A population-based sample of 400 Tijuana adult residents responded to a tobacco survey, and 397 of the surveys were analyzed. About 22.9% (95% confidence interval (CI): 18.7%-27.1%) of Tijuana adults reported current smoking, and 53.9% (95% CI: 48.8%-58.9%) reported chronic exposure to secondhand smoke. Approximately 44.4% (95% CI: 37.9%-50.9%) of Tijuana adults had a nonsmoking policy in their workplace, while 65.8% (95% CI: 61.0%-70.6%) of Tijuana households were smoke-free. The results underline the need for increased tobacco control efforts, particularly stricter enforcement of existing passive smoking regulations, in order to expand protection from secondhand smoke from private settings to public ones and to curb the tobacco epidemic in Tijuana and elsewhere in Mexico.

Factors influencing Dutch practice nurses' intention to adopt a new smoking cessation intervention.

PubMed

Leitlein, Lisa; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-10-01

This article is a report of a study that aimed to identify factors influencing practice nurses' and nurse practitioners' intention to adopt a new smoking cessation intervention. Although effective smoking cessation interventions exist and practice nurses can offer a considerable resource in advertising patients to quit smoking, due to several reasons the majority of practice nurses do not implement these interventions. A cross-sectional study was undertaken among Dutch practice nurses and nurse practitioners working in general practices (n = 139) using electronic questionnaires. Data were collected from January until March in 2009. T-tests were used to compare adopters with non-adopters about their predisposing and motivational factors. Logistic regression analyses were conducted to assess the variation in intention explained by these factors. The majority of practice nurses did not intend to adopt the new intervention (n = 85; 61.2%). More practice nurses than nurse practitioners intended to adopt the intervention. Attitude and perceived social norms were found to be positively correlated with the intention to adopt the intervention whereas satisfaction with current smoking cessation activities was found to be negatively correlated. Important associations were found between profession, attitude, social norms and satisfaction, and the intention to adopt the new smoking cessation intervention. Practice nurses who do not intend to adopt need to be persuaded of the advantages of adopting. Perceived social norms need to be restructured and before presenting the intervention to a general practice current smoking cessation activities should be determined to increase the intervention's compatibility with these current practices. © 2011 Blackwell Publishing Ltd.

Cigarette smoking and postmenopausal breast cancer risk in a prospective cohort

PubMed Central

Nyante, S J; Gierach, G L; Dallal, C M; Freedman, N D; Park, Y; Danforth, K N; Hollenbeck, A R; Brinton, L A

2014-01-01

Background: The relationship between cigarette smoking and breast cancer risk has been inconsistent, potentially due to modification by other factors or confounding. Methods: We examined smoking and breast cancer risk in a prospective cohort of 186 150 female AARP (formerly American Association of Retired Persons) members, ages 50–71 years, who joined the study in 1995–96 by responding to a questionnaire. Through 2006, 7481 breast cancers were diagnosed. Multivariable-adjusted hazard ratios (HRs) were estimated, overall and stratified by breast cancer risk factors, using Cox proportional hazards regression. Multiplicative interactions were evaluated using the likelihood ratio test. Results: Increased breast cancer risk was associated with current (HR 1.19, 95% confidence interval (CI) 1.10–1.28) and former (HR 1.07, CI 1.01–1.13) smoking. The current smoking association was stronger among women without (HR 1.24, CI 1.15–1.35) as compared to those with a family history of breast cancer (HR 0.94, CI 0.78–1.13) (P-interaction=0.03). The current smoking association was also stronger among those with later (⩾15 years: HR 1.52, CI 1.20–1.94) as compared with earlier (⩽12 years: HR 1.14, CI 1.03–1.27; 13–14 years: HR 1.18, CI 1.05–1.32) ages at menarche (P-interaction=0.03). Conclusions: Risk was elevated in smokers, particularly in those without a family history or late menarche. Research into smoking's effects on the genome and breast development may clarify these relationships. PMID:24642621

Electronic Cigarette Use and Uptake of Cigarette Smoking: A Longitudinal Examination of U.S. College Students

PubMed Central

Spindle, Tory R.; Hiler, Marzena M.; Cooke, Megan; Eissenberg, Thomas; Kendler, Kenneth S.; Dick, Danielle

2016-01-01

Introduction Electronic cigarette (e-cigarette) use prevalence is increasing among U.S. adolescents and adults but recent longitudinal data for college/university students are scarce. Furthermore, the extent that e-cigarette use is associated with the onset of cigarette smoking and the factors that lead to the uptake of e-cigarettes in college students has not been explored. Methods 3,757 participants from a Mid-Atlantic university (women: 66%; White: 45%; Black: 21%; Asian: 19%; Hispanic/Latino: 6%) were surveyed in 2014 and again in 2015. Results Among participants reporting never smoking at time 1, those who had ever tried e-cigarettes or were currently using e-cigarettes (at least one use in past 30 days) were more likely to have ever tried cigarettes by time 2 relative to individuals who had not used e-cigarettes. Ever use of e-cigarettes (but not current use) also increased participants’ likelihood of being current cigarette smokers at time 2. Among initial never users of e-cigarettes or cigarettes, males and ever marijuana users had an increased probability of trying e-cigarettes by time 2. Furthermore, less perseverance (an index of impulsivity) and ever use of other tobacco products increased initial never users’ chances of trying both cigarettes and e-cigarettes by time 2. Conclusions Given that never-smoking participants who had tried e-cigarettes were more likely to initiate cigarette use later, limiting young adults’ access to these products may be beneficial. As the long-term health implications of e-cigarette use become clearer, predictors of e-cigarette use could help identify future populations likely to use and abuse these products. PMID:28038364

Modelling the implications of reducing smoking prevalence: the benefits of increasing the UK tobacco duty escalator to public health and economic outcomes.

PubMed

Knuchel-Takano, Andre; Hunt, Daniel; Jaccard, Abbygail; Bhimjiyani, Arti; Brown, Martin; Retat, Lise; Brown, Katrina; Hinde, Sebastian; Selvarajah, Chit; Bauld, Linda; Webber, Laura

2017-12-06

Taxing tobacco is one of the most effective ways to reduce smoking prevalence, mitigate its devastating consequential health harms and progress towards a tobacco-free society. This study modelled the health and economic impacts of increasing the existing cigarette tobacco duty escalator (TDE) in the UK from the current 2% above consumer price inflation to 5%. A two-stage modelling process was used. First, a non-linear multivariate regression model was fitted to cross-sectional smoking data, creating longitudinal projections from 2015 to 2035. Second, these projections were used to predict the future incidence, prevalence and cost of 17 smoking-related diseases using a Monte Carlo microsimulation approach. A sustained increase in the duty escalator was evaluated against a baseline of continuing historical smoking trends and the existing duty escalator. A sustained increase in the TDE is projected to reduce adult smoking prevalence to 6% in 2035, from 10% in a baseline scenario. After increasing the TDE, only 65% of female and 60% of male would-be smokers would actually be smoking in 2035. The intervention is projected to avoid around 75 200 new cases of smoking-related diseases between 2015 and 2035. In 2035 alone, £49 m in National Health Service and social care costs and £192 m in societal premature mortality and morbidity costs are projected to be avoided. Increasing the UK TDE to 5% above inflation could effectively reduce smoking prevalence, prevent diseases and avoid healthcare costs. It would deliver substantial progress towards a tobacco-free society and should be implemented by the UK Government with urgency. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Attitudes toward nonsmoking policies and tobacco tax increases: a cross-sectional study among Vietnamese adults.

PubMed

Dao, Thi Minh An; Hoang, Van Minh; Le, Thi Huong; Kim, Bao Giang; Le, Thi Thanh Xuan; Pham, Thi Quynh Nga; Hsia, Jason

2015-03-01

Following the 2009 update of the 2005 Framework Convention on Tobacco Control, Vietnam issued a new policy to ban smoking at workplaces and public places. This cross-sectional survey explored public attitudes toward this new regulation and provides evidence to inform future laws. Using stratified cluster sampling, 10 383 Vietnamese people older than 15 years were drawn from 11 142 selected households. Policies mandating "no smoking at workplaces" were supported by 88.7% of Vietnamese adults, whereas "no smoking in public places" and "increasing the tobacco tax" received less support. Educational level, knowledge of health effects, access to information on quitting and smoking health risks, smoking status, ethnicity, and region had significant associations with positive attitudes toward all 3 tobacco control policies. Adults belonging to the non-Kinh ethnic group, those who do not live in the Red river delta, people with lower educational levels, and current smokers should be targeted in tobacco control communication programs. © 2012 APJPH.

Tobacco smoking: From 'glamour' to 'stigma'. A comprehensive review.

PubMed

Castaldelli-Maia, João Mauricio; Ventriglio, Antonio; Bhugra, Dinesh

2016-01-01

In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries. © 2015 The Authors. Psychiatry and Clinical Neurosciences © 2015 Japanese Society of Psychiatry and Neurology.

Un Jalón, Un Volteón, y Otra Vez: High-Risk Crack Smoking Paraphernalia in México City.

PubMed

Valdez, Avelardo; Nowotny, Kathryn M; Negi, Nalini; Mora, Eduardo Zafra; Cepeda, Alice

2016-01-01

During the past decade, crack smoking has increased in Mexico among poor urban populations. Despite this increasing prevalence, little is known about the types of paraphernalia used and related sharing practices and physical harms. Data come from in-depth semi-structured interviews and observations with 156 current crack smokers in Mexico City. Findings reveal a complex, crack-smoking process in Mexico City that represents an interconnected structure of paraphernalia items and pipes that could contribute to detrimental health consequences. Specifically, we identify essential paraphernalia items that make the smoking of crack possible; describe the homemade construction of two categories of pipes; and detail the sharing practices and physical harms associated with these paraphernalia. Results point towards a smoking process that is embedded in impoverished urban neighborhoods sustained by an accessible street-level crack market. Discussed are the policy and intervention implications associated with reducing crack-related health consequences in Mexico and other Latin American countries.

Un Jalón, Un Volteón, y Otra Vez: High-Risk Crack Smoking Paraphernalia in México City

PubMed Central

Valdez, Avelardo; Cepeda, Alice; Nowotny, Kathryn M.; Mora, Eduardo Zafra; Negi, Nalini

2016-01-01

During the past decade, crack smoking has increased in Mexico among poor urban populations. Despite this increasing prevalence, little is known about the types of paraphernalia used and related sharing practices and physical harms. Data come from in-depth semi-structured interviews and observations with 156 current crack smokers in Mexico City. Findings reveal a complex, crack-smoking process in Mexico City that represents an interconnected structure of paraphernalia items and pipes that could contribute to detrimental health consequences. Specifically, we identify essential paraphernalia items that make the smoking of crack possible; describe the home- made construction of two categories of pipes; and the sharing practices and physical harms associated with these paraphernalia. Results point towards a smoking process that is embedded in impoverished urban neighborhoods sustained by an accessible street-level crack market. Discussed are the policy and intervention implications associated with reducing crack related health consequences in Mexico and other Latin American countries. PMID:27356211

Assessing the impact of a respiratory diagnosis on smoking cessation.

PubMed

Jones, Alexandra

2017-07-27

The aim of this study was to assess the impact of respiratory diagnoses on smoking cessation. A total of 229 current and former smokers, with and without respiratory diagnoses completed an anonymous online questionnaire assessing how their smoking habit changed when diagnosed with various respiratory conditions. Among all participants the most common reason for quitting smoking was to reduce the risk of health problems in general. In those with a chronic respiratory diagnosis, this was their most common reason for quitting. Motivation to quit smoking, scored by participants on a scale of 0-10, increased at the time of diagnosis then further increased after diagnosis of a chronic respiratory condition but declined after diagnosis of an acute respiratory condition. The research had a small sample size so further research is required. However, important themes are highlighted with the potential to influence clinical practice. All clinicians should receive training to promote cessation at the time of diagnosing respiratory conditions.

Beliefs and attitudes of male and female adolescents and the risk of smoking behavior.

PubMed

Kasim, K; Al-Zalabani, A; Abd El-Moneim, E S; Abd El-Moneim, S

2016-01-01

Adolescent smoking relates to numerous risk factors, of which beliefs and attitudes toward smoking may play a role. The study aimed to investigate the association between beliefs and attitudes and the risk of adolescent smoking. In a school-based cross-sectional study, 3,400 students were recruited from 34 intermediate and secondary schools in Madinah City, Al Madinah Region, Saudi Arabia. Data about sociodemographics, smoking-related factors, and beliefs and attitudes toward smoking were collected using a valid and reliable self-administered questionnaire. Prevalence of smoking was estimated and the studied beliefs and attitudes were compared by smoking status and sex using appropriate statistical analyses including multivariate logistic regression. Of the 3,322 respondents, 33.02% (38.9% males and 26.4% females) were current smokers. Beliefs and attitudes toward smoking significantly differed between smokers and nonsmokers in the studied male and female students. The adjusted risk of smoking was significantly increased among female adolescents who believed that male smokers were more attractive [odds ratio (OR) = 2.2; 95% confidence interval (CI) = 1.6-2.9] and among male smokers who believed that female smokers are more attractive (OR = 1.7; 95% CI = 1.2-2.2). The risk was also increased among all adolescents who believed that smoking lent comfort in social gatherings. Belief that smoking is harmful, however, was negatively associated with the risk of smoking, particularly among females (OR = 0.55; 95% CI = 0.35-0.91). The study revealed a considerable high prevalence of smoking among male and female adolescents. Addressing the beliefs and knowledge about smoking during childhood is crucial in any antismoking program.

Panic attack history and anxiety sensitivity in relation to cognitive-based smoking processes among treatment-seeking daily smokers.

PubMed

Johnson, Kirsten A; Farris, Samantha G; Schmidt, Norman B; Smits, Jasper A J; Zvolensky, Michael J

2013-01-01

Empirical research has found that panic attacks are related to increased risk of more severe nicotine withdrawal and poor cessation outcome. Anxiety sensitivity (AS; fear of anxiety and related sensations) has similarly been found to be related to an increased risk of acute nicotine withdrawal and poorer cessation outcome. However, research has yet to examine the relative contributions of panic attacks and AS in terms of cognitive-based smoking processes (e.g., negative reinforcement smoking expectancies, addictive and negative affect-based reduction smoking motives, barriers to cessation, problem symptoms experienced while quitting). Participants (n = 242; 57.4% male; M (age) = 38.1) were daily smokers recruited as a part of a larger randomized control trial for smoking cessation. It was hypothesized that both panic attacks and AS would uniquely and independently predict the studied cognitive-based smoking processes. As hypothesized, AS was uniquely and positively associated with all smoking processes after controlling for average number of cigarettes smoked per day, current Axis I diagnosis, and participant sex. However, panic attack history was only significantly related to problem symptoms experienced while quitting smoking. Although past research has demonstrated significant associations between panic attacks and certain aspects of cigarette smoking (e.g., severity of nicotine withdrawal; lower abstinence rates, and negative affect reduction motives), the present findings suggest that AS may be more relevant to understanding beliefs about and motives for smoking behavior as well as perceptions of cessation-related difficulties.

Cigarette Smoking and Pancreatic Cancer: A Pooled Analysis From the Pancreatic Cancer Cohort Consortium

PubMed Central

Vrieling, Alina; Lubin, Jay H.; Kraft, Peter; Mendelsohn, Julie B.; Hartge, Patricia; Canzian, Federico; Steplowski, Emily; Arslan, Alan A.; Gross, Myron; Helzlsouer, Kathy; Jacobs, Eric J.; LaCroix, Andrea; Petersen, Gloria; Zheng, Wei; Albanes, Demetrius; Amundadottir, Laufey; Bingham, Sheila A.; Boffetta, Paolo; Boutron-Ruault, Marie-Christine; Chanock, Stephen J.; Clipp, Sandra; Hoover, Robert N.; Jacobs, Kevin; Johnson, Karen C.; Kooperberg, Charles; Luo, Juhua; Messina, Catherine; Palli, Domenico; Patel, Alpa V.; Riboli, Elio; Shu, Xiao-Ou; Rodriguez Suarez, Laudina; Thomas, Gilles; Tjønneland, Anne; Tobias, Geoffrey S.; Tong, Elissa; Trichopoulos, Dimitrios; Virtamo, Jarmo; Ye, Weimin; Yu, Kai; Zeleniuch-Jacquette, Anne; Bueno-de-Mesquita, H. Bas; Stolzenberg-Solomon, Rachael Z.

2009-01-01

Smoking is an established risk factor for pancreatic cancer; however, detailed examination of the association of smoking intensity, smoking duration, and cumulative smoking dose with pancreatic cancer is limited. The authors analyzed pooled data from the international Pancreatic Cancer Cohort Consortium nested case-control study (1,481 cases, 1,539 controls). Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Smoking intensity effects were examined with an excess odds ratio model that was linear in pack-years and exponential in cigarettes smoked per day and its square. When compared with never smokers, current smokers had a significantly elevated risk (odds ratio (OR) = 1.77, 95% confidence interval (CI): 1.38, 2.26). Risk increased significantly with greater intensity (≥30 cigarettes/day: OR = 1.75, 95% CI: 1.27, 2.42), duration (≥50 years: OR = 2.13, 95% CI: 1.25, 3.62), and cumulative smoking dose (≥40 pack-years: OR = 1.78, 95% CI: 1.35, 2.34). Risk more than 15 years after smoking cessation was similar to that for never smokers. Estimates of excess odds ratio per pack-year declined with increasing intensity, suggesting greater risk for total exposure delivered at lower intensity for longer duration than for higher intensity for shorter duration. This finding and the decline in risk after smoking cessation suggest that smoking has a late-stage effect on pancreatic carcinogenesis. PMID:19561064

Particle and Smoke Detection on ISS for Next Generation Smoke Detectors

NASA Technical Reports Server (NTRS)

Urban, David L.; Ruff, Gary; Yuan, Zeng-guang; Sheredy, William; Funk, Greg

2007-01-01

Rapid fire detection requires the ability to differentiate fire signatures from background conditions and nuisance sources. Proper design of a fire detector requires detailed knowledge of all of these signal sources so that a discriminating detector can be designed. Owing to the absence of microgravity smoke data, all current spacecraft smoke detectors were designed based upon normal-g conditions. The removal of buoyancy reduces the velocities in the high temperature zones in flames, increasing the residence time of smoke particles and consequently allowing longer growth time for the particles. Recent space shuttle experiments confirmed that, in some cases, increased particles sizes are seen in low-gravity and that the relative performance of the ISS (International Space Station) and space-shuttle smoke-detectors changes in low-gravity; however, sufficient particle size information to design new detectors was not obtained. To address this issue, the SAME (Smoke Aerosol Measurement Experiment) experiment is manifested to fly on the ISS in 2007. The SAME experiment will make measurements of the particle size distribution of the smoke particulate from several typical spacecraft materials providing quantitative design data for spacecraft smoke detectors. A precursor experiment (DAFT: Dust Aerosol measurement Feasibility Test) flew recently on the ISS and provided the first measurement of the background smoke particulate levels on the ISS. These background levels are critical to the design of future smoke detectors. The ISS cabin was found to be a very clean environment with particulate levels substantially below the space shuttle and typical ground-based environments.

Smoke exposure and associated health effects across several fire seasons and locations in the Western US

NASA Astrophysics Data System (ADS)

O'Dell, K.; Ford, B.; Gan, R.; Liu, J.; Lassman, W.; Burke, M.; Pfister, G.; Vaidyanathan, A.; Volckens, J.; Magzamen, S.; Fischer, E. V.; Pierce, J. R.

2017-12-01

Wildfires are a significant source of particulate matter in the western United States. Wildfire activity in this region has increased over the past few decades and is projected to continue to increase further due to warmer and drier conditions. Particulate matter with diameters smaller than or equal to 2.5 microns (PM2.5) has known adverse effects on human health. However, due to an inconsistent association of wildfire PM2.5 and several disease outcomes, it is unclear if wildfire PM exerts similar health impacts as anthropogenic PM. Improved wildfire smoke exposure estimates are needed to gain a clearer understanding of the health impacts of wildfire PM2.5. Characterizing PM2.5 concentrations from wildfire smoke is challenging due to the transient nature of smoke. Current methods of determining smoke exposure rely on satellite retrievals of aerosol optical depth (AOD), estimates from chemical transport models (CTMs), or values reported by surface monitoring sites; each of these data sources has some limitations. To improve the accuracy of our exposure estimates, we developed new methods to blend these data. Our results indicate that blending information from the above-mentioned data sources along with counts of wildfire-smoke-related social-media posts results in better characterization of smoke exposure than any individual tool. We link our daily smoke PM2.5 exposure estimates with hospitalization and urgent-care admission data from Washington, Oregon, and Colorado during several fire seasons as well as prescription filling data from Oregon. We find a robust relationship, where a 10 μg m-3 increase in smoke is significantly associated with a 9.5% (95% CI: 6.2, 12.9) increase in the rate of asthma admissions and a 7.7% increase (95% CI: 6.5. 8.8) in the risk for respiratory rescue medication prescription refills. There was no significant association between smoke exposure and any cardiovascular endpoints. Our findings support the association of wildfire smoke exposure with adverse respiratory events, including subclinical outcomes, but we did not find significant associations with any cardiovascular outcomes. Public health messaging should target vulnerable populations to avoid smoke exposure during wildfire events.

Results and Insights on the Impact of Smoke on Digital Instrumentation and Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanaka, T. J.; Nowlen, S. P.

2001-01-31

Smoke can cause interruptions and upsets in active electronics. Because nuclear power plants are replacing analog with digital instrumentation and control systems, qualification guidelines for new systems are being reviewed for severe environments such as smoke and electromagnetic interference. Active digital systems, individual components, and active circuits have been exposed to smoke in a program sponsored by the U.S. Nuclear Regulatory Commission. The circuits and systems were all monitored during the smoke exposure, indicating any immediate effects of the smoke. The major effect of smoke has been to increase leakage currents (through circuit bridging across contacts and leads) and tomore » cause momentary upsets and failures in digital systems. This report summarizes two previous reports and presents new results from conformal coating, memory chip, and hard drive tests. The report describes practices for mitigation of smoke damage through digital system design, fire barriers, ventilation, fire suppressants, and post fire procedures.« less

The self-medication hypothesis: Evidence from terrorism and cigarette accessibility.

PubMed

Pesko, Michael F; Baum, Christopher F

2016-09-01

We use single equation and system instrumental variable models to explore if individuals smoke during times of stress (the motivation effect) and if they are successful in self-medicating short-term stress (the self-medication effect). Short-term stress is a powerful motivator of smoking, and the decision to smoke could trigger biological feedback that immediately reduces short-term stress. We use data on self-reported smoking and stress from 240,388 current and former smokers. We instrument short-term stress with temporal distance from September 11, 2001 (using date of interview). We instrument smoking with cigarette accessibility measures of cigarette price changes and distance to state borders. In the absence of accounting for endogeneity, we find that smoking is associated with increases in short-term stress. However, when we account for endogeneity we find no evidence of smoking affecting short-term stress. We do find a consistent positive effect of short-term stress on smoking. Copyright © 2016 Elsevier B.V. All rights reserved.

A Longitudinal Analysis of Hispanic Youth Acculturation and Cigarette Smoking: The Roles of Gender, Culture, Family, and Discrimination

PubMed Central

2013-01-01

Introduction: Risk for smoking initiation increases as Hispanic youth acculturate to U.S. society, and this association seems to be stronger for Hispanic girls than boys. To better understand the influence of culture, family, and everyday discrimination on cigarette smoking, we tested a process-oriented model of acculturation and cigarette smoking. Methods: Data came from Project RED (Reteniendo y Entendiendo Diversidad para Salud), which included 1,436 Hispanic students (54% girls) from Southern California. We used data from 9th to 11th grade (85% were 14 years old, and 86% were U.S. born) to test the influence of acculturation-related experiences on smoking over time. Results: Multigroup structural equation analysis suggested that acculturation was associated with increased familismo and lower traditional gender roles, and enculturation was linked more with familismo and respeto. Familismo, respeto, and traditional gender roles were linked with lower family conflict and increased family cohesion, and these links were stronger for girls. Familismo and respeto were further associated with lower discrimination. Conversely, fatalismo was linked with worse family functioning (especially for boys) and increased discrimination in both the groups. Discrimination was the only predictor of smoking for boys and girls. Conclusions: In all, the results of the current study indicate that reducing discrimination and helping youth cope with discrimination may prevent or reduce smoking in Hispanic boys and girls. This may be achieved by promoting familismo and respeto and by discouraging fatalistic beliefs. PMID:23109671

Understanding how mass media campaigns impact on smokers.

PubMed

Borland, R; Balmford, J

2003-09-01

To explore the immediate impact of the 2001 National Tobacco Campaign (NTC) advertising on movement towards quitting in a broadly representative sample of smokers. Repeated measures design with surveys two weeks apart. 1000 current smokers aged 18-40 were interviewed. 250 telephone interviews were conducted in each of Sydney and Melbourne (both unexposed at initial survey) and Brisbane and Adelaide (both exposed at initial survey) to measure frequency of negative thoughts about smoking and passive smoking, positive thoughts about smoking, and thoughts about the conduct of tobacco companies; perspective on change; and thoughts and actions about quitting. At the initial survey, those in regions exposed to the campaign were more advanced in thoughts about quitting. Between surveys, 33% progressed toward cessation and 21% regressed. 69% of participants reported recalling NTC advertising at follow up, which was significantly associated with greater self reported quitting activity and a greater increase in frequency of negative thoughts about smoking. The results show increased frequency of negative thoughts about smoking and an increase in quitting related thoughts and actions following onset of the NTC campaign. There was also evidence of sustained increase in cessation activity for a month following onset of the campaign. This all occurred in the context of considerable naturally occurring smoking cessation activity, suggesting that the challenge of campaigns in Australia is to induce progress toward quitting among people who are generally engaged with the issue at some level, rather than attempt to stimulate fundamentally new consideration of smoking.

A longitudinal analysis of Hispanic youth acculturation and cigarette smoking: the roles of gender, culture, family, and discrimination.

PubMed

Lorenzo-Blanco, Elma I; Unger, Jennifer B; Ritt-Olson, Anamara; Soto, Daniel; Baezconde-Garbanati, Lourdes

2013-05-01

Risk for smoking initiation increases as Hispanic youth acculturate to U.S. society, and this association seems to be stronger for Hispanic girls than boys. To better understand the influence of culture, family, and everyday discrimination on cigarette smoking, we tested a process-oriented model of acculturation and cigarette smoking. Data came from Project RED (Reteniendo y Entendiendo Diversidad para Salud), which included 1,436 Hispanic students (54% girls) from Southern California. We used data from 9th to 11th grade (85% were 14 years old, and 86% were U.S. born) to test the influence of acculturation-related experiences on smoking over time. Multigroup structural equation analysis suggested that acculturation was associated with increased familismo and lower traditional gender roles, and enculturation was linked more with familismo and respeto. Familismo, respeto, and traditional gender roles were linked with lower family conflict and increased family cohesion, and these links were stronger for girls. Familismo and respeto were further associated with lower discrimination. Conversely, fatalismo was linked with worse family functioning (especially for boys) and increased discrimination in both the groups. Discrimination was the only predictor of smoking for boys and girls. In all, the results of the current study indicate that reducing discrimination and helping youth cope with discrimination may prevent or reduce smoking in Hispanic boys and girls. This may be achieved by promoting familismo and respeto and by discouraging fatalistic beliefs.

Cross-sectional and longitudinal associations of neighbourhood social environment and smoking behaviour: the multiethnic study of atherosclerosis.

PubMed

Mayne, Stephanie L; Auchincloss, Amy H; Moore, Kari A; Michael, Yvonne L; Tabb, Loni Philip; Echeverria, Sandra E; Diez Roux, Ana V

2017-04-01

Social features of neighbourhood environments may influence smoking by creating a stressful environment or by buffering stress through social cohesion. However, the association of the overall neighbourhood social environment (NSE) with smoking, and the association of specific neighbourhood social factors with change in smoking behaviour over time, has rarely been examined. This study included 5856 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (2000-2012, average follow-up: 7.8 years). Outcomes included current smoking status and smoking intensity (average number of cigarettes smoked per day among baseline smokers). NSE was assessed as a composite score composed of aesthetic quality, safety and social cohesion scales (derived from neighbourhood surveys). Generalised linear mixed models evaluated the association of baseline NSE (composite score and individual scales) with current smoking (modified Poisson models) and smoking intensity (negative binomial models) cross-sectionally and longitudinally. Each SD increase in baseline NSE composite score was associated with 13% lower prevalence of smoking at baseline (adjusted prevalence ratio (aPR) 0.87 (95% CI 0.78 to 0.98). Neighbourhood safety and aesthetic quality were similarly associated with lower smoking prevalence (aPR 0.87 (0.78 to 0.97) and aPR 0.87 (0.77 to 0.99), respectively) but the association with social cohesion was weaker or null. No significant associations were observed for smoking intensity among baseline smokers. Baseline NSE was not associated with changes in smoking risk or intensity over time. Results suggest that neighbourhood social context influences whether older adults smoke, but does not promote smoking cessation or reduction over time. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Public spirometry for primary prevention of COPD.

PubMed

Zirlik, Sabine; Wich, Christina; Frieser, Markus; Hildner, Kai; Kleye, Christin; Neurath, Markus F; Fuchs, Florian S

2014-02-01

The most effective action for primary prevention of chronic obstructive lung disease is smoking cessation early enough. In secondary prevention, smokers with airway obstruction were more likely to quit smoking. The aim of this study was to evaluate the impact of a public spirometry on smoking habits in terms of primary prevention. Spirometry with its medical analysis was offered to visitors of a local public event called 'Lange Nacht der Wissenschaften' ('Long night of sciences'). The impact of results on smoking habits was evaluated in all smokers with an anonymized questionnaire afterwards. Two hundred fifty-seven people with the median age of 30 years (interquartile range 22-46) were examined. Out of 44 current smokers (17.1%), only two individuals showed a prebronchodilator FEV1/forced vital capacity-value <0.7. Fourteen smokers stated to have an increased motivation to quit smoking whereas 28 smokers declared that their motivation to quit smoking was independent of spirometry result. These smokers were significantly younger (median age 28 vs. 40 years, P = 0.025) without differences in spirometry results or smoking habits. In an unselected population with a high amount of younger adults, normal spirometry did not show a short-term benefit for primary prevention of chronic obstructive lung disease in terms of increasing motivation to quit smoking. © 2013 John Wiley & Sons, Ltd.

Cigarette smoking, alcohol intake, and risk of glioma in the NIH-AARP Diet and Health Study.

PubMed

Braganza, M Z; Rajaraman, P; Park, Y; Inskip, P D; Freedman, N D; Hollenbeck, A R; de González, A Berrington; Kitahara, C M

2014-01-07

Although cigarette smoking and alcohol drinking increase the risk of several cancers and certain components of cigarette smoke and alcohol can penetrate the blood-brain barrier, it remains unclear whether these exposures influence the risk of glioma. We examined the associations between cigarette smoking, alcohol intake, and risk of glioma in the National Institutes of Health-AARP Diet and Health Study, a prospective study of 477,095 US men and women ages 50-71 years at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using models with age as the time metric and adjusted for sex, race/ethnicity, education, and marital status. During a median 10.5 person-years of follow-up, 492 men and 212 women were diagnosed with first primary glioma. Among men, current, heavier smoking was associated with a reduced risk of glioma compared with never smoking, but this was based on only nine cases. No associations were observed between smoking behaviours and glioma risk in women. Greater alcohol consumption was associated with a decreased risk of glioma, particularly among men (>2 drinks per day vs <1 drink per week: HR=0.67, 95% CI=0.51-0.90). Smoking and alcohol drinking do not appear to increase the risk of glioma.

Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding

PubMed Central

Krosnick, Jon A.; Malhotra, Neil; Bruera, Eduardo F.; Chang, LinChiat; Pasek, Josh; Thomas, Randall K.

2017-01-01

Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans’ perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans’ smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence. PMID:28806420

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

PubMed

Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

Distributional benefits of tobacco tax and smoke-free workplaces in China: A modeling study.

PubMed

Verguet, Stéphane; Tarr, Gillian; Gauvreau, Cindy L; Mishra, Sujata; Jha, Prabhat; Liu, Lingrui; Xiao, Yue; Qiu, Yingpeng; Zhao, Kun

2017-12-01

Tobacco taxation and smoke-free workplaces reduce smoking, tobacco-related premature deaths and associated out-of-pocket health care expenditures. We examine the distributional consequences of a price increase in tobacco products through an excise tax hike, and of an implementation of smoke-free workplaces, in China. We use extended cost-effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population (the large majority of Chinese smokers), the premature deaths averted, the change in tax revenues generated, and the financial risk protection procured (eg, poverty cases averted, defined as the number of individuals no longer facing tobacco-related out-of-pocket expenditures for disease treatment, that would otherwise impoverish them), that would follow a 75% increase in cigarette prices through substantial increments in excise tax fully passed onto consumers, and a nationwide total implementation of workplace smoking bans. A 75% increase in cigarette prices would avert about 24 million premature deaths among the current Chinese male population, with a third among the bottom income quintile, increase additional tax revenues by US$ 46 billion annually, and prevent around 9 million poverty cases, 19% of which among the bottom income quintile. Implementation of smoking bans in workplaces would avert about 12 million premature deaths, with a fifth among the bottom income quintile, decrease tax revenues by US$ 7 billion annually, and prevent around 4 million poverty cases, 12% of which among the bottom income quintile. Increased excise taxes on tobacco products and workplace smoking bans can procure large health and economic benefits to the Chinese population, especially among the poor.

The effect of Taiwan's tax-induced increases in cigarette prices on brand-switching and the consumption of cigarettes.

PubMed

Tsai, Yi-Wen; Yang, Chung-Lin; Chen, Chin-Shyan; Liu, Tsai-Ching; Chen, Pei-Fen

2005-06-01

The effect of raising cigarette taxes to reduce smoking has been the subject of several studies, which often treat the price of cigarettes as an exogenous factor given to smokers who respond to it by adjusting their smoking behavior. However, cigarette prices vary with brand and quality, and smokers can and do switch to lower-priced brands to reduce the impact of the tax on the cost of cigarettes as they try to consume the same number of cigarettes as they had before a tax hike. Using data from a two-year follow-up interview survey conducted before and after a new cigarette tax scheme was imposed in Taiwan in 2002, this study examines three behavioral changes smokers may make to respond to tax-induced cigarette price increase: brand-switching, amount consumed, and amount spent on smoking. These changes were studied in relation to smoker income, before-tax cigarette price, level of addiction, exposure to advertizing, and consumer loyalty. We found that smokers, depending upon exposure to advertizing, level of consumer loyalty and initial price of cigarettes, switched brands to maintain current smoking habits and control costs. We also found that the initial amount smoked and level of addiction, not price, at least not at the current levels in Taiwan, determined whether a smoker reduced the number of cigarettes he consumed. Copyright 2005 John Wiley & Sons, Ltd.

Employment characteristics and socioeconomic factors associated with disparities in smoking abstinence and former smoking among U.S. workers.

PubMed

Fagan, Pebbles; Shavers, Vickie L; Lawrence, Deirdre; Gibson, James Todd; O'Connell, Mary E

2007-11-01

This study examines the associations among employment and socioeconomic factors and the outcomes, current smoking, cigarette abstinence and former smoking among adult U.S. workers ages 18-64 (n=288,813). Multivariate logistic regression was used to examine the associations among the variables using cross-sectional data from the 1998-1999 and 2001-2002 Tobacco Use Supplements to the Current Population Survey. Lower odds of current smoking was observed among part-time workers compared to those working variable hours and multiple job holders compared to persons holding one job. The self-employed, part-time workers and multiple job holders had higher odds of former smoking than comparison groups. Employment factors were not associated with short-term abstinence or 12-month abstinence from smoking, but income, education, marital status, and duration of smoking were associated with 12-month abstinence. These data suggest that while employment factors are associated with current and former smoking, socioeconomic factors are associated with long-term quitting.

Smoking prevalence, its determinants and short-term health implications in the Australian Defence Force.

PubMed

Barton, Christopher A; McGuire, Annabel; Waller, Michael; Treloar, Susan A; McClintock, Christine; McFarlane, Alexander C; D'Este, Cate

2010-04-01

The objectives of this study were to determine the prevalence of smoking, identify the effects of deployment on smoking behavior and risk factors for smoking, and determine the short-term health outcomes associated with smoking in Australian Defence Force (ADF) personnel. Participants were randomly sampled from ADF members who deployed to the Solomon Islands between 2003 and 2005 and from a nondeployed comparison group. In total, 435 of 995 (44%) eligible individuals completed the study questionnaires. The prevalence of current smoking was highest in those who had completed less formal education and those who served in the Navy. Nearly two-thirds (63%) of current or former smokers smoked more while on overseas deployment. Current smokers were more likely to report current wheeze, shortness of breath, and persistent cough compared with nonsmokers. The ADF should continue to address cigarette smoking through its health promotion and health review programs and implement activities to reduce cigarette smoking on deployment.

Waterpipe tobacco smoking among sexual minorities in the United States: Evidence from the National Adult Tobacco Survey (2012-2014).

PubMed

Ortiz, Kasim; Mamkherzi, Jamal; Salloum, Ramzi; Matthews, Alicia K; Maziak, Wasim

2017-11-01

The current study examined differences in waterpipe smoking (both lifetime and current) comparing sexual minority populations - those identifying with lesbian, gay, or bisexual identity - to their heterosexual counterparts using a nationally representative dataset. The current study used pooled data from the 2012-2013 & 2013-2014 National Adult Tobacco Survey (NATS). Log-Poisson multivariable regression models were deployed to determine the prevalence of waterpipe smoking behavior among sexual minority individuals controlling for sociodemographic characteristics and stratified by current gender status. In fully-adjusted models assessing lifetime WTS, lesbian/gay and bisexual respondents reported higher prevalence of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models among gay men [gay men: PR 1.25, 95%CI [1.06, 1.47] and women ([lesbians: PR 1.38, 95%CI [1.12, 1.69] and bisexual women: 1.69, 95%CI [1.45, 1.97]). In fully-adjusted models assessing current WTS, lesbian/gay and bisexual respondents reported higher risk of WTS compared to their heterosexual counterparts. This trend held true in gender-stratified models, only for among gay men [gay men: PR 1.56, 95%CI [1.18, 2.05] and bisexual women: 2.38, 95%CI [1.84, 3.09]). Among the US general adult population, sexual minorities exhibited increased prevalence of current waterpipe smoking compared to their heterosexual counterparts. This pattern is also shaped by gender and variation of sexual orientation identification (e.g., lesbian/gay vs. bisexual). This warrants development of tailored interventions aimed at decreasing waterpipe smoking among sexual minority populations. Copyright © 2017. Published by Elsevier Ltd.

A survey of UK optometry trainees' smoking cessation training.

PubMed

Lorencatto, Fabiana; Harper, Alice M; Francis, Jill J; Lawrenson, John G

2016-07-01

Smoking is a risk factor for a number of eye conditions, including age-related macular degeneration, cataracts and thyroid eye disease. Smoking cessation interventions have been shown to be highly cost-effective when delivered by a range of healthcare professionals. Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers. Yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. Surveys of UK medical/nursing schools and of optometrists' training internationally demonstrate significant deficits in current curricular coverage regarding smoking cessation. This study aimed to identify the extent of smoking cessation training in UK optometry trainees' undergraduate and pre-registration training. All undergraduate optometry schools in the UK (n = 9) were invited to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was conducted to identify competence indicators related to smoking cessation. Nine undergraduate optometry schools (100%) responded to the survey. The majority reported dedicating limited hours (0-3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidence-based smoking cessation interventions, including very brief advice. The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates' abilities to deliver smoking cessation interventions as 'poor' (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre-registration competency framework does not include any competence indicators related to providing support for quitting smoking. There are substantial gaps in the current curricula of UK optometry training, particularly regarding practical skills for supporting smoking cessation. Increased curricular coverage of these issues is essential to ensure trainee optometrists are adequately trained and competent in supporting patients to quit smoking. © 2016 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education

PubMed Central

Mishra, Sujata; Joseph, Renu Ann; Gupta, Prakash C; Pezzack, Brendon; Ram, Faujdar; Sinha, Dhirendra N; Dikshit, Rajesh; Patra, Jayadeep; Jha, Prabhat

2016-01-01

Objectives Smoking of cigarettes or bidis (small, locally manufactured smoked tobacco) in India has likely changed over the last decade. We sought to document trends in smoking prevalence among Indians aged 15–69 years between 1998 and 2015. Design Comparison of 3 nationally representative surveys representing 99% of India's population; the Special Fertility and Mortality Survey (1998), the Sample Registration System Baseline Survey (2004) and the Global Adult Tobacco Survey (2010). Setting India. Participants About 14 million residents from 2.5 million homes, representative of India. Main outcome measures Age-standardised smoking prevalence and projected absolute numbers of smokers in 2015. Trends were stratified by type of tobacco smoked, age, gender and education level. Findings The age-standardised prevalence of any smoking in men at ages 15–69 years fell from about 27% in 1998 to 24% in 2010, but rose at ages 15–29 years. During this period, cigarette smoking in men became about twofold more prevalent at ages 15–69 years and fourfold more prevalent at ages 15–29 years. By contrast, bidi smoking among men at ages 15–69 years fell modestly. The age-standardised prevalence of any smoking in women at these ages was 2.7% in 2010. The smoking prevalence in women born after 1960 was about half of the prevalence in women born before 1950. By contrast, the intergenerational changes in smoking prevalence in men were much smaller. The absolute numbers of men smoking any type of tobacco at ages 15–69 years rose by about 29 million or 36% in relative terms from 79 million in 1998 to 108 million in 2015. This represents an average increase of about 1.7 million male smokers every year. By 2015, there were roughly equal numbers of men smoking cigarettes or bidis. About 11 million women aged 15–69 smoked in 2015. Among illiterate men, the prevalence of smoking rose (most sharply for cigarettes) but fell modestly among men with grade 10 or more education. The ex-smoking prevalence in men at ages 45–59 years rose modestly but was low: only 5% nationally with about 4 current smokers for every former smoker. Conclusions Despite modest decreases in smoking prevalence, the absolute numbers of male smokers aged 15–69 years has increased substantially over the last 15 years. Cigarettes are displacing bidi smoking, most notably among young adult men and illiterate men. Tobacco control policies need to adapt to these changes, most notably with higher taxation on tobacco products, so as to raise the currently low levels of adult smoking cessation. PMID:28588906

Smoking is not associated with autoantibody production in systemic lupus erythematosus patients, unaffected first-degree relatives, nor healthy controls

PubMed Central

Young, Kendra A; Terrell, Deirdra R; Guthridge, Joel M; Kamen, Diane L; Gilkeson, Gary S; Karp, David R; Ishimori, Mariko L; Weisman, Michael H; Holers, V Michael; Harley, John B; Norris, Jill M; James, Judith A

2014-01-01

Objective To examine whether smoking is associated with autoantibody production in systemic lupus erythematosus (SLE) patients, unaffected first-degree relatives (FDR) of individuals with SLE - a group at increased risk of developing SLE, or unaffected, unrelated controls. Methods Detailed demographic, environmental, clinical, and therapeutic information was collected by questionnaire on 1,242 SLE patients, 981 FDRs, and 946 controls in the Lupus Family Registry and Repository; a blood sample was obtained. All sera were tested for multiple lupus autoantibodies by immunofluorescence and luminex bead-based assays. Generalized estimating equations, adjusting for age, gender, and ethnicity and accounting for correlation within families, were used to assess smoking status with the dichotomous outcome variables of positivity for SLE status, positivity of ANA by immunofluorescence (≥ 1:120), positivity for ≥ 1 autoantibody by the luminex assay, and positivity for each of the 11 autoantibodies. Results Current smoking was associated with being positive for ≥ 1 autoantibody (excluding ANA) (adjusted OR=1.53, 95% CI 1.04–2.24) in our subjects with SLE. No association was observed in unaffected FDRs or healthy controls. Former smoking was associated with anti-Ro/SS-A60 in our unaffected FDRs. There was an increased association with anti-nRNP A seropositivity, as well as a decreased association with anti-nRNP 68 positivity, in current smokers in SLE subjects. Conclusions No clear association between smoking status and individual autoantibodies was detected in SLE patients, unaffected FDRs, nor healthy controls within this collection. The association of smoking with SLE may therefore manifest its risk through mechanisms outside of autoantibody production, at least for the specificities tested. PMID:24449338

Influence of smoking status at time of surgery for herniated lumbar disk on postoperative pain and health-related quality of life.

PubMed

Stienen, Martin N; Smoll, Nicolas R; Hildebrandt, Gerhard; Schaller, Karl; Gautschi, Oliver P

2014-07-01

It is well established that smoking has a myriad of negative effects on varies aspects of bodily health. The aim of this study was to examine the effects of the smoking status at time of surgery on the postoperative subjective pain course and health related quality of life (HRQoL) until 1 year after surgery for lumbar disc herniation (LDH). This prospective cohort study included patients ≥18 and ≤90 years of age with a symptomatic and radiological verified LDH. The current smoking patient collective (smoking 1 or more cigarettes a day) was compared with the nonsmoking collective (previous smokers without cigarette consumption for >2 months and never smokers) in respect of subjective pain sensation (measured with the visual analogue scale (VAS)) and HRQoL using the short-form (SF-12) questionnaire preoperatively, before discharge, as well as after 4 weeks and 1 year postoperatively. The primary outcome measures were the 1-year SF-12 scores (MCS and PCS) categorized into responders and non-responders. A total of 102 patients were enrolled in the study. Thirty-eight patients were current smokers (37.2%), whereas 43 (42.2%) and 21 (20.6%) patients were never-smokers and previous smokers, respectively. Four weeks and one year after surgery, both smokers and nonsmokers reported increase in the HRQoL as compared to preoperative values - the MCS increased more than the PCS. From a univariate and multivariate perspective, smoking status at time of surgery did not predict responder status. The present study results could not confirm the hypothesis that smoking at time of surgery was associated with worse outcome after surgery for LDH. Copyright © 2014 Elsevier B.V. All rights reserved.

Cigarette smoking in young adults: the influence of the HTR2A T102C polymorphism and punishment sensitivity.

PubMed

White, Melanie J; Young, Ross McD; Morris, C Phillip; Lawford, Bruce R

2011-04-01

The C allele of a common polymorphism of the serotonin 2A receptor (HTR2A) gene, T102C, results in reduced synthesis of 5-HT2A receptors and has been associated with current smoking status in adults. The -1438A/G polymorphism, located in the regulatory region of this gene, is in linkage disequilibrium with T102C, and the A allele is associated with increased promoter activity and with smoking in adult males. We investigated the contributions of the HTR2A gene, chronic psychological stress, and impulsivity to the prediction of cigarette smoking status and dependence in young adults. T102C and -1438A/G genotyping was conducted on 132 healthy Caucasian young adults (47 smokers) who completed self-report measures of chronic stress, depressive symptoms, impulsive personality and cigarette use. A logistic regression analysis of current cigarette smoker user status, after adjusting for gender, depressive symptom severity and chronic stress, indicated that the T102C TT genotype relative to the CC genotype (OR=7.53), and lower punishment sensitivity (OR=0.91) were each significant predictive risk factors. However, for number of cigarettes smoked, only lower punishment sensitivity was a significant predictor (OR=0.81). These data indicate the importance of the T102C polymorphism to tobacco use but not number of cigarettes smoked for Caucasian young adults. Future studies should examine whether this is explained by effects of nicotine on the serotonin system. Lower punishment sensitivity increased risk of both smoking and of greater consumption, perhaps via a reduced sensitivity to cigarette health warnings and negative physiological effects. Crown Copyright © 2010. Published by Elsevier Ireland Ltd. All rights reserved.

Impact of inflammation, gene variants, and cigarette smoking on coronary artery disease risk.

PubMed

Merhi, Mahmoud; Demirdjian, Sally; Hariri, Essa; Sabbah, Nada; Youhanna, Sonia; Ghassibe-Sabbagh, Michella; Naoum, Joseph; Haber, Marc; Othman, Raed; Kibbani, Samer; Chammas, Elie; Kanbar, Roy; Bayeh, Hamid El; Chami, Youssef; Abchee, Antoine; Platt, Daniel E; Zalloua, Pierre; Khazen, Georges

2015-06-01

The role of inflammation in coronary artery disease (CAD) pathogenesis is well recognized. Moreover, smoking inhalation increases the activity of inflammatory mediators through an increase in leukotriene synthesis essential in atherosclerosis pathogenesis. The aim of this study is to investigate the effect of "selected" genetic variants within the leukotriene (LT) pathway and other variants on the development of CAD. CAD was detected by cardiac catheterization. Logistic regression was performed to investigate the association of smoking and selected susceptibility variants in the LT pathway including ALOX5AP, LTA4H, LTC4S, PON1, and LTA as well as CYP1A1 on CAD risk while controlling for age, gender, BMI, family history, diabetes, hyperlipidemia, and hypertension. rs4769874 (ALOX5AP), rs854560 (PON1), and rs4646903 (CYP1A1 MspI polymorphism) are significantly associated with an increased risk of CAD with respective odds ratios of 1.53703, 1.67710, and 1.35520; the genetic variant rs9579646 (ALOX5AP) is significantly associated with a decreased risk of CAD (OR 0.76163). Moreover, a significant smoking-gene interaction is determined with CYP1A1 MspI polymorphism rs4646903 and is associated with a decreased risk of CAD in current smokers (OR 0.52137). This study provides further evidence that genetic variation of the LT pathway, PON1, and CYP1A1 can modulate the atherogenic processes and eventually increase the risk of CAD in our study population. Moreover, it also shows the effect of smoking-gene interaction on CAD risk, where the CYP1A1 MspI polymorphism revealed a decreased risk in current smokers.

Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis

PubMed Central

Townsend, Julie S.; Tai, Eric; White, Arica; Davis, Shane P.; Fairley, Temeika L.

2015-01-01

Introduction People who continue to smoke after a cancer diagnosis have an increased risk for recurrences or development of new malignancies. These risks may be even higher among tobacco-related cancer survivors (TRCS). We describe tobacco use behaviors among TRCS, other cancer survivors, and people without a history of cancer. Methods We used 2009 Behavioral Risk Factor Surveillance System data to describe demographic characteristics, smoking history, current smoking prevalence, and smokeless tobacco use among TRCS, other cancer survivors, and people without a history of cancer (cigarette smoking and smokeless tobacco use were calculated after adjusting for age, sex, race, and insurance status). Tobacco-related cancers were defined as lung/bronchial, pharyngeal, laryngeal, esophageal, stomach, pancreatic, kidney/renal, urinary bladder, cervical, and acute myeloid leukemia. Results A total of 20 % of all cancer survivors were TRCS. TRCS were primarily female (68 %) and white (78 %). Smoking prevalence was higher among TRCS (27 %) compared with other cancer survivors (16 %) and respondents without a history of cancer (18 %). Smokeless tobacco use was higher among respondents without a history of cancer (4 %) compared with TRCS (3 %) and other cancer survivors (3 %). Conclusions The self-reported smoking prevalence among TRCS is higher than among other cancer survivors and people without a history of cancer. Targeted smoking prevention and cessation interventions are needed for cancer survivors, especially those diagnosed with a tobacco-related cancer. Implications for cancer survivors We recommend all cancer survivors be made aware of the health risks associated with smoking after a cancer diagnosis, and smoking cessation services be offered to those who currently smoke. Condensed abstract We provide the first population-based report on demographic characteristics and tobacco use behaviors among self-reported tobacco-related cancer survivors. PMID:22706885

A pilot study of smoking and associated behaviors of low-income expectant fathers.

PubMed

Everett, Kevin D; Gage, Jeffrey; Bullock, Linda; Longo, Daniel R; Geden, Elizabeth; Madsen, Richard W

2005-04-01

Pregnancy is considered a teachable moment for helping women who smoke to quit, yet few studies have examined smoking behavior of expectant fathers. The present study considers the possibility that pregnancy is a teachable moment for expectant fathers as well and describes smoking and associated behaviors of men during their partner's pregnancy. Participants were 138 low-income men living with their pregnant partners. Using telephone interviews, we found 63% of the men had smoked at least 100 cigarettes in their lifetime. Current smoking was reported by 49.3% of expectant fathers (39.1% daily smoking; 10.2% some days). Expectant fathers' current smoking was associated with having a lower level of education (p<.0001), pregnant partner being a current smoker (p=.0002), higher quantity of alcohol consumption per day of drinking (p=.0003), and absence of smoking prohibitions inside the home (p<.0001). In the past year, 70.1% of the current smokers tried to quit. We found high rates of smoking in low-income expectant fathers, and an expectant father's smoking during his partner's pregnancy was associated with his pregnant partner continuing to smoke. A majority of expectant fathers identified as current smokers tried to quit in the past year or indicated an intention to quit in the near future. Intervention during pregnancy that targets pregnant women and expectant fathers who smoke could lead to more households without tobacco use and thus have positive implications for paternal, maternal, and family health. Further clinical and research attention is needed to address the smoking behaviors of both expectant fathers and their pregnant partners.

Brief Report: Valued Life Activities and Readiness to Quit Smoking among Mobility Impaired Smokers

PubMed Central

Busch, Andrew M.; Borrelli, Belinda

2011-01-01

Objective People with physical disabilities smoke at a higher rate than their non-disabled peers, with rates as high as 28–40% among non-elderly adults with functional impairments. One possible explanation for these findings is that restriction of valued life activities (social, professional, pleasurable or otherwise meaningful) due to mobility impairment interferes with smoking cessation. Methods Forty-seven smokers (48.9% female; Mage = 48.91) with chronic mobility impairments (i.e., regularly use equipment to ambulate) were interviewed over the telephone. We assessed demographics, self-efficacy to quit smoking, stage of change, current engagement in valued activities, current restriction of valued activities due to physical limitations, and efforts to replace restricted valued activities in a cross sectional design. Results Bivariate results indicate that 74% of those in the preparation stage had satisfactory replacements for their most valued restricted activity, while only 27% in the contemplation stage and 17% in the pre-contemplation stage had such satisfactory replacements. Multinomial ordinal regression analyses revealed that (a) having satisfactory replacements for activities restricted due to physical disability was significantly associated with higher stage of change and (b) more current valued activities and, to a lesser extent, fewer restricted activities were significantly associated with higher levels of self-efficacy to quit smoking. Conclusions These results support the need for the development of treatments for smoking cessation that aim to increase engagement in valued activities, such as Behavioral Activation. PMID:21875204

Anticipated motivation for genetic testing among smokers, nonsmokers, and former smokers: an exploratory qualitative study of decision making.

PubMed

Giordimaina, Alicia M; Sheldon, Jane P; Petty, Elizabeth M

2014-01-01

This qualitative study explores the public's interest in genetic testing related to cigarette smoking, comparing the public's motivations with researchers' intentions for this technology. Adult nonsmokers (n=463), former smokers (n=163), and current smokers (n=129) completed an online survey. Within a hypothetical scenario, respondents decided whether they desired genetic testing related to smoking and explained their decision making. A non-parametric Kruskal-Wallis test was used to compare the interest in genetic testing by smoking history group. Inductive content analysis was used to investigate respondents' explanations for their testing decisions. Most nonsmokers (64%) and former smokers (58%) did not want genetic testing. While most current daily smokers were interested in testing (56%), most current occasional smokers were not (52%). Respondents' decision-making explanations were categorized into 3 major themes: Causality, Relevancy and Utility (e.g. personal benefits or harms). The use of causality, relevancy and utility explanations varied by smoking history. Notable perceived benefits of testing included recreation and altruism. Notable perceived harms included fear of fatalistic thoughts and concern about genetic discrimination. Interest in genetic testing was highest among current daily smokers, despite potential utility in other groups. Although respondents' motivations for testing paralleled researchers' intentions of tailoring smoking cessation therapies and increasing motivation to quit or abstain, respondents also raised alternative motivations and fears that healthcare providers would need to address. © 2014 S. Karger AG, Basel.

Lymphocyte DNA damage in elevator manufacturing workers in Guangzhou, China.

PubMed

Lam, Tai Hing; Zhu, Chang Qi; Jiang, Chao Qiang

2002-03-25

To study the effect of smoking, passive smoking, alcohol drinking, and occupational exposure to low level of benzene on DNA strand breaks in elevator manufacturing workers in Guangzhou, China. Three hundred and fifty-nine workers (252 men and 107 women) of a modern elevator manufacturing factory, 205 were from production departments and 154 from managerial department. Information on the workers' health conditions, smoking, passive smoking, alcohol consumption and occupational exposure history was collected by personal interview. Lymphocyte DNA damage was measured by the Comet assay. None of the women smoked and 20.6% of the men were daily smokers. In non-smokers, the prevalence of passive smoking at work was 25% for men and 11.2% for women, and at home, 37.8 and 48.6%, respectively. Smoking significantly increased tail moment (P<0.001). Daily smokers had the largest tail moment (geometric mean, 95% CI) (0.93 microm (0.81-0.94)), followed by occasional smokers (0.76 microm (0.59-0.95)), ex-smokers (0.70 microm (0.58-0.85)), and never smokers (0.56 microm (0.53-0.60)). Tail moment increased significantly with daily tobacco consumption (cigarettes per day) (r=0.26, P<0.001) after adjusting for age, gender, occupational exposure, passive smoking, and drinking. Analysis of covariance (ANCOVA) showed that smoking (P<0.001), passive smoking at home (P=0.026), occupational exposure (P<0.001), male gender (P<0.001), and age (P=0.001) had independent effects on tail moment, whereas passive smoking at work and alcohol drinking had no significant effect. Smoking, passive smoking at home, male gender, age and occupational exposure independently increased lymphocyte DNA strand breaks. The presence of excess DNA damage under low level of occupational exposure to benzene or other solvents suggest that the current allowance concentrations may not be safe to prevent genotoxicity.

Abnormal sympathetic nerve activity in women exposed to cigarette smoke: a potential mechanism to explain increased cardiac risk.

PubMed

Middlekauff, Holly R; Park, Jeanie; Agrawal, Harsh; Gornbein, Jeffrey A

2013-11-15

In women, cardiac deaths attributable to tobacco exposure have reached the same high levels as men. Normally, sympathetic nerve activity (SNA) fluctuates according to the menstrual phase, but in habitual smokers, SNA levels remain constant. Our purpose is to extend these observations to other groups of women exposed to tobacco smoke and to explore potential mechanisms. We hypothesize that women exposed to secondhand smoke, but not former smokers, have nonfluctuating SNA compared with never smokers, and that impaired baroreflex suppression of SNA, and/or heightened central SNA responses, underlie this nonfluctuating SNA. We also hypothesize that female smokers have impaired nocturnal blood pressure dipping, normally mediated by modulation of SNA. In 49 females (19 never, 12 current, 9 former, 9 passive smokers), SNA was recorded (microneurography) during high- and low-hormone ovarian phases at rest, during pharmacological baroreflex testing, and during the cold pressor test (CPT). Twenty-four hour blood pressure (BP) monitoring was performed. Current and passive smokers, but not former smokers, had a nonfluctuating pattern of SNA, unlike never smokers in whom SNA varied with the menstrual phase. Baroreflex control of SNA was significantly blunted in current smokers, independent of menstrual phase. In passive smokers, SNA response to CPT was markedly increased. Nondipping was unexpectedly high in all groups. SNA does not vary during the menstrual cycle in active and passive smokers, unlike never and former smokers. Baroreflex control of SNA is blunted in current smokers, whereas SNA response to CPT is heightened in passive smokers. Smoking cessation is associated with return of the altered SNA pattern to normal.

Pain, Nicotine, and Smoking: Research Findings and Mechanistic Considerations

PubMed Central

Ditre, Joseph W.; Brandon, Thomas H.; Zale, Emily L.; Meagher, Mary M.

2011-01-01

Tobacco addiction and chronic pain represent two highly prevalent and comorbid conditions that engender substantial burdens upon individuals and systems. Although interrelations between pain and smoking have been of clinical and empirical interest for decades, research on the topic of pain, nicotine, and tobacco smoking has increased dramatically over the past five years. We conceptualize the interaction of pain and smoking as a prototypical example of the biopsychosocial model. Accordingly, the current review extrapolated from behavioral, cognitive, affective, biomedical, and social perspectives to propose causal mechanisms that may contribute to the observed comorbidity between these two conditions. Research in the broad area of pain and smoking was first dichotomized into investigations of either "effects of smoking on pain" or "effects of pain on smoking." We then integrated the extant literature to present a reciprocal model of pain and smoking that is hypothesized to interact in the manner of a positive feedback loop, resulting in greater pain, increased smoking, and the maintenance of tobacco addiction. Finally, we proposed directions for future research, and discussed clinical implications for smokers with comorbid pain disorders. We observed modest evidence to support the notions that smoking may be a risk factor in the multifactorial etiology of some chronically painful conditions, and that the experience of pain may come to serve as a potent motivator of smoking. We also found that whereas animal studies yielded consistent support for direct pain-inhibitory effects of nicotine and tobacco smoke, results from human studies were much less consistent. Future research in the emerging area of pain and smoking has the potential to inform theoretical and clinical applications with respect to tobacco smoking, chronic pain, and their comorbid presentation. PMID:21967450

[Smoke-free environment--nurse attitudes towards smoke-free regulations].

PubMed

Kaleta, Dorota; Polańska, Kinga; Dziankowska-Zaborszczyk, Elzbieta; Bak-Romaniszyn, Leokadia; Czarnecka, Karolina; Drygas, Wojciech

2009-01-01

The aim of the study was to analyze the nurse attitudes towards smoke-free regulations in public places. The study population consisted of 299 nurses. Among the study population questionnaire was conducted including socio-demographic characteristic, smoking and ETS profile, knowledge about health effects of smoking and abilities for conduction of antismoking counseling. Detail information was collected about nurse opinion on smoke-free public places such as offices, other workplaces, health and educational buildings, restaurants and bars. About 18% of study participants declared current tobacco smoking and 25% were former smokers. Almost all participating in the study women (85%-98%) are in favor of smoking ban in offices, health and educational buildings. 75% supported smoking ban in workplaces but 15% of them were somewhat opposed. Most of the nurses were in favor of smoke-free restaurants (64%) but they were less likely to support smoke-free bars, pubs and clubs (45%). Unfortunately 63% of interview women do not accept smoking ban in private cars. The percentage of women who support total ban of smoking in the presence of pregnant women was 93% and in the presence of children 79%. It is important to conduct educational and informational activities to increase public awareness on health consequences of active and passive smoking and the ways of elimination of such exposures.

Passive smoking, air pollution, and acute respiratory symptoms in a diary study of student nurses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwartz, J.; Zeger, S.

1990-01-01

A cohort of approximately 100 student nurses in Los Angeles was recruited for a diary study of the acute effects of air pollution. Smoking histories and presence of asthma and other allergies were determined by questionnaire. Diaries were completed daily and collected weekly for as long as 3 yr. Air pollution was measured at a monitoring location within 2.5 miles of the school. Incidence and duration of a symptom were modeled separately. Pack-years of cigarettes were predictive of the number of episodes of coughing (p less than 0.0001) and of bringing up phlegm (p less than 0.0001). Current smoking, rathermore » than cumulative smoking, was a better predictor of the duration of a phlegm episode (p less than 0.0001). Controlling for personal smoking, a smoking roommate increased the risk of an episode of phlegm (odds ratio (OR) = 1.41, p less than 0.001), but not of cough. Excluding asthmatics (who may be medicated), increased the odds ratio for passive smoking to 1.76 (p less than 0.0001). In logistic regression models controlling for temperature and serial correlation between days, an increase of 1 SD in carbon monoxide exposure (6.5 ppm) was associated with increased risk of headache (OR = 1.09, p less than 0.001), photochemical oxidants (7.4 pphm) were associated with increased risk of chest discomfort (OR = 1.17, p less than 0.001) and eye irritation (OR = 1.20 p less than 0.001), and nitrogen dioxide (9.1 pphm) was associated with increased risk of phlegm (OR = 1.08 p less than 0.01), sore throats (OR = 1.26, p less than 0.001), and eye irritation (OR = 1.16, p less than 0.001).« less

The forgotten smoker: a qualitative study of attitudes towards smoking, quitting, and tobacco control policies among continuing smokers.

PubMed

Uppal, Navneet; Shahab, Lion; Britton, John; Ratschen, Elena

2013-05-03

Although research suggests that the majority of smokers want to quit smoking, the uptake of Stop Smoking Services, designed to assist smokers with quitting, remains low. Little is known about continuing smokers who do not access these services, and opportunities to influence their motivation and encourage quit attempts through the uptake of services. Using PRIME theory, this study explored differences between continuing smokers who had varying levels of motivation to quit, in terms of their plans to quit, evaluative beliefs about smoking, cigarette dependence, and attitudes towards tobacco control policies and services. Twenty-two current smokers, recruited from the community, were classified by motivation level to quit using a self-report questionnaire (two groups: high/low). Four focus groups (n=13) and individual interviews (n=9) were conducted with both groups using an interview guide incorporating aspects of PRIME theory. Discussion areas included motives for smoking, attitudes towards smoking and quitting, perceptions of dependence, motives for quitting, barriers to quitting, and attitudes towards existing and impending tobacco control policies and services. Verbatim transcripts were analysed using thematic framework analysis. All participants expressed low motivation to quit during discussions, despite some initially self-classifying as having high explicit levels of motivation to quit. Both groups reported similar attitudes towards smoking and quitting, including a perceived psychological addiction to smoking, positive evaluations about smoking which inhibited plans to quit, and similar suggested methods to increase motivation (simply wanting to, save money, improve health). Most felt that they 'ought' to quit as opposed to 'wanted' to. Little influence was ascribed towards tobacco control policies such as plain packaging and hidden sales displays, and participants felt that price increases of tobacco products needed to be considerable in order to influence motivation. Highly motivated smokers expressed more willingness to visit Stop Smoking Services, although none had done so. Continuing smokers' attitudes towards smoking and quitting suggests that research and policy need to focus on increasing smokers' implicit motivation to quit smoking, even for those who classified themselves as having high motivation to quit. Targeted information and further education about Stop Smoking Services is required to increase uptake.

Driving kids to smoke? Children's reported exposure to smoke in cars and early smoking initiation.

PubMed

Glover, Marewa; Scragg, Robert; Min, Sandar; Kira, Anette; Nosa, Vili; McCool, Judith; Bullen, Chris

2011-11-01

The health risks associated with second hand smoke (SHS) are well-known. However, little is known about exposure to SHS in cars and risk of smoking uptake. This paper investigates the association between pre-adolescents reported exposure to smoking in cars and prevalence of early stage smoking activity. Data from Keeping Kids Smokefree baseline surveys of students were used to investigate smoking status and reported exposure to smoking in cars. Log binomial regression analyses were used to investigate if reported exposure to SHS in cars was associated with smoking prevalence. 83% of 5676 students invited took part. After controlling for all variables reported exposure to smoking in cars and homes were significantly associated with increased risk of initiated smoking (RR 1.87, 95% CI 1.43-2.44, and RR 1.5, 95% CI 1.13-1.97, respectively). Exposure to smoking in cars was substantially and significantly associated with risk of current smoking (RR 3.21, 95% CI 1.45-7.08). Early smoking uptake is associated with students' reported exposure to smoking in cars which confirms the importance of protecting children from SHS. Smoking in cars is under parental control and therefore modifiable. Moreover, children's reports of SHlS exposure offer a simple way of identifying families who can be targeted for tobacco control interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Economic costs attributable to smoking in Hong Kong in 2011: a possible increase from 1998.

PubMed

Chen, Jing; McGhee, Sarah; Lam, Tai Hing

2017-11-15

Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates. We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing. We followed guidelines on estimating costs of active smoking for those aged 35 years or above (35+) and costs due to SHS exposure for 35+, infants aged 12 months and under and children aged 15 and below. All costs are in US$. We estimated that 6154 deaths among 35+ in Hong Kong in 2011 were attributable to active smoking, an increase of 10% from 1998. Besides, 672 deaths were attributable to SHS exposure, i.e. 10% of the total 6826 smoking-attributable deaths. The estimate of productive life lost due to deaths from active smoking by those aged under 65 years in 2011 was $166 million, an increase of about 4% over the estimate in 1998. Our conservative estimate of the annual tobacco-related disease cost in 2011 was $716 million which accounted for 0.3% of GDP. If we added the value of attributable lives lost, the annual cost would be $4.7 billion. Despite the reduction in smoking prevalence, smoking-attributable disease still imposes a substantial economic burden on Hong Kong society. These findings support more stringent and effective tobacco control legislation, polices and measures. Current evidence shows reduction in smoking prevalence does not necessarily reduce the economic costs of smoking. Most studies in developed countries employed a societal perspective, including costs of productivity loss and indirect costs, but not all studies estimated costs associated with second-hand smoking (SHS). The present study estimated the total costs of smoking in Hong Kong including direct and indirect costs attributable to active smoking and to SHS exposure. Our study confirms the pattern of smoking epidemic in developed countries, forewarns the increasing economic burdens from tobacco, and provides East Asian countries with a prediction of their own future costs. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Is there a role for e-cigarettes in smoking cessation?

PubMed

Leduc, Charlotte; Quoix, Elisabeth

2016-04-01

The use of e-cigarettes has dramatically increased over the past few years and their role in smoking cessation remains controversial. Several clinical studies have evaluated their efficacy in smoking cessation but most of them are prospective cohort studies. Only two randomized, controlled trials have compared e-cigarettes versus placebo or patches. A meta-analysis of these two randomized, controlled trials has been performed. Nicotine-containing e-cigarettes appear to help smokers unable to stop smoking altogether to reduce their cigarette consumption when compared with placebo. However, these results are rated 'low' by GRADE standards. Many cohort studies have been conducted, with contradictory results. For some, e-cigarettes could increase the risk of nonsmokers developing nicotine dependence and of current smokers maintaining their dependence. The debate remains open and more randomized trials are needed with long-term data about the efficacy and safety of e-cigarettes. © The Author(s), 2015.

Electronic Cigarette Use in US Adults at Risk for or with COPD: Analysis from Two Observational Cohorts.

PubMed

Bowler, Russell P; Hansel, Nadia N; Jacobson, Sean; Graham Barr, R; Make, Barry J; Han, MeiLan K; O'Neal, Wanda K; Oelsner, Elizabeth C; Casaburi, Richard; Barjaktarevic, Igor; Cooper, Chris; Foreman, Marilyn; Wise, Robert A; DeMeo, Dawn L; Silverman, Edwin K; Bailey, William; Harrington, Kathleen F; Woodruff, Prescott G; Drummond, M Bradley

2017-12-01

Electronic cigarettes (e-cigarettes) are battery-operated nicotine-delivery devices used by some smokers as a cessation tool as well as by never smokers. To determine the usage of e-cigarettes in older adults at risk for or with chronic obstructive pulmonary disease (COPD). Prospective cohorts. COPDGene (N = 3536) and SPIROMICS (N = 1060) subjects who were current or former smokers aged 45-80. Participants were surveyed to determine whether e-cigarette use was associated with longitudinal changes in COPD progression or smoking habits. From 2010 to 2016, participants who had ever used e-cigarettes steadily increased to 12-16%, but from 2014 to 2016 current use was stable at ~5%. E-cigarette use in African-Americans (AA) and whites was similar; however, AA were 1.8-2.9 times as likely to use menthol-flavored e-cigarettes. Current e-cigarette and conventional cigarette users had higher nicotine dependence and consumed more nicotine than those who smoked only conventional cigarettes. E-cigarette users had a heavier conventional cigarette smoking history and worse respiratory health, were less likely to reduce or quit conventional cigarette smoking, had higher nicotine dependence, and were more likely to report chronic bronchitis and exacerbations. Ever e-cigarette users had more rapid decline in lung function, but this trend did not persist after adjustment for persistent conventional cigarette smoking. E-cigarette use, which is common in adults with or at risk for COPD, was associated with worse pulmonary-related health outcomes, but not with cessation of smoking conventional cigarettes. Although this was an observational study, we find no evidence supporting the use of e-cigarettes as a harm reduction strategy among current smokers with or at risk for COPD.

Flavored E-cigarette Use and Cigarette Smoking Reduction and Cessation-A Large National Study among Young Adult Smokers.

PubMed

Chen, Julia Cen

2018-04-06

E-cigarette use prevalence has increased drastically among young adult cigarette smokers in recent years. This study seeks to understand which e-cigarette flavors-sweet and fruity or tobacco and menthol/mint-are more likely to be associated with smoking reduction and cessation among young adults. Longitudinal data (waves 1 and 2) of the Population Assessment of Tobacco and Health (PATH) Study from young adult (aged 18-34) cigarette smokers (n = 4,645) at wave 1 and current e-cigarette users (n = 844) at wave 2 were used. Univariate and multivariate regressions were conducted to examine the associations between past-year smoking reduction and cessation and current e-cigarette flavor use at wave 2. At wave 2, 25.9% of respondents either reduced or quit smoking, and 6.7%, 5.2%, and 6.3% of them reported currently using e-cigarettes with tobacco/menthol (TM) flavors, one non-tobacco/non-menthol (NTM) flavor, and multiple NTM flavors, respectively. E-cigarette users with one (AOR = 2.5, p < 0.001) and multiple NTM flavors (AOR = 3.0, p < 0.001) were more likely to have reduced or quit smoking over the past year compared to non-e-cigarette users. NTM flavor use was positively associated with e-cigarette use of a higher frequency and larger amount. The positive association between past-year smoking reduction and cessation and current NTM flavored e-cigarette use may be explained by young adults' escalated e-cigarette use with NTM flavors. Public health professionals should prevent and reduce multiple tobacco use through enhanced education about the harm of vaping NTM flavors and by advising young adult smokers to quit tobacco altogether using evidence-based methods.

Treatment Attrition: Associations with Negative Affect Smoking Motives and Barriers to Quitting Among Treatment-Seeking Smokers

PubMed Central

Garey, Lorra; Kauffman, Brooke Y.; Neighbors, Clayton; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Introduction Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. Method The current study sought to evaluate the relation between negative affect reduction smoking motives with pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage = 37.69; SD = 13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (Odds Ratio = 1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. Conclusions This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation. PMID:27518764

Tobacco and the risk of acute leukaemia in adults

PubMed Central

Kane, E V; Roman, E; Cartwright, R; Parker, J; Morgan, G

1999-01-01

Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0–1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1–1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years ‘stopped smoking’ increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL. © 1999 Cancer Research Campaign PMID:10584886

TSNA levels in machine-generated mainstream cigarette smoke: 35 years of data.

PubMed

Appleton, Scott; Olegario, Raquel M; Lipowicz, Peter J

2013-07-01

This paper characterizes historical and current tobacco specific nitrosamine (TSNA) levels in mainstream (MS) cigarette smoke of US commercial cigarettes. To conduct this analysis, we gathered 35 years of published data of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and N-nitrosonornicotine (NNN) levels in MS cigarette smoke. We also assessed internal data of MS smoke NNK and NNN levels generated from various market monitoring initiatives and from control cigarettes used in a multi-year program for testing cigarette ingredients. In all, we analyzed machine smoking data from 401 cigarette samples representing a wide range of products and design characteristics from multiple manufacturers and market leaders. There was no indication that TSNA levels systematically increased in cigarette MS smoke over the 35-year analysis period. In particular, TSNA levels expressed as either per cigarette or normalized for tar suggest a downward trend in MS smoke over the past 10 years. The apparent downward trend in TSNA levels in MS smoke may reflect industry and agricultural community efforts to reduce levels of TSNAs in tobacco and cigarette smoke. Copyright © 2013 Elsevier Inc. All rights reserved.

The effects of cigarette costs on BMI and obesity.

PubMed

Baum, Charles L

2009-01-01

About 30% of Americans are currently obese, which is roughly a 100% increase from 25 years ago. Public health officials have consequently become alarmed because recent research indicates that societal costs of obesity now exceed those of cigarette smoking and alcoholism. Cigarette taxes may have exacerbated the prevalence of obesity. In 1964, the US Surgeon General issued its first report relating smoking and health, and since that time, federal and state governments have increased cigarette taxes in a successful effort to reduce cigarette smoking. However, because cigarette smoking and obesity seem inversely related, cigarette taxes may have simultaneously increased obesity. This paper examines the effects of cigarette costs on BMI and obesity and finds that they have significant positive effects. This paper attempts to reconcile conflicting evidence in the literature by controlling more carefully for correlation with state-specific time trends using panel data. Results indicate that the net benefit to society of increasing cigarette taxes may not be as large as previously thought, though this research in no way concludes that they should be decreased to prompt weight loss. Copyright (c) 2008 John Wiley & Sons, Ltd.

Social integration, psychological distress, and smoking behaviors in a midwest LGBT community.

PubMed

Sivadon, Angela; Matthews, Alicia K; David, Kevin M

2014-01-01

Lesbian, gay, bisexual, and transgender (LGBT) populations have smoking rates twice that of their heterosexual counterparts. To design effective outreach, prevention, and treatments for these individuals, a comprehensive understanding of associated factors is needed. To increase understanding of how social integration and psychological distress are related to smoking behaviors among LGBT populations. A cross-sectional, descriptive study of 135 LGBT adults using an online data collection strategy. Multivariate analyses were performed to examine factors associated with current smoking status. Social integration was not significantly related to smoking behaviors in this LGBT population, although psychological distress was higher among smokers than nonsmokers. Although social support has been reported to have an impact on health behaviors in the general population, the present findings suggest that the benefits of social support may not apply to the smoking activities of LGBT individuals. © The Author(s) 2014.

Socioeconomic inequalities in smoking habits are still increasing in Italy.

PubMed

Verlato, Giuseppe; Accordini, Simone; Nguyen, Giang; Marchetti, Pierpaolo; Cazzoletti, Lucia; Ferrari, Marcello; Antonicelli, Leonardo; Attena, Francesco; Bellisario, Valeria; Bono, Roberto; Briziarelli, Lamberto; Casali, Lucio; Corsico, Angelo Guido; Fois, Alessandro; Panico, MariaGrazia; Piccioni, Pavilio; Pirina, Pietro; Villani, Simona; Nicolini, Gabriele; de Marco, Roberto

2014-08-27

Socioeconomic inequalities in smoking habits have stabilized in many Western countries. This study aimed at evaluating whether socioeconomic disparities in smoking habits are still enlarging in Italy and at comparing the impact of education and occupation. In the frame of the GEIRD study (Gene Environment Interactions in Respiratory Diseases) 10,494 subjects, randomly selected from the general population aged 20-44 years in seven Italian centres, answered a screening questionnaire between 2007 and 2010 (response percentage = 57.2%). In four centres a repeated cross-sectional survey was performed: smoking prevalence recorded in GEIRD was compared with prevalence recorded between 1998 and 2000 in the Italian Study of Asthma in Young Adults (ISAYA). Current smoking was twice as prevalent in people with a primary/secondary school certificate (40-43%) compared with people with an academic degree (20%), and among unemployed and workmen (39%) compared with managers and clerks (20-22%). In multivariable analysis smoking habits were more affected by education level than by occupation. From the first to the second survey the prevalence of ever smokers markedly decreased among housewives, managers, businessmen and free-lancers, while ever smoking became even more common among unemployed (time-occupation interaction: p = 0.047). At variance, the increasing trend in smoking cessation was not modified by occupation. Smoking prevalence has declined in Italy during the last decade among the higher socioeconomic classes, but not among the lower. This enlarging socioeconomic inequality mainly reflects a different trend in smoking initiation.

Support for smoking restrictions in bars and gaming areas: review of Australian studies.

PubMed

Walsh, Raoul A; Tzelepis, Flora

2003-01-01

To document levels of public support in Australia for smoking restrictions in licensed premises, including trends over time, and to examine the potential effects of a ban on patronage. Systematic review of published and unpublished studies of community and staff attitudes towards smoking in bars, gaming areas and related venues were identified using Medline, Current Contents, PsycINFO and AUSTHealth prior to September 2002. State and Territory health departments, cancer organisations and branches of the National Heart Foundation were approached. Cross-sectional surveys reporting data on attitudes towards smoking restrictions and/or perceptions of effects on patronage were sought. Two reviewers assessed studies for inclusion. One extracted data using pre-coded categories with checking by the second. Thirty-four community and seven staff surveys were synthesised qualitatively, with greater emphasis given to surveys using random selection. All surveys conducted since 1993, which included the separate smoking area response option, have demonstrated majority support for some form of smoking restriction on licensed premises. From 2000, surveys with the ban option alone report majority support for prohibiting smoking completely in bars (52-68%) and gaming areas (64-76%). Support increased significantly after the Sharp damages award. Customer preference data indicate banning smoking is most likely to have a neutral or positive effect on patronage. Support for a ban on smoking in licensed premises has increased by almost 20% in the past decade. State and Territory governments should introduce legislation banning smoking in all indoor drinking and gaming areas immediately.

Smoking-related changes or brand switching? Smokers' anticipated responses to a large increase in Taiwan's Tobacco Health and Welfare Surcharge.

PubMed

Yeh, C-Y; Schafferer, C; Lee, J-M; Hsieh, C-J

2016-07-01

This study examines the impact on smokers' behaviour of a planned increase in the Health and Welfare Surcharge of Tobacco Products in Taiwan. This study used a structured questionnaire to perform telephone interviews. Stratified random sampling was applied to interview current smokers aged 18-65 years in Taiwan. Based on nationwide survey data of smokers' responses to future increases in cigarette prices, this study used multinomial logistic regression to perform its analyses. After the proposed increase in the Health and Welfare Surcharge of Tobacco Products, subsequent cigarette price increases would motivate nearly 30% of the smokers to adopt smoking-related changes and 10% to change to lower-priced brands. The study suggests that a large increase in the Health and Welfare Surcharge of Tobacco Products would lead to considerable changes in smoking behaviour, which in turn would increase cessation rate at the population level. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Improving measurement of normative beliefs involving smoking among adolescents.

PubMed

Primack, Brian A; Switzer, Galen E; Dalton, Madeline A

2007-05-01

To identify different components of smoking normative beliefs and determine if each component is independently associated with 2 clinically relevant measures of smoking in adolescents. Cross-sectional survey. One large suburban high school. A total of 1211 high school students aged 14 to 18 years. Current smoking and susceptibility to smoking. Of the 1138 students with data on current smoking, 216 (19.0%) reported current smoking, and 342 (38.3%) of the 893 nonsmoking students with susceptibility data were susceptible to future smoking. Factor analysis identified 3 normative belief constructs, labeled "perceived prevalence of smoking," "perceived popularity of smoking among elite/successful elements of society," and "disapproval of smoking by parents/peers." On average, students believed that 56% of people in the United States smoke cigarettes; 27.7% believed that wealthy people smoke more than poor people. Multiple logistic regression showed that each of the 3 constructs was independently associated with current smoking (adjusted odds ratios, 1.05 [95% confidence interval {CI}, 1.02-1.08], 1.12 [95% CI, 1.02-1.23], and 0.66 [95% CI, 0.59-0.75], respectively), even after controlling for covariates. Students' perceptions of smoking among the successful/elite and disapproval by parents/peers were independently associated with susceptibility to future smoking (adjusted odds ratios, 1.20 [95% CI, 1.11-1.29] and 0.87 [95% CI, 0.79-0.96], respectively). Adolescents' normative beliefs about smoking are multidimensional and include at least 3 distinct components, each of which was independently related to smoking outcomes. These distinct components should be considered in the design and evaluation of programs related to prevention and cessation of adolescent smoking.

Social normative beliefs regarding cigarette smoking in Hungarian adolescents.

PubMed

Page, Randy M; Piko, Bettina F; Balazs, Mate A; Struk, Tamara

2011-10-01

Hungary will continue to experience a high burden of disease and death from lung cancer and other tobacco-induced disease unless there is a significant reduction in youth smoking. Social factors have been found to be among the most important determinants of adolescent smoking, yet few studies have investigated social normative beliefs in Hungarian youth. The purpose of the current study was to investigate three measures of smoking normative beliefs thought to influence adolescent smoking: perceived prevalence of smoking; perceived popularity of smoking among successful/elite elements of society; and perceived disapproval by friends and family. A cross-sectional school-based survey of eighth grade (n = 258) and 12th grade (n = 288) students in Mako, Hungary was conducted to assess social normative beliefs about smoking, current smoking, ever smoking, and susceptibility to smoking. The association of the normative beliefs with the smoking behavior variables was examined through logistic regression analysis, and the underlying factor structure of the normative belief items in the current sample was determined through factor analysis. The percent of boys reporting current smoking was 40.5% in 12th grade and 27.0% in eighth grade. Among girls, the percent was 44.0% of 12th graders and 29.1% of eighth graders. Parent/peer disapproval was the most consistently associated normative belief with smoking behavior and susceptibility to smoking across both samples. Youth smoking prevention programs should consider assessing and taking into account normative beliefs and develop strategies that provide accurate information about the actual prevalence of smoking, the types of individuals who smoke, and approval/disapproval of smoking by parents and peers. © 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

Risk factors for occupational acute mountain sickness.

PubMed

Vinnikov, D; Brimkulov, N; Krasotski, V; Redding-Jones, R; Blanc, P D

2014-10-01

Studies of occupational acute mountain sickness (AMS) have not focused on the more severe end of the spectrum to date. To examine risk factors associated with the development of occupational AMS severe enough to receive treatment in a compression chamber. A nested case referent study in a cohort of high-altitude (4000 m) mine workers, comparing cases of severe, chamber-treated AMS to matched referents. Using logistic regression, we tested potential risk factors based on premorbid surveillance examinations, including cigarette smoking (current smoking, smoking intensity and exhaled carbon monoxide [CO]). There were 15 cases and 30 controls. In multivariate analysis including age, sex and place of residence, current smoking was associated with increased risk of severe AMS (odds ratio [OR] 10.0; 95% confidence interval [CI] 1.5-67.4), taking into account any prior, less severe AMS event, which was also a potent risk factor (OR 33.3; 95% CI 2.8-390). Smoking intensity (cigarettes per day) and exhaled CO were also statistically significantly associated with severe AMS. Cigarette smoking is a strong, previously under-appreciated risk factor for severe AMS. Because this is a modifiable factor, these findings suggest that workplace-based smoking cessation should be tested as an intervention to prevent such morbidity. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.