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.

“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

Smoking rate and periodontal disease prevalence: 40-year trends in Sweden 1970-2010.

PubMed

Bergstrom, Jan

2014-10-01

To investigate the relationship between smoking rate and periodontal disease prevalence in Sweden. National smoking rates were found from Swedish National Statistics on smoking habits. Based on smoking rates for the years 1970-2010, periodontal disease prevalence estimates were calculated for the age bracket 40-70 years and smoking-associated relative risks between 2.0 and 20.0. The impact of smoking on the population was estimated according to the concept of population attributable fraction. The age-standardized smoking rate in Sweden declined from 44% in 1970 to 15% in 2010. In parallel with the smoking decline the calculated prevalence estimate of periodontal disease dropped from 26% to 12% assuming a 10-fold smoking-associated relative risk. Even at more moderate magnitudes of the relative risk, e.g. 2-fold or 5-fold, the prevalence decrease was quite tangible, suggesting that the current prevalence in Sweden is about 20-50% of the level 40 years ago. The population attributable fraction, estimating the portion of the disease that would have been avoided in the absence of smoking, was 80% in 1970 and 58% in 2010 at a ten-fold relative risk. Calculated estimates of periodontal disease prevalence are closely related to real changes in smoking rate. As smoking rate drops periodontal disease prevalence will drop. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The prevalence of and factors associated with tobacco smoking behavior among long-distance drivers in Lagos, Nigeria.

PubMed

Ozoh, Obianuju B; Akanbi, Maxwell O; Amadi, Casmir E; Vollmer, William; Bruce, Nigel

2017-09-01

Factors associated with tobacco smoking are useful in designing tobacco control programs. To estimate the prevalence of and factors associated with tobacco smoking among long-distance drivers. This was a cross-sectional study. Stratified cluster sampling approach was used to select drivers based on if they received annual health screening (AHS) or not (non AHS). We used a structured questionnaire to obtain information and weighted the resulting observations to derive population based estimates. Association between tobacco smoking and socio-demographic factors was explored in multivariate models. 414 male drivers, mean age 43.6 (standard error 0.6) years. Population weighted prevalence of current smoking was 18.9% (95% CI: 14.3-23.4) of all drivers, 6.5% (95% CI: 2.6-10.4) of AHS drivers and 19.5 (95% CI: 14.7-24.2) of non AHS drivers (p<0.001). In multivariate models, having close friends that smoked (OR= 6.36, 95% CI= 2.49 - 16.20) cargo driving (OR= 2.58, 95% CI= 1.29 - 5.15) and lower education levels (OR for post-secondary education vs. primary education or less= 0.17, 95% CI= 0.04 - 0.81) were associated with current smoking. Prevalence of tobacco smoking is higher among non AHS compared to AHS drivers. Having close friends that smoked, cargo driving, and lower education levels were associated with current smoking.

Smoking behaviors and intentions among current e-cigarette users, cigarette smokers, and dual users: A national survey of U.S. high school seniors.

PubMed

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

2017-06-01

E-cigarette use among adolescents has increased significantly in recent years, but it remains unclear whether cigarette smoking behaviors and intentions for future cigarette smoking 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 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 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, intentions for future cigarette smoking, 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 intentions for future cigarette smoking in the next 5years (AOR=2.57, 95% CI: 1.21-5.24) than current non-users. Dual users and only cigarette smokers had higher odds of cigarette smoking behaviors and intentions for future cigarette smoking than non-users or only e-cigarette users. Adolescents who engage in current dual use have cigarette smoking behaviors and intentions for future cigarette smoking that more closely resemble cigarette smokers than e-cigarette users. Adolescents who only use e-cigarettes have higher intentions to engage in future cigarette smoking relative to their peers who do not engage in e-cigarette use or cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

The role of education in the production of health: an empirical analysis of smoking behavior.

PubMed

Tenn, Steven; Herman, Douglas A; Wendling, Brett

2010-05-01

We estimate the effect of education on smoking. Our estimation strategy "differences out" the impact of unobserved characteristics correlated with education by exploiting education differences between similarly selected groups 1 year apart in their life cycle. Individuals with a given age, education, and student status in the current and previous year are compared to their counterparts born 1 year later with the same age, education, and student status in the following and current year. We find that an additional year of education does not have a causal effect on smoking. Unobserved factors correlated with education entirely explain their cross-sectional relationship.

Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries.

PubMed

Kostova, Deliana; Ross, Hana; Blecher, Evan; Markowitz, Sara

2011-11-01

To estimate the price elasticity of cigarette demand among youth in low- and middle-income countries (LMIC). The Global Youth Tobacco Survey was used to obtain data on the smoking behaviour of 315,353 adolescents from 17 LMIC. Two-part model of cigarette demand with country fixed effects. The first part estimates the impact of prices on smoking participation while the second part estimates the impact of prices on the number of cigarettes smoked among current smokers. Besides controlling for individual characteristics such as Age, Gender, Parental Smoking and availability of Pocket Money, the authors control for confounding environmental factors such as anti-smoking sentiment, the prevalence of cigarette advertising and anti-tobacco media messAges, and ease of purchasing cigarettes. All countries in this study are represented with at least two observations over time, which allows us to control for unobserved country characteristics and/or policies that may influence smoking patterns within countries. Cigarette price is an important determinant of smoking. The estimated price elasticity of smoking participation is -0.74, and the estimated price elasticity of conditional cigarette demand is approximately -1.37. The total price elasticity of cigarette demand is -2.11, implying that an increase in price of 10% would reduce youth cigarette consumption by 21.1% at the mean.

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

The Effect of the California Tobacco Control Program on Smoking Prevalence, Cigarette Consumption, and Healthcare Costs: 1989–2008

PubMed Central

Lightwood, James; Glantz, Stanton A.

2013-01-01

Background Previous research has shown that tobacco control funding in California has reduced per capita cigarette consumption and per capita healthcare expenditures. This paper refines our earlier model by estimating the effect of California tobacco control funding on current smoking prevalence and cigarette consumption per smoker and the effect of prevalence and consumption on per capita healthcare expenditures. The results are used to calculate new estimates of the effect of the California Tobacco Program. Methodology/Principal Findings Using state-specific aggregate data, current smoking prevalence and cigarette consumption per smoker are modeled as functions of cumulative California and control states' per capita tobacco control funding, cigarette price, and per capita income. Per capita healthcare expenditures are modeled as a function of prevalence of current smoking, cigarette consumption per smoker, and per capita income. One additional dollar of cumulative per capita tobacco control funding is associated with reduction in current smoking prevalence of 0.0497 (SE.00347) percentage points and current smoker cigarette consumption of 1.39 (SE.132) packs per smoker per year. Reductions of one percentage point in current smoking prevalence and one pack smoked per smoker are associated with $35.4 (SE $9.85) and $3.14 (SE.786) reductions in per capita healthcare expenditure, respectively (2010 dollars), using the National Income and Product Accounts (NIPA) measure of healthcare spending. Conclusions/Significance Between FY 1989 and 2008 the California Tobacco Program cost $2.4 billion and led to cumulative NIPA healthcare expenditure savings of $134 (SE $30.5) billion. PMID:23418411

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.

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.

Prevalence and psychosocial correlates of current smoking among adolescent students in Thailand, 2005.

PubMed

McKnight-Eily, Lela; Arrazola, René; Merritt, Robert; Malarcher, Ann; Sirichotiratana, Nithat

2010-12-01

This article examines the prevalence of current smoking and associated psychosocial correlates and whether these correlates differ by sex among adolescent students in Thailand. Data were analyzed from the Thailand Global Youth Tobacco Survey (GYTS), a school-based, cross-sectional survey conducted in 2005 and completed by Mathayom 1, 2, and 3 (U.S. seventh through ninth grades) students. Weighted prevalence estimates of the percentage of students who were current smokers (smoked on ≥ 1 day during the past 30 days) and noncurrent smokers were calculated for the sample and for each psychosocial variable. Separate logistic regression models were calculated for males and females to examine the independent association of the psychosocial correlates of current smoking. Significant correlates for both males and females included close peer smoking, secondhand smoke exposure, being offered a free cigarette by a tobacco industry representative, and belief that smoking is not harmful. These correlates are examined in the context of comprehensive tobacco control laws in Thailand.

Reduction of risk of dying from tobacco-related diseases after quitting smoking in Italy.

PubMed

Carreras, Giulia; Pistelli, Francesco; Falcone, Franco; Carrozzi, Laura; Martini, Andrea; Viegi, Giovanni; Gorini, Giuseppe

2015-01-01

The aims of this paper are to compute the risks of dying of ischemic heart disease (IHD), lung cancer (LC), stroke, and chronic obstructive pulmonary disease (COPD) for Italian smokers by gender, age and daily number of cigarettes smoked, and to estimate the benefit of stopping smoking in terms of risk reduction. Life tables by sex and smoking status were computed for each smoking-related disease based on Italian smoking data, and risk charts with 10-year probabilities of death were computed for never, current and former smokers. Men aged 45-49 years, current smokers, have a 8, 10, 3 and 1 in 1,000 chance of dying of IHD, LC, stroke and COPD, respectively, whereas women with the same characteristics have a 2, 6, 3 and 1 in 1,000 chance, respectively, for all smokers combined, i.e., independent of the smoking intensity. The risk reduction rates from quitting smoking are remarkable: a man who quits smoking at 45-49 years can reduce the risk of dying of IHD, LC, stroke and COPD in the next 10 years by 43%, 53%, 57% and 55%, respectively; a woman by 49%, 49%, 59% and 57%, respectively. Estimates of risk reduction by quitting smoking are useful to provide a sounder scientific basis for public health messages and clinical advice.

Smokers and non smokers with rheumatoid arthritis have similar clinical status: data from the multinational QUEST-RA database.

PubMed

Naranjo, A; Toloza, S; Guimaraes da Silveira, I; Lazovskis, J; Hetland, M L; Hamoud, H; Peets, T; Mäkinen, H; Gossec, L; Herborn, G; Skopouli, F N; Rojkovich, B; Aggarwal, A; Minnock, P; Cazzato, M; Yamanaka, H; Oyoo, O; Rexhepi, S; Andersone, D; Baranauskaite, A; Hajjaj-Hassouni, N; Jacobs, J W G; Haugeberg, G; Sierakowski, S; Ionescu, R; Karateew, D; Dimic, A; Henrohn, D; Gogus, F; Badsha, H; Choy, E; Bergman, M; Sokka, T

2010-01-01

To analyse clinical severity/activity of rheumatoid arthritis (RA) according to smoking status. The QUEST-RA multinational database reviews patients for Core Data Set measures including 28 swollen and tender joint count, physician global estimate, erythrocyte sedimentation rate (ESR), HAQ-function, pain, and patient global estimate, as well as DAS28, rheumatoid factor (RF), nodules, erosions and number of DMARDs were recorded. Smoking status was assessed by self-report as 'never smoked', 'currently smoking' and 'former smokers'. Patient groups with different smoking status were compared for demographic and RA measures. Among the 7,307 patients with smoking data available, status as 'never smoked,' 'current smoker' and 'former smoker' were reported by 65%, 15% and 20%. Ever smokers were more likely to be RF-positive (OR 1.32;1.17-1.48, p<0.001). Rheumatoid nodules were more frequent in ever smokers (OR 1.41;1.24-1.59, p<0.001). The percentage of patients with erosive arthritis and extra-articular disease was similar in all smoking categories. Mean DAS28 was 4.4 (SD 1.6) in non-smokers vs. 4.0 (SD 1.6) in those who had ever smoked. However, when adjusted by age, sex, disease duration, and country gross domestic product, only ESR remained significantly different among Core Data Set measures (mean 31.7mm in non-smokers vs. 26.8mm in ever smoked category). RA patients who had ever smoked were more likely to have RF and nodules, but values for other clinical status measures were similar in all smoking categories (never smoked, current smokers and former smokers).

Estimated Budget Impact of Adopting the Affordable Care Act's Required Smoking Cessation Coverage on United States Healthcare Payers.

PubMed

Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey

2017-01-01

Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact on health plan's budgets. Pfizer Inc.

An ecological momentary intervention for smoking cessation: The associations of just-in-time, tailored messages with lapse risk factors.

PubMed

Hébert, Emily T; Stevens, Elise M; Frank, Summer G; Kendzor, Darla E; Wetter, David W; Zvolensky, Michael J; Buckner, Julia D; Businelle, Michael S

2018-03-01

Smartphone apps can provide real-time, tailored interventions for smoking cessation. The current study examines the effectiveness of a smartphone-based smoking cessation application that assessed risk for imminent smoking lapse multiple times per day and provided messages tailored to current smoking lapse risk and specific lapse triggers. Participants (N=59) recruited from a safety-net hospital smoking cessation clinic completed phone-based ecological momentary assessments (EMAs) 5 times/day for 3 consecutive weeks (1week pre-quit, 2weeks post-quit). Risk for smoking lapse was estimated in real-time using a novel weighted lapse risk estimator. With each EMA, participants received messages tailored to current level of risk for imminent smoking lapse and self-reported presence of smoking urge, stress, cigarette availability, and motivation to quit. Generalized linear mixed model analyses determined whether messages tailored to specific lapse risk factors were associated with greater reductions in these triggers than messages not tailored to specific triggers. Overall, messages tailored to smoking urge, cigarette availability, or stress corresponded with greater reductions in those triggers than messages that were not tailored to specific triggers (p's=0.02 to <0.001). Although messages tailored to stress were associated with greater reductions in stress than messages not tailored to stress, the association was non-significant (p=0.892) when only moments of high stress were included in the analysis. Mobile technology can be used to conduct real-time smoking lapse risk assessment and provide tailored treatment content. Findings provide initial evidence that tailored content may impact users' urge to smoke, stress, and cigarette availability. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort.

PubMed

Mirabelli, Maria C; Preisser, John S; Loehr, Laura R; Agarwal, Sunil K; Barr, R Graham; Couper, David J; Hankinson, John L; Hyun, Noorie; Folsom, Aaron R; London, Stephanie J

2016-04-01

Interpretation of longitudinal information about lung function decline from middle to older age has been limited by loss to follow-up that may be correlated with baseline lung function or the rate of decline. We conducted these analyses to estimate age-related decline in lung function across groups of race, sex, and smoking status while accounting for dropout from the Atherosclerosis Risk in Communities Study. We analyzed data from 13,896 black and white participants, aged 45-64 years at the 1987-1989 baseline clinical examination. Using spirometry data collected at baseline and two follow-up visits, we estimated annual population-averaged mean changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by race, sex, and smoking status using inverse-probability-weighted independence estimating equations conditioning-on-being-alive. Estimated rates of FEV1 decline estimated using inverse-probability-weighted independence estimating equations conditioning on being alive were higher among white than black participants at age 45 years (e.g., male never smokers: black: -29.5 ml/year; white: -51.9 ml/year), but higher among black than white participants by age 75 (black: -51.2 ml/year; white: -26). Observed differences by race were more pronounced among men than among women. By smoking status, FEV1 declines were larger among current than former or never smokers at age 45 across all categories of race and sex. By age 60, FEV1 decline was larger among former and never than current smokers. Estimated annual declines generated using unweighted generalized estimating equations were smaller for current smokers at younger ages in all four groups of race and sex compared with results from weighted analyses that accounted for attrition. Using methods accounting for dropout from an approximately 25-year health study, estimated rates of lung function decline varied by age, race, sex, and smoking status, with largest declines observed among current smokers at younger ages. Published by Elsevier Ltd.

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.

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.

Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh

2015-01-01

Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT) products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.

Hospital costs associated with smoking in veterans undergoing general surgery.

PubMed

Kamath, Aparna S; Vaughan Sarrazin, Mary; Vander Weg, Mark W; Cai, Xueya; Cullen, Joseph; Katz, David A

2012-06-01

Approximately 30% of patients undergoing elective general surgery smoke cigarettes. The association between smoking status and hospital costs in general surgery patients is unknown. The objectives of this study were to compare total inpatient costs in current smokers, former smokers, and never smokers undergoing general surgical procedures in Veterans Affairs (VA) hospitals; and to determine whether the relationship between smoking and cost is mediated by postoperative complications. Patients undergoing general surgery during the period of October 1, 2005 to September 30, 2006 were identified in the VA Surgical Quality Improvement Program (VASQIP) data set. Inpatient costs were extracted from the VA Decision Support System (DSS). Relative surgical costs (incurred during index hospitalization and within 30 days of operation) for current and former smokers relative to never smokers, and possible mediators of the association between smoking status and cost were estimated using generalized linear regression models. Models were adjusted for preoperative and operative variables, accounting for clustering of costs at the hospital level. Of the 14,853 general surgical patients, 34% were current smokers, 39% were former smokers, and 27% were never smokers. After controlling for patient covariates, current smokers had significantly higher costs compared with never smokers: relative cost was 1.04 (95% Cl 1.00 to 1.07; p = 0.04); relative costs for former smokers did not differ significantly from those of never smokers: 1.02 (95% Cl 0.99 to 1.06; p = 0.14). The relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications. These findings complement emerging evidence recommending effective smoking cessation programs in general surgical patients and provide an estimate of the potential savings that could be accrued during the preoperative period. Published by Elsevier Inc.

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.

Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys

PubMed Central

Sreeramareddy, Chandrashekhar T.; Pradhan, Pranil Man Singh

2015-01-01

Background Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Methods Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for ‘current smoking’ and ‘current use of smokeless tobacco (SLT) products’ among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Findings Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Conclusion Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries. PMID:26131888

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.

Cost-effectiveness of alternative smoking cessation scenarios in Spain: results from the EQUIPTMOD.

PubMed

Trapero-Bertran, Marta; Muñoz, Celia; Coyle, Kathryn; Coyle, Doug; Lester-George, Adam; Leidl, Reiner; Németh, Bertalan; Cheung, Kei-Long; Pokhrel, Subhash; Lopez-Nicolás, Ángel

2018-03-13

To assess the cost-effectiveness of alternative smoking cessation scenarios from the perspective of the Spanish National Health Service (NHS). We used the European study on Quantifying Utility of Investment in Protection from Tobacco model (EQUIPTMOD), a Markov-based state transition economic model, to estimate the return on investment (ROI) of: (a) the current provision of smoking cessation services (brief physician advice and printed self-helped material + smoking ban and tobacco duty at current levels); and (b) four alternative scenarios to complement the current provision: coverage of proactive telephone calls; nicotine replacement therapy (mono and combo) [prescription nicotine replacement therapy (Rx NRT)]; varenicline (standard duration); or bupropion. A rate of 3% was used to discount life-time costs and benefits. Spain. Adult smoking population (16+ years). Health-care costs associated with treatment of smoking attributable diseases (lung cancer, coronary heart disease, chronic obstructive pulmonary infection and stroke); intervention costs; quality-adjusted life years (QALYs). Costs and outcomes were summarized using various ROI estimates. The cost of implementing the current provision of smoking cessation services is approximately €61 million in the current year. This translates to 18 quitters per 1000 smokers and a life-time benefit-cost ratio of 5, compared with no such provision. All alternative scenarios were dominant (cost-saving: less expensive to run and generated more QALYs) from the life-time perspective, compared with the current provision. The life-time benefit-cost ratios were: 1.87 (proactive telephone calls); 1.17 (Rx NRT); 2.40 (varenicline-standard duration); and bupropion (2.18). The results remained robust in the sensitivity analysis. According to the EQUIPTMOD modelling tool it would be cost-effective for the Spanish authorities to expand the reach of existing GP brief interventions for smoking cessation, provide pro-active telephone support, and reimburse smoking cessation medication to smokers trying to stop. Such policies would more than pay for themselves in the long run. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

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.

The association of smoking status with healthcare utilisation, productivity loss and resulting costs: results from the population-based KORA F4 study.

PubMed

Wacker, Margarethe; Holle, Rolf; Heinrich, Joachim; Ladwig, Karl-Heinz; Peters, Annette; Leidl, Reiner; Menn, Petra

2013-07-17

Smoking is seen as the most important single risk to health today, and is responsible for a high financial burden on healthcare systems and society. This population-based cross-sectional study compares healthcare utilisation, direct medical costs, and costs of productivity losses for different smoking groups: current smokers, former smokers, and never smokers. Using a bottom-up approach, data were taken from the German KORA F4 study (2006/2008) on self-reported healthcare utilisation and work absence due to illness for 3,071 adults aged 32-81 years. Unit costs from a societal perspective were applied to utilisation. Utilisation and resulting costs were compared across different smoking groups using generalised linear models to adjust for age, sex, education, alcohol consumption and physical activity. Average annual total costs per survey participant were estimated as €3,844 [95% confidence interval: 3,447-4,233], and differed considerably between smoking groups with never smokers showing €3,237 [2,802-3,735] and former smokers causing €4,398 [3,796-5,058]. There was a positive effect of current and former smoking on the utilisation of healthcare services and on direct and indirect costs. Total annual costs were more than 20% higher (p<0.05) for current smokers and 35% higher (p<0.01) for former smokers compared with never smokers, which corresponds to annual excess costs of €743 and €1,108 per current and former smoker, respectively. Results indicate that excess costs for current and former smokers impose a large burden on society, and that previous top-down cost approaches produced lower estimates for the costs of care for smoking-related diseases. Efforts must be focused on prevention of smoking to achieve sustainable containment on behalf of the public interest.

Differences in Current Cigarette Smoking Between Non-Hispanic Whites and Non-Hispanic Blacks by Gender and Age Group, United States, 2001 – 2013

PubMed Central

Caraballo, Ralph S.; Sharapova, Saida; Asman, Katherine J.

2015-01-01

Introduction For years, national U.S. surveys have consistently found a lower cigarette smoking prevalence among non-Hispanic (NH) black adolescents and young adults than their NH white counterpart while finding either similar or higher smoking prevalence in NH blacks among older adults. Because these surveys do not collect biomarker information to validate smoking self-reports, we also present results from the National Health and Nutrition Examination Survey (NHANES), which collects cotinine (a nicotine biomarker) to determine if U.S. surveys consistently show racial differences in smoking prevalence. Methods We present NH black and NH white current smoking estimates in the Youth Risk Behavior Survey (2001–2013), National Youth Tobacco Survey (2004–2012), National Survey on Drug Use and Health (2002–2012), National Health Interview Survey (2001–2013), and NHANES (2001–2012). Results Using cotinine by itself or with self-reports to compare smoking prevalence between NH black and NH white males aged 12 – 25 years, no difference in current smoking was found. For male adult ≥26 years, all surveys consistently found a higher smoking prevalence among NH blacks. For females aged 12 – 25 years, all surveys found a higher smoking prevalence among NH whites. While inconsistent results across surveys were found for those aged ≥26 years, cotinine results showed a higher smoking prevalence among NH black females. Conclusion Some racial differences in self-reported smoking are not confirmed when supplemented with serum cotinine to detect current cigarette smokers. Improving the measurement of current smoking is important to accurately evaluate racial smoking differences. PMID:26980863

Smoking and caffeine consumption: a genetic analysis of their association.

PubMed

Treur, Jorien L; Taylor, Amy E; Ware, Jennifer J; Nivard, Michel G; Neale, Michael C; McMahon, George; Hottenga, Jouke-Jan; Baselmans, Bart M L; Boomsma, Dorret I; Munafò, Marcus R; Vink, Jacqueline M

2017-07-01

Smoking and caffeine consumption show a strong positive correlation, but the mechanism underlying this association is unclear. Explanations include shared genetic/environmental factors or causal effects. This study employed three methods to investigate the association between smoking and caffeine. First, bivariate genetic models were applied to data of 10 368 twins from the Netherlands Twin Register in order to estimate genetic and environmental correlations between smoking and caffeine use. Second, from the summary statistics of meta-analyses of genome-wide association studies on smoking and caffeine, the genetic correlation was calculated by LD-score regression. Third, causal effects were tested using Mendelian randomization analysis in 6605 Netherlands Twin Register participants and 5714 women from the Avon Longitudinal Study of Parents and Children. Through twin modelling, a genetic correlation of r0.47 and an environmental correlation of r0.30 were estimated between current smoking (yes/no) and coffee use (high/low). Between current smoking and total caffeine use, this was r0.44 and r0.00, respectively. LD-score regression also indicated sizeable genetic correlations between smoking and coffee use (r0.44 between smoking heaviness and cups of coffee per day, r0.28 between smoking initiation and coffee use and r0.25 between smoking persistence and coffee use). Consistent with the relatively high genetic correlations and lower environmental correlations, Mendelian randomization provided no evidence for causal effects of smoking on caffeine or vice versa. Genetic factors thus explain most of the association between smoking and caffeine consumption. These findings suggest that quitting smoking may be more difficult for heavy caffeine consumers, given their genetic susceptibility. © 2016 The Authors.Addiction Biology published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Smoking and caffeine consumption: a genetic analysis of their association

PubMed Central

Taylor, Amy E.; Ware, Jennifer J.; Nivard, Michel G.; Neale, Michael C.; McMahon, George; Hottenga, Jouke‐Jan; Baselmans, Bart M. L.; Boomsma, Dorret I.; Munafò, Marcus R.; Vink, Jacqueline M.

2016-01-01

Abstract Smoking and caffeine consumption show a strong positive correlation, but the mechanism underlying this association is unclear. Explanations include shared genetic/environmental factors or causal effects. This study employed three methods to investigate the association between smoking and caffeine. First, bivariate genetic models were applied to data of 10 368 twins from the Netherlands Twin Register in order to estimate genetic and environmental correlations between smoking and caffeine use. Second, from the summary statistics of meta‐analyses of genome‐wide association studies on smoking and caffeine, the genetic correlation was calculated by LD‐score regression. Third, causal effects were tested using Mendelian randomization analysis in 6605 Netherlands Twin Register participants and 5714 women from the Avon Longitudinal Study of Parents and Children. Through twin modelling, a genetic correlation of r0.47 and an environmental correlation of r0.30 were estimated between current smoking (yes/no) and coffee use (high/low). Between current smoking and total caffeine use, this was r0.44 and r0.00, respectively. LD‐score regression also indicated sizeable genetic correlations between smoking and coffee use (r0.44 between smoking heaviness and cups of coffee per day, r0.28 between smoking initiation and coffee use and r0.25 between smoking persistence and coffee use). Consistent with the relatively high genetic correlations and lower environmental correlations, Mendelian randomization provided no evidence for causal effects of smoking on caffeine or vice versa. Genetic factors thus explain most of the association between smoking and caffeine consumption. These findings suggest that quitting smoking may be more difficult for heavy caffeine consumers, given their genetic susceptibility. PMID:27027469

Tobacco Retail Environments and Social Inequalities in Individual-Level Smoking and Cessation Among Scottish Adults.

PubMed

Pearce, Jamie; Rind, Esther; Shortt, Niamh; Tisch, Catherine; Mitchell, Richard

2016-02-01

Many neighborhood characteristics may constrain or enable smoking. This study investigated whether the neighborhood tobacco retail environment was associated with individual-level smoking and cessation in Scottish adults, and whether inequalities in smoking status were related to tobacco retailing. Tobacco outlet density measures were developed for neighborhoods across Scotland using the September 2012 Scottish Tobacco Retailers Register. The outlet data were cleaned and geocoded (n = 10,161) using a Geographic Information System. Kernel density estimation was used to calculate an outlet density measure for each postcode. The kernel density estimation measures were then appended to data on individuals included in the 2008-2011 Scottish Health Surveys (n = 28,751 adults aged ≥16), via their postcode. Two-level logistic regression models examined whether neighborhood density of tobacco retailing was associated with current smoking status and smoking cessation and whether there were differences in the relationship between household income and smoking status, by tobacco outlet density. After adjustment for individual- and area-level confounders, compared to residents of areas with the lowest outlet densities, those living in areas with the highest outlet densities had a 6% higher chance of being a current smoker, and a 5% lower chance of being an ex-smoker. There was little evidence to suggest that inequalities in either current smoking or cessation were narrower in areas with lower availability of tobacco retailing. The findings suggest that residents of environments with a greater availability of tobacco outlets are more likely to start and/or sustain smoking, and less likely to quit. © 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 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.

What proportion of cancer deaths in the contemporary United States is attributable to cigarette smoking?

PubMed

Jacobs, Eric J; Newton, Christina C; Carter, Brian D; Feskanich, Diane; Freedman, Neal D; Prentice, Ross L; Flanders, W Dana

2015-03-01

The proportion of cancer deaths in the contemporary United States caused by cigarette smoking (the population attributable fraction [PAF]) is not well documented. The PAF of all cancer deaths due to active cigarette smoking among adults 35 years and older in the United States in 2010 was calculated using age- and sex-specific smoking prevalence from the National Health Interview Survey (NHIS) and age- and sex-specific relative risks from the Cancer Prevention Study-II (for ages 35-54 years) and from the Pooled Contemporary Cohort data set (for ages 55 years and older). The PAF for active cigarette smoking was 28.7% when estimated conservatively, including only deaths from the 12 cancers currently formally established as caused by smoking by the US Surgeon General. The PAF was 31.7% when estimated more comprehensively, including excess deaths from all cancers. These estimates do not include additional potential cancer deaths from environmental tobacco smoke or other type of tobacco use such as cigars, pipes, or smokeless tobacco. Cigarette smoking causes a large proportion of cancer deaths in the contemporary United States. Reducing smoking prevalence as rapidly as possible should be a top priority for the US public health efforts to prevent cancer deaths. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Cigarette Smoking among US- and Foreign-Born European and Arab American Non-Hispanic White Men and Women.

PubMed

Kindratt, Tiffany B; Dallo, Florence J; Roddy, Juliette

2018-03-09

Using 15 years (2000-2014) of restricted cross-sectional National Health Interview Survey data (n = 276,914), we estimated and compared the age-adjusted and sex-specific prevalence of cigarette smoking between US- and foreign-born Europeans and Arab Americans and examined associations between ethnicity and current smoking. Arab Americans were categorized as non-Hispanic Whites born in 15 countries located in the Middle East. Current smoking, average cigarettes per day, and quit attempts were compared. Collectively, we found that current smoking was highest among males compared to females. Prevalence was highest among Arab American males (26%) compared to other US-born (24%) and foreign-born European males (21%). US-born males smoked more cigarettes per day (20.2) yet more Arab American males (61%) tried to quit in the last year compared to European (41%) and US-born (42%) counterparts. Arab American females were least likely to smoke compared to other groups. In crude analyses, Arab American males had greater odds (OR = 1.33; 95% CI = 1.02, 1.74) of smoking compared to US-born White males. After adjusting for demographics, socioeconomic status, health insurance, comorbidity, and acculturation effects, Arab American males had lower odds (OR = 0.64; 95% CI = 0.46, 0.88) of current smoking compared to US-born males. Arab American females had lower odds (OR = 0.28; 95% CI = 0.15, 0.53) of current smoking compared to US-born White females. This is the first national study to examine smoking among Arab Americans. Our study was limited to cigarette smoking behaviors as opposed to other forms of tobacco consumption. More studies are needed to explore smoking among US- and foreign-born Europeans and Arab Americans.

Smoking characteristics of Polish immigrants in Dublin.

PubMed

Kabir, Zubair; Clarke, Vanessa; Keogan, Sheila; Currie, Laura M; Zatonski, Witold; Clancy, Luke

2008-12-31

This study examined two main hypotheses: a) Polish immigrants' smoking estimates are greater than their Irish counterparts (b) Polish immigrants purchasing cigarettes from Poland smoke "heavier" (>/= 20 cigarettes a day) when compared to those purchasing cigarettes from Ireland. The study also set out to identify significant predictors of 'current' smoking (some days and everyday) among the Polish immigrants. Dublin residents of Polish origin (n = 1,545) completed a previously validated Polish questionnaire in response to an advertisement in a local Polish lifestyle magazine over 5 weekends (July-August, 2007). The Office of Tobacco Control telephone-based monthly survey data were analyzed for the Irish population in Dublin for the same period (n = 484). Age-sex adjusted smoking estimates were: 47.6% (95% Confidence Interval [CI]: 47.3%; 48.0%) among the Poles and 27.8% (95% CI: 27.2%; 28.4%) among the general Irish population (p < 0.001). Of the 57% of smokers (n = 345/606) who purchased cigarettes solely from Poland and the 33% (n = 198/606) who purchased only from Ireland, 42.6% (n = 147/345) and 41.4% (n = 82/198) were "heavy" smokers, respectively (p = 0.79). Employment (Odds Ratio [OR]: 2.89; 95% CI: 1.25-6.69), lower education (OR: 3.76; 95%CI: 2.46-5.74), and a longer stay in Ireland (>24 months) were significant predictors of current smoking among the Poles. An objective validation of the self-reported smoking history of a randomly selected sub-sample immigrant group, using expired carbon monoxide (CO) measurements, showed a highly significant correlation coefficient (r = 0.64) of expired CO levels with the reported number of cigarettes consumed (p < 0.0001). Polish immigrants' smoking estimates are higher than their Irish counterparts, and particularly if employed, with only primary-level education, and are overseas >2 years.

Intercomparison of Fire Size, Fuel Loading, Fuel Consumption, and Smoke Emissions Estimates on the 2006 Tripod Fire, Washington, USA

Treesearch

Stacy A. Drury; Narasimhan Larkin; Tara T. Strand; ShihMing Huang; Scott J. Strenfel; Theresa E. O' Brien; Sean M. Raffuse

2014-01-01

Land managers rely on prescribed burning and naturally ignited wildfires for ecosystem management, and must balance trade-offs of air quality, carbon storage, and ecosystem health. A current challenge for land managers when using fire for ecosystem management is managing smoke production. Smoke emissions are a potential human health hazard due to the production of fine...

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.

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

Perceived discrimination and smoking among rural-to-urban migrant women in China.

PubMed

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

2013-02-01

Smoking may be a coping mechanism for psychosocial stress caused by discrimination. We conducted a cross-sectional survey of rural-to-urban migrant women working as restaurant/hotel workers (RHWs) and those working as sex workers (FSWs) in 10 Chinese cities to investigate whether perceived discrimination is associated with smoking. We interviewed RHWs at medical examination clinics and FSWs at entertainment venues. Modified Poisson regression was used to estimate prevalence ratios. Of the 1,696 RHWs and 532 FSWs enrolled, 155 (9.1%) and 63 (11.8%) reported perceived discrimination, respectively. Perceived discrimination was independently associated with ever tried smoking (prevalence ratio [PR], 1.71; 95% confidence interval [CI], 1.31-2.23) and current smoking (PR, 2.52; 95% CI, 1.32-4.79) among RHWs and ever tried smoking (PR, 1.36; 95% CI, 1.16-1.61) and current smoking (PR, 1.63; 95% CI, 1.28-2.06) among FSWs. Perceived discrimination is associated with higher prevalence of smoking among rural-to-urban migrant women in China.

Determinants of exposure to second-hand tobacco smoke (SHS) among current non-smoking in-school adolescents (aged 11-18 years) in South Africa: results from the 2008 GYTS study.

PubMed

Peltzer, Karl

2011-09-01

The aim of this study was to estimate the prevalence and identify correlates of second-hand tobacco smoke (SHS) among 6,412 current non-smoking school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey. Overall, 25.7% of students were exposed to SHS at home, 34.2% outside of the home and 18.3% were exposed to SHS at home and outside of the home. Parental and close friends smoking status, allowing someone to smoke around you and perception that passive smoking was harmful were significant determinants of adolescent's exposure to both SHS at home and outside of the home. Identified factors can inform the implementation of public health interventions in order to reduce passive smoking among adolescents.

Smoking Behavior and Healthcare Expenditure in the United States, 1992–2009: Panel Data Estimates

PubMed Central

Lightwood, James; Glantz, Stanton A.

2016-01-01

Background Reductions in smoking in Arizona and California have been shown to be associated with reduced per capita healthcare expenditures in these states compared to control populations in the rest of the US. This paper extends that analysis to all states and estimates changes in healthcare expenditure attributable to changes in aggregate measures of smoking behavior in all states. Methods and Findings State per capita healthcare expenditure is modeled as a function of current smoking prevalence, mean cigarette consumption per smoker, other demographic and economic factors, and cross-sectional time trends using a fixed effects panel data regression on annual time series data for each the 50 states and the District of Columbia for the years 1992 through 2009. We found that 1% relative reductions in current smoking prevalence and mean packs smoked per current smoker are associated with 0.118% (standard error [SE] 0.0259%, p < 0.001) and 0.108% (SE 0.0253%, p < 0.001) reductions in per capita healthcare expenditure (elasticities). The results of this study are subject to the limitations of analysis of aggregate observational data, particularly that a study of this nature that uses aggregate data and a relatively small sample size cannot, by itself, establish a causal connection between smoking behavior and healthcare costs. Historical regional variations in smoking behavior (including those due to the effects of state tobacco control programs, smoking restrictions, and differences in taxation) are associated with substantial differences in per capita healthcare expenditures across the United States. Those regions (and the states in them) that have lower smoking have substantially lower medical costs. Likewise, those that have higher smoking have higher medical costs. Sensitivity analysis confirmed that these results are robust. Conclusions Changes in healthcare expenditure appear quickly after changes in smoking behavior. A 10% relative drop in smoking in every state is predicted to be followed by an expected $63 billion reduction (in 2012 US dollars) in healthcare expenditure the next year. State and national policies that reduce smoking should be part of short term healthcare cost containment. PMID:27163933

Prevalence and concordance of smoking among mothers and fathers within the Pacific Islands Families Study.

PubMed

Tautolo, El-Shadan; Schluter, Philip J; Taylor, Steve

2011-09-01

Cigarette smoking continues to contribute to the adverse mortality and morbidity rates for Pacific people in New Zealand. Using a large cohort study of Pacific families, this paper investigates the prevalence of smoking amongst Pacific mothers and fathers over three time-points, up to six years after the arrival of their child, to determine the concordance of both partners' reports of that smoking. Moreover, the patterns of smoking between partners were investigated over the three major Pacific ethnicities that reside in New Zealand (Samoan, Tongan and Cook Island Māori). Maternal self-report prevalence of smoking estimates ranged from 29.8% (1-year) to 33.6% (6-years). Paternal self-reported prevalence of smoking estimates were higher, and ranged from 37.9% (2-years) to 45.2% (6-years). The prevalence estimates for smoking in both mothers and fathers over all three measurement waves were higher than the 26.9% reported for Pacific people in the 2006/07 New Zealand Health Survey. No significant change in fathers' smoking prevalence over time was observed (p = 0.37); however a significant increase in mothers' smoking prevalence over time was noted (p = 0.002). Significantly, for about 25% of Pacific children both their parents were current smokers. Reducing infant exposure to tobacco smoke, by encouraging parents to quit smoking or banning smoking in the home and local environment (such as vehicles), is likely to bring about improved health outcomes for many Pacific children. Findings suggest that the interaction between parents should be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation.

Associations of advertisement-promotion-sponsorship-related factors with current cigarette smoking among in-school adolescents in Zambia.

PubMed

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

2009-01-01

Tobacco use is the leading cause of noncommunicable disease morbidity and mortality. Most smokers initiate the smoking habit as adolescents or young adults. Survey data from the 2007 Lusaka (Zambia) Global Youth Tobacco Survey were used to estimate the prevalence of current cigarette smoking and assess whether exposure to pro-tobacco media and perception of the potential harm of secondhand smoke are associated with adolescents' smoking. Logistic regression analysis was used to estimate the associations. Altogether, 2378 students, of whom 56.8% were females, participated in the study. Overall, 10.5% of the students (9.3% among males and 12.1% among females) smoked cigarettes in the 30 days prior to the survey. Students who favored banning smoking in public places were 33% (OR = 0.67; 95% CI [0.47, 0.96]) less likely to smoke cigarettes compared to those who were not in favor of the ban. Seeing actors smoking in TV shows, videos or movies was positively associated with smoking (OR = 1.90; 95% CI [1.26, 2.88]). However, possessing an item with a cigarette brand logo on it, seeing advertisements of cigarettes on billboards and being ever offered a free cigarette by a cigarette sales representative were negatively associated with smoking (OR=0.39, 95% CI [0.26, 0.58]; OR=0.63, 95% CI [0.43, 0.92]; and OR=0.43, 95% CI [0.29, 0.65], respectively). Findings from this study indicate that TV advertisement-promotion-sponsorship was positively associated with smoking, while it was the opposite with other forms of advertisement; there is a need for further studies.

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.

Smoking habits and nicotine dependence of North Korean male defectors.

PubMed

Kim, Sei Won; Lee, Jong Min; Ban, Woo Ho; Park, Chan Kwon; Yoon, Hyoung Kyu; Lee, Sang Haak

2016-07-01

The smoking rates and patterns in the North Korean population are not well known. More than 20,000 North Korean defectors have settled in South Korea; thus, we can estimate the current North Korean smoking situation using this group. All North Korean defectors spend their first 3 months in a South Korean facility learning to adapt to their new home. We retrospectively analyzed the results from a questionnaire conducted among North Korean male defectors in this facility from August 2012 to February 2014. Of 272 men, 84.2% were current smokers, 12.5% were ex-smokers, and 3.3% were non-smokers. The mean age of this group was 35.9 ± 11.3 years, and smoking initiation occurred at a mean age of 18.2 ± 4.7 years. Among the subjects, 78.1% had a family member who smoked. Of the 221 current smokers, 67.4% responded that they intended to quit smoking. Fagerström test and Kano test for social nicotine dependence (KTSND) results for current smokers were 3.35 ± 2.26 and 13.76 ± 4.87, respectively. Question 9 on the KTSND (doctors exaggerate the ill effects of smoking) earned a significantly higher score relative to the other questions and a significantly higher score in current smokers compared with non-smokers. The smoking rate in North Korean male defectors was higher than that indicated previously. However, interest in smoking cessation was high and nicotine dependence was less severe than expected. Further investigation is needed to identify an efficient method for North Korean smokers to stop smoking.

Gender Differences in Smoking Among U.S. Working Adults

PubMed Central

Syamlal, Girija; Mazurek, Jacek M.; Dube, Shanta R.

2015-01-01

Background Cigarette smoking remains a leading cause of morbidity and mortality. Although gender differences in cigarette smoking in the U.S. population have been documented, information on these differences among working adults is limited. Purpose To describe the current smoking prevalence by gender among working U.S. adults and examine gender differences in smoking by occupation. Methods The 2004–2011 National Health Interview Survey data for adults aged ≥18 years that were working in the week prior to the interview (N=132,215) were analyzed in 2013. Current cigarette smokers were those who smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days. Results During 2004–2011, an estimated 22.8% of men workers and 18.3% of women workers were current smokers. Of the current smokers, women workers had higher odds of being an everyday smoker (prevalence OR [POR]=1.17, 95% CI=1.09, 1.26); having poor self-rated emotional health (POR=1.28, 95% CI=1.15, 1.41); and having chronic obstructive pulmonary disease (POR=2.45, 95% CI=2.14, 2.80), heart disease (POR=1.27, 95% CI=1.12, 1.45), and current asthma (POR=2.21, 95% CI=1.96, 2.49) compared with men workers. Women in “supervisors, construction, and extraction” (38.9%) occupations and men in “extraction” (40.5%) occupations had the highest smoking prevalence. Conclusion Among working adults, women had lower prevalence of smoking than men, yet women who smoke were more likely than men to have adverse health outcomes, including self-rated poorer physical and emotional health. PMID:25049215

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.

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

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.

Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes.

PubMed

Peters, Sanne A E; Huxley, Rachel R; Woodward, Mark

2013-10-01

It is currently unknown whether the excess risk of stroke by smoking is the same for women and men. We performed a systematic review and meta-analysis to estimate the effect of smoking on stroke in women compared with men. PubMed MEDLINE was systematically searched for prospective population-based cohort studies published between January 1, 1966, and January 26, 2013. Studies that presented sex-specific estimates of the relative risk of stroke comparing current smoking with nonsmoking and its associated variability were selected. The sex-specific relative risks and their ratio (RRR), comparing women with men, were pooled using random-effects meta-analysis with inverse variance weighting. Similarly, the RRR for former versus never smoking was pooled. Data from 81 prospective cohort studies that included 3,980,359 individuals and 42,401 strokes were available. Smoking was an independent risk factor for stroke in both sexes. Overall, the pooled multiple-adjusted RRR indicated a similar risk of stroke associated with smoking in women compared with men (RRR, 1.06 [95% confidence interval, 0.99-1.13]). In a regional analysis, there was evidence of a more harmful effect of smoking in women than in men in Western (RRR, 1.10 [1.02-1.18)] but not in Asian (RRR, 0.97 [0.87-1.09]) populations. Compared with never-smokers, the beneficial effects of quitting smoking among former smokers on stroke risk were similar between the sexes (RRR, 1.10 [0.99-1.22]). Compared with nonsmokers, the excess risk of stroke is at least as great among women who smoke compared with men who smoke.

What proportion of people who try one cigarette become daily smokers? A meta analysis of representative surveys.

PubMed

Birge, Max; Duffy, Stephen; Miler, Joanna Astrid; Hajek, Peter

2017-11-04

The 'conversion rate' from initial experimentation to daily smoking is a potentially important metric of smoking behavior, but estimates of it based on current representative data are lacking. The Global Health Data Exchange was searched for representative surveys conducted in English speaking, developed countries after year 2000 that included questions about ever trying a cigarette and ever smoking daily. The initial search identified 2776 surveys that were further screened for language, location, year, sample size, survey structure and representativeness. 44 surveys that passed the screening process were accessed and their codebooks were examined to see whether the two questions of interest were included. Eight datasets allowed extraction or estimation of relevant information. Survey quality was assessed with regards to response rates, sampling methods and data collection procedures. PRISMA guidelines were followed, with explicit rules for approaching derived variables and skip patterns. Proportions were pooled using random effects meta-analysis. The eight surveys used representative samples of the general adult population. Response rates varied from 45% to 88%. Survey methods were on par with the best practice in this field. Altogether 216,314 respondents were included of whom 60.3% (95%CI 51.3-69.3) ever tried a cigarette. Among those, 68.9% (95% CI 60.9-76.9%) progressed to daily smoking. Over two thirds of people who try one cigarette become, at least temporarily, daily smokers. The finding provides strong support for the current efforts to reduce cigarette experimentation among adolescents. The transition from trying the first cigarette through occasional to daily smoking usually implies that a recreational activity is turning into a compulsive need that has to be satisfied virtually continuously. The 'conversion rate' from initial experimentation to daily smoking is thus a potentially important metric of smoking behavior, but estimates of it based on representative data are lacking. The present meta analysis addressed this gap. Currently, about two thirds of non-smokers experimenting with cigarettes progress to daily smoking. The finding supports strongly the current efforts to reduce cigarette experimentation among adolescents. © 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.

Indirectly estimated absolute lung cancer mortality rates by smoking status and histological type based on a systematic review

PubMed Central

2013-01-01

Background National smoking-specific lung cancer mortality rates are unavailable, and studies presenting estimates are limited, particularly by histology. This hinders interpretation. We attempted to rectify this by deriving estimates indirectly, combining data from national rates and epidemiological studies. Methods We estimated study-specific absolute mortality rates and variances by histology and smoking habit (never/ever/current/former) based on relative risk estimates derived from studies published in the 20th century, coupled with WHO mortality data for age 70–74 for the relevant country and period. Studies with populations grossly unrepresentative nationally were excluded. 70–74 was chosen based on analyses of large cohort studies presenting rates by smoking and age. Variations by sex, period and region were assessed by meta-analysis and meta-regression. Results 148 studies provided estimates (Europe 59, America 54, China 22, other Asia 13), 54 providing estimates by histology (squamous cell carcinoma, adenocarcinoma). For all smoking habits and lung cancer types, mortality rates were higher in males, the excess less evident for never smokers. Never smoker rates were clearly highest in China, and showed some increasing time trend, particularly for adenocarcinoma. Ever smoker rates were higher in parts of Europe and America than in China, with the time trend very clear, especially for adenocarcinoma. Variations by time trend and continent were clear for current smokers (rates being higher in Europe and America than Asia), but less clear for former smokers. Models involving continent and trend explained much variability, but non-linearity was sometimes seen (with rates lower in 1991–99 than 1981–90), and there was regional variation within continent (with rates in Europe often high in UK and low in Scandinavia, and higher in North than South America). Conclusions The indirect method may be questioned, because of variations in definition of smoking and lung cancer type in the epidemiological database, changes over time in diagnosis of lung cancer types, lack of national representativeness of some studies, and regional variation in smoking misclassification. However, the results seem consistent with the literature, and provide additional information on variability by time and region, including evidence of a rise in never smoker adenocarcinoma rates relative to squamous cell carcinoma rates. PMID:23570286

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

Cigarette smoking in Chinese adolescents: importance of controlling the amount of pocket money.

PubMed

Ma, J; Zhu, J; Li, N; He, Y; Cai, Y; Qiao, Y; Redmon, P; Wang, Z

2013-07-01

To estimate the proportion of smokers that could potentially have been prevented from smoking by limiting the amount of pocket money received by Chinese adolescents. Cross-sectional study. Current smoking, ever smoking and the amount of pocket money were determined through self-administered questionnaires among 12,708 adolescents (aged 12-18 years) from 21 schools in Shanghai, China. Adjusted odds ratios for current smoking ranged from 2.0 [95% confidence interval (CI) 1.5-2.7] for adolescents receiving 200-399 Reminbin (RMB)/month as pocket money to 6.5 (95% CI 3.3-12.7) for those receiving ≥1000 RMB/month, compared with those receiving <200 RMB/month. The crude population-attributable risk percentage (PAR%) due to higher pocket money (≥200 RMB/month) for current smoking was 50.4% (95% CI 42.2-57.4), and adjusted PAR% was 43.3% (95% CI 30.7-53.1). Approximately half of current smokers may have been prevented from smoking if pocket money was limited to <200 RMB/month among Chinese adolescents. An even larger proportion could have been prevented from smoking if pocket money was reduced further. It is recommended that future intervention programmes should target parents to reduce the amount of pocket money in China. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

Natural radionuclides in cigarette tobacco from Serbian market and effective dose estimate from smoke inhalation.

PubMed

Janković Mandić, Ljiljana; Đolić, Maja; Marković, Dragana; Todorović, Dragana; Onjia, Antonije; Dragović, Snežana

2016-01-01

The activity concentrations of natural radionuclides ((40)K, (210)Pb, (210)Po, (226)Ra and (228)Ra) in 17 most frequently used cigarette brands in Serbia and corresponding effective doses due to smoke inhalation are presented. The mean annual effective doses for (210)Pb and (210)Po were estimated to be 47.3 and 724 µSv y(-1) for (210)Pb and (210)Po, respectively. Serbia currently has the highest smoking rate in the world. The results of this study indicate the high contribution of the annual effective dose due to smoke inhalation to the total inhalation dose from natural radionuclides. The more effective implementation of actions for reducing smoking prevalence in Serbia is highly needed. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

Smoking habits and nicotine dependence of North Korean male defectors

PubMed Central

Kim, Sei Won; Lee, Jong Min; Ban, Woo Ho; Park, Chan Kwon; Yoon, Hyoung Kyu; Lee, Sang Haak

2016-01-01

Background/Aims: The smoking rates and patterns in the North Korean population are not well known. More than 20,000 North Korean defectors have settled in South Korea; thus, we can estimate the current North Korean smoking situation using this group. Methods: All North Korean defectors spend their first 3 months in a South Korean facility learning to adapt to their new home. We retrospectively analyzed the results from a questionnaire conducted among North Korean male defectors in this facility from August 2012 to February 2014. Results: Of 272 men, 84.2% were current smokers, 12.5% were ex-smokers, and 3.3% were non-smokers. The mean age of this group was 35.9 ± 11.3 years, and smoking initiation occurred at a mean age of 18.2 ± 4.7 years. Among the subjects, 78.1% had a family member who smoked. Of the 221 current smokers, 67.4% responded that they intended to quit smoking. Fagerström test and Kano test for social nicotine dependence (KTSND) results for current smokers were 3.35 ± 2.26 and 13.76 ± 4.87, respectively. Question 9 on the KTSND (doctors exaggerate the ill effects of smoking) earned a significantly higher score relative to the other questions and a significantly higher score in current smokers compared with non-smokers. Conclusions: The smoking rate in North Korean male defectors was higher than that indicated previously. However, interest in smoking cessation was high and nicotine dependence was less severe than expected. Further investigation is needed to identify an efficient method for North Korean smokers to stop smoking. PMID:26951917

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

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

Smoking, activity level and exercise test outcomes in a young population sample without cardiopulmonary disease.

PubMed

Vozoris, N T; O'donnell, D E

2015-01-01

Whether reduced activity level and exercise intolerance precede the clinical diagnosis of cardiopulmonary disorders in smokers is not known. We examined activity level and exercise test outcomes in a young population-based sample without overt cardiopulmonary disease, differentiating by smoking history. This was a multiyear cross-sectional study using United States National Health and Nutrition Examination Survey data from 1999-2004. Self-reported activity level and incremental exercise treadmill testing were obtained on survey participants ages 20-49 years, excluding individuals with cardio-pulmonary disease. Three thousand seven hundred and one individuals completed exercise testing. Compared to never smokers, current smokers with >10 pack years reported significantly higher odds of little or no recreation, sport, or physical activity (adjusted OR 1.62; 95% CI 1.12-2.35). Mean perceived exertion ratings (Borg 6-20) at an estimated standardized workload were significantly greater among current smokers (18.3-18.6) compared to never (17.3) and former smokers (17.9) (p<0.05). There were no significant differences in the proportions of individuals across estimated peak oxygen uptake categories among the groups after adjusting for age and sex. Among former smokers, increasing duration of smoking abstinence was associated with significantly lower likelihood of low estimated peak oxygen uptake categorization (p<0.05). Among young individuals without overt cardiopulmonary disease, current smokers had reduced daily activity and higher perceived exertion ratings. Besides supporting early smoking cessation, these results set the stage for future studies that examine mechanisms of activity restriction in young smokers and the utility of measures of activity restriction in the earlier diagnosis of smoking-related diseases.

Attributable causes of cancer in Japan in 2005--systematic assessment to estimate current burden of cancer attributable to known preventable risk factors in Japan.

PubMed

Inoue, M; Sawada, N; Matsuda, T; Iwasaki, M; Sasazuki, S; Shimazu, T; Shibuya, K; Tsugane, S

2012-05-01

To contribute to evidence-based policy decision making for national cancer control, we conducted a systematic assessment to estimate the current burden of cancer attributable to known preventable risk factors in Japan in 2005. We first estimated the population attributable fractions (PAFs) of each cancer attributable to known risk factors from relative risks derived primarily from Japanese pooled analyses and large-scale cohort studies and the prevalence of exposure in the period around 1990. Using nationwide vital statistics records and incidence estimates, we then estimated the attributable cancer incidence and mortality in 2005. In 2005, ≈ 55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest PAF (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%). In Japan, tobacco smoking and infections are major causes of cancer. Further control of these factors will contribute to substantial reductions in cancer incidence and mortality in Japan.

Adult Cigarette Smoking in the United States: Current Estimates

MedlinePlus

... Tobacco Use Hispanics/Latinos and Tobacco Use Lesbian, Gay, Bisexual, and Transgender Persons and Tobacco Use Cigarette ... limitation (14.4%) By Sexual Orientation 2 Lesbian/gay/bisexual adults were more likely to be current ...

Prediction of inspired oxygen fraction for targeted arterial oxygen tension following open heart surgery in non-smoking and smoking patients.

PubMed

Bou-Khalil, Pierre; Zeineldine, Salah; Chatburn, Robert; Ayyoub, Chakib; Elkhatib, Farouk; Bou-Akl, Imad; El-Khatib, Mohamad

2017-10-01

Simple and accurate expressions describing the P a O 2 -F i O 2 relationship in mechanically ventilated patients are lacking. The current study aims to validate a novel mathematical expression for accurate prediction of the fraction of inspired oxygen that will result in a targeted arterial oxygen tension in non-smoking and smoking patients receiving mechanical ventilation following open heart surgeries. One hundred P a O 2 -F i O 2 data pairs were obtained from 25 non-smoking patients mechanically ventilated following open heart surgeries. One data pair was collected at each of F i O 2 of 40, 60, 80, and 100% while maintaining same mechanical ventilation support settings. Similarly, another 100 hundred P a O 2 -F i O 2 data pairs were obtained from 25 smoking patients mechanically ventilated following open heart surgeries. The utility of the new mathematical expression in accurately describing the P a O 2 -F i O 2 relationship in these patients was assessed by the regression and Bland-Altman analyses. Significant correlations were seen between the true and estimated F i O 2 values in non-smoking (r 2  = 0.9424; p < 0.05) and smoking (r 2  = 0.9466; p < 0.05) patients. Tight biases between the true and estimated F i O 2 values for non-smoking (3.1%) and smoking (4.1%) patients were observed. Also, significant correlations were seen between the true and estimated P a O 2 /F i O 2 ratios in non-smoking (r 2  = 0.9530; p < 0.05) and smoking (r 2  = 0.9675; p < 0.05) patients. Tight biases between the true and estimated P a O 2 /F i O 2 ratios for non-smoking (-18 mmHg) and smoking (-16 mmHg) patients were also observed. The new mathematical expression for the description of the P a O 2 -F i O 2 relationship is valid and accurate in non-smoking and smoking patients who are receiving mechanical ventilation for post cardiac surgery.

The enduring effects of smoking in Latin America.

PubMed

Palloni, Alberto; Novak, Beatriz; Pinto-Aguirre, Guido

2015-06-01

We estimated smoking-attributable mortality, assessed the impact of past smoking on recent mortality, and computed expected future losses in life expectancy caused by past and current smoking behavior in Latin America and the Caribbean. We used a regression-based procedure to estimate smoking-attributable mortality and information for 6 countries (Argentina, Brazil, Chile, Cuba, Mexico, and Uruguay) for the years 1980 through 2009 contained in the Latin American Mortality Database (LAMBdA). These countries jointly comprise more than two thirds of the adult population in Latin America and the Caribbean and have the region's highest rates of smoking prevalence. During the last 10 years, the impact of smoking was equivalent to losses in male (aged ≥ 50 years) life expectancy of about 2 to 6 years. These effects are likely to increase, particularly for females, both in the study countries and in those that joined the epidemic at later dates. Unless innovations in the detection and treatment of chronic diseases are introduced soon, continued gains in adult survival in Latin America and the Caribbean region may slow down considerably.

Mortality and Burden of Disease Attributable to Cigarette Smoking in Qingdao, China.

PubMed

Wang, Yani; Qi, Fei; Jia, Xiaorong; Lin, Peng; Liu, Hui; Geng, Meiyun; Liu, Yunning; Li, Shanpeng; Tan, Jibin

2016-09-09

In China, smoking is the leading preventable cause of deaths by a disease. Estimating the disease burden attributable to smoking contributes to an evaluation of the adverse impact of smoking. To aid in policy change and implementation, this study estimated the population-attributable fractions (PAFs) of smoking, the all-cause mortality and the loss of life expectancy attributable to smoking in 2014 of Qingdao. PAFs were calculated using the smoking impact ratio (SIR) or current smoking rate (P) and relative risk (RR). We determined the smoking-attributable mortality by multiplying the smoking-attributable fraction by the total mortality. This study used the method of an abridged life table to calculate the loss of life expectancy caused by smoking. Smoking caused about 8635 deaths (6883 males, 1752 females), and accounted for 16% of all deaths; 22% in males and 8% in females. The leading causes of deaths attributable to smoking were lung cancer (38%), ischemic heart disease (19%) and chronic obstructive pulmonary disease (COPD, 12%). The PAF for all causes was 22%; 30% in males and 10% in females. Tobacco use may cause a reduction of about 2.01 years of the loss of life expectancy; 3 years in males and 0.87 years in females. The findings highlight the need for taking effective measures to prevent initiation and induce cessation.

Mortality and Burden of Disease Attributable to Cigarette Smoking in Qingdao, China

PubMed Central

Wang, Yani; Qi, Fei; Jia, Xiaorong; Lin, Peng; Liu, Hui; Geng, Meiyun; Liu, Yunning; Li, Shanpeng; Tan, Jibin

2016-01-01

In China, smoking is the leading preventable cause of deaths by a disease. Estimating the disease burden attributable to smoking contributes to an evaluation of the adverse impact of smoking. To aid in policy change and implementation, this study estimated the population-attributable fractions (PAFs) of smoking, the all-cause mortality and the loss of life expectancy attributable to smoking in 2014 of Qingdao. PAFs were calculated using the smoking impact ratio (SIR) or current smoking rate (P) and relative risk (RR). We determined the smoking-attributable mortality by multiplying the smoking-attributable fraction by the total mortality. This study used the method of an abridged life table to calculate the loss of life expectancy caused by smoking. Smoking caused about 8635 deaths (6883 males, 1752 females), and accounted for 16% of all deaths; 22% in males and 8% in females. The leading causes of deaths attributable to smoking were lung cancer (38%), ischemic heart disease (19%) and chronic obstructive pulmonary disease (COPD, 12%). The PAF for all causes was 22%; 30% in males and 10% in females. Tobacco use may cause a reduction of about 2.01 years of the loss of life expectancy; 3 years in males and 0.87 years in females. The findings highlight the need for taking effective measures to prevent initiation and induce cessation. PMID:27618084

Differences in tobacco smoking prevalence and frequency between adolescent Palestine refugee and non-refugee populations in Jordan, Lebanon, Syria, and the West Bank: cross-sectional analysis of the Global Youth Tobacco Survey.

PubMed

Jawad, Mohammed; Khader, Ali; Millett, Christopher

2016-01-01

Evidence is conflicting as to the whether tobacco smoking prevalence is higher in refugee than non-refugee populations. The aim of this study was to compare the prevalence and frequency of tobacco smoking in Palestine refugee and non-refugee adolescent populations in the Middle East. We conducted a cross-sectional analysis of the Global Youth Tobacco Survey (GYTS) conducted in Jordan, Lebanon, Syria, and the West Bank among adolescent Palestine refugees and non-refugees. Age- and sex-adjusted regression models assessed the association between refugee status and current (past-30 day) tobacco use prevalence and frequency. Prevalence estimates for current tobacco smoking were similar between Palestine refugee and non-refugee groups in Jordan (26.7 % vs. 24.0 %), Lebanon (39.4 % vs. 38.5 %), and the West Bank (39.5 % vs. 38.4 %). In Syria, Palestine refugees had nearly twice the odds of current tobacco smoking compared to non-refugees (23.2 % vs. 36.6 %, AOR 1.96, 95 % CI 1.46-2.62). Palestine refugees consumed more cigarettes per month than non-refugees in Lebanon (β 0.57, 95 % CI 0.17-0.97) and Palestine refugees consumed more waterpipe tobacco per month than non-refugees in Syria (β 0.40, 95 % CI 0.19-0.61) and the West Bank (β 0.42, 95 % CI 0.21-0.64). Current tobacco smoking prevalence is in excess of 20 % in both adolescent Palestine refugee and non-refugee populations in Middle Eastern countries, however Palestine refugees may smoke tobacco more frequently than non-refugees. Comparison of simple prevalence estimates may therefore mask important differences in tobacco use patterns within population groups.

Historical declines and disparities in cigarette coupon saving among adolescents in the United States, 1997-2013.

PubMed

Owotomo, Olusegun; Maslowsky, Julie; Pasch, Keryn E

2017-07-01

Exposure to cigarette coupons is associated with smoking initiation and likelihood of cigarette purchase among adolescents. Some adolescents who are exposed to cigarette coupons take a step further by choosing to save or collect these coupons, a further risk factor for cigarette smoking. This study examines historical trends and disparities in cigarette coupon saving among adolescents in the United States from 1997 to 2013. National samples of 10th and 12th grade students (n=129,111) were obtained from Monitoring the Future surveys in 1997-2013. Prevalence of lifetime and current cigarette coupon saving was estimated in each year in the overall adolescent population, and in race/ethnicity, parent education level, sex, and urban/rural subgroups. Prevalence of lifetime and current cigarette coupon saving was then estimated in each year based on smoking status. Prevalence of cigarette coupon saving has decreased dramatically among adolescents; only 1.2% reported currently saving coupons in 2013. However, disparities in cigarette coupon saving remain with prevalence higher among rural, White, and low parental education level students. Adolescent smokers continue to save coupons at high rates; 21.2% had ever saved coupons and 6.9% currently saved coupons as of 2013. Despite overall declines in adolescent cigarette coupon saving, existing sociodemographic disparities and the considerably high prevalence of coupon saving among adolescent smokers suggest that cigarette coupons remain a threat to smoking prevention among youth. Additional research is needed to further elucidate longitudinal associations between cigarette coupon saving and smoking initiation and maintenance among adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

Who, What, When, Where? Determining the Health Implications of Wildfire Smoke Exposure

NASA Astrophysics Data System (ADS)

Ford, B.; Lassman, W.; Gan, R.; Burke, M.; Pfister, G.; Magzamen, S.; Fischer, E. V.; Volckens, J.; Pierce, J. R.

2016-12-01

Exposure to poor air quality is associated with negative impacts on human health. A large natural source of PM in the western U.S. is from wildland fires. Accurately attributing health endpoints to wildland-fire smoke requires a determination of the exposed population. This is a difficult endeavor because most current methods for monitoring air quality are not at high temporal and spatial resolutions. Therefore, there is a growing effort to include multiple datasets and create blended products of smoke exposure that can exploit the strengths of each dataset. In this work, we combine model (WRF-Chem) simulations, NASA satellite (MODIS) observations, and in-situ surface monitors to improve exposure estimates. We will also introduce a social-media dataset of self-reported smoke/haze/pollution to improve population-level exposure estimates for the summer of 2015. Finally, we use these detailed exposure estimates in different epidemiologic study designs to provide an in-depth understanding of the role wildfire exposure plays on health outcomes.

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.

Smoking characteristics of Polish immigrants in Dublin

PubMed Central

Kabir, Zubair; Clarke, Vanessa; Keogan, Sheila; Currie, Laura M; Zatonski, Witold; Clancy, Luke

2008-01-01

Background This study examined two main hypotheses: a) Polish immigrants' smoking estimates are greater than their Irish counterparts (b) Polish immigrants purchasing cigarettes from Poland smoke "heavier" (≥ 20 cigarettes a day) when compared to those purchasing cigarettes from Ireland. The study also set out to identify significant predictors of 'current' smoking (some days and everyday) among the Polish immigrants. Methods Dublin residents of Polish origin (n = 1,545) completed a previously validated Polish questionnaire in response to an advertisement in a local Polish lifestyle magazine over 5 weekends (July–August, 2007). The Office of Tobacco Control telephone-based monthly survey data were analyzed for the Irish population in Dublin for the same period (n = 484). Results Age-sex adjusted smoking estimates were: 47.6% (95% Confidence Interval [CI]: 47.3%; 48.0%) among the Poles and 27.8% (95% CI: 27.2%; 28.4%) among the general Irish population (p < 0.001). Of the57% of smokers (n = 345/606) who purchased cigarettes solely from Poland and the 33% (n = 198/606) who purchased only from Ireland, 42.6% (n = 147/345) and 41.4% (n = 82/198) were "heavy" smokers, respectively (p = 0.79). Employment (Odds Ratio [OR]: 2.89; 95% CI: 1.25–6.69), lower education (OR: 3.76; 95%CI: 2.46–5.74), and a longer stay in Ireland (>24 months) were significant predictors of current smoking among the Poles. An objective validation of the self-reported smoking history of a randomly selected sub-sample immigrant group, using expired carbon monoxide (CO) measurements, showed a highly significant correlation coefficient (r = 0.64) of expired CO levels with the reported number of cigarettes consumed (p < 0.0001). Conclusion Polish immigrants' smoking estimates are higher than their Irish counterparts, and particularly if employed, with only primary-level education, and are overseas >2 years. PMID:19117510

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

Joint and independent effect of alcohol and tobacco use on the risk of subsequent cancer incidence among cancer survivors: A cohort study using cancer registries.

PubMed

Tabuchi, Takahiro; Ozaki, Koken; Ioka, Akiko; Miyashiro, Isao

2015-11-01

Drinking alcohol and smoking tobacco are major modifiable risk factors for cancer. However, little is known about whether these modifiable factors of cancer survivors are associated with subsequent primary cancer (SPC) incidence, regardless of the first cancer sites. 27,762 eligible cancer survivors diagnosed between 1985 and 2007 were investigated for SPC until the end of 2008, using hospital-based and population-based cancer registries. The association between drinking, smoking and combined drinking and smoking (interaction) at the time of the first cancer diagnosis and incidence of SPCs (i.e., all SPCs, alcohol-related, smoking-related and specific SPCs) was estimated by Poisson regression. Compared with never-drinker/never-smoker, the categories ever-drinker/ever-smoker, current-drinker/current-smoker and heavy-drinker/heavy-smoker had 43-108%, 51-126% and 167-299% higher risk for all, alcohol-related and tobacco-related SPCs, respectively. The interaction of drinking and smoking had significantly high incidence rate ratios (IRRs) for SPCs among ever-drinker/ever-smoker and current-drinker/current-smoker, although ever drinking did not show a significant risk. Ever-drinker/ever-smoker had also significantly higher IRRs for esophageal and lung SPCs than never-drinker/never-smoker. Among comprehensive cancer survivors, ever and current drinkers only had a SPC risk when combined with smoking, while ever and current smokers had a SPC risk regardless of drinking status. Heavy drinking and heavy smoking were considered to be independent additive SPC risk factors. To reduce SPC incidence, it may be necessary (i) to reduce or stop alcohol use, (ii) to stop tobacco smoking and (iii) dual users, especially heavy users, should be treated as a high-risk population for behavioral-change intervention. © 2015 UICC.

Cigarette Smoking and Exposure to Environmental Tobacco Smoke in China: The International Collaborative Study of Cardiovascular Disease in Asia

PubMed Central

Gu, Dongfeng; Wu, Xigui; Reynolds, Kristi; Duan, Xiufang; Xin, Xue; Reynolds, Robert F.; Whelton, Paul K.; He, Jiang

2004-01-01

Objectives. We estimated the prevalence of cigarette smoking and the extent of environmental tobacco smoke exposure (ETS) in the general population in China. Methods. A cross-sectional survey was conducted on a nationally representative sample of 15540 Chinese adults aged 35–74 years in 2000–2001. Information on cigarette smoking was obtained by trained interviewers using a standard questionnaire. Results. The prevalence of current cigarette smoking was much higher among men (60.2%) than among women (6.9%). Among nonsmokers, 12.1% of men and 51.3% of women reported exposure to ETS at home, and 26.7% of men and 26.2% of women reported exposure to ETS in their workplaces. On the basis of our findings, 147358000 Chinese men and 15895000 Chinese women aged 35–74 years were current cigarette smokers, 8658000 men and 108402000 women were exposed to ETS at home, and 19072000 men and 55372000 women were exposed to ETS in their workplaces. Conclusions. The high prevalence of cigarette smoking and environmental tobacco smoke exposure in the Chinese population indicates an urgent need for smoking prevention and cessation efforts. PMID:15514239

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.

Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh; Mir, Imtiyaz Ali; Sin, Shwe

2014-01-01

In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command. Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.

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.

Estimating the decline in excess risk of cerebrovascular disease following quitting smoking--a systematic review based on the negative exponential model.

PubMed

Lee, Peter N; Fry, John S; Thornton, Alison J

2014-02-01

We attempted to quantify the decline in stroke risk following quitting using the negative exponential model, with methodology previously employed for IHD. We identified 22 blocks of RRs (from 13 studies) comparing current smokers, former smokers (by time quit) and never smokers. Corresponding pseudo-numbers of cases and controls/at risk formed the data for model-fitting. We tried to estimate the half-life (H, time since quit when the excess risk becomes half that for a continuing smoker) for each block. The method failed to converge or produced very variable estimates of H in nine blocks with a current smoker RR <1.40. Rejecting these, and combining blocks by amount smoked in one study where problems arose in model-fitting, the final analyses used 11 blocks. Goodness-of-fit was adequate for each block, the combined estimate of H being 4.78(95%CI 2.17-10.50) years. However, considerable heterogeneity existed, unexplained by any factor studied, with the random-effects estimate 3.08(1.32-7.16). Sensitivity analyses allowing for reverse causation or differing assumed times for the final quitting period gave similar results. The estimates of H are similar for stroke and IHD, and the individual estimates similarly heterogeneous. Fitting the model is harder for stroke, due to its weaker association with smoking. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Exposure to Smoking in Popular Contemporary Movies and Youth Smoking in Germany

PubMed Central

Hanewinkel, Reiner; Sargent, James D.

2007-01-01

Background Studies have linked exposure to movie smoking and smoking initiation among U.S. adolescents, but there has been only one published study of adolescents outside the U.S. Method Cross sectional survey of 5586 schoolchildren aged 10–17 with a mean of 12.8 (SD=1.2) years from randomly selected secondary schools in Schleswig-Holstein, Germany, in October/November 2005. In August 2006, using previously validated methods, exposure to movie smoking was estimated from 398 internationally distributed films (98% produced and distributed by U.S. studios) released in Germany, and examined its relation with ever and current (30 day) smoking. Results Overall, 40.7% of the sample had tried smoking, and 12.3% were current smokers. The sample quartile (Q) of movie smoking exposure was significantly associated with the prevalence of smoking initiation: 0.17 of adolescents in Q1 had tried smoking; 0.35 in Q2; 0.47 in Q3; and 0.64 in Q4. Movie smoking exposure was significantly associated with the prevalence of current smoking: 0.03 for adolescents in Q1; 0.08 in Q2; 0.14 in Q3; and 0.25 in Q4. After controlling for sociodemographics, parent/friend/sibling smoking, school performance, personality characteristics, TV consumption, receptivity to tobacco marketing and parenting style, the adjusted odds ratios for having tried smoking were 1.7 (95% confidence interval [CI]: 1.4, 2.1) for Q2, 1.8 (95% CI: 1.5, 2.3) for Q3, and 2.2 (95% CI: 1.8, 2.8) for Q4 compared with adolescents in Q1. The adjusted odds ratios for current smoking were 1.4 (95% CI: 0.9, 2.2) for Q2, 1.7 (95% CI: 1.1, 2.6) for Q3, and 2.0 (95% CI: 1.3, 3.1) for Q4 compared with adolescents in Q1. Conclusions Smoking in internationally distributed movies is associated with ever and current smoking among German adolescents. This suggests the need for prospective studies of this association in countries other than the U.S. and research into the potential impact of countrywide policies that would limit exposure of young adolescents to movie smoking. PMID:17533061

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.

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.

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

The Pot Calling the Kettle Black? A Comparison of Measures of Current Tobacco Use

PubMed Central

ROSENMAN, ROBERT

2014-01-01

Researchers often use the discrepancy between self-reported and biochemically assessed active smoking status to argue that self-reported smoking status is not reliable, ignoring the limitations of biochemically assessed measures and treating it as the gold standard in their comparisons. Here, we employ econometric techniques to compare the accuracy of self-reported and biochemically assessed current tobacco use, taking into account measurement errors with both methods. Our approach allows estimating and comparing the sensitivity and specificity of each measure without directly observing true smoking status. The results, robust to several alternative specifications, suggest that there is no clear reason to think that one measure dominates the other in accuracy. PMID:25587199

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

An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study.

PubMed

Hunt, Kate; Sweeting, Helen; Sargent, James; Lewars, Heather; Dal Cin, Sonya; Worth, Keilah

2009-02-01

The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002-04) from a longitudinal cohort originally surveyed at age 11 (1994-95) were conducted. The main outcome measure is smoking at age 19. No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers. There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland.

An examination of the association between seeing smoking in films and tobacco use in young adults in the west of Scotland: cross-sectional study

PubMed Central

Hunt, Kate; Sweeting, Helen; Sargent, James; Lewars, Heather; Cin, Sonya Dal; Worth, Keilah

2009-01-01

The objective is to examine the association between the amount of smoking seen in films and current smoking in young adults living in the west of Scotland in the UK. Cross-sectional analyses (using multivariable logistic regression) of data collected at age 19 (2002–04) from a longitudinal cohort originally surveyed at age 11 (1994–95) were conducted. The main outcome measure is smoking at age 19. No association was found between the number of occurrences of smoking estimated to have been seen in films (film smoking exposure) and current (or ever) smoking in young adults. This lack of association was unaffected by adjustment for predictors of smoking, including education, risk-taking orientation and smoking among peers. There was no association between film smoking exposure and smoking behaviour for any covariate-defined subgroup. Associations have been found between film smoking exposure and smoking initiation in younger adolescents in the United States. In this study, conducted in Scotland, no similar association was seen, suggesting that there may be age or cultural limitations on the effects of film smoking exposure on smoking. The lack of association could be due to methodological issues or greater sophistication of older adolescents and young adults in interpreting media images or the greater ubiquity of real-life smoking instances in Scotland. If the latter, film smoking exposure could become a more important risk factor for smoking uptake and maintenants in older adolescents following the recent ban on smoking in public places in Scotland. PMID:18203682

Using the negative exponential distribution to quantitatively review the evidence on how rapidly the excess risk of ischaemic heart disease declines following quitting smoking.

PubMed

Lee, Peter N; Fry, John S; Hamling, Jan S

2012-10-01

No previous review has formally modelled the decline in IHD risk following quitting smoking. From PubMed searches and other sources we identified 15 prospective and eight case-control studies that compared IHD risk in current smokers, never smokers, and quitters by time period of quit, some studies providing separate blocks of results by sex, age or amount smoked. For each of 41 independent blocks, we estimated, using the negative exponential model, the time, H, when the excess risk reduced to half that caused by smoking. Goodness-of-fit to the model was adequate for 35 blocks, others showing a non-monotonic pattern of decline following quitting, with a variable pattern of misfit. After omitting one block with a current smoker RR 1.0, the combined H estimate was 4.40 (95% CI 3.26-5.95) years. There was considerable heterogeneity, H being <2years for 10 blocks and >10years for 12. H increased (p<0.001) with mean age at study start, but not clearly with other factors. Sensitivity analyses allowing for reverse causation, or varying assumed midpoint times for the final open-ended quitting period little affected goodness-of-fit of the combined estimate. The US Surgeon-General's view that excess risk approximately halves after a year's abstinence seems over-optimistic. Copyright © 2012 Elsevier Inc. All rights reserved.

Predicting the future prevalence of cigarette smoking in Italy over the next three decades.

PubMed

Carreras, Giulia; Gorini, Giuseppe; Gallus, Silvano; Iannucci, Laura; Levy, David T

2012-10-01

Smoking prevalence in Italy decreased by 37% from 1980 to now. This is due to changes in smoking initiation and cessation rates and is in part attributable to the development of tobacco control policies. This work aims to estimate the age- and sex-specific smoking initiation and cessation probabilities for different time periods and to predict the future smoking prevalence in Italy, assuming different scenarios. A dynamic model describing the evolution of current, former and never smokers was developed. Cessation and relapse rates were estimated by fitting the model with smoking prevalence in Italy, 1986-2009. The estimated parameters were used to predict prevalence, according to scenarios: (1) 2000-09 initiation/cessation; (2) half initiation; (3) double cessation; (4) Scenarios 2+3; (5) triple cessation; and (6) Scenarios 2+5. Maintaining the 2000-09 initiation/cessation, the 10% goal will not be achieved within next three decades: prevalence will stabilize at 12.1% for women and 20.3% for men. The goal could be rapidly achieved for women by halving initiation and tripling cessation (9.9%, 2016), or tripling cessation only (10.4%, 2017); for men halving initiation and tripling cessation (10.8%, 2024), or doubling cessation and halving initiation (10.5%, 2033), or tripling cessation only (10.8%, 2033). The 10% goal will be achieved within the next few decades, mainly by increasing smoking cessation. Policies to reach this goal would include increasing cigarette taxes, introducing total reimbursement of smoking cessation treatment, with a further development of quitlines and smoking cessation services. These measures are not yet fully implemented in Italy.

Estimating the public economic consequences of introducing varenicline smoking cessation therapy in South Korea using a fiscal analytic framework.

PubMed

Connolly, Mark P; Baker, Christine L; Kotsopoulos, Nikolaos

2018-06-01

Smoking gives rise to many cross-sectorial public costs and benefits for government. Costs arise from increased healthcare spending and work-related social benefits, while smoking itself provides significant revenue for government from tobacco taxes. To better understand the public economic impact of smoking and smoking cessation therapies, this study developed a government perspective framework for assessing smoking-attributable morbidity and mortality and associated public costs. This framework includes changes in lifetime tax revenue and health costs, as well as changes in tobacco tax revenue, from fewer smokers. A modified generational accounting framework was developed to assess relationships between smoking-attributable morbidity and mortality and public economic consequences of smoking, including lifetime tax revenue gains/losses, government social transfers, and health spending. Based on the current prevalence of smoking in South Korean males, a cohort model was developed for smokers, former-smokers, and never-smokers. The model simulated the lifetime discounted fiscal transfers for different age cohorts in 5 year age bands, and the return on investment (ROI) from smoking cessation therapy. Former smokers are estimated to generate higher lifetime earnings and direct tax revenues and lower lifetime healthcare costs due to the reduction of smoking-attributable mortality and morbidity compared to smokers, even after accounting for reduced tobacco taxes paid. Based on the costs of public investments in varenicline, this study estimated a ROI from 1.4-1.7, depending on treatment age, with higher ROI in younger cohorts, with an average ROI of 1.6 for those aged less than 65. This analysis suggests that reductions in smoking can generate positive public economic benefits for government, even after accounting for lost tobacco tax revenues. The results described here are likely applicable to countries having similar underlying smoking prevalence, comparable taxation rates, and social benefit protection provided to individuals with smoking-related conditions.

Perceived discrimination and smoking among rural-to-urban migrant women working as restaurant/hotel workers and sex workers in China

PubMed Central

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

2013-01-01

Background Smoking may be a coping mechanism for psychosocial stress caused by discrimination. Methods We conducted a cross-sectional survey of rural-to-urban migrant women working as restaurant/hotel workers (RHWs) and those working as sex workers (FSWs) in 10 Chinese cities to investigate whether perceived discrimination is associated with smoking. We interviewed RHWs at medical examination clinics and FSWs at entertainment venues. Modified Poisson regression was used to estimate prevalence ratios. Results Of the 1696 RHWs and 532 FSWs enrolled, 155 (9.1%) and 63 (11.8%) reported perceived discrimination, respectively. Perceived discrimination was independently associated with ever tried smoking (prevalence ratio [PR], 1.71; 95% confidence interval [CI], 1.31–2.23) and current smoking (PR, 2.52; 95% CI, 1.32–4.79) among RHWs and ever tried smoking (PR, 1.36; 95% CI, 1.16–1.61) and current smoking (PR, 1.63; 95% CI, 1.28–2.06) among FSWs. Discussion Perceived discrimination is associated with higher prevalence of smoking among rural-to-urban migrant women in China. PMID:22389186

The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in Southern California

USGS Publications Warehouse

Richardson, L.A.; Champ, P.A.; Loomis, J.B.

2012-01-01

There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles County's modern history. A cost of illness estimate is $9.50 per exposed person per day. However, theory and empirical research consistently find that this measure largely underestimates the true economic cost of health effects from exposure to a pollutant in that it ignores the cost of defensive actions taken as well as disutility. For the first time, the defensive behavior method is applied to calculate the willingness to pay for a reduction in one wildfire smoke induced symptom day, which is estimated to be $84.42 per exposed person per day. ?? 2011.

Cigarette smoking reduced renal function deterioration in hypertensive patients may be mediated by elevated homocysteine.

PubMed

Huang, Feifei; Chen, Jie; Liu, Xun; Han, Feng; Cai, Qingqing; Peng, Guicheng; Zhang, Kun; Chen, Weiqing; Wang, Jingfeng; Huang, Hui

2016-12-27

Elevated homocysteine (HCY) and smoking are both important risk factors for hypertensive patients. However, whether they have crossing effect on renal function deterioration of hypertensive patients and what is the underlying mechanism are unclear. In the present study, 3033 participants diagnosed as essential hypertension with estimated glomerular filtration rate (eGFR)> 30 ml/min/1.73 m2 from southern China were enrolled in this cross-sectional study. We collected the demographic and clinical data. In addition, the mediation effects were analyzed. The results showed that, comparing with non-smokers, smokers had significant higher levels of HCY (13.10 (11.20-16.87) vs. 11.00 (8.90-13.40) umol/L, P < 0.001) and lower eGFR (79.71 (66.83-91.05) vs. 82.89 (69.80-95.85) ml/min/1.73m2, P < 0.001). HCY levels and smoking were independently associated with decreased eGFR. Meanwhile, eGFR levels were significantly negatively correlated with HCY (P < 0.001), and this correlation might be stronger in current smokers. Current smoker consuming over 20 cigarettes per day would accelerate early renal function deterioration (OR = 1.859, P = 0.019). The mediation effects analysis further showed that the association between smoking and renal function deterioration was mediated by HCY. And elevated HCY was accounted for 56.94% of the estimated causal effect of smoking on renal function deterioration in hypertensive patients. Our findings indicated that cigarette smoking was associated with renal function deterioration in hypertensive patients, and the association between cigarette smoking and renal function deterioration was probably mediated by elevated HCY. Therefore, HCY-lowering therapy may be beneficial for renal function deterioration in hypertensive smoking patients.

Is Some Provider Advice on Smoking Cessation Better Than No Advice? An Instrumental Variable Analysis of the 2001 National Health Interview Survey

PubMed Central

Bao, Yuhua; Duan, Naihua; Fox, Sarah A

2006-01-01

Research Objective To estimate the effect of provider advice in routine clinical contacts on patient smoking cessation outcome. Data Source The Sample Adult File from the 2001 National Health Interview Survey. We focus on adult patients who were either current smokers or quit during the last 12 months and had some contact with the health care providers or facilities they most often went to for acute or preventive care. Study Design We estimate a joint model of self-reported smoking cessation and ever receiving advice to quit during medical visits in the past 12 months. Because providers are more likely to advise heavier smokers and/or patients already diagnosed with smoking-related conditions, we use provider advice for diet/nutrition and for physical activity reported by the same patient as instrumental variables for smoking cessation advice to mitigate the selection bias. We conduct additional analyses to examine the robustness of our estimate against the various scenarios by which the exclusion restriction of the instrumental variables may fail. Principal Findings Provider advice doubles the chances of success in (self-reported) smoking cessation by their patients. The probability of quitting by the end of the 12-month reference period increased from 6.9 to 14.7 percent, an effect that is of both statistical (p<.001) and clinical significance. Conclusions Provider advice delivered in routine practice settings has a substantial effect on the success rate of smoking cessation among smoking patients. Providing advice consistently to all smoking patients, compared with routine care, is more effective than doubling the federal excise tax and, in the longer run, likely to outperform some of the other tobacco control policies such as banning smoking in private workplaces. PMID:17116112

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

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.

Sexual-orientation disparities in cigarette smoking in a longitudinal cohort study of adolescents.

PubMed

Corliss, Heather L; Wadler, Brianna M; Jun, Hee-Jin; Rosario, Margaret; Wypij, David; Frazier, A Lindsay; Austin, S Bryn

2013-01-01

Youths with a minority sexual orientation (i.e., gay, lesbian, bisexual, and mostly heterosexual) are at high risk for cigarette smoking. We examined sexual-orientation disparities in smoking during adolescence and emerging adulthood and investigated the role of age at first smoking in contributing to smoking disparities. We used data from the Growing Up Today Study, a large longitudinal cohort of adolescents followed from ages 12 to 24 years (N = 13,913). Self-administered questionnaires filled out annually or biennially assessed age at first smoking, current smoking, frequency of smoking, number of cigarettes smoked daily, and nicotine dependence. Proportional hazards survival analysis and repeated measures regression estimated sexual-orientation differences in smoking. Compared with completely heterosexuals, lesbian/gay, bisexual, and mostly heterosexual youths smoked their first cigarette at younger ages, were more likely to be current smokers, and had higher frequency of smoking. Among past-year smokers, sexual-minority females smoked more cigarettes daily and scored higher on nicotine dependence than completely heterosexual females. In some instances, gender and age modified relationships between sexual orientation and smoking, with relative risk accentuated in female sexual minorities and in sexual minorities during younger ages. Younger age of smoking onset contributed to elevated smoking in mostly heterosexuals and bisexuals, and to a lesser extent in lesbians, but not in gay males. Sexual-orientation minorities are at greater risk for smoking during adolescence and emerging adulthood than heterosexuals. Disparities are larger in females and evident in early adolescence. Prevention and cessation efforts should target this population, preferably beginning in early adolescence.

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.

Patterns and predictors of current cigarette smoking in women and men of reproductive age-Ecuador, El Salvador, Guatemala, and Honduras.

PubMed

Tong, Van T; Turcios-Ruiz, Reina M; Dietz, Patricia M; England, Lucinda J

2011-09-01

To estimate smoking prevalence by gender, describe patterns of cigarette use, and identify predictors of current smoking in reproductive-age adults in four Latin American countries. Self-reported smoking was examined using data from Reproductive Health Surveys of women aged 15-49 years in Ecuador (2004), El Salvador (2002-2003), Guatemala (2002), and Honduras (2001), and of men aged 15-59 years in El Salvador, Guatemala, and Honduras for the same years. Current smoking was assessed by demographic characteristics, and independent associations were examined using logistic regression. Data were weighted to be nationally representative of households with reproductive-age women and men. Current smoking prevalence ranged from 2.6% (Guatemala) to 13.1% (Ecuador) for women and from 23.1% (Guatemala) to 34.9% (El Salvador) for men. In Ecuador, 67.6% of female smokers were non-daily users; in other countries, daily use was more prevalent than non-daily use for both men and women. In daily users, the median number of cigarettes smoked per day ranged from 1.9 (Ecuador, Honduras) to 2.3 (Guatemala) for women and from 2.1 (Guatemala) to 3.6 (Honduras) for men. In bivariate analysis, smoking prevalence in all countries was highest in women who lived in urban areas, were previously married, and/or had high socioeconomic status. Risk factors for smoking varied by country and gender. National tobacco control programs in these countries should aggressively target high-risk populations (reproductive-age men) and maintain low prevalence in low-risk populations (reproductive-age women). More research is needed to understand addiction patterns in non-daily smokers.

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.

Socioeconomic Distinction, Cultural Tastes, and Cigarette Smoking*

PubMed Central

Pampel, Fred C.

2011-01-01

Objectives The inverse relationship between socioeconomic status (SES) and smoking is typically seen in terms of the greater economic and social resources of advantaged groups, but it may also relate to cultural resources. This study aims to test theories of symbolic distinction by examining relationships between smoking and ostensibly unrelated cultural preferences. Methods Using the 1993 General Social Survey, ordinal logistic regression models, and a three-category dependent variable (never, former, and current smoker), the analysis estimates relationships of musical likes and dislikes with smoking while controlling for SES and social strain. Results Preferences for classical music are associated with lower smoking, while preferences for bluegrass, jazz, and heavy metal music are associated with higher smoking. Conclusions The results suggest that SES groups may use smoking, like other cultural tastes, to distinguish their lifestyles from those of others. PMID:21874073

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.

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.

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.

Cigarette Smoking Among Working Women of Reproductive Age—United States, 2009–2013

PubMed Central

Mazurek, Jacek M.; England, Lucinda J.

2016-01-01

Background Employers play a vital role in promoting and supporting tobacco use cessation among tobacco-using workers. Cigarette smoking during pregnancy is a preventable cause of complications in pregnancy and adverse infant health outcomes. Purpose To estimate cigarette smoking prevalence and attempts to quit among working women of reproductive age in different industries and occupations using a nationally representative survey. Methods: The 2009–2013 National Health Interview Survey data for women of reproductive age (18–49 years) who were working in the week prior to the interview (n = 30 855) were analyzed. Data were adjusted for nonresponse and weighted to produce nationally representative estimates. Results During 2009–2013, among working women of reproductive age, an estimated 17.3% (95% confidence interval [CI]: 16.7–17.8) and 12.9% (95% CI: 12.4–13.4) were current and former cigarette smokers, respectively. Of women who smoke daily, 44.5% (95% CI: 42.5–46.5) had made a quit attempt for more than 1 day in the year before the interview. Cigarette smoking prevalence was highest among women working in the construction industry (29.2%; 95% CI: 22.8–35.7) and in construction and extraction occupations (34.6%; 95% CI: 23.4–45.9). Among working women who were pregnant at the time of the interview, 6.8% (95% CI: 4.4–9.2) and 20.4% (95% CI: 16.9–24.0) were current and former cigarette smokers, respectively. Conclusions Cigarette smoking prevalence varies by industry and occupation. Intensifying tobacco control efforts in high prevalence industries and occupations could result in higher cessation rates and improvements in health among women of reproductive age. Implications This study identified discrepancies in cigarette smoking among women of reproductive age across industries and occupations. In the absence of smoke-free local and state laws, employer-established smoke-free policies and workplace cessation programs are important for achieving reduction of tobacco use among women and for protecting other workers’ health. Results in this report may assist in developing educational campaigns targeting women in industries and occupations with high prevalence of cigarette smoking and low percentage of ever-smokers who had quit. PMID:26791371

Cigarette Smoking Among Working Women of Reproductive Age-United States, 2009-2013.

PubMed

Mazurek, Jacek M; England, Lucinda J

2016-05-01

Employers play a vital role in promoting and supporting tobacco use cessation among tobacco-using workers. Cigarette smoking during pregnancy is a preventable cause of complications in pregnancy and adverse infant health outcomes. To estimate cigarette smoking prevalence and attempts to quit among working women of reproductive age in different industries and occupations using a nationally representative survey. The 2009-2013 National Health Interview Survey data for women of reproductive age (18-49 years) who were working in the week prior to the interview (n = 30855) were analyzed. Data were adjusted for nonresponse and weighted to produce nationally representative estimates. During 2009-2013, among working women of reproductive age, an estimated 17.3% (95% confidence interval [CI]: 16.7-17.8) and 12.9% (95% CI: 12.4-13.4) were current and former cigarette smokers, respectively. Of women who smoke daily, 44.5% (95% CI: 42.5-46.5) had made a quit attempt for more than 1 day in the year before the interview. Cigarette smoking prevalence was highest among women working in the construction industry (29.2%; 95% CI: 22.8-35.7) and in construction and extraction occupations (34.6%; 95% CI: 23.4-45.9). Among working women who were pregnant at the time of the interview, 6.8% (95% CI: 4.4-9.2) and 20.4% (95% CI: 16.9-24.0) were current and former cigarette smokers, respectively. Cigarette smoking prevalence varies by industry and occupation. Intensifying tobacco control efforts in high prevalence industries and occupations could result in higher cessation rates and improvements in health among women of reproductive age. This study identified discrepancies in cigarette smoking among women of reproductive age across industries and occupations. In the absence of smoke-free local and state laws, employer-established smoke-free policies and workplace cessation programs are important for achieving reduction of tobacco use among women and for protecting other workers' health. Results in this report may assist in developing educational campaigns targeting women in industries and occupations with high prevalence of cigarette smoking and low percentage of ever-smokers who had quit. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The hidden cost of wildfires: Economic valuation of health effects of wildfire smoke exposure in southern California

Treesearch

Leslie A. Richardson; Patricia A. Champ; John B. Loomis

2012-01-01

There is a growing concern that human health impacts from exposure to wildfire smoke are ignored in estimates of monetized damages from wildfires. Current research highlights the need for better data collection and analysis of these impacts. Using unique primary data, this paper quantifies the economic cost of health effects from the largest wildfire in Los Angeles...

Exploring the relationship between cigarette prices and smoking among adults: a cross-country study of low- and middle-income nations.

PubMed

Kostova, Deliana; Tesche, Jean; Perucic, Anne-Marie; Yurekli, Ayda; Asma, Samira

2014-01-01

Evidence on the relationship between cigarette prices and adult smoking in low- and middle-income countries (LMICs) is relatively limited. This study offers new descriptive evidence on this relationship using data from a set of 13 LMICs. We use Global Adult Tobacco Survey (GATS) cross-country data from approximately 200,000 participants aged 15 and older. Estimates on the relationship between prices and adult smoking were obtained from logit models of smoking participation and ordinary least squares models of conditional cigarette demand. Higher prices were associated with lower demand across countries, in terms of both smoking prevalence and daily number of cigarettes smoked among smokers. Our estimates suggest that the total price elasticity of cigarette demand in LMICs is approximately -0.53. We find that higher socioeconomic status (SES), represented through wealth and education effects is associated with lower chance of smoking overall, but among existing smokers, it may be associated with a larger number of cigarettes smoked. After controlling for a set of individual demographic and country characteristics, cigarette prices retain a significant role in shaping cigarette demand across LMICs. Because higher SES is associated with a reduced chance of smoking overall but also with increased daily consumption among current smokers, optimal tobacco tax policies in LMICs may face an added need to accommodate to shifting SES structures within the populations of these countries.

Smoking is rank! But, not as rank as other drugs and bullying say New Zealand parents of pre-adolescent children.

PubMed

Glover, Marewa; Kira, Anette; Min, Sandar; Scragg, Robert; Nosa, Vili; McCool, Judith; Bullen, Chris

2011-12-01

Despite the established risks associated with smoking, 21% of New Zealand adults smoke. Prevalence among Māori (indigenous) and Pacific Island New Zealanders is disproportionately high. Prevention of smoking initiation is a key component of tobacco control. Keeping Kids Smokefree--a quasi-experimental trial--aimed to do this by changing parental smoking behaviour and attitudes. However, little is known about parents' attitudes to smoking in comparison with other concerns. Parents of 4,144 children attending five urban schools in a high smoking prevalence population in Auckland, New Zealand, were asked to rank seven concerns on a paper-based questionnaire, including smoking, alcohol and bullying, from most to least serious. Methamphetamine and other illicit 'hard' drugs were ranked as most serious followed by marijuana smoking, alcohol drinking, bullying, cigarette smoking, sex and obesity. Never smokers ranked cigarette smoking as more serious than current or ex-smokers. Parents' under-estimation of the serious nature of tobacco smoking relative to other drugs could partly explain low participation rates in parent-focused smoking initiation prevention programs.

Update and extension of the Brazil SimSmoke model to estimate the health impact of cigarette smoking by pregnant women in Brazil.

PubMed

Szklo, André Salem; Yuan, Zhe; Levy, David

2017-12-18

A previous application of the Brazil SimSmoke tobacco control policy simulation model was used to show the effect of policies implemented between 1989 and 2010 on smoking-attributable deaths (SADs). In this study, we updated and further validated the Brazil SimSmoke model to incorporate policies implemented since 2011 (e.g., a new tax structure with the purpose of increasing revenues/real prices). In addition, we extended the model to estimate smoking-attributable maternal and child health outcomes (MCHOs), such as placenta praevia, placental abruption, preterm birth, low birth weight, and sudden infant death syndrome, to show the role of tobacco control in achieving the Millennium Development Goals. Using data on population, births, smoking, policies, and prevalence of MCHOs, the model is used to assess the effect on both premature deaths and MCHOs of tobacco control policies implemented in Brazil in the last 25 years relative to a counterfactual of policies kept at 1989 levels. Smoking prevalence in Brazil has fallen by an additional 17% for males (16%-19%) and 19% for females (14%-24%) between 2011 and 2015. As a result of the policies implemented since 1989, 7.5 million (6.4-8.5) deaths among adults aged 18 years or older are projected to be averted by 2050. Current policies are also estimated to reduce a cumulative total of 0.9 million (0.4-2.4) adverse MCHOs by 2050. Our findings show the benefits of tobacco control in reducing both SADs and smoking-attributable MCHOs at population level. These benefits may be used to better inform policy makers in low and middle income countries about allocating resources towards tobacco control policies in this important area.

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

Waterpipe Use and Susceptibility to Cigarette Smoking Among Never-Smoking Youth.

PubMed

Veeranki, Sreenivas P; Alzyoud, Sukaina; Kheirallah, Khalid A; Pbert, Lori

2015-10-01

Susceptibility to cigarette smoking, defined as the lack of a firm decision against smoking, is a strong predictor of regular smoking and addiction. Several modifiable risk factors have been identified among never cigarette smokers, and one potential factor of interest is waterpipe use. The purpose of this study is to determine the association of waterpipe use with susceptibility to cigarette smoking among never-smoking youth. In a pooled analysis of 17 Arab nations with nationally representative Global Youth Tobacco Surveys conducted during 2002-2011, tobacco-related information was obtained from 30,711 never-smoking adolescents representing 4,962,872 youth. Study outcome was susceptibility to cigarette smoking, and primary exposure was waterpipe use. Data were analyzed in 2014 using weighted logistic regression models, including stratified models by gender, to determine the odds of susceptibility to cigarette smoking with waterpipe use, adjusting for confounders. Overall, 20% of never-smoking youth were susceptible to cigarette smoking, ranging from 13.1% in Oman to 32.6% in Somalia; 5.2% currently used waterpipe, ranging from 0.3% in Morocco to 23.5% in Kuwait. The estimated odds of susceptibility to cigarette smoking were 2.5 (95% CI=1.9, 3.4) times higher for adolescents who used waterpipe in the past month compared with those who did not, controlling for confounders. Estimates were similar when stratified by gender. Waterpipe use is associated with susceptibility to cigarette smoking. Study findings identify a novel risk factor for never smokers to initiate smoking and will help the public health community develop and implement policies around waterpipe use prevention. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Mansingh; Sin, Shwe

2014-12-18

Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). Prevalence of smoking among women was much lower than in men, although the social patterns of tobacco use were similar to those in men. Tobacco control strategies should target the poor, not/least educated, and agricultural and unskilled workers, who are the most vulnerable social groups in sub-Saharan Africa.

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.

What would menthol smokers do if menthol in cigarettes were banned? Behavioral intentions and simulated demand

PubMed Central

O'Connor, Richard J.; Bansal-Travers, Maansi; Carter, Lawrence P.; Cummings, K. Michael

2012-01-01

Aims The US Food and Drug Administration must consider whether to ban the use of menthol in cigarettes. This study examines how current smokers might respond to such a ban on menthol cigarettes. Design Convenience sample of adolescent and adult smokers recruited from an online survey panel. Setting United States, 2010. Participants 471 adolescent and adult current cigarette smokers. Measurements Respondents were asked a series of questions about how they might react if menthol cigarettes were banned. In addition, participants completed a simulation purchase task to estimate the demand for menthol and nonmenthol cigarettes across a range of prices. Findings Overall, 36% respondents said they always or usually smoked menthol cigarettes. When asked how they might respond to a ban on menthol cigarettes, 35% of current menthol smokers said they would stop smoking, and 25% said they would ‘find a way to buy a menthol brand.’ Those who reported they might quit tended to have greater current intentions to quit (OR=4.46), while those who reported they might seek illicit menthol cigarettes were far less likely to report current intentions to quit (OR = 0.06). Estimates for individual demand elasticity for preferred cigarette type were similar for menthol (α = .0051) and nonmenthol (α = .0049) smokers. Demand elasticity and peak consumption were related to usual cigarette type and cigarettes smoked per day, but did not appear to differ by race, gender, or age. Conclusions Preliminary evidence suggests that a significant minority of smokers of menthol cigarettes in the US would try to stop smoking altogether if such cigarettes were banned. PMID:22471735

Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

2012-01-01

To assess the magnitude and pattern of socioeconomic inequality in current smoking in low and middle income countries. We used data from the World Health Survey [WHS] in 48 low-income and middle-income countries to estimate the crude prevalence of current smoking according to household wealth quintile. A Poisson regression model with a robust variance was used to generate the Relative Index of Inequality [RII] according to wealth within each of the countries studied. In males, smoking was disproportionately prevalent in the poor in the majority of countries. In numerous countries the poorest men were over 2.5 times more likely to smoke than the richest men. Socioeconomic inequality in women was more varied showing patterns of both pro-rich and pro-poor inequality. In 20 countries pro-rich relative socioeconomic inequality was statistically significant: the poorest women had a higher prevalence of smoking compared to the richest women. Conversely, in 9 countries women in the richest population groups had a statistically significant greater risk of smoking compared to the poorest groups. Both the pattern and magnitude of relative inequality may vary greatly between countries. Prevention measures should address the specific pattern of smoking inequality observed within a population.

Socioeconomic Inequality in Smoking in Low-Income and Middle-Income Countries: Results from the World Health Survey

PubMed Central

Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

2012-01-01

Objectives To assess the magnitude and pattern of socioeconomic inequality in current smoking in low and middle income countries. Methods We used data from the World Health Survey [WHS] in 48 low-income and middle-income countries to estimate the crude prevalence of current smoking according to household wealth quintile. A Poisson regression model with a robust variance was used to generate the Relative Index of Inequality [RII] according to wealth within each of the countries studied. Results In males, smoking was disproportionately prevalent in the poor in the majority of countries. In numerous countries the poorest men were over 2.5 times more likely to smoke than the richest men. Socioeconomic inequality in women was more varied showing patterns of both pro-rich and pro-poor inequality. In 20 countries pro-rich relative socioeconomic inequality was statistically significant: the poorest women had a higher prevalence of smoking compared to the richest women. Conversely, in 9 countries women in the richest population groups had a statistically significant greater risk of smoking compared to the poorest groups. Conclusion Both the pattern and magnitude of relative inequality may vary greatly between countries. Prevention measures should address the specific pattern of smoking inequality observed within a population. PMID:22952617

Reassessing the importance of 'lost pleasure' associated with smoking cessation: implications for social welfare and policy.

PubMed

Pechacek, Terry Frank; Nayak, Pratibha; Slovic, Paul; Weaver, Scott R; Huang, Jidong; Eriksen, Michael P

2017-11-28

Benefit-cost analyses of tobacco regulations include estimates of the informed choice of smokers to continue smoking. Few studies have focused on subjective feelings associated with continued smoking. This study estimates how smoker discontent and regret relate to risk perceptions and health concerns. We analysed data from a 2015 nationally representative, online survey of 1284 US adult current smokers. Information was collected on regret, intention to quit, perceived addiction, risk perceptions and health concerns. Multivariate logistic regression adjusting for sociodemographics and health status was used to examine factors associated with smoker discontent. More than 80% of current smokers report high (22.5%) or very high (59.8%) discontent due to inability to quit, perceived addiction and regret about having started to smoke. Higher levels of discontent did not vary significantly by sex, age, race/ethnicity, education or income (adjusted odds ratios (AORs) 0.5-1.2). Compared with the smokers expressing low (5.9%) or very low (3.6%) discontent, those expressing higher levels of discontent perceived their health status as fair/poor (AOR=2.3), worried most of the time about lung cancer (AOR=4.6) and felt they were more likely to develop lung cancer in the future (AOR=5.1). The proportion of smokers who might be characterised as having a preference to continue smoking are greatly outnumbered by addicted, discontent and concerned smokers who want to quit and regret ever having started to smoke. These discontent smokers could have a substantial net welfare gain if new regulations helped them escape their concerns about the health effects from continuing smoking. © 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.

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.

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

Economic Burden of Smoking in Iran: A Prevalence-Based Annual Cost Approach

PubMed Central

Rezaei, Satar; Matin, Behzad Karami; Hajizadeh, Mohammad; Bazyar, Mohammad; Sari, Ali Akbari

2017-01-01

Objectives: The burden of smoking on the health system and society is significant. The current study aimed to estimate the annual direct and indirect costs of smoking in Iran for the year 2014. Methods: A prevalence-based disease-specific approach was used to determine costs associated with the three most common smoking-related diseases: lung cancer (LC), chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD). Data on healthcare utilization were obtained from an original survey, hospital records and questionnaires. The number of deaths was extracted from the global burden diseases study (GBD). The human capital approach was applied to estimate the costs of morbidity and mortality due to smoking-related diseases, classified as direct (hospitalization, outpatients and non-medical costs) and indirect (mortality and morbidity). Results: The total economic cost of the three most common smoking-attributable diseases in Iran was US$1.46 billion in 2014, including US$1.05 billion (71.7%) in indirect and US$0.41 billion (28.3%) in direct costs. Direct costs of the three smoking-related diseases accounted for 1.6% of total healthcare expenditures and total costs were about 0.26% of Iran’s gross domestic product (GDP) in 2014. Conclusions: Our study indicated that smoking places a substantial economic burden on Iranian society. Therefore, sustained smoking cessation interventions and tobacco control policies are required to reduce the magnitude and extent of smoking-attributable costs in Iran. PMID:29072438

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.

Reduction of smoking in Dutch adolescents over the past decade and its health gains: a repeated cross-sectional study.

PubMed

Gielkens-Sijstermans, Cindy M; Mommers, Monique A; Hoogenveen, Rudolf T; Feenstra, Talitha L; de Vreede, Jacqueline; Bovens, Fons M; van Schayck, Onno C

2010-04-01

Smoking is the main preventable lifestyle-related risk factor threatening human health. In this study, time trends in smoking behaviour between 1996 and 2005 among adolescents enrolled in secondary school were assessed. In 1996, 2001 and 2005, a survey was conducted in the south-eastern region of the Netherlands. All students in second and fourth year of secondary education (1996: n = 20 000; 2001: n = 27 500; 2005: n = 24 000) were asked to complete a questionnaire about their smoking behaviour. A simulation model was used to estimate lifetime health gains related to the observed trends. In 1996, 2001 and 2005, the number of questionnaires analysed were 13 554 (68%), 20 767 (76%) and 17 896 (75%), respectively. The results show a decrease in 'ever smoking' as well as 'current smoking' between 1996 and 2005. Among second year high school students, current smoking prevalence decreased from 22.2% in 1996 to 8.0% in 2005 (P(trend) < 0.001). Among fourth year students, current smoking declined from 37.5% in 1996 to 22.0% in 2005 (P(trend) < 0.001). Time trends were not influenced by gender or educational level. Model projections show that if these students not take up smoking later in life, 11 500 new cases of COPD, 3400 new cases of lung cancer and 1800 new cases of myocardial infarction could be prevented for the Dutch 13-year-olds. This study found that, in the past decade, smoking prevalence among adolescents has declined by almost 50%, potentially resulting in a considerable reduction in new cases of COPD or lung cancer.

Variation across Canada in the economic burden attributable to excess weight, tobacco smoking and physical inactivity.

PubMed

Krueger, Hans; Krueger, Joshua; Koot, Jacqueline

2015-04-30

Tobacco smoking, excess weight and physical inactivity contribute substantially to the preventable disease burden in Canada. The purpose of this paper is to determine the potential reduction in economic burden if all provinces achieved prevalence rates of these three risk factors (RFs) equivalent to those of the province with the lowest rates, and to update and address a limitation noted in our previous model. We used a previously developed approach based on population attributable fractions to estimate the economic burden associated with these RFs. Sex-specific relative risk and age-/sex-specific prevalence data were used in the modelling. The previous model was updated using the most current data for developing resource allocation weights. In 2012, the prevalence of tobacco smoking, excess weight and physical inactivity was the lowest in British Columbia. If age- and sex-specific prevalence rates from BC were applied to populations living in the other provinces, the annual economic burden attributable to these three RFs would be reduced by $5.3 billion. Updating the model resulted in a considerable shift in economic burden from smoking to excess weight, with the estimated annual economic burden attributable to excess weight now 25% higher compared to that of tobacco smoking ($23.3 vs. $18.7 billion). Achieving RF prevalence rates equivalent to those of the province with the lowest rates would result in a 10% reduction in economic burden attributable to excess weight, smoking and physical inactivity in Canada. This study shows that using current resource use data is important for this type of economic modelling.

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

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach

PubMed Central

Tarantilis, Filippos; Athanasakis, Kostas; Zavras, Dimitris; Vozikis, Athanassios; Kyriopoulos, Ioannis

2015-01-01

Objective During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers’ sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. Methods Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers’ income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. Results Short-run price elasticity is estimated at −0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. Conclusions Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece. PMID:25564137

Associations of Smoking, Physical Inactivity, Heavy Drinking, and Obesity with Quality-Adjusted Life Expectancy among US Adults with Depression.

PubMed

Jia, Haomiao; Zack, Matthew M; Gottesman, Irving I; Thompson, William W

2018-03-01

To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults. Copyright © 2018. Published by Elsevier Inc.

Link Between Perceived Body Weight and Smoking Behavior Among Adolescents.

PubMed

Yoon, Jangho; Bernell, Stephanie L

2016-11-01

This study investigates a relationship between overweight perception and smoking among adolescents. Data were retrieved from the Youth Risk Behavior Survey (YRBS), a biennial survey of a nationally representative sample of students in grades 9 through 12 in the United States. We analyze five waves of repeated cross-sections (N = 73 376) for the years 2005-2013. We estimate a recursive simultaneous-equations system in which body weight perception, which is a function of actual weight, influences smoking status. Outcome measures are binary indicators for current smoking and frequent current smoking. Perceived weight is categorized into very overweight perception, slightly overweight perception, and about the right weight/underweight perception. In comparison to adolescents who perceive themselves to be the right weight or underweight, adolescents who perceive themselves to be very overweight are 6.1 percentage points (pp) (standard error [SE] = 1.6pp) more likely to currently smoking and 3.3pp (SE = 1.2pp) more likely to frequently smoke. Adolescents with slightly overweight perception are 7.9pp (SE = 1.0pp) and 2.5pp (SE = 0.6pp) more likely to currently smoke and frequently smoke, respectively, as compared to those with the right weight/underweight perception. The relationships are larger for females, and appear to be mediated by weight-loss activity. In an era of tight budgets, it is crucial to address both obesity and smoking in manners that do not work at cross purposes. Strategies to combat youth smoking may be more effective if the perception of being overweight is considered an important risk factor, especially among female adolescents. We find that perception of being overweight is an important causal risk factor for adolescent smoking. Main findings of this study imply that even a slight change in the perception of body weight may lead to a significant change in smoking behavior among adolescents, especially among females and that the perception of being overweight induces adolescents to smoke regularly. Unlike most prior studies, we discovered a positive effect of slight overweight perception on smoking for adolescent males. Our findings emphasize the importance of addressing both obesity and smoking in manners that do not work at cross purposes. © 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.

Risks for heart disease and lung cancer from passive smoking by workers in the catering industry.

PubMed

Hedley, Anthony J; McGhee, Sarah M; Repace, James L; Wong, Lai-Chin; Yu, Marcus Y S; Wong, Tze-Wai; Lam, Tai-Hing

2006-04-01

Workers in the catering industry are at greater risk of exposure to secondhand smoke (SHS) when smoke-free workplace policies are not in force. We determined the exposure of catering workers to SHS in Hong Kong and their risk of death from heart disease and lung cancer. Nonsmoking catering workers were provided with screening at their workplaces and at a central clinic. Participants reported workplace, home, and leisure time exposure to SHS. Urinary cotinine was estimated by enzyme immunoassay. Catering facilities were classified into three types: nonsmoking, partially restricted smoking (with nonsmoking areas), and unrestricted smoking. Mean urinary cotinine levels ranged from 3.3 ng/ml in a control group of 16 university staff through 6.4 ng/ml (nonsmoking), 6.1 ng/ml (partially restricted), and 15.9 ng/ml (unrestricted smoking) in 104 workers who had no exposures outside of work. Workers in nonsmoking facilities had exposures to other smoking staff. We modeled workers' mortality risks using average cotinine levels, estimates of workplace respirable particulates, risk data for cancer and heart disease from cohort studies, and national (US) and regional (Hong Kong) mortality for heart disease and lung cancer. We estimated that deaths in the Hong Kong catering workforce of 200,000 occur at the rate of 150 per year for a 40-year working-lifetime exposure to SHS. When compared with the current outdoor air quality standards for particulates in Hong Kong, 30% of workers exceeded the 24-h and 98% exceeded the annual air quality objectives due to workplace SHS exposures.

Current use of smokeless tobacco among adolescents in the Republic of Congo.

PubMed

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

2010-01-14

Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT). Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations. Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]). Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and at leisure must also be factored in order to prevent their uptake or maintenance of tobacco use.

Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico.

PubMed

Fleischer, Nancy L; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Cummings, K Michael; Meza, Rafael; Zhang, Yian; Levy, David T

2017-07-01

We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.

Smoking habits of Greek preschool children's parents.

PubMed

Vardavas, Constantine I; Athanasopoulos, Dimitrios; Balomenaki, Evaggelia; Niaounaki, Dora; Linardakis, Manolis K; Kafatos, Anthony G

2007-06-14

Smoking is Greece's largest public health threat. Greece has the highest adult smoking prevalence among all E.U countries, which in turn possibly predisposes Greek children and adolescents to smoke. The purpose of our study was to research into the smoking habits of preschool children's parents since children of that age could be vulnerable to parental negative role modeling and to investigate into the necessity of conducting a public health awareness programme aimed at the general population. A cross-sectional study was performed on the parents of children enrolled in kindergarten in western Crete-Greece (2809 parents), and interviewed during the 2004-2005 Cretan school health promotion programme. 63% of households had at least one parent a current smoker and in 26% both parents were found to be current smokers. Smoking prevalence among adults with preschool children was estimated at 44% (52% of fathers and 36% of mothers). Paternal education and nationality were statistically significantly related to smoking (p < 0.001), unlike place of residence (p = 0.862) and level of maternal education (p = 0.132). Smoking prevalence is high even among parents with preschool children. Taking into account the parents' significant primary role in the children's upbringing and the effect that parental induced passive smoking has on children's health and health attitude; one can deduce that the health of Greek children is under threat. It is of major importance that educational and policy intervention measures are implemented to reduce such a situation that could contribute to promoting the initiation of smoking among Greek adolescents.

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.

Relationship between impulsive sensation seeking traits, smoking, alcohol and caffeine intake, and Parkinson's disease.

PubMed

Evans, A H; Lawrence, A D; Potts, J; MacGregor, L; Katzenschlager, R; Shaw, K; Zijlmans, J; Lees, A J

2006-03-01

An inverse relation exists between smoking and coffee intake and Parkinson's disease (PD). The present study explored whether this is explained by low sensation seeking, a personality trait believed to characterise PD. A total of 106 non-demented patients with PD and 106 age and sex matched healthy controls completed a short version of Zuckerman's Sensation Seeking Scale (SSS), the Geriatric Depression Scale, and the Trait Anxiety Inventory. Data were collected on past and current cigarette smoking, and participants also completed food frequency questionnaires to estimate current caffeine and alcohol intake. Patients with PD had lower sensation seeking and higher depression and anxiety scores. They were also less likely to have ever smoked, and had lower caffeine and alcohol intakes. Analysis of the data using conditional logistic regression suggested that the inverse association of PD risk with sensation seeking was independent of smoking, and caffeine and alcohol intake. Moreover, low sensation seeking explained some of the apparent effect of caffeine and alcohol intake on PD. However, the effect of smoking was weakened only slightly when SSS was included in the regression model. This study raises the possibility that there is a neurobiological link between low sensation seeking traits--which might underlie the parkinsonian personality--and the hypothetical protective effect of cigarette smoking and caffeine consumption on PD.

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 Exposure to Welding Fume on Lung Function: Results from the German WELDOX Study.

PubMed

Lehnert, M; Hoffmeyer, F; Gawrych, K; Lotz, A; Heinze, E; Berresheim, H; Merget, R; Harth, V; Van Gelder, R; Hahn, J-U; Hartwig, A; Weiß, T; Pesch, B; Brüning, T

2015-01-01

The association between exposure to welding fume and chronic obstructive pulmonary disease (COPD) has been insufficiently clarified. In this study we assessed the influence of exposure to welding fume on lung function parameters. We investigated forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and expiratory flow rates in 219 welders. We measured current exposure to respirable particles and estimated a worker's lifetime exposure considering welding techniques, working conditions and protective measures at current and former workplaces. Multiple regression models were applied to estimate the influence of exposure to welding fume, age, and smoking on lung function. We additionally investigated the duration of working as a welder and the predominant welding technique. The findings were that age- and smoking-adjusted lung function parameters showed no decline with increasing duration, current exposure level, and lifetime exposure to welding fume. However, 15% of the welders had FEV1/FVC below the lower limit of normal, but we could not substantiate the presence of an association with the measures of exposure. Adverse effects of cigarette smoking were confirmed. In conclusion, the study did not support the notion of a possible detrimental effect of exposure to welding fume on lung function in welders.

Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students.

PubMed

Lewis, K E; Shin, D; Davies, G

2011-08-01

A group of United Kingdom (UK) hospitals. To estimate the current smoking habits of health care professionals (HCPs) in a country with active tobacco control measures, and to record their attitudes to national and hospital tobacco bans. A cross-sectional survey of 500 HCPs. HCPs reported a lower rate of current smoking (7%) than the general population (24%). Doctors (2.6%) and medical students (3.8%) were less likely to be current smokers than both nurses (8.7%) and allied health professionals (10.9%, P < 0.001). The vast majority felt national legislation had been effective (88%) and well complied with (82%). Around a third of respondents believed the ban had led to a reduction in admissions for acute coronary syndrome. Almost all respondents were in favour of restrictions on smoking in health care premises. A higher proportion of UK doctors (69%) than nurses (52%) favoured a complete ban (odds ratio 2.01, 95% confidence interval 1.14-3.56). Self-reported smoking patterns in UK health professionals are lower than previously and compared to other industrialised and developing countries. Support for bans is very high, but differences remain in behaviour and especially attitudes to local bans according to professional status, although this gap is also narrowing.

The Application of a Decision-Theoretic Model to Estimate the Public Health Impact of Vaporized Nicotine Product Initiation in the United States

PubMed Central

Borland, Ron; Villanti, Andrea C.; Niaura, Raymond; Yuan, Zhe; Zhang, Yian; Meza, Rafael; Holford, Theodore R.; Fong, Geoffrey T.; Cummings, K. Michael; Abrams, David B.

2017-01-01

Introduction: The public health impact of vaporized nicotine products (VNPs) such as e-cigarettes is unknown at this time. VNP uptake may encourage or deflect progression to cigarette smoking in those who would not have otherwise smoked, thereby undermining or accelerating reductions in smoking prevalence seen in recent years. Methods: The public health impact of VNP use are modeled in terms of how it alters smoking patterns among those who would have otherwise smoked cigarettes and among those who would not have otherwise smoked cigarettes in the absence of VNPs. The model incorporates transitions from trial to established VNP use, transitions to exclusive VNP and dual use, and the effects of cessation at later ages. Public health impact on deaths and life years lost is estimated for a recent birth cohort incorporating evidence-informed parameter estimates. Results: Based on current use patterns and conservative assumptions, we project a reduction of 21% in smoking-attributable deaths and of 20% in life years lost as a result of VNP use by the 1997 US birth cohort compared to a scenario without VNPs. In sensitivity analysis, health gains from VNP use are especially sensitive to VNP risks and VNP use rates among those likely to smoke cigarettes. Conclusions: Under most plausible scenarios, VNP use generally has a positive public health impact. However, very high VNP use rates could result in net harms. More accurate projections of VNP impacts will require better longitudinal measures of transitions into and out of VNP, cigarette and dual use. Implications: Previous models of VNP use do not incorporate whether youth and young adults initiating VNP would have been likely to have been a smoker in the absence of VNPs. This study provides a decision-theoretic model of VNP use in a young cohort that incorporates tendencies toward smoking and shows that, under most plausible scenarios, VNP use yields public health gains. The model makes explicit the type of surveillance information needed to better estimate the effect of new products and thereby inform public policy. PMID:27613952

Alcohol and smoking consumption behaviours in older Australian adults: prevalence, period and socio-demographic differentials in the DYNOPTA sample.

PubMed

Burns, Richard A; Birrell, Carole L; Steel, David; Mitchell, Paul; Anstey, Kaarin J

2013-03-01

Alcohol consumption and tobacco use are key risk factors for chronic disease and health burden across the adult lifespan. We estimate the prevalence of alcohol consumption and smoking by age and time period in adults from mid to old age. Participants (n = 50,652) were drawn from the Dynamic Analyses to Optimise Ageing (DYNOPTA) project and were compared with Australian National Health Survey data. Alcohol and smoking consumption DYNOPTA data were weighted to the estimated resident population of the sampling frame for each contributing study according to age and sex distributions within major statistical regions. Comparisons in the rates of smoking and alcohol consumption between DYNOPTA and other national surveys were comparable. Males were more likely to be (RRR = 2.12) or have been smokers (RRR = 2.97), whilst females were more likely to be non-drinkers (RRR = 2.52). Period effects were also identified; higher prevalence rates in consumption of alcohol (RRR = 3.21) and smoking (RRR = 1.67) for those contributing studies from the early 1990's, in comparison with those studies from the latter half of the decade, were reported. Over a decade, prevalence rates for high-risk consumption of alcohol and current smoking behaviour declined and suggest the possible impact of government health policy, with targeted-health policies, that included bans on public smoking, and a toughening of legislation against alcohol-related crime.

Cigarette smoking, educational level and total and site-specific cancer: a cohort study in men in Lithuania.

PubMed

Everatt, Rūta; Kuzmickienė, Irena; Virvičiūtė, Dalia; Tamošiūnas, Abdonas

2014-11-01

Smoking is an established risk factor for cancer. However, most studies have been carried out on western populations, and less is known about the impact in central and eastern Europe. Our objective was to investigate the association between cigarette smoking, educational level and risk of cancer in a Lithuanian population-based cohort study. The study included 6976 men initially free from cancer. During the follow-up (1978-2008), 1780 cancer cases were identified. Cox proportional hazards models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs). In addition, the burden of cancer attributable to smoking was assessed by the population attributable fraction. Following adjustment for age, education, alcohol consumption and BMI, for current compared with never smokers, highly significant and strongly elevated estimates were found for total (HR=1.79, 95% CI 1.59-2.02), tobacco-related (HR=2.52, 95% CI 2.16-2.95), upper aerodigestive tract (UADT) (HR=5.77, 95% CI 2.73-12.21), lung (HR=10.47, 95% CI 6.74-16.25), bladder (HR=3.31, 95% CI 1.71-6.41) and liver (HR=4.64, 95% CI 1.53-14.08) cancer. Findings suggest a lower risk of prostate cancer in current smokers. In addition, the occurrence of lung and UADT cancer was significantly elevated in men in the lowest educational attainment category. If smoking had not occurred, ∼23% of total cancer, 37% of tobacco-related, 77% of lung, 58% of UADT, 43% of liver and 45% of bladder cancer cases could have been prevented in this cohort of men. Cancer-control strategies focused on reducing smoking should be a public health priority.

Estimating micro area behavioural risk factor prevalence from large population-based surveys: a full Bayesian approach.

PubMed

Seliske, L; Norwood, T A; McLaughlin, J R; Wang, S; Palleschi, C; Holowaty, E

2016-06-07

An important public health goal is to decrease the prevalence of key behavioural risk factors, such as tobacco use and obesity. Survey information is often available at the regional level, but heterogeneity within large geographic regions cannot be assessed. Advanced spatial analysis techniques are demonstrated to produce sensible micro area estimates of behavioural risk factors that enable identification of areas with high prevalence. A spatial Bayesian hierarchical model was used to estimate the micro area prevalence of current smoking and excess bodyweight for the Erie-St. Clair region in southwestern Ontario. Estimates were mapped for male and female respondents of five cycles of the Canadian Community Health Survey (CCHS). The micro areas were 2006 Census Dissemination Areas, with an average population of 400-700 people. Two individual-level models were specified: one controlled for survey cycle and age group (model 1), and one controlled for survey cycle, age group and micro area median household income (model 2). Post-stratification was used to derive micro area behavioural risk factor estimates weighted to the population structure. SaTScan analyses were conducted on the granular, postal-code level CCHS data to corroborate findings of elevated prevalence. Current smoking was elevated in two urban areas for both sexes (Sarnia and Windsor), and an additional small community (Chatham) for males only. Areas of excess bodyweight were prevalent in an urban core (Windsor) among males, but not females. Precision of the posterior post-stratified current smoking estimates was improved in model 2, as indicated by narrower credible intervals and a lower coefficient of variation. For excess bodyweight, both models had similar precision. Aggregation of the micro area estimates to CCHS design-based estimates validated the findings. This is among the first studies to apply a full Bayesian model to complex sample survey data to identify micro areas with variation in risk factor prevalence, accounting for spatial correlation and other covariates. Application of micro area analysis techniques helps define areas for public health planning, and may be informative to surveillance and research modeling of relevant chronic disease outcomes.

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

Cigarette Smoking Among Urban American Indian Adults - Hennepin and Ramsey Counties, Minnesota, 2011.

PubMed

Forster, Jean; Poupart, John; Rhodes, Kristine; Peterson-Hickey, Melanie; Lamont, Genelle; D'Silva, Joanne; Erickson, Darin

2016-06-03

In 2013, it was estimated that the prevalence of cigarette smoking among American Indians was 36.5%, the highest of all racial/ethnic groups in the continental United States (1). Among American Indians, considerable cultural and geographic variation in cigarette smoking exists. Smoking prevalence among American Indians is lowest in the Southwest and highest in the Upper Midwest/Northern Plains (2). Little information is available about tobacco use among urban American Indians, who might not have ever lived on a reservation or be enrolled in or affiliated with a tribe. In Minnesota, a significant proportion of American Indians reside in urban areas. Among Minnesota's residents who identify as American Indian alone or in combination with another race, 30% live in Hennepin County and Ramsey County, which encompass Minneapolis and St. Paul, respectively (collectively known as the Twin Cities). The predominant tribes (Ojibwe [Chippewa] and Dakota/Lakota/Nakota [Sioux]) traditionally have used locally grown tobacco (Nicotiana rustica), red willow, and other plants for religious ceremonies, although nonceremonial tobacco is often substituted for traditional plants. To assess prevalence of cigarette smoking among this population, it is important to distinguish ceremonial tobacco use (smoked or used in other ways) from nonceremonial tobacco use. To obtain estimates of cigarette smoking prevalence among American Indians in Hennepin and Ramsey counties, the American Indian Adult Tobacco Survey was administered to 964 American Indian residents in 2011, using respondent-driven sampling. Among all participants, 59% were current smokers, 19% were former smokers, and 22% had never smoked. Approximately 40% of employed participants reported that someone smoked in their workplace area during the preceding week. High prevalences of cigarette smoking and secondhand smoke exposure among urban American Indians in Minnesota underscores the need for a comprehensive and culturally appropriate approach to reducing nonceremonial tobacco use.

Asynchronous Processing of a Constellation of Geostationary and Polar-Orbiting Satellites for Fire Detection and Smoke Estimation

NASA Astrophysics Data System (ADS)

Hyer, E. J.; Peterson, D. A.; Curtis, C. A.; Schmidt, C. C.; Hoffman, J.; Prins, E. M.

2014-12-01

The Fire Locating and Monitoring of Burning Emissions (FLAMBE) system converts satellite observations of thermally anomalous pixels into spatially and temporally continuous estimates of smoke release from open biomass burning. This system currently processes data from a constellation of 5 geostationary and 2 polar-orbiting sensors. Additional sensors, including NPP VIIRS and the imager on the Korea COMS-1 geostationary satellite, will soon be added. This constellation experiences schedule changes and outages of various durations, making the set of available scenes for fire detection highly variable on an hourly and daily basis. Adding to the complexity, the latency of the satellite data is variable between and within sensors. FLAMBE shares with many fire detection systems the goal of detecting as many fires as possible as early as possible, but the FLAMBE system must also produce a consistent estimate of smoke production with minimal artifacts from the changing constellation. To achieve this, NRL has developed a system of asynchronous processing and cross-calibration that permits satellite data to be used as it arrives, while preserving the consistency of the smoke emission estimates. This talk describes the asynchronous data ingest methodology, including latency statistics for the constellation. We also provide an overview and show results from the system we have developed to normalize multi-sensor fire detection for consistency.

Behavioral problems and the occurrence of tobacco, cannabis, and coca paste smoking in Chile: evidence based on multivariate response models for school survey data.

PubMed

Caris, Luis; Anthony, Christopher B; Ríos-Bedoya, Carlos F; Anthony, James C

2009-09-01

In this study we estimate suspected links between youthful behavioral problems and smoking of tobacco, cannabis, and coca paste. In the Republic of Chile, school-attending youths were sampled from all 13 regions of the country, with sample size of 46,907 youths from 8th to 12th grades. A Generalized Estimating Equations (GEE) approach to multiple logistic regression was used to address three interdependent response variables, tobacco smoking, cannabis smoking, and coca paste smoking, and to estimate associations. Drug-specific adjusted slope estimates indicate that youths at the highest levels of behavioral problems are an estimated 1.1 times more likely to have started smoking tobacco, an estimated 1.6 times more likely to have started cannabis smoking, and an estimated 2.0 times more likely to have started coca paste smoking, as compared to youths at the lowest level of behavioral problems (p<0.001). In Chile, there is an association linking behavioral problems with onsets of smoking tobacco and cannabis, as well as coca paste; strength of association is modestly greater for coca paste smoking.

Effects of grain dust on lungs prior to and following dust remediation.

PubMed

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

2008-12-01

To determine longitudinal estimates of pulmonary function decline in Canadian grain elevator workers before and after dust control by analyzing data collected from five regions of Canada over 15 years. Declines in forced expired volume in one second and forced vital capacity before and after dust control were estimated by using a generalized estimating equations approach. For grain workers who were in the grain industry for 20 or more years both before and after dust control: the mean annual loss of forced expired volume in one second was greatest among current smoking grain workers followed by ex-smokers and nonsmokers, respectively. Similar results were obtained for forced vital capacity. Grain dust control was effective in reducing decline in the lung function measurements among grain workers in all smoking and exposure categories.

Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?

PubMed

Gartner, Coral E; Barendregt, Jan J; Wallace, Angela; Hall, Wayne D

2012-04-01

We used epidemiological modelling to assess whether nicotine vaccines would be a cost-effective way of preventing smoking uptake in adolescents. We built an epidemiological model using Australian data on age-specific smoking prevalence; smoking cessation and relapse rates; life-time sex-specific disability-adjusted life years lived for cohorts of 100,000 smokers and non-smokers; government data on the costs of delivering a vaccination programme by general practitioners; and a range of plausible and optimistic estimates of vaccine cost, efficacy and immune response rates based on clinical trial results. We first estimated the smoking uptake rates for Australians aged 12-19 years. We then used these estimates to predict the expected smoking prevalence in a birth cohort aged 12 in 2003 by age 20 under (i) current policy and (ii) different vaccination scenarios that varied in cost, initial vaccination uptake, yearly re-vaccination rates, efficacy and a favourable vaccine immune response rate. Under the most optimistic assumptions, the cost to avert a smoker at age 20 was $44,431 [95% confidence interval (CI) $40,023-49,250]. This increased to $296,019 (95% CI $252,307-$355,930) under more plausible scenarios. The vaccine programme was not cost-effective under any scenario. A preventive nicotine vaccination programme is unlikely to be cost-effective. The total cost of a universal vaccination programme would be high and its impact on population smoking prevalence negligible. For these reasons, such a programme is unlikely to be publicly funded in Australia or any other developed country. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Smoking Cessation Classes and Their Effectiveness in the Federal Bureau of Prisons

DTIC Science & Technology

1999-05-15

and mortality attributed to tobacco products. Health Effects ofTobacco Multiple journal articles. books and other references are in agreement that... books , and special reports have shown that from 2500 to 5100 nonsmokers may have died because of ETS (U.S Dept. Of Health And Human Services, 1996...ETS causes an estimated 35,000 to 40,000 deaths from heart disease in people who are not current smokers. Secondhand smoke causes other respiratory

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.

Evaluation of Bar and Nightclub Intervention to Decrease Young Adult Smoking in New Mexico.

PubMed

Kalkhoran, Sara; Lisha, Nadra E; Neilands, Torsten B; Jordan, Jeffrey W; Ling, Pamela M

2016-08-01

Over 20% of young adults in New Mexico currently smoke. We evaluated cigarette smoking prevalence of young adult bar patrons during an anti-tobacco Social Branding intervention. The Social Branding intervention used a smoke-free brand, "HAVOC," to compete with tobacco marketing within the "Partier" young adult peer crowd. A series of cross-sectional surveys were collected from adults aged 18-26 in bars and nightclubs in Albuquerque, New Mexico, from 2009 to 2013 using randomized time-location sampling. Multivariable multinomial regression using full information maximum likelihood estimation to account for missing data evaluated differences in daily and nondaily smoking during the intervention, controlling for demographics, other risk behaviors, and tobacco-related attitudes. Data were collected from 1,069 individuals at Time 1, and 720, 1,142, and 1,149 participants at Times 2, 3, and 4, respectively. Current smoking rates decreased from 47.5% at Time 1 to 37.5% at Time 4 (p < .001). Among Partiers, the odds of daily smoking decreased significantly, but nondaily smoking was unchanged. Partiers that recalled, liked, and understood the smoke-free message of HAVOC had lower odds of nondaily (odds ratio: .48, 95% CI: .31-.75) and daily (odds ratio: .31, 95% CI: .14-.68) smoking than those who did not recall HAVOC. HAVOC recall was associated with attitudes that were also associated with smoking behavior. The significant decrease in daily smoking among young adult Partiers in New Mexico was associated with HAVOC recall and understanding. Social Branding interventions efficiently target and may decrease tobacco use among young adult bar patrons. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of Bar and Nightclub Intervention to Decrease Young Adult Smoking in New Mexico

PubMed Central

Kalkhoran, Sara; Lisha, Nadra E.; Neilands, Torsten B.; Jordan, Jeffrey W.; Ling, Pamela M.

2016-01-01

Purpose Over 20% of young adults in New Mexico currently smoke. We evaluated cigarette smoking prevalence of young adult bar patrons during an anti-tobacco Social Branding intervention. Methods The Social Branding intervention used a smoke-free brand, “HAVOC,” to compete with tobacco marketing within the “Partier” young adult peer crowd. A series of cross-sectional surveys were collected from adults aged 18–26 in bars and nightclubs in Albuquerque, New Mexico, from 2009 to 2013 using randomized time-location sampling. Multivariable multinomial regression using full information maximum likelihood estimation to account for missing data evaluated differences in daily and nondaily smoking during the intervention, controlling for demographics, other risk behaviors, and tobacco-related attitudes. Results Data were collected from 1,069 individuals at Time 1, and 720, 1,142, and 1,149 participants at Times 2, 3, and 4, respectively. Current smoking rates decreased from 47.5% at Time 1 to 37.5% at Time 4 (p < .001). Among Partiers, the odds of daily smoking decreased significantly, but nondaily smoking was unchanged. Partiers that recalled, liked, and understood the smoke-free message of HAVOC had lower odds of nondaily (odds ratio: .48, 95% CI: .31–.75) and daily (odds ratio: .31,95% CI: .14–.68) smoking than those who did not recall HAVOC. HAVOC recall was associated with attitudes that were also associated with smoking behavior. Conclusions The significant decrease in daily smoking among young adult Partiers in New Mexico was associated with HAVOC recall and understanding. Social Branding interventions efficiently target and may decrease tobacco use among young adult bar patrons. PMID:27265423

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.

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

Longitudinal Examination of the Influence of Individual Posttraumatic Stress Disorder Symptoms and Clusters of Symptoms on the Initiation of Cigarette Smoking.

PubMed

Seelig, Amber D; Bensley, Kara M; Williams, Emily C; Armenta, Richard F; Rivera, Anna C; Peterson, Arthur V; Jacobson, Isabel G; Littman, Alyson J; Maynard, Charles; Bricker, Jonathan B; Rull, Rudolph P; Boyko, Edward J

2018-06-06

The aim of this study was to determine whether specific individual posttraumatic stress disorder (PTSD) symptoms or symptom clusters predict cigarette smoking initiation. Longitudinal data from the Millennium Cohort Study were used to estimate the relative risk for smoking initiation associated with PTSD symptoms among 2 groups: (1) all individuals who initially indicated they were nonsmokers (n = 44,968, main sample) and (2) a subset of the main sample who screened positive for PTSD (n = 1622). Participants were military service members who completed triennial comprehensive surveys that included assessments of smoking and PTSD symptoms. Complementary log-log models were fit to estimate the relative risk for subsequent smoking initiation associated with each of the 17 symptoms that comprise the PTSD Checklist and 5 symptom clusters. Models were adjusted for demographics, military factors, comorbid conditions, and other PTSD symptoms or clusters. In the main sample, no individual symptoms or clusters predicted smoking initiation. However, in the subset with PTSD, the symptoms "feeling irritable or having angry outbursts" (relative risk [RR] 1.41, 95% confidence interval [CI] 1.13-1.76) and "feeling as though your future will somehow be cut short" (RR 1.19, 95% CI 1.02-1.40) were associated with increased risk for subsequent smoking initiation. Certain PTSD symptoms were associated with higher risk for smoking initiation among current and former service members with PTSD. These results may help identify individuals who might benefit from more intensive smoking prevention efforts included with PTSD treatment.

Susceptibility to cigarette smoking among middle and high school e-cigarette users in Canada.

PubMed

Azagba, Sunday; Baskerville, Neill Bruce; Foley, Kristie

2017-10-01

There is a growing concern that the historic reductions in tobacco consumption witnessed in the past decades may be undermined by the rapid increase in e-cigarette use. This study examined the association between e-cigarette use and future intention to smoke cigarettes among middle and high school students who had never smoked cigarettes. Data were drawn from the 2014-2015 Canadian Student Tobacco, Alcohol and Drugs Survey (n=25,637). A multivariable logistic regression model was used to examine the association between e-cigarette use and susceptibility to cigarette smoking. In addition, an inverse probability of treatment weighted regression adjustment method (doubly robust estimator), which models both the susceptibility to smoking and the probability of e-cigarette use, was conducted. About 10% of the students had ever tried an e-cigarette. There were higher rates of ever e-cigarette use among students in grades 10-12 (12.5%) than those in grades 7-9 (7.3%). Students who had ever tried an e-cigarette had higher odds of susceptibility to cigarette smoking (adjusted odds ratio=2.16, 95% confidence interval=1.80-2.58) compared to those that had never tried an e-cigarette. Current use of an e-cigarette was associated with higher odds of smoking susceptibility (adjusted odds ratio=2.02, 95% confidence interval=1.43-2.84). Similar results were obtained from the doubly robust estimation. Among students who had never smoked cigarettes, e-cigarette use was associated with a higher susceptibility to cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study

PubMed Central

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-01-01

Objective While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Setting Computer-based simulation model. Participants Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Interventions Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary and secondary outcome measures Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Results Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Conclusions Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. PMID:26928026

Complete workplace indoor smoking ban and smoking behavior among male workers and female nonsmoking workers' husbands: a pseudo cohort study of Japanese public workers.

PubMed

Tabuchi, Takahiro; Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (-4.7, 19.2) and 8.4 (-2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study.

Complete Workplace Indoor Smoking Ban and Smoking Behavior among Male Workers and Female Nonsmoking Workers' Husbands: A Pseudo Cohort Study of Japanese Public Workers

PubMed Central

Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (−4.7, 19.2) and 8.4 (−2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study. PMID:24783199

The role of smokeless tobacco use in smoking persistence among male college students

PubMed Central

Wolfson, Mark; Suerken, Cynthia K.; Egan, Kathleen L.; Sutfin, Erin L.; Reboussin, Beth A.; Wagoner, Kimberly G.; Spangler, John

2015-01-01

Background Significant changes in the tobacco industry have led to heightened concern about co-use of cigarettes and smokeless tobacco (SLT) products. Objectives The aim of this study was to assess whether male cigarette smokers who also used SLT products, in the first semester of their first year of college, were more or less likely than male cigarette smokers who did not use SLT products to still be smoking by the first semester of their senior year. Methods Using a longitudinal, observational study, we followed a cohort of undergraduate students from 11 four-year universities in North Carolina and Virginia through their college career. Mixed-effects logistic regression analysis was conducted to estimate the likelihood of being a current smoker fall of senior year for male students who used both cigarettes and SLT at baseline, compared to those who only smoked cigarettes, after adjustment for potential confounders (n = 274). Results At baseline, 67.2% of participants were smoking cigarettes only (no SLT use) and 32.8% were dual users (cigarettes and SLT). A total of 62% were still smoking at senior year. Dual users were 30% more likely to be current smokers senior year compared to cigarette only users, although this difference was not statistically significant. Having at least one friend who smoked cigarettes and heavier cigarette smoking at baseline were significantly related to senior year smoking. Conclusions Our findings do not support the argument that SLT use may help male college smokers discontinue their smoking habit. In fact, it may contribute to smoking persistence. PMID:26375618

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.

Associations between smoking and caffeine consumption in two European cohorts

PubMed Central

Taylor, Amy E.; Ware, Jennifer J.; McMahon, George; Hottenga, Jouke‐Jan; Baselmans, Bart M. L.; Willemsen, Gonneke; Boomsma, Dorret I.; Munafò, Marcus R.; Vink, Jacqueline M.

2016-01-01

Abstract Aims To estimate associations between smoking initiation, smoking persistence and smoking heaviness and caffeine consumption in two population‐based samples from the Netherlands and the United Kingdom. Design Observational study employing data on self‐reported smoking behaviour and caffeine consumption. Setting Adults from the general population in the Netherlands and the United Kingdom. Participants Participants from the Netherlands Twin Register [NTR: n = 21 939, mean age 40.8, standard deviation (SD) = 16.9, 62.6% female] and the Avon Longitudinal Study of Parents and Children (ALSPAC: n = 9086, mean age 33.2, SD = 4.7, 100% female). Measurements Smoking initiation (ever versus never smoking), smoking persistence (current versus former smoking), smoking heaviness (number of cigarettes smoked) and caffeine consumption in mg per day through coffee, tea, cola and energy drinks. Findings After correction for age, gender (NTR), education and social class (ALSPAC), smoking initiation was associated with consuming on average 52.8 [95% confidence interval (CI) = 45.6–60.0; NTR] and 59.5 (95% CI = 51.8–67.2; ALSPAC) mg more caffeine per day. Smoking persistence was also associated with consuming more caffeine [+57.9 (95% CI = 45.2–70.5) and +83.2 (95% CI = 70.2–96.3) mg, respectively]. Each additional cigarette smoked per day was associated with 3.7 (95% CI = 1.9–5.5; NTR) and 8.4 (95% CI = 6.9–10.0; ALSPAC) mg higher daily caffeine consumption in current smokers. Smoking was associated positively with coffee consumption and less strongly with cola and energy drinks. For tea, associations were positive in ALSPAC and negative in NTR. Conclusions There appears to be a positive association between smoking and caffeine consumption in the Netherlands and the United Kingdom. PMID:26750569

Urban Indians' smoking patterns and interest in quitting.

PubMed Central

Lando, H A; Johnson, K M; Graham-Tomasi, R P; McGovern, P G; Solberg, L

1992-01-01

Little is known about smoking patterns of urban American Indians and their interest in quitting. Most published research has focused upon American Indians who live on rural reservations. In this study, personal interviews were conducted with a convenience sample of patients at Urban Indian Health Clinics in four geographically diverse sites: Milwaukee, WI, Minneapolis, MN, and Seattle and Spokane, WA. A total of 419 current smokers and 173 ex-smokers completed interviews. Current smokers reported a median cigarette consumption of 11 per day. Smokers indicated both a moderate desire to quit (mean 5.97, on a scale 0-10) and moderate confidence in their ability to do so (mean 5.56, on a scale 0-10). More than 70 percent of current smokers indicated having previously tried to quit. The most common reasons cited for relapse included craving, social situations, stress, and nervousness. The most common reasons for quitting given by ex-smokers included being "sick" of smoking, health concerns, respiratory problems, and pregnancy. The estimated quit-ratio (former smokers divided by current+former smokers) was 29.7 percent. This quit-ratio, although substantial, is lower than the 45 percent quit-ratio reported for the general U.S. population. Perhaps the most striking findings are the similarities between American Indians and the overall population in both interest in quitting and reasons for doing so. Smoking cessation previously has been viewed as a low priority for this population. The current results suggest the viability of systematic efforts to encourage urban American Indians to quit smoking. PMID:1594745

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.

Status update: is smoke on your mind? Using social media to assess smoke exposure

NASA Astrophysics Data System (ADS)

Ford, Bonne; Burke, Moira; Lassman, William; Pfister, Gabriele; Pierce, Jeffrey R.

2017-06-01

Exposure to wildland fire smoke is associated with negative effects on human health. However, these effects are poorly quantified. Accurately attributing health endpoints to wildland fire smoke requires determining the locations, concentrations, and durations of smoke events. Most current methods for assessing these smoke events (ground-based measurements, satellite observations, and chemical transport modeling) are limited temporally, spatially, and/or by their level of accuracy. In this work, we explore using daily social media posts from Facebook regarding smoke, haze, and air quality to assess population-level exposure for the summer of 2015 in the western US. We compare this de-identified, aggregated Facebook dataset to several other datasets that are commonly used for estimating exposure, such as satellite observations (MODIS aerosol optical depth and Hazard Mapping System smoke plumes), daily (24 h) average surface particulate matter measurements, and model-simulated (WRF-Chem) surface concentrations. After adding population-weighted spatial smoothing to the Facebook data, this dataset is well correlated (R2 generally above 0.5) with the other methods in smoke-impacted regions. The Facebook dataset is better correlated with surface measurements of PM2. 5 at a majority of monitoring sites (163 of 293 sites) than the satellite observations and our model simulation. We also present an example case for Washington state in 2015, for which we combine this Facebook dataset with MODIS observations and WRF-Chem-simulated PM2. 5 in a regression model. We show that the addition of the Facebook data improves the regression model's ability to predict surface concentrations. This high correlation of the Facebook data with surface monitors and our Washington state example suggests that this social-media-based proxy can be used to estimate smoke exposure in locations without direct ground-based particulate matter measurements.

What would menthol smokers do if menthol in cigarettes were banned? Behavioral intentions and simulated demand.

PubMed

O'Connor, Richard J; Bansal-Travers, Maansi; Carter, Lawrence P; Cummings, K Michael

2012-07-01

  The US Food and Drug Administration must consider whether to ban the use of menthol in cigarettes. This study examines how current smokers might respond to such a ban on menthol cigarettes.   Convenience sample of adolescent and adult smokers recruited from an online survey panel.   United States, 2010.   A total of 471 adolescent and adult current cigarette smokers.   Respondents were asked a series of questions about how they might react if menthol cigarettes were banned. In addition, participants completed a simulation purchase task to estimate the demand for menthol and non-menthol cigarettes across a range of prices.   Overall, 36.1% of respondents said they always (18.9%) or usually (17.2%) smoked menthol cigarettes. When asked how they might respond to a ban on menthol cigarettes, 35% of current menthol smokers said they would stop smoking, and 25% said they would 'find a way to buy a menthol brand'. Those who reported they might quit tended to have greater current intentions to quit [odds ratio (OR) = 4.47], while those who reported that they might seek illicit menthol cigarettes were far less likely to report current intentions to quit (OR = 0.06). Estimates for demand elasticity for preferred cigarette type were similar for menthol (α = 0.0051) and non-menthol (α = 0.0049) smokers. Demand elasticity and peak consumption were related to usual cigarette type and cigarettes smoked per day, but did not appear to differ by race, gender or age.   Preliminary evidence suggests that a significant minority of smokers of menthol cigarettes in the United States would try to stop smoking altogether if such cigarettes were banned. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Counting the costs of children's smoking.

PubMed Central

Foulds, J.; Godfrey, C.

1995-01-01

The recent publication of the 1994 OPCS survey of smoking among secondary school children confirmed that the Health of the Nation target for children's smoking (a reduction in regular smoking from 8% in 1988 to less than 6% in 1994) has not been achieved. In 1994, 12% of English schoolchildren aged 11-15 were regular smokers (as were 12% in Scotland, 9% in Wales, and 12.5% in Northern Ireland). In 1994 the government spent around 10 million pounds on initiatives to prevent smoking, but received around 8643 million pounds in tax receipts from tobacco sales, about 108 million pounds of which was tax receipts from the illegal sale of cigarettes to children under 16 years old. The tobacco industry spent an estimated 100 million pounds on promotional activities. Improving current trends in children's smoking by the year 2000 will require decisive action by the government. The government should legislate to ban tobacco advertising and should use the 108 million pounds taken each year in taxes from smoking children to fund smoking cessation and prevention initiatives. PMID:7580715

Smoking, health knowledge, and anti-smoking campaigns: an empirical study in Taiwan.

PubMed

Hsieh, C R; Yen, L L; Liu, J T; Lin, C J

1996-02-01

This paper uses a measure of health knowledge of smoking hazards to investigate the determinants of health knowledge and its effect on smoking behavior. In our analysis, two equations are estimated: smoking participation and health knowledge. The simultaneity problem in estimating smoking behavior and health knowledge is also considered. Overall, the estimated results suggest that anti-smoking campaigns have a significantly positive effect on the public's health knowledge, and this health knowledge in turn, has a significantly negative effect on smoking participation. The health knowledge elasticities of smoking participation are -0.48 and -0.56 for all adults and adult males, respectively.

The Economic Impact of Exposure to Secondhand Smoke in Minnesota

PubMed Central

Foldes, Steven S.; Alesci, Nina L.; Samet, Jonathan

2009-01-01

Objectives. Using the risk categories established by the 2006 US surgeon general's report, we estimated medical treatment costs related to exposure to secondhand tobacco smoke (SHS) in the state of Minnesota. Methods. We estimated the prevalence and costs of treated medical conditions related to SHS exposure in 2003 with data from Blue Cross and Blue Shield (Minnesota's largest insurer), the Current Population Survey, and population attributable risk estimates for these conditions reported in the scientific literature. We adjusted treatment costs to the state level by health insurance category by using the Medical Expenditure Panel Survey. Results. The total annual cost of treatment in Minnesota for conditions for which the 2006 surgeon general's report found sufficient evidence to conclude a causal link with exposure to SHS was $228.7 million in 2008 dollars—equivalent to $44.58 per Minnesota resident. Sensitivity analyses showed a range from $152.1 million to $330.0 million. Conclusions. The results present a strong rationale for regulating smoking in public places and were used to support the passage of Minnesota's Freedom to Breathe Act of 2007. PMID:19197082

Prevalence of waterpipe tobacco smoking among population aged 15 years or older, Vietnam, 2010.

PubMed

Xuan, Le Thi Thanh; Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

2013-04-18

The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45-54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking.

Blood cadmium by race/hispanic origin: The role of smoking

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

Aoki, Yutaka, E-mail: yaoki@cdc.gov

Background: There have been increasing concerns over health effects of low level exposure to cadmium, especially those on bones and kidneys. Objective: To explore how age-adjusted geometric means of blood cadmium in adults varied by race/Hispanic origin, sex, and smoking status among U.S. adults and the extent to which the difference in blood cadmium by race/Hispanic origin and sex may be explained by intensity of smoking, a known major source of cadmium exposure. Methods: Our sample included 7,368 adults from National Health and Nutrition Examination Survey (NHANES) 2011–2014. With direct age adjustment, geometric means of blood cadmium and number ofmore » cigarettes smoked per day were estimated for subgroups defined by race/Hispanic origin, smoking status, and sex using interval regression, which allows mean estimation in the presence of left- and right-censoring. Results: Among never and former smoking men and women, blood cadmium tended to be higher for non-Hispanic Asian adults than adults of other race/Hispanic origin. Among current smokers, who generally had higher blood cadmium than never and former smokers, non-Hispanic white, black, and Asian adults had similarly elevated blood cadmium compared to Hispanic adults. A separate analysis revealed that non-Hispanic white adults tended to have the highest smoking intensity regardless of sex, than adults of the other race/Hispanic origin groups. Conclusions: The observed pattern provided evidence for smoking as a major source of cadmium exposure, yet factors other than smoking also appeared to contribute to higher blood cadmium of non-Hispanic Asian adults. - Highlights: • Among never and former smoking adults, Asians have the highest blood cadmium. • White adults tend to have the highest smoking intensity, but not blood cadmium. • Women overall have higher levels of blood cadmium than men regardless of smoking. • Non-smoking sources of exposure likely contribute to Asians’ higher blood cadmium.« less

Estimates of price and income elasticity in Greece. Greek debt crisis transforming cigarettes into a luxury good: an econometric approach.

PubMed

Tarantilis, Filippos; Athanasakis, Kostas; Zavras, Dimitris; Vozikis, Athanassios; Kyriopoulos, Ioannis

2015-01-05

During the past decades, smoking prevalence in Greece was estimated to be near or over 40%. Following a sharp fall in cigarette consumption, as shown in current data, our objective is to assess smokers' sensitivity to cigarette price and consumer income changes as well as to project health benefits of an additional tax increase. Cigarette consumption was considered as the dependent variable, with Weighted Average Price as a proxy for cigarette price, gross domestic product as a proxy for consumers' income and dummy variables reflecting smoking restrictions and antismoking campaigns. Values were computed to natural logarithms and regression was performed. Then, four scenarios of tax increase were distinguished in order to calculate potential health benefits. Short-run price elasticity is estimated at -0.441 and short-run income elasticity is estimated at 1.040. Antismoking campaigns were found to have a statistically significant impact on consumption. Results indicate that, depending on the level of tax increase, annual per capita consumption could fall by at least 209.83 cigarettes; tax revenue could rise by more than €0.74 billion, while smokers could be reduced by up to 530 568 and at least 465 smoking-related deaths could be averted. Price elasticity estimates are similar to previous studies in Greece, while income elasticity estimates are far greater. With cigarettes regarded as a luxury good, a great opportunity is presented for decisionmakers to counter smoking. Increased taxation, along with focused antismoking campaigns, law reinforcement (to ensure compliance with smoking bans) and intensive control for smuggling could invoke a massive blow to the tobacco epidemic in Greece. 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.

Secondhand smoke exposure in the workplace.

PubMed

Skeer, Margie; Cheng, Debbie M; Rigotti, Nancy A; Siegel, Michael

2005-05-01

Currently, there is little understanding of the relationship between the strength of workplace smoking policies and the likelihood and duration, not just the likelihood, of exposure to secondhand smoke at work. This study assessed self-reported exposure to secondhand smoke at work in hours per week among a cross-sectional sample of 3650 Massachusetts adults who were employed primarily at a single worksite outside the home that was not mainly outdoors. The sample data were from a larger longitudinal study designed to examine the effect of community-based tobacco control interventions on adult and youth smoking behavior. Participants were identified through a random-digit-dialing telephone survey. Multiple logistic regression and zero-inflated negative binomial regression models were used to estimate the independent effect of workplace smoking policies on the likelihood and duration of exposure to secondhand smoke. Compared to employees whose workplace banned smoking completely, those whose workplace provided designated smoking areas had 2.9 times the odds of being exposed to secondhand smoke and 1.74 times the duration of exposure, while those with no restrictions had 10.27 times the odds of being exposed and 6.34 times the duration of exposure. Workplace smoking policies substantially reduce the likelihood of self-reported secondhand smoke exposure among employees in the workplace and also greatly affect the duration of exposure.

Ecological momentary assessment of antecedents and consequences of smoking in adults with attention-deficit/hyperactivity disorder.

PubMed

Mitchell, John T; Dennis, Michelle F; English, Joseph S; Dennis, Paul A; Brightwood, Amy; Beckham, Jean C; Kollins, Scott H

2014-09-01

The current study assessed antecedents and consequences of ad lib cigarette smoking in smokers diagnosed with attention-deficit/hyperactivity disorder (ADHD) using ecological momentary assessment (EMA). Adult smokers with ADHD (n = 17) completed 870 smoking and 622 nonsmoking electronic diary entries over a 7-day observation period of their naturalistic smoking behavior. Data collection occurred from 2011 to 2012. Generalized estimating equations indicated that ADHD smokers were more likely to smoke when urge to smoke, negative affect, boredom, stress, worry, and restlessness were elevated. In addition, participants were more likely to smoke in situations that elicited higher levels of nervousness and frustration. ADHD symptoms, in general, did not differ between smoking and nonsmoking contexts, though hyperactive-impulsive ADHD symptoms were elevated prior to smoking in frustrating situations. Additional situational antecedent variables were associated with smoking, including being in the presence of others smoking, being in a bar or restaurant, while outside, and while consuming caffeinated or alcoholic beverages. Participants also reported a significant improvement in urge to smoke, negative affect, stress, hunger, and ADHD symptoms after smoking a cigarette. Findings suggest certain contextual factors that may maintain ad lib cigarette smoking in smokers with ADHD and identify potential treatment targets in smoking cessation interventions for this at-risk group. Clinical implications and future research directions are discussed. Funding for this study was provided by the National Institute on Drug Abuse.

Perceptions and Perceived Impact of Graphic Cigarette Health Warning Labels on Smoking Behavior Among U.S. Young Adults

PubMed Central

2014-01-01

Introduction: In 2011, the Food and Drug Administration published a final rule requiring cigarette packages and advertisements to include graphic health warning labels (HWLs) with new warning statements. Implementation of this rule has been stalled by legal challenge. This study assessed correlates of smoking-related intentions related to graphic HWLs among current cigarette smokers and nonsmokers in a national sample of U.S. young adults aged 18–34. Methods: Data were collected from 4,236 participants aged 18–34 using an online panel in January 2012 for the Legacy Young Adult Cohort Study. Analyses were weighted to provide nationally representative estimates. Our main outcome was assessed with a single item: “Do you think that new warning labels with graphic pictures would make you think about not smoking?” Results: Twenty-two percent of the young adults were current cigarette smokers. Fifty-three percent endorsed that new graphic HWLs would make them think about not smoking (40% among current smokers compared with 56% among nonsmokers). Among nonsmokers, those aged 18–24, females, Hispanics, and those who were aware of graphic cigarette HWLs were more likely to report intention to not smoke related to graphic HWLs. Among current smokers, intending to quit within the next 6 months was correlated with intention resulting from graphic HWLs. Hispanic ethnicity and intention to quit within 30 days were strong correlates of intention in light, nondaily, and self-identified social/occasional smokers. Conclusions: This study supports previous findings that graphic HWLs play an important role in preventing smoking, in addition to encouraging cessation in young adults. PMID:24212476

The Use of E-cigarettes among school-going adolescents in a predominantly rural environment of Central Appalachia

PubMed Central

Owusu, Daniel; Aibangbee, Jocelyn; Collins, Candice; Robertson, Crystal; Wang, Liang; Littleton, Mary A.; Rafie, Boghozian; Casenburg, Vicki; Mamudu, Hadii M.

2017-01-01

Introduction E-cigarette use among youth in the United States (U.S.) continues to increase. In the rural Northeast Tennessee, where prevalence of tobacco use is higher than national and state averages, there is no literature on e-cigarette use to inform policies and programs. This study aimed to estimate the prevalence of e-cigarette use and examine association of e-cigarette use with two tobacco products among school-going adolescents. Method Data from 894 participants of a school-based survey conducted in 2016 in Northeast Tennessee were analyzed. Descriptive statistics and logistic regression analyses were conducted to estimate the prevalence and delineate the associations between e-cigarette use and other tobacco products. Results Approximately 11% of the participants currently used e-cigarettes, and 35% had ever used e-cigarettes. About 6% of the participants were current users of both e-cigarettes and cigarettes; 4% were current users of e-cigarettes and smokeless tobacco; 3% were current users of all the three products, and 15% had ever tried all the three products. More than one-half of current e-cigarette users (52%) also smoked cigarette. Adjusting for covariates, current e-cigarette use was positively associated with cigarette smoking [Odds Ratio (OR)=27.32, 95% confidence interval (CI)=14.4–51.7] and smokeless tobacco use [OR=7.92, 95% CI=3.8–16.5]. Conclusion E-cigarette use was more common among the high school students than cigarette and smokeless tobacco use, and a significant proportion of users either smoked cigarettes, used smokeless tobacco, or both. Thus, there is a critical need for preventive policies and programs to address dual and poly-use of these products. PMID:27868166

Smoking, health-related quality of life and economic evaluation.

PubMed

López-Nicolás, Ángel; Trapero-Bertran, Marta; Muñoz, Celia

2018-06-01

The economic evaluation of tobacco control policies requires the adoption of assumptions about the impact of changes in smoking status on health-related quality of life (HRQoL). Estimates for such impacts are necessary for different populations. This paper aims to test whether smoking status has an independent effect on HRQoL over and above the effect derived from the increased likelihood of suffering a tobacco related disease, and to calculate utility values for the Spanish population. Using data from the Spanish Encuesta Nacional de Salud of 2011-12, we estimate statistical models for HRQoL as measured by the EQ-5D-5L instrument as a function of smoking status. We include a comprehensive set of controls for biological, clinical, lifestyle and socioeconomic characteristics. Smoking status has an independent, statistically significant effect on HRQoL. However, the size of the effect is small. The typical smoking related diseases, such as lung cancer, are associated with a reduction in HRQoL about 5 times larger than the difference between current smokers and never smokers. Attributing substantive HRQoL gains to quitting smoking as well as accounting for the concomitant HRQoL gain derived from a smaller likelihood of contracting tobacco related diseases might lead to an overestimation of the benefits of tobacco control policies. Nonetheless, the relatively large drops in HRQoL associated with being diagnosed with diseases that might be causally linked to tobacco suggest that such diseases should not be omitted from the economic evaluations of tobacco control policies.

Dissipation function and adaptive gradient reconstruction based smoke detection in video

NASA Astrophysics Data System (ADS)

Li, Bin; Zhang, Qiang; Shi, Chunlei

2017-11-01

A method for smoke detection in video is proposed. The camera monitoring the scene is assumed to be stationary. With the atmospheric scattering model, dissipation function is reflected transmissivity between the background objects in the scene and the camera. Dark channel prior and fast bilateral filter are used for estimating dissipation function which is only the function of the depth of field. Based on dissipation function, visual background extractor (ViBe) can be used for detecting smoke as a result of smoke's motion characteristics as well as detecting other moving targets. Since smoke has semi-transparent parts, the things which are covered by these parts can be recovered by poisson equation adaptively. The similarity between the recovered parts and the original background parts in the same position is calculated by Normalized Cross Correlation (NCC) and the original background's value is selected from the frame which is nearest to the current frame. The parts with high similarity are considered as smoke parts.

Costs of employee smoking in the workplace in Scotland

PubMed Central

Parrott, S.; Godfrey, C.; Raw, M.

2000-01-01

BACKGROUND—Employers have responded to new regulations on the effects of passive smoking by introducing a range of workplace policies. Few policies include provision of smoking cessation intervention.
OBJECTIVE—To estimate the cost to employers of smoking in the workplace in Scotland to illustrate the potential gains from smoking cessation provision. Costs vary with type of smoking policy in place; therefore, to estimate these costs results from a survey were combined with evidence drawn from a literature review.
STUDY DESIGN—A telephone survey of 200 Scottish workplaces, based on a stratified random sample of workplaces with 50 or more employees, was conducted in 1996. Additional evidence was compiled from a review of the literature of smoking related costs and specific smoking related effects.
RESULTS—167 completed responses were received, of which 156 employers (93%) operated a smoking policy, 57 (34%) operated smoke free buildings, and 89 (53%) restricted smoking to a "smoke room". The research literature shows absenteeism to be higher among smokers when compared to non-smokers. The estimated cost of smoking related absence in Scotland is £40 million per annum. Total productivity losses are estimated at approximately £450 million per annum. In addition, the resource cost in terms of losses from fires caused by smoking materials is estimated at approximately £4 million per annum. In addition, there are costs from smoking related deaths and smoking related damage to premises.
CONCLUSION—This study shows how smoking cessation interventions in the workplace can yield positive cost savings for employers, resulting in gains in productivity and workplace attendance which may outweigh the cost of any smoking cessation programme.


Keywords: costs of employee smoking; Scotland; smoking related absence PMID:10841855

Assessment of health impacts of decreased smoking prevalence in Copenhagen: Application of the DYNAMO-HIA model.

PubMed

Holm, Astrid Ledgaard; Brønnum-Hansen, Henrik; Robinson, Kirstine Magtengaard; Diderichsen, Finn

2014-07-01

Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data from Danish population registers. We modelled the effects of four intervention scenarios aimed at different target groups, compared to a reference scenario. The potential effects of each scenario were modelled until 2040. A combined scenario affecting both initiation rates among youth, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re-initiation rates, whereas an intervention targeting only initiation among youth had marginal effects on morbidity and mortality within the modelled time frame. By modifying the DYNAMO-HIA model, we were able to estimate the potential health effects of four interventions to reduce smoking prevalence in the population of Copenhagen. The effect of the interventions on future public health depended on population subgroup(s) targeted, duration of implementation and intervention reach. © 2014 the Nordic Societies of Public Health.

Factors Associated with Cigarette Smoking and Motivation to Quit among Street Food Sellers in Vietnam

PubMed Central

Le, Xuan Thanh Thi; To, Lien Thi; Le, Huong Thi; Hoang, Hanh Duc; Do, Khanh Nam; Nguyen, Cuong Tat; Tran, Bach Xuan; Nguyen, Luong Thanh; Latkin, Carl A.; Zhang, Melvyn W. B.; Ho, Roger C. M.

2018-01-01

Since 2013, smoke-free signs in public places, including in restaurants and food stores, have been introduced in Vietnam, aiming to prevent passive smoking. Although extensive research has been carried out on second-hand smoking among clients in public places (e.g., hospitals, restaurants) in Vietnam, no single study exists which captures the current practice of smoking among street food outlets. This study aims to estimate the prevalence of smoking and identify factors associated with smoking status and cessation motivation amongst food sellers in Vietnam. A cross-sectional study involving 1733 food providers at outlets was conducted in 29 districts in Hanoi capital, Vietnam, in 2015. The prevalence of smoking amongst food sellers was determined to be 8.5% (25% for men and 0.8% for women). The enforcement of the smoke-free policy remains modest, since only 7.9% observed outlets complied with the law, providing a room designated for smokers. Although approximately 80% of the participants were aware of the indoor smoke-free regulations in public places, such as restaurants and food stores, 40.2% of smokers reported no intention of quitting smoking. A percentage of 37.6% of current smokers reported that despite having intentions to quit, they did not receive any form of support for smoking cessation. Being male and having hazardous drinking habits and a poor quality of life were all factors that were significantly associated with smoking status. Additionally, having awareness of smoking’s adverse effects and being frequently supervised by the authority were associated with a greater motivation to quit. This study highlights the importance of an accompanying education and smoking cessation program in addition to the frequent inspection and reinforcement of smoke-free policy in food stores. This research extends on our knowledge of smoking prevalence and its factors related to smoking events and motivation to quit among street food outlets. Overall, this study strengthens the idea that more government efforts towards preventing passive smoking and smoking cessation education are necessary in restaurants and other street food outlets. PMID:29382157

Early Exposure to Movie Smoking Predicts Established Smoking by Older Teens and Young Adults

PubMed Central

Dalton, Madeline A.; Beach, Michael L.; Adachi-Mejia, Anna M.; Longacre, Meghan R.; Matzkin, Aurora L.; Sargent, James D.; Heatherton, Todd F.; Titus-Ernstoff, Linda

2009-01-01

OBJECTIVE Movie smoking exposure is a strong predictor of smoking initiation by adolescents; however, we do not know whether it is a long-term predictor of established smoking. We conducted a prospective study to determine whether movie smoking exposure during early adolescence predicts established smoking in older teens and young adults. DESIGN We assessed movie smoking exposure and smoking status through a written school-based survey in 1999, when participants were 10 to 14 years of age. We enrolled 73% (n = 2603) of those who had never tried smoking in a follow-up study. In 2006–2007, we conducted telephone interviews with 69% (n = 1791) of the cohort to ascertain current smoking status. The primary outcome was established smoking, defined as having smoked >100 cigarettes. Mean age at follow-up was 18.7 years. RESULTS Thirteen percent (n = 235) progressed from never smoking to established smoking during the follow-up period. Eighty-nine percent (n = 209) of established smokers smoked during the 30 days before the survey. Even after controlling for a wide range of baseline characteristics, the relative risk for established smoking increased by one third with each successive quartile of movie smoking exposure. Those in the highest quartile for baseline movie smoking exposure were twice as likely to be established smokers at follow-up compared with those in the lowest quartile. CONCLUSIONS Movie smoking exposure significantly predicted progression to established smoking in long-term follow-up. We estimate that 34.9% of established smoking in this cohort can be attributed to movie smoking exposure. PMID:19336346

Smoking restrictions in bars and bartender smoking in the US, 1992-2007.

PubMed

Bitler, Marianne P; Carpenter, Christopher; Zavodny, Madeline

2011-05-01

The present work is an analysis of whether adoption of state clean indoor air laws (SCIALs) covering bars reduces the proportion of bartenders who smoke primarily by reducing smoking among people already employed as bartenders when restrictions are adopted or by changing the composition of the bartender workforce with respect to smoking behaviours. Logistic regressions were estimated for a variety of smoking outcomes, controlling for individual demographic characteristics, state economic characteristics, and state, year, and month fixed effects, using data on 1380 bartenders from the 1992-2007 Tobacco Use Supplement to the Current Population Survey combined with data on SCIALs from ImpacTeen. State restrictions on smoking in bars are negatively associated with whether a bartender smokes, with a 1-point increase in restrictiveness (on a scale of 0-3) associated with a 5.3% reduction in the odds of smoking. Bar SCIALs are positively associated with the likelihood a bartender reports never having smoked cigarettes but not with the likelihood a bartender reports having been a former smoker. State clean indoor air laws covering bars appear to reduce smoking among bartenders primarily by changing the composition of the bartender workforce with respect to smoking rather than by reducing smoking among people already employed as bartenders when restrictions are adopted. Such laws may nonetheless be an important public health tool for reducing secondhand smoke.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy.

PubMed

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell'Omo, Marco

2015-08-13

We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996-2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices' smoking behavior. It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: -1% in smoking prevalence, +2% in quitting, and -3% in smoking intensity of apprentices with at least a diploma.

Estimating the Smoking Ban Effects on Smoking Prevalence, Quitting and Cigarette Consumption in a Population Study of Apprentices in Italy

PubMed Central

Pieroni, Luca; Muzi, Giacomo; Quercia, Augusto; Lanari, Donatella; Rundo, Carmen; Minelli, Liliana; Salmasi, Luca; dell’Omo, Marco

2015-01-01

Objectives: We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. Data and Methods: The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996–2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices’ smoking behavior. Results: It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: −1% in smoking prevalence, +2% in quitting, and −3% in smoking intensity of apprentices with at least a diploma. PMID:26287220

Association Between Neighborhood Context and Smoking Prevalence Among Asian Americans

PubMed Central

Wen, Ming; Jacobs, Elizabeth A.; Lauderdale, Diane S.

2009-01-01

Objectives. To study neighborhood-level determinants of smoking among Asian Americans, we examined 3 neighborhood factors (ethnic enclave, socioeconomics, and perceived social cohesion) and smoking prevalence in a population-based sample. Methods. We linked data from the 2003 California Health Interview Survey to tract-level data from the 2000 Census. We used multivariate logistic regression models to estimate the associations between smoking and neighborhood-level factors, independent of individual factors. Results. Twenty-two percent of 1693 Asian men and 6% of 2174 Asian women reported current smoking. Women living in an Asian enclave were less likely to smoke (adjusted odds ratio [AOR] = 0.27; 95% confidence interval [CI] = 0.08, 0.88). Among men, higher levels of perceived neighborhood social cohesion were associated with lower odds of smoking (AOR = 0.74; 95% CI = 0.61, 0.91). Conclusions. The association between contextual factors and smoking differed for men and women. For women, living in an Asian enclave may represent cultural behavioral norms. For men, neighborhood trust and cohesiveness may buffer stress. Smoking prevention and cessation interventions among Asian Americans may be more effective if they address contextual factors. PMID:19299683

Estimates of Smoking Before and During Pregnancy, and Smoking Cessation During Pregnancy: Comparing Two Population-Based Data Sources

PubMed Central

Dietz, Patricia M.; Farr, Sherry L.; D'Angelo, Denise V.; England, Lucinda J.

2013-01-01

Objectives We compared three measures of maternal smoking status—-prepregnancy, during pregnancy, and smoking cessation during pregnancy—between the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire and the 2003 revised birth certificate (BC). Methods We analyzed data from 10,485 women with live births in eight states from the 2008 PRAMS survey, a confidential, anonymous survey administered in the postpartum period that is linked to select BC variables. We calculated self-reported prepregnancy and prenatal smoking (last trimester only) prevalence based on the BC, the PRAMS survey, and the two data sources combined, and the percentage of smoking cessation during pregnancy based on the BC and PRAMS survey. We used two-sided t-tests to compare BC and PRAMS estimates. Results Prepregnancy smoking prevalence estimates were 17.3% from the BC, 24.4% from PRAMS, and 25.4% on one or both data sources. Prenatal smoking prevalence estimates were 11.3% from the BC, 14.0% from PRAMS, and 15.2% on one or both data sources. The percentages of prepregnancy smokers who indicated that they quit smoking by the last trimester were 35.1% from the BC and 42.6% from PRAMS. The PRAMS estimates of prepregnancy and prenatal smoking, and smoking cessation during pregnancy were statistically higher than the corresponding BC estimates (t-tests, p<0.05). Conclusions PRAMS captured more women who smoked before and during the last trimester than the revised BC. States implementing PRAMS and the revised BC should consider information from both sources when developing population-based estimates of smoking before pregnancy and during the last trimester of pregnancy. PMID:23633733

Influence of retail cigarette advertising, price promotions, and retailer compliance on youth smoking-related attitudes and behaviors.

PubMed

Kim, Annice E; Loomis, Brett R; Busey, Andrew H; Farrelly, Matthew C; Willett, Jeffrey G; Juster, Harlan R

2013-01-01

Exposure to retail tobacco marketing is associated with youth smoking, but most studies have relied on self-reported measures of exposure, which are prone to recall bias. To examine whether exposure to retail cigarette advertising, promotions, and retailer compliance is associated with youth smoking-related outcomes using observational estimates of exposure. Data on retail cigarette advertising and promotions were collected from a representative sample of licensed tobacco retailers in New York annually since 2004. County-level estimates of retail cigarette advertising and promotions and retailer compliance with youth access laws were calculated and linked to the New York Youth Tobacco Survey, administered to 54,671 middle and high school students in 2004, 2006, and 2008. Regression models examined whether cigarette advertising, promotions, and retailer compliance were associated with youth's awareness of retail cigarette advertising, attitudes about smoking, susceptibility to smoking, cigarette purchasing behaviors, and smoking behaviors. Living in counties with more retail cigarette advertisements is associated with youth having positive attitudes about smoking (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.03-1.19, P < .01). Living in counties with more retail cigarette promotions is associated with youth current smoking (OR = 1.57, 95% CI = 1.01-2.44, P < .05). Living in counties with higher retailer compliance with youth access laws is associated with higher odds of youth being refused cigarettes when attempting to buy in stores (OR = 1.12, 95% CI = 1.01-1.25, P < .05) and lower odds of retail stores being youth's usual source of cigarettes (OR = 0.88, 95% CI = 0.80-0.97, P < .01). Strong retailer compliance programs and policies that eliminate cigarette advertising and promotions may help reduce youth smoking.

Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study.

PubMed

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-02-29

While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Computer-based simulation model. Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. 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/

Effects of individual characteristics and school environment on cigarette smoking among students ages 13-15: A multilevel analysis of the 2007 Global Youth Tobacco Survey (GYTS) data from Vietnam.

PubMed

Van Minh, Hoang; Hai, Phan Thi; Giang, Kim Bao; Nga, Pham Quynh; Khanh, Pham Huyen; Lam, Nguyen Tuan; Kinh, Ly Ngoc

2011-01-01

This paper aims to estimate the prevalence of cigarette smoking among students in Vietnam ages 13-15 and examines its relationship with compositional and contextual factors. The data used in this paper were obtained from the 2007 Global Youth Tobacco Survey conducted in nine provinces in Vietnam. A multilevel logistic regression model was applied to analyse the association between the current incidence of cigarette smoking and factors on both the individual and school level. The prevalence of cigarette smoking among students was 3.3% overall. The prevalence of smoking among male students (5.9%) was higher than that among females (1.2%). Parental smoking was a significant risk factor for smoking among the students. Having a friend who smoked was the strongest predictor of smoking status among the study subjects. We have demonstrated that school-level factors appeared to impact the prevalence of cigarette smoking among students ages 13-15. This paper highlights the importance of utilising an extensive range of actions to prevent students from using tobacco in Vietnam. These actions should include providing specific curricula for students that address both individual characteristics and the school environment. Further, prevention programmes should also target both parental- and peer-smoking issues.

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.

The effect of intensive care unit admission on smokers' attitudes and their likelihood of quitting smoking.

PubMed

Polmear, C M; Nathan, H; Bates, S; French, C; Odisho, J; Skinner, E; Karahalios, A; McGain, F

2017-11-01

We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent. A purpose-designed questionnaire which included the Fagerstrom test for nicotine dependence and evaluation of patients' attitude towards smoking cessation was completed by participants following ICU discharge and prior to hospital discharge. Participants were re-interviewed over the phone at six months post-ICU discharge. Of the 1,062 patients admitted to ICU, 253 (23%) were current smokers and 100 were enrolled. Six months post-ICU discharge, 28 (33%) of the 86 participants who were alive and contactable had quit smoking and 35 (41%) had reduced smoking. The median number of reported cigarettes smoked per day reduced by 40%. Participants who initially believed their ICU admission was smoking-related were more likely to have quit six months post-ICU discharge (odds ratio 2.98; 95% confidence interval 1.07 to 8.26; P=0.036). Six months post-ICU discharge, 63/86 (74%) of participants had quit or reduced their smoking. Further research into targeted smoking cessation counselling for ICU survivors is indicated.

The impact of prenatal parental tobacco smoking on risk of diabetes mellitus in middle-aged women.

PubMed

La Merrill, M A; Cirillo, P M; Krigbaum, N Y; Cohn, B A

2015-06-01

Growing evidence indicates that parental smoking is associated with risk of offspring obesity. The purpose of this study was to identify whether parental tobacco smoking during gestation was associated with risk of diabetes mellitus. This is a prospective study of 44- to 54-year-old daughters (n = 1801) born in the Child Health and Development Studies pregnancy cohort between 1959 and 1967. Their mothers resided near Oakland California, were members of the Kaiser Foundation Health Plan and reported parental tobacco smoking during an early pregnancy interview. Daughters reported physician diagnoses of diabetes mellitus and provided blood samples for hemoglobin A1C measurement. Prenatal maternal smoking had a stronger association with daughters' diabetes mellitus risk than prenatal paternal smoking, and the former persisted after adjustment for parental race, diabetes and employment (aRR = 2.4 [95% confidence intervals 1.4-4.1] P < 0.01 and aRR = 1.7 [95% confidence intervals 1.0-3.0] P = 0.05, respectively). Estimates of the effect of parental smoking were unchanged when further adjusted by daughters' birth weight or current body mass index (BMI). Maternal smoking was also significantly associated with self-reported type 2 diabetes diagnosis (2.3 [95% confidence intervals 1.0-5.0] P < 0.05). Having parents who smoked during pregnancy was associated with an increased risk of diabetes mellitus among adult daughters, independent of known risk factors, providing further evidence that prenatal environmental chemical exposures independent of birth weight and current BMI may contribute to adult diabetes mellitus. While other studies seek to confirm our results, caution toward tobacco smoking by or proximal to pregnant women is warranted in diabetes mellitus prevention efforts.

The Application of a Decision-Theoretic Model to Estimate the Public Health Impact of Vaporized Nicotine Product Initiation in the United States.

PubMed

Levy, David T; Borland, Ron; Villanti, Andrea C; Niaura, Raymond; Yuan, Zhe; Zhang, Yian; Meza, Rafael; Holford, Theodore R; Fong, Geoffrey T; Cummings, K Michael; Abrams, David B

2017-02-01

The public health impact of vaporized nicotine products (VNPs) such as e-cigarettes is unknown at this time. VNP uptake may encourage or deflect progression to cigarette smoking in those who would not have otherwise smoked, thereby undermining or accelerating reductions in smoking prevalence seen in recent years. The public health impact of VNP use are modeled in terms of how it alters smoking patterns among those who would have otherwise smoked cigarettes and among those who would not have otherwise smoked cigarettes in the absence of VNPs. The model incorporates transitions from trial to established VNP use, transitions to exclusive VNP and dual use, and the effects of cessation at later ages. Public health impact on deaths and life years lost is estimated for a recent birth cohort incorporating evidence-informed parameter estimates. Based on current use patterns and conservative assumptions, we project a reduction of 21% in smoking-attributable deaths and of 20% in life years lost as a result of VNP use by the 1997 US birth cohort compared to a scenario without VNPs. In sensitivity analysis, health gains from VNP use are especially sensitive to VNP risks and VNP use rates among those likely to smoke cigarettes. Under most plausible scenarios, VNP use generally has a positive public health impact. However, very high VNP use rates could result in net harms. More accurate projections of VNP impacts will require better longitudinal measures of transitions into and out of VNP, cigarette and dual use. Previous models of VNP use do not incorporate whether youth and young adults initiating VNP would have been likely to have been a smoker in the absence of VNPs. This study provides a decision-theoretic model of VNP use in a young cohort that incorporates tendencies toward smoking and shows that, under most plausible scenarios, VNP use yields public health gains. The model makes explicit the type of surveillance information needed to better estimate the effect of new products and thereby inform public policy. © 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.

Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors.

PubMed

Aekplakorn, Wichai; Hogan, Margaret C; Tiptaradol, Siriwat; Wibulpolprasert, Suwit; Punyaratabandhu, Porapan; Lim, Stephen S

2008-04-01

This study estimates the individual and joint prevalence of cigarette smoking and alcohol misuse, and examines the association between these risks and socioeconomic factors in Thailand. The self-reported data on cigarette and alcohol use are from a 2004 nationally representative cross-sectional survey of 39290 individuals aged 15 and over. Substantially more men than women were current smokers (45.8% vs. 2.3%; p<0.001) as well as harmful (5.4% vs. 0.9%, p<0.0001) and hazardous alcohol users (11.2% vs. 1.2%, p<0.001). The strongest predictor of alcohol misuse was smoking, and the strongest predictor of smoking was alcohol misuse in both sexes. There was an inverse relationship between education and family income with the odds of current smoking, whereas average levels of family income (not low or high) were associated with higher odds of harmful or hazardous alcohol use. Tobacco and alcohol misuse could be more effectively addressed by targeting and tailoring programs towards those who are most at risk - joint tobacco and harmful or hazardous alcohol users, and those of lower socioeconomic status.

Estimation of mouth level exposure to smoke constituents of cigarettes with different tar levels using filter analysis.

PubMed

Hyodo, T; Minagawa, K; Inoue, T; Fujimoto, J; Minami, N; Bito, R; Mikita, A

2013-12-01

A nicotine part-filter method can be applied to estimate smokers' mouth level exposure (MLE) to smoke constituents. The objectives of this study were (1) to generate calibration curves for 47 smoke constituents, (2) to estimate MLE to selected smoke constituents using Japanese smokers of commercially available cigarettes covering a wide range of International Organization for Standardization tar yields (1-21mg/cigarette), and (3) to investigate relationships between MLE estimates and various machine-smoking yields. Five cigarette brands were machine-smoked under 7 different smoking regimes and smoke constituents and nicotine content in part-filters were measured. Calibration curves were then generated. Spent cigarette filters were collected from a target of 50 smokers for each of the 15 brands and a total of 780 filters were obtained. Nicotine content in part-filters was then measured and MLE to each smoke constituent was estimated. Strong correlations were identified between nicotine content in part-filters and 41 out of the 47 smoke constituent yields. Estimates of MLE to acetaldehyde, acrolein, 1,3-butadiene, benzene, benzo[a]pyrene, carbon monoxide, and tar showed significant negative correlations with corresponding constituent yields per mg nicotine under the Health Canada Intense smoking regime, whereas significant positive correlations were observed for N-nitrosonornicotine and (4-methylnitrosoamino)-1-(3-pyridyl)-1-butanone. Copyright © 2013 Elsevier Inc. All rights reserved.

Use of an online smoking cessation community promotes abstinence: Results of propensity score weighting.

PubMed

Graham, Amanda L; Papandonatos, George D; Erar, Bahar; Stanton, Cassandra A

2015-12-01

We estimated the causal effects of use of an online smoking cessation community on 30-day point prevalence abstinence at 3 months. Participants (N = 492) were adult current smokers in the enhanced Internet arm of The iQUITT Study, a randomized trial of Internet and telephone treatment for smoking cessation. All participants accessed a Web-based smoking-cessation program that included a large, established online community. Automated tracking metrics of passive (e.g., reading forum posts, viewing member profiles) and active (e.g., writing forum posts, sending private messages) community use were extracted from the site at 3 months. Self-selected community use defines the groups of interest: "None," "Passive," and "Both" (passive + active). Inverse probability of treatment weighting corrected for baseline imbalances on demographic, smoking, psychosocial, and medical history variables. Propensity weights estimated via generalized boosted models were used to calculate Average Treatment Effects (ATE) and Average Treatment effects on the Treated (ATT). Patterns of community use were: None = 198 (40.2%), Passive = 110 (22.4%), and Both = 184 (37.4%). ATE-weighted abstinence rates were: None = 4.2% (95% CI = 1.5-6.9); Passive = 15.1% (95% CI = 8.4-21.9); Both = 20.4% (95% CI = 13.9-26.8). ATT-weighted abstinence rates indicated even greater benefits of community use. Community users were more likely to quit smoking at 3 months than nonusers. The estimated benefit from use of online community resources was even larger among subjects with high propensity to use them. No differences in abstinence emerged between passive and passive/active users. Results suggest that lurking in online communities confers specific abstinence benefits. Implications of these findings for online cessation communities are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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.

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.

Exposure to smoking imagery in popular films and adolescent smoking in Mexico.

PubMed

Thrasher, James F; Jackson, Christine; Arillo-Santillán, Edna; Sargent, James D

2008-08-01

Exposure to smoking imagery in films is consistently associated with smoking behavior and its psychological antecedents among adolescents in high-income countries, but its association with adolescent smoking in middle-income countries is unknown. In 2006, a cross-sectional sample of 3876 Mexican adolescents in secondary school was surveyed on smoking behavior, smoking risk factors, and exposure to 42 popular films that contained smoking. Participants were classified into quartiles of exposure to smoking imagery across all films they reported having seen. Models were estimated to determine associations among quartiles of film-smoking exposure, smoking behavior, and the psychological antecedents of smoking, adjusting for age, gender, sensation seeking, self-esteem, parental smoking, sibling smoking, best-friend smoking, having a bedroom TV, and private versus public school attendance. Analyses were conducted in 2007. Adolescents were exposed to an average of 51.7 (SE=1.3) minutes of smoking in the films they viewed. Crude and adjusted ORs indicated positive associations between quartiles of film-smoking exposure and both current smoking (AOR4v1=3.13; p<0.0001) and having ever smoked (AOR4v1=2.42; p<0.0001). Data from never-smokers (n=2098) were analyzed to determine associations between film-smoking exposure and psychological antecedents of smoking uptake. Crude and adjusted coefficients indicated significant, positive associations between exposure and susceptibility to smoking (AOR4v1=1.66; p<0.05); favorable attitudes toward smoking (Adjusted B4v1=0.44; p<0.0001); and perceived peer prevalence of smoking (Adjusted B4v1=0.26; p<0.0001). Exposure to smoking in films appears associated with smoking among Mexican adolescents. Policies could aim to decrease youth exposure to smoking in nationally and internationally distributed films.

Exposure to Smoking Imagery in Popular Films and Adolescent Smoking in Mexico

PubMed Central

Thrasher, James F.; Jackson, Christine; Arillo-Santillán, Edna; Sargent, James D.

2008-01-01

Background Exposure to smoking imagery in films is consistently associated with smoking behavior and its psychological antecedents among adolescents in high-income countries, but its association with adolescent smoking in middle-income countries is unknown. Methods In 2006, a cross-sectional sample of 3876 Mexican adolescents in secondary school was surveyed on smoking behavior, smoking risk factors, and exposure to 42 popular films that contained smoking. Participants were classified into quartiles of exposure to smoking imagery across all films they reported having seen. Models were estimated to determine associations among quartiles of film-smoking exposure, smoking behavior, and the psychological antecedents of smoking, adjusting for age, gender, sensation seeking, self-esteem, parental smoking, sibling smoking, best-friend smoking, having a bedroom TV, and private versus public school attendance. Analyses were conducted in 2007. Results Adolescents were exposed to an average of 51.7 (SE=1.3) minutes of smoking in the films they viewed. Crude and adjusted ORs indicated positive associations between quartiles of film-smoking exposure and both current smoking (AOR4v1=3.13; p<0.0001) and having ever smoked (AOR4v1=2.42; p<0.0001). Data from never-smokers (n=2098) were analyzed to determine associations between film-smoking exposure and psychological antecedents of smoking uptake. Crude and adjusted coefficients indicated significant, positive associations between exposure and susceptibility to smoking (AOR4v1=1.66; p<0.05); favorable attitudes toward smoking (Adjusted B4v1=0.44; p<0.0001); and perceived peer prevalence of smoking (Adjusted B4v1=0.26; p<0.0001). Conclusions Exposure to smoking in films appears associated with smoking among Mexican adolescents. Policies could aim to decrease youth exposure to smoking in nationally and internationally distributed films. PMID:18617078

The economics of tobacco use in Jordan.

PubMed

Sweis, Nadia J; Chaloupka, Frank J

2014-01-01

We conducted an independent survey of tobacco use in Jordan following the methods and template of the Global Adult Tobacco Survey. Using data collected on cigarette use and cigarette prices, we estimated the price elasticity of cigarette demand in Jordan. We used a 2-part model of cigarette demand. In the first part, we estimate the impact of prices on the decision to smoke while controlling for individual demographic and environmental characteristics. Conditional on smoking, we then estimate the effect of price on the number of cigarettes smoked. The total price elasticity of cigarette demand in Jordan was estimated to be -0.6. Smoking among women was found to be relatively unresponsive to price (elasticity of -0.01), whereas smoking among men was much more responsive to price (elasticity of -0.81). The price elasticity estimates suggest that significant increases in tobacco taxes are likely to be effective in reducing smoking in Jordan, particularly smoking among men.

Impact of cigarette smoking on utilization of nursing home services.

PubMed

Warner, Kenneth E; McCammon, Ryan J; Fries, Brant E; Langa, Kenneth M

2013-11-01

Few studies have examined the effects of smoking on nursing home utilization, generally using poor data on smoking status. No previous study has distinguished utilization for recent from long-term quitters. Using the Health and Retirement Study, we assessed nursing home utilization by never-smokers, long-term quitters (quit >3 years), recent quitters (quit ≤3 years), and current smokers. We used logistic regression to evaluate the likelihood of a nursing home admission. For those with an admission, we used negative binomial regression on the number of nursing home nights. Finally, we employed zero-inflated negative binomial regression to estimate nights for the full sample. Controlling for other variables, compared with never-smokers, long-term quitters have an odds ratio (OR) for nursing home admission of 1.18 (95% CI: 1.07-1.2), current smokers 1.39 (1.23-1.57), and recent quitters 1.55 (1.29-1.87). The probability of admission rises rapidly with age and is lower for African Americans and Hispanics, more affluent respondents, respondents with a spouse present in the home, and respondents with a living child. Given admission, smoking status is not associated with length of stay (LOS). LOS is longer for older respondents and women and shorter for more affluent respondents and those with spouses present. Compared with otherwise identical never-smokers, former and current smokers have a significantly increased risk of nursing home admission. That recent quitters are at greatest risk of admission is consistent with evidence that many stop smoking because they are sick, often due to smoking.

Risks associated with crack cocaine smoking among exotic dancers in Baltimore, MD.

PubMed

Sherman, Susan G; Reuben, Jacqueline; Chapman, Chris Serio; Lilleston, Pamela

2011-04-01

There is a dearth of research focusing on sex work in exotic dance clubs. We conducted a cross-sectional study to examine the prevalence and correlates of crack cocaine smoking among a sample of exotic dancers. The "block," a historical red-light district in downtown Baltimore, MD, is comprised of 30 adult-entertainment establishments. Between 01/09 and 08/09, we conducted a survey with exotic dancers (N=98). The survey explored demographic, and drug and sexual/drug risk behaviors. Bivariate and multivariate analysis was conducted using Poisson regression with robust variance estimates to examine correlates of current crack smoking. Crack cocaine smokers compared to non-crack cocaine smokers were significantly more likely to report: older age (29 vs. 23 years, respectively, p<0.0001); being White (79% vs. 50%, respectively, p=0.008); having been arrested (93% vs. 67%, respectively, p=0.008); daily alcohol consumption (36% vs. 17%, p=0.047); current heroin injection (57% vs. 13%, p<0.001); and current sex exchange (79% vs. 30%, p<0.001). In the presence of other variables, crack cocaine smokers compared to non-crack cocaine smokers were significantly older, more likely to report current heroin injection, and more likely to report current sex exchange. We found high levels of drug use and sexual risk behaviors as well as a number of risks behaviors associated with crack cocaine smoking among this very under-studied population. Targeted interventions are greatly needed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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.

Twelve-Year Cardiovascular and Mortality Risk in Relation to Smoking Habits in Type 2 Diabetic and Non-Diabetic Men: Tehran Lipid and Glucose Study.

PubMed

Hadaegh, Farzad; Derakhshan, Arash; Mozaffary, Amirhossein; Hasheminia, Mitra; Khalili, Davood; Azizi, Fereidoun

2016-01-01

To examine the associations between smoking and cardiovascular disease (CVD) / coronary heart disease (CHD) and all-cause mortality events in men with and without type 2 diabetes (T2D) in a Middle Eastern cohort during a median follow-up of 12 years. The study population included 2230 subjects aged ≥ 40 years, free from CVD, comprised of 367 participants with diabetes (21.2% current smokers) and 1863 without (27.3% current smokers). Multivariate Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for smoking (considering different definitions) for those with and without diabetes. Potential confounding factors including age, body mass index, estimated Glomerular Filtration Rate, hypertension, hypercholesterolemia and educational level were entered in the multivariate analysis. In men with diabetes, the HR (95% CI) of comparing current and non-smokers was 1.25 (0.74-2.12) for incident CHD, 1.52 (0.96-2.40) for CVD and 2.10 (1.27-3.47) for mortality events; the corresponding values for men without diabetes were 1.65 (1.24-2.20), 1.70 (1.30-2.22) and 1.72 (1.14-2.58), respectively (all P values for interactions > 0.46). After pooling past smokers with current smokers, among diabetic individuals there was no significant risk for CVD [1.29 (0.89-1.86)] or mortality events [1.25 (0.81-1.92)]; however, among non-diabetic individuals the HRs of current/past smokers reached significant levels for CVD [1.53 (1.23-1.91)] but not for mortality outcomes (all P values for interactions > 0.51). The strength of the associations between smoking habits and incident CVD/CHD and mortality events from all causes did not differ significantly among diabetic and non-diabetic participants. Therefore, a comprehensive community-based smoking prevention program is important, given the increasing trend of smoking among the Iranian population regardless of diabetes status.

Estimating the cost of a smoking employee.

PubMed

Berman, Micah; Crane, Rob; Seiber, Eric; Munur, Mehmet

2014-09-01

We attempted to estimate the excess annual costs that a US private employer may attribute to employing an individual who smokes tobacco as compared to a non-smoking employee. Reviewing and synthesising previous literature estimating certain discrete costs associated with smoking employees, we developed a cost estimation approach that approximates the total of such costs for U.S. employers. We examined absenteeism, presenteesim, smoking breaks, healthcare costs and pension benefits for smokers. Our best estimate of the annual excess cost to employ a smoker is $5816. This estimate should be taken as a general indicator of the extent of excess costs, not as a predictive point value. Employees who smoke impose significant excess costs on private employers. The results of this study may help inform employer decisions about tobacco-related policies. 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.

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.

Sex differences in the association between countries' smoking prevalence and happiness ratings.

PubMed

Drehmer, J E

2018-05-02

To examine the cross-sectional relationship between measures of countries' happiness and countries' prevalence of tobacco smoking. Since smoking prevalence differs widely based on sex in some countries and is similar in other countries, it was examined if there was a sex difference in the relationship between smoking prevalence and country-specific happiness ratings. Ecological study design. Countries' age-standardized prevalence estimates of smoking any tobacco product among persons aged 15 years and older (%) for 2015 were obtained from the World Health Organization (WHO) Global Health Observatory. Country-specific scores from the World Happiness Report 2016 Update Ranking of Happiness (2013-15) and the 2015 Gallup Positive Experience Index were matched and correlated to 2015 WHO estimates of tobacco smoking prevalence for males and females. The difference between male and female age-standardized smoking prevalence estimates in each country was calculated by subtracting female prevalence from male prevalence and was then correlated to countries' World Happiness Report scores. The analyses did not control for potential confounders. The association between male age-standardized smoking prevalence estimates and countries' World Happiness Report scores was inversely correlated [r(104) = -0.22, P = 0.03], whereas the association between female age-standardized smoking prevalence estimates and countries' World Happiness Report scores was positively correlated [r(104) = 0.48, P = 0.00]. An inverse correlation was found between the difference in male and female smoking prevalence estimates and countries' World Happiness Report scores [r(104) = -0.50, P = 0.00]. The association between countries' male age-standardized smoking prevalence estimates and the Positive Experience Index scores was inversely correlated [r(99) = -0.37, P = 0.00], whereas the female age-standardized smoking prevalence estimates in countries were not significantly associated with Positive Experience Index scores [r(99) = -0.03, P = 0.75]. There are distinct sex differences between the amounts of happiness measured in countries and male and female smoking rates. Greater inequality in age-standardized smoking prevalence estimates between males and females is associated with lower amounts of happiness as measured by the World Happiness Report. These findings can be applied to population-based strategies aimed at reducing national smoking rates in men and women. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

[Trends in smoking in an urban population over recent decades].

PubMed

Villalbí, Joan R; Bartoll, Xavier; Rodríguez-Sanz, Maica; Borrell, Carme

2016-05-06

The objective of this study is to describe the distribution of smoking in the population and to assess changes and trends over recent decades. Cross sectional study in a sample of the non-institutionalized resident population (n=3,509) in Barcelona (Catalonia, Spain) using data from persons over 14 years of age from the health survey of 2011, and assessing trends for 1983-2011 using previous surveys. Dependent variables are having ever been a smoker, having quit, being a current smoker, and smoking daily. Independent variables include sex, age, and time. Prevalence and proportions are estimated, stratifying or adjusting for age. The prevalence of daily smokers is 18.8% in 2011: 22.2% for men and 15.9% for women. The age groups with higher smoking prevalence are 25-34 years for men and 15-24 for women. From 1983 to 2011 the reduction among men has been intense, and for women the prevalence has been decreasing since the survey of 2000. Among smokers, the proportion of both genders who do not smoke daily has increased. The smoking epidemic over the last years shows promising trends. The data do not lend support to the hardening hypothesis for current smokers. Smokers are a shrinking minority, although to improve public health it would be desirable to speed the process of change. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Effects of IL6 C-634G polymorphism on tooth loss and their interaction with smoking habits.

PubMed

Suma, S; Naito, M; Wakai, K; Sasakabe, T; Hattori, Y; Okada, R; Kawai, S; Hishida, A; Morita, E; Nakagawa, H; Tamura, T; Hamajima, N

2015-09-01

To examine the association between an IL6 (Interleukin-6) polymorphism (C-634G or rs1800796) and tooth loss, and an interaction between the polymorphism and smoking habits for the loss. Our subjects were 4917 check-up examinees ages 35-69. They reported tooth loss and lifestyle in a questionnaire. We regressed the number of teeth on the IL6 genotype, gender, age, smoking, drinking, diabetes, hypertension, physical activity, energy intake, education, and brushing. We further estimated multivariate-adjusted odds ratios (ORs) for having <20 teeth. Participants with a GG genotype tended to have less teeth than those with CC; β = -0.798 (95% confidence interval [CI] = -1.501--0.096). Subjects with a GG genotype were more likely to have <20 teeth than those with CC; OR was 1.56 (95% CI = 1.08-2.25). Association between current smoking and tooth loss was stronger among those with GG than among those with CC. In a multiple regression analysis, a significant interaction was found between GG genotype and current smoking in the prediction of tooth loss (P = 0.018). The IL6 C-634G polymorphism was significantly associated with tooth loss. Our results suggest greater effects of smoking on tooth loss in GG genotype individuals. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence and correlates of tobacco use among school-going adolescents in Madagascar.

PubMed

Veeranki, Sreenivas P; Mamudu, Hadii M; John, Rijo M; Ouma, Ahmed E O

2015-09-01

Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents' tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13-15 years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors. Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females' tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents' tobacco use. Copyright © 2015 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Waterpipe Tobacco Smoking in the United States: Findings from the National Adult Tobacco Survey

PubMed Central

Salloum, Ramzi G.; Thrasher, James F.; Kates, Frederick R.; Maziak, Wasim

2014-01-01

Objective To report prevalence and correlates of waterpipe tobacco smoking (WTS) use among U.S. adults. Methods Data were from the 2009–2010 National Adult Tobacco Survey, a nationally representative sample of U.S. adults. Estimates of WTS ever and current use were reported overall, and by sex, age, race/ethnicity, educational attainment, annual household income, sexual orientation, and cigarette smoking status. State-level prevalence rates of WTS ever were reported using choropleth thematic maps for the overall population and by sex. Results The national prevalence of WTS ever was 9.8% and 1.5% for current use. WTS ever was more prevalent among those who are male (13.4%), 18–24 years old (28.4%) compared to older adults, non-Hispanic White (9.8%) compared to non-Hispanic Black, with some college education (12.4%) compared to no high school diploma, and reporting sexual minority status (21.1%) compared to heterosexuals. States with highest prevalence included DC(17.3%), NV(15.8%), and CA(15.5%). Conclusion WTS is now common among young adults in the US and high in regions where cigarette smoking prevalence is lowest and smoke-free policies have a longer history. To reduce its use, WTS should be included in smoke-free regulations and state and federal regulators should consider policy development in other areas, including taxes, labeling, and distribution. PMID:25535678

Nicotine deprivation elevates neural representation of smoking-related cues in object-sensitive visual cortex: a proof of concept study.

PubMed

Havermans, Anne; van Schayck, Onno C P; Vuurman, Eric F P M; Riedel, Wim J; van den Hurk, Job

2017-08-01

In the current study, we use functional magnetic resonance imaging (fMRI) and multi-voxel pattern analysis (MVPA) to investigate whether tobacco addiction biases basic visual processing in favour of smoking-related images. We hypothesize that the neural representation of smoking-related stimuli in the lateral occipital complex (LOC) is elevated after a period of nicotine deprivation compared to a satiated state, but that this is not the case for object categories unrelated to smoking. Current smokers (≥10 cigarettes a day) underwent two fMRI scanning sessions: one after 10 h of nicotine abstinence and the other one after smoking ad libitum. Regional blood oxygenated level-dependent (BOLD) response was measured while participants were presented with 24 blocks of 8 colour-matched pictures of cigarettes, pencils or chairs. The functional data of 10 participants were analysed through a pattern classification approach. In bilateral LOC clusters, the classifier was able to discriminate between patterns of activity elicited by visually similar smoking-related (cigarettes) and neutral objects (pencils) above empirically estimated chance levels only during deprivation (mean = 61.0%, chance (permutations) = 50.0%, p = .01) but not during satiation (mean = 53.5%, chance (permutations) = 49.9%, ns.). For all other stimulus contrasts, there was no difference in discriminability between the deprived and satiated conditions. The discriminability between smoking and non-smoking visual objects was elevated in object-selective brain region LOC after a period of nicotine abstinence. This indicates that attention bias likely affects basic visual object processing.

Prevalence of Waterpipe Tobacco Smoking Among Population Aged 15 Years or Older, Vietnam, 2010

PubMed Central

Van Minh, Hoang; Giang, Kim Bao; Nga, Pham Thi Quynh; Hai, Phan Thi; Minh, Nguyen Thac; Hsia, Jason

2013-01-01

Introduction The prevalence of waterpipe tobacco smoking is increasing globally and is associated with adverse outcomes requiring tobacco control interventions. We estimated the prevalence of waterpipe tobacco use among adult populations in Vietnam in 2010 and examined its association with sociodemographic factors. Methods We used data from the Global Adult Tobacco Survey (GATS) conducted in Vietnam in 2010. GATS surveyed a national representative sample of adults aged 15 years or older from 11,142 households by using a 2-phase sampling design analogous to a 3-stage stratified cluster sampling. Descriptive statistical analyses and multivariate logistic regression modeling were conducted. Results A total of 6.4% of Vietnamese aged 15 years or older (representing about 4.1 million adult waterpipe smokers) reported current waterpipe tobacco smoking. The prevalence of waterpipe tobacco smoking was significantly higher among men than women (13% vs 0.1%). Area of residence (rural or urban), age group, asset-based wealth quintile, and geographic region of residence were significantly associated with waterpipe tobacco smoking among men. The significant correlates of current waterpipe tobacco smoking among men were lower education levels, being middle-aged (45–54 years), lower asset-based wealth levels, living in rural areas, not living in the South East and the Mekong River Delta geographic regions, and the belief that smoking does not causes diseases. Conclusion Rural dwellers who are poor should be targeted in tobacco control programs. Further studies are needed that examine perceptions of the adverse health effects and the cultural factors of waterpipe tobacco smoking. PMID:23597395

English language proficiency and smoking prevalence among California's Asian Americans.

PubMed

Tang, Hao; Shimizu, Robin; Chen, Moon S

2005-12-15

The authors documented California's tobacco control initiatives for Asian Americans and the current tobacco use status among Asian subgroups and provide a discussion of the challenges ahead. The California Tobacco Control Program has employed a comprehensive approach to decrease tobacco use in Asian Americans, including ethnic-specific media campaigns, culturally competent interventions, and technical assistance and training networks. Surveillance of tobacco use among Asian Americans and the interpretation of the results have always been a challenge. Data from the 2001 The California Health Interview Survey (CHIS) were analyzed to provide smoking prevalence estimates for all Asian Americans and Asian-American subgroups, including Korean, Filipino, Japanese, South Asian, Chinese, and Vietnamese. Current smoking prevalence was analyzed by gender and by English proficiency level. Cigarette smoking prevalence among Asian males in general was almost three times of that among Asian females. Korean and Vietnamese males had higher cigarette smoking prevalence rates than males in other subgroups. Although Asian females in general had low smoking prevalence rates, significant differences were found among Asian subgroups, from 1.1% (Vietnamese) to 12.7% (Japanese). Asian men who had high English proficiency were less likely to be smokers than men with lower English proficiency. Asian women with high English proficiency were more likely to be smokers than women with lower English proficiency. Smoking prevalence rates among Asian Americans in California differed significantly on the basis of ethnicity, gender, and English proficiency. English proficiency seemed to have the effect of reducing smoking prevalence rates among Asian males but had just the opposite effect among Asian females. Cancer 2005. (c) 2005 American Cancer Society.

Misclassification rates for current smokers misclassified as nonsmokers.

PubMed

Wells, A J; English, P B; Posner, S F; Wagenknecht, L E; Perez-Stable, E J

1998-10-01

This paper provides misclassification rates for current cigarette smokers who report themselves as nonsmokers. Such rates are important in determining smoker misclassification bias in the estimation of relative risks in passive smoking studies. True smoking status, either occasional or regular, was determined for individual current smokers in 3 existing studies of nonsmokers by inspecting the cotinine levels of body fluids. The new data, combined with an approximately equal amount in the 1992 Environmental Protection Agency (EPA) report on passive smoking and lung cancer, yielded misclassification rates that not only had lower standard errors but also were stratified by sex and US minority majority status. The misclassification rates for the important category of female smokers misclassified as never smokers were, respectively, 0.8%, 6.0%, 2.8%, and 15.3% for majority regular, majority occasional, US minority regular, and US minority occasional smokers. Misclassification rates for males were mostly somewhat higher. The new information supports EPA's conclusion that smoker misclassification bias is small. Also, investigators are advised to pay attention to minority/majority status of cohorts when correcting for smoker misclassification bias.

Ecological Momentary Assessment of Antecedents and Consequences of Smoking in Adults with Attention-Deficit/Hyperactivity Disorder

PubMed Central

Mitchell, John T.; Dennis, Michelle F.; English, Joseph S.; Dennis, Paul A.; Brightwood, Amy G.; Beckham, Jean C.; Kollins, Scott H.

2014-01-01

The current study assessed antecedents and consequences of ad lib cigarette smoking in smokers diagnosed with attention-deficit/hyperactivity disorder (ADHD) using ecological momentary assessment (EMA). Adult smokers with ADHD (n = 17) completed 870 smoking and 622 nonsmoking electronic diary entries over a seven-day observation period of their naturalistic smoking behavior. Data collection occurred from 2011 to 2012. Generalized estimating equations indicated that ADHD smokers were more likely to smoke when urge to smoke, negative affect, boredom, stress, worry, and restlessness were elevated. In addition, participants were more likely to smoke in situations that elicited higher levels of nervousness and frustration. ADHD symptoms, in general, did not differ between smoking and nonsmoking contexts, though hyperactive-impulsive ADHD symptoms were elevated prior to smoking in frustrating situations. Additional situational antecedent variables were associated with smoking, including being in the presence of others smoking, being in a bar or restaurant, while outside, and while consuming caffeinated or alcoholic beverages. Participants also reported a significant improvement in urge to smoke, negative affect, stress, hunger, and ADHD symptoms after smoking a cigarette. Findings suggest certain contextual factors that may maintain ad lib cigarette smoking in smokers with ADHD and identify potential treatment targets in smoking cessation interventions for this at-risk group. Clinical implications and future research directions are discussed. Funding for this study was provided by the National Institute on Drug Abuse. PMID:24827866

Smoke-free legislation and child health

PubMed Central

Faber, Timor; Been, Jasper V; Reiss, Irwin K; Mackenbach, Johan P; Sheikh, Aziz

2016-01-01

In this paper, we aim to present an overview of the scientific literature on the link between smoke-free legislation and early-life health outcomes. Exposure to second-hand smoke is responsible for an estimated 166 ,000 child deaths each year worldwide. To protect people from tobacco smoke, the World Health Organization recommends the implementation of comprehensive smoke-free legislation that prohibits smoking in all public indoor spaces, including workplaces, bars and restaurants. The implementation of such legislation has been found to reduce tobacco smoke exposure, encourage people to quit smoking and improve adult health outcomes. There is an increasing body of evidence that shows that children also experience health benefits after implementation of smoke-free legislation. In addition to protecting children from tobacco smoke in public, the link between smoke-free legislation and improved child health is likely to be mediated via a decline in smoking during pregnancy and reduced exposure in the home environment. Recent studies have found that the implementation of smoke-free legislation is associated with a substantial decrease in the number of perinatal deaths, preterm births and hospital attendance for respiratory tract infections and asthma in children, although such benefits are not found in each study. With over 80% of the world’s population currently unprotected by comprehensive smoke-free laws, protecting (unborn) children from the adverse impact of tobacco smoking and SHS exposure holds great potential to benefit public health and should therefore be a key priority for policymakers and health workers alike. PMID:27853176

Declining mortality from smoking in the United States.

PubMed

Rodu, Brad; Cole, Philip

2007-07-01

The proportion of Americans who smoke cigarettes has declined 50% since 1965. The effect on mortality of this considerable reduction has received little attention and is described in this study. U.S. national data were used to enumerate current, former, and never-smokers aged 35 years or older in 1987 and 2002. Mortality rate ratios were used to estimate smoking-attributable deaths among these groups, and corresponding age-adjusted smoking-attributable mortality rates (SAMRs) were calculated. There were 402,000 deaths attributable to smoking in 1987 and 322,000 in 2002. The SAMR for men aged 35 years or more was 556 deaths per 100,000 person-years in 1987, accounting for 24% of all male deaths. By 2002 the SAMR declined 41% to 329 and accounted for only 17% of deaths. The SAMR for women in 1987 was 175, accounting for 12% of deaths. By 2002 the SAMR among women had declined 30% to 122, representing 9% of deaths. The U.S. mortality rate attributable to smoking declined about 35% between 1987 and 2002. The impact of smoking on American society will diminish even further in the foreseeable future as smoking prevalence continues its decline among men and women.

Synthesizing Econometric Evidence: The Case of Demand Elasticity Estimates.

PubMed

DeCicca, Philip; Kenkel, Don

2015-06-01

Econometric estimates of the responsiveness of health-related consumer demand to higher prices are often key ingredients for risk policy analysis. We review the potential advantages and challenges of synthesizing econometric evidence on the price-responsiveness of consumer demand. We draw on examples of research on consumer demand for health-related goods, especially cigarettes. We argue that the overarching goal of research synthesis in this context is to provide policy-relevant evidence for broad-brush conclusions. We propose three main criteria to select among research synthesis methods. We discuss how in principle and in current practice synthesis of research on the price-elasticity of smoking meets our proposed criteria. Our analysis of current practice also contributes to academic research on the specific policy question of the effectiveness of higher cigarette prices to reduce smoking. Although we point out challenges and limitations, we believe more work on research synthesis in this area will be productive and important. © 2015 Society for Risk Analysis.

Assessing the performance of two lung age equations on the Australian population: using data from the cross-sectional BOLD-Australia study.

PubMed

Ivey, Marsha A; Johns, David P; Stevenson, Christopher; Maguire, Graeme P; Toelle, Brett G; Marks, Guy B; Abramson, Michael J; Wood-Baker, Richard

2014-12-01

Lung age, a simple concept for patients to grasp, is frequently used as an aid in smoking cessation programs. Lung age equations should be continuously updated and should be made relevant for target populations. We observed how new lung age equations developed for Australian populations performed when utilizing the Burden of Obstructive Lung Disease (BOLD)-Australia dataset compared to more commonly used equations. Data from a cross-sectional population study of noninstitutionalized Australians aged ≥40 years with analysis restricted to Caucasians <75 years. Lung age calculated using equations developed by Newbury et al. and Morris and Temple was compared with chronological age by smoking status and within smoking status. There were 2,793 participants with a mean age of 57 (±10 SD) years. More than half (52%) ever smoked, and 10.4% were current smokers. Prevalence of chronic obstructive pulmonary disease stage I or higher was 13.4% (95% confidence interval = 12.2, 14.7). For both genders, newer Newbury equations estimated lung ages significantly higher than actual age across all smoking groups (p < .05). Morris and Temple equations resulted in lung age estimates significantly lower than chronological age for nonsmokers (p < .05) but no difference among current smokers. Both equations showed exposure to smoking had lung ages higher than never-smokers (p < .001). Lung age also increased with increased pack-years. This supports the use of updated equations suited to the population of interest. The Australian Newbury equations performed well in the BOLD-Australia dataset, providing more meaningful lung age profile compared to chronological age among smokers. Using equations not developed or ideally suited for our population is likely to produce misleading results. © The Author 2014. 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.

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.

Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries.

PubMed

Farsalinos, Konstantinos E; Poulas, Konstantinos; Voudris, Vassilis; Le Houezec, Jacques

2016-11-01

To assess prevalence of electronic cigarette (e-cigarette) use, reported changes in smoking status due to e-cigarette use and correlates of e-cigarette use in the European Union (EU) member states in 2014. Cross-sectional survey of EU citizens representative of the population (Special Eurobarometer 429). All 28 Member States of the EU. A total of 27 460 EU citizens aged ≥ 15 years (after excluding those who responded 'Do not know' to the questions about smoking status and e-cigarette use). Descriptive analysis [%, 95% confidence interval (CI)] of e-cigarette use prevalence (current use, past use and past experimentation) according to smoking status, self-reported changes in smoking status according to patterns of e-cigarette use and logistic regression analysis to examine correlates of e-cigarette use, especially socio-demographic factors and smoking status. Ever e-cigarette use was reported by 31.1% (95% CI = 30.0-32.2%) of current smokers, 10.8% (95% CI = 10.0-11.7%) of former smokers and 2.3% (95% CI = 2.1-2.6%) of never smokers. Past experimentation [7.2% (95% CI = 6.9-7.5%)] was more common than current [1.8% (95% CI = 1.6-1.9%)] and past use [2.6% (95% CI = 2.4-2.8%)]. Extrapolated to the whole population, approximately 48.5 million EU citizens were ever e-cigarette users, with 76.8% using nicotine-containing e-cigarettes. An estimated 6.1 and 9.2 million EU citizens had quit and reduced smoking with the help of e-cigarettes, respectively. Initiation with e-cigarettes was reported by 0.8% (95% CI = 0.6-0.9%) of participants who reported ever use of any tobacco-related product. Only 1.3% (95% CI = 1.1-1.5%) of never smokers used nicotine-containing e-cigarettes, with 0.09% (95% CI = 0.04-0.14%) reporting daily nicotine use. Smoking cessation with the help of e-cigarettes was reported by 35.1% (95% CI = 30.7-39.5%) of current e-cigarette users, while a further 32.2% (95% CI = 29.9-36.5%) reported smoking reduction. Being current [odds ratio (OR) = 21.23, 95% CI = 18.32-24.59) or former smokers (OR = 6.49, 95% CI = 5.49-7.67) were the strongest correlates of ever e-cigarette use. E-cigarette use in the European Union appears to be largely confined to current or former smokers, while current use and nicotine use by people who have never smoked is rare. More than one-third of current e-cigarette users polled reported smoking cessation and reduction. © 2016 Society for the Study of Addiction.

Assessing the feasibility, acceptability and potential effectiveness of an integrated approach to smoking cessation for new and expectant fathers: The Dads in Gear study protocol.

PubMed

Bottorff, Joan L; Oliffe, John L; Sarbit, Gayl; Caperchione, Cristina; Clark, Marianne; Anand, Anima; Howay, Kym

2017-03-01

Evidence related to the effects of tobacco exposure in pregnancy and on infant and child health have focused on women's smoking cessation. Less often addressed is men's smoking, which when continued in fatherhood, reduces the chances of female partners' cessation and can negatively impact children's health as well as men's health. Dads in Gear (DIG) is an innovative program designed specifically for new fathers who want to reduce and quit smoking that includes three components: smoking cessation, fathering, and physical activity. The over-arching purpose of this study is to evaluate the feasibility of the DIG program and provide estimates of program efficacy. The purpose of this article is to describe the rationale and protocol for evaluating the DIG program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the DIG program will be implemented and evaluated in six communities. The program will be offered by trained facilitators to fathers who currently smoke and want to quit. The RE-AIM framework will guide the evaluation. Open-ended questions in participant surveys, and semi-structured interviews and weekly telephone de-briefs with facilitators will provide data for a process evaluation. Estimates of effectiveness include smoking behavior, fathering and physical activity measures at baseline, end of program, and 3-month follow up. The DIG program could support positive changes with respect to smoking cessation, physical activity and overall health for men. These effects could also promote family health. The program might also provide an effective model for engaging men in other health behavior change. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Maternal Smoking Among Women With and Without Use of Assisted Reproductive Technologies

PubMed Central

Tong, Van T.; Kissin, Dmitry M.; Bernson, Dana; Copeland, Glenn; Boulet, Sheree L.; Zhang, Yujia; Jamieson, Denise J.; England, Lucinda J.

2016-01-01

Objective To estimate smoking prevalence during the year before pregnancy and during pregnancy and adverse outcomes among women who delivered infants with and without assisted reproductive technology (ART) using linked birth certificates (BC) and National ART Surveillance System (NASS) data. Methods Data were analyzed for 384,390 women and 392,248 infants born in Massachusetts and Michigan during 2008–2009. Maternal smoking prevalence was estimated using smoking indicated from BC by ART status. For ART users, to evaluate underreporting, prepregnancy smoking was estimated from BC, NASS, or both sources. Effect of prenatal smoking on preterm and mean birthweight (term only) for singleton infants were examined by ART status. Results Maternal smoking prevalence estimates were significantly lower for ART users than nonusers (pre-pregnancy = 3.2% vs. 16.7%; prenatal = 1.0% vs. 11.1%, p < 0.05). When combining smoking information from BC and NASS, prepregnancy smoking prevalence estimates for ART users could be as high as 4.4% to 6.1%. Adverse effects of smoking on infant outcomes in ART pregnancies were consistent with the effects seen in non-ART pregnancies, specifically decline in infant birthweight and increase in preterm delivery, although association between smoking and preterm was not significant. Conclusion A low, but substantial proportion of ART users smoked before and during pregnancy. As ART users are highly motivated to get pregnant, it should be clearly communicated that smoking can decrease fertility and adversely affect pregnancy outcomes. Continued efforts are needed to encourage smoking cessation and maintain tobacco abstinence among all women of reproductive age. PMID:27243366

Risk of Heart Failure and Death after Prolonged Smoking Cessation: Role of Amount and Duration of Prior Smoking

PubMed Central

Ahmed, Amiya A.; Patel, Kanan; Nyaku, Margaret A.; Kheirbek, Raya E.; Bittner, Vera; Fonarow, Gregg C.; Filippatos, Gerasimos S.; Morgan, Charity J.; Aban, Inmaculada B.; Mujib, Marjan; Desai, Ravi V.; Allman, Richard M.; White, Michel; Deedwania, Prakash; Howard, George; Bonow, Robert O.; Fletcher, Ross D.; Aronow, Wilbert S.; Ahmed, Ali

2017-01-01

Background According to the 2004 Surgeon General’s Report on Health Consequences of Smoking, after >15 years of abstinence, the cardiovascular risk of former smokers becomes similar to that of never-smokers. Whether this health benefit of smoking cessation varies by amount and duration of prior smoking remains unclear. Methods and Results Of the 4482 adults ≥65 years without prevalent heart failure (HF) in the Cardiovascular Health Study (CHS), 2556 were never-smokers, 629 current smokers, and 1297 former smokers with >15 years of cessation, of whom 312 were heavy smokers (highest quartile; ≥32 pack-years). Age-sex-race-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for centrally-adjudicated incident HF and mortality during 13 years of follow-up were estimated using Cox regression models. Compared to never-smokers, former smokers as a group had similar risk for incident HF (aHR, 0.99; 95% CI, 0.85–1.16) and all-cause mortality (aHR, 1.08; 95% CI, 0.96–1.20), but former heavy smokers had higher risk for both HF (aHR, 1.45; 95% CI, 1.15–1.83) and mortality (aHR, 1.38; 95% CI, 1.17–1.64). However, when compared to current smokers, former heavy smokers had lower risk of death (aHR, 0.64; 95% CI, 0.53–0.77), but not of HF (aHR, 0.97; 95% CI, 0.74–1.28). Conclusions After >15 years of smoking cessation, older adults who smoked <32 pack-years appear to achieve the health profile of never-smokers. Although former heavy (≥32 pack-years) smokers may not achieve this health benefit of prolonged smoking cessation, their risk is clearly lower relative to current smokers. PMID:26038535

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.

Unemployment Rate, Smoking in China: Are They Related?

PubMed

Wang, Qing; Shen, Jay J; Cochran, Chris

2016-01-08

Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent for those who smoked including a 2.9% increase for those who smoked 1-10 cigarettes per day; a 2.8% increase for those who smoked 11-20 cigarettes per day; and a 3.4% increase for those who smoked 20 cigarettes or more per day. The effects were stronger for those who were employed. Non-drinkers were more likely to engage in smoking with increased unemployment rate. 2SLS estimation revealed the same association. The unemployment rate was positively associated with smoking behavior. Smoking control and intervention strategies should focus on both the individual's characteristics and the physical environment in which unemployment rate tend to rise.

A comparison of UK primary care data with other national data sources for monitoring the prevalence of smoking during pregnancy.

PubMed

Dhalwani, Nafeesa N; Tata, Laila J; Coleman, Tim; Fiaschi, Linda; Szatkowski, Lisa

2015-09-01

We aimed to assess the potential usefulness of primary care data in the UK for estimating smoking prevalence in pregnancy by comparing the primary care data estimates with those obtained from other data sources. In The Health Improvement Network (THIN) primary care database, we identified pregnant smokers using smoking information recorded during pregnancy. Where this information was missing, we used smoking information recorded prior to pregnancy. We compared annual smoking prevalence from 2000 to 2012 in THIN with measures from the Infant Feeding Survey (IFS), Smoking At Time of Delivery (SATOD), Child Health Systems Programme (CHSP) and Scottish Morbidity Record (SMR). Smoking estimates from THIN data converged with estimates from other sources after 2004, though still do not agree completely. For example, in 2012 smoking prevalence at booking was 11.6% in THIN using data recorded only during pregnancy, compared with 19.6% in SMR data. However, the use of smoking data recorded up to 27 months before conception increased the THIN prevalence to 20.3%, improving the comparability. Under-recording of smoking status during pregnancy results in unreliable prevalence estimates from primary care data and needs improvement. However, in the absence of gestational smoking data, the inclusion of pre-conception smoking records may increase the utility of primary care data. One strategy to improve gestational smoking status recording in primary care could be the inclusion of pregnancy in the Quality and Outcome's Framework as a condition for which smoking status and smoking cessation advice must be recorded electronically in patient records. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

Instrumental variables estimates of peer effects in social networks.

PubMed

An, Weihua

2015-03-01

Estimating peer effects with observational data is very difficult because of contextual confounding, peer selection, simultaneity bias, and measurement error, etc. In this paper, I show that instrumental variables (IVs) can help to address these problems in order to provide causal estimates of peer effects. Based on data collected from over 4000 students in six middle schools in China, I use the IV methods to estimate peer effects on smoking. My design-based IV approach differs from previous ones in that it helps to construct potentially strong IVs and to directly test possible violation of exogeneity of the IVs. I show that measurement error in smoking can lead to both under- and imprecise estimations of peer effects. Based on a refined measure of smoking, I find consistent evidence for peer effects on smoking. If a student's best friend smoked within the past 30 days, the student was about one fifth (as indicated by the OLS estimate) or 40 percentage points (as indicated by the IV estimate) more likely to smoke in the same time period. The findings are robust to a variety of robustness checks. I also show that sharing cigarettes may be a mechanism for peer effects on smoking. A 10% increase in the number of cigarettes smoked by a student's best friend is associated with about 4% increase in the number of cigarettes smoked by the student in the same time period. Copyright © 2014 Elsevier Inc. All rights reserved.

The impact of smoke-free workplaces on declining cigarette consumption in Australia and the United States.

PubMed Central

Chapman, S; Borland, R; Scollo, M; Brownson, R C; Dominello, A; Woodward, S

1999-01-01

OBJECTIVES: This study estimates the contribution of smoke-free workplaces to the recent national declines in cigarette consumption in Australia and the United States. METHODS: Nineteen studies of the impact of smoke-free workplaces on workday cigarette consumption were reviewed. The number and cost of cigarettes forgone were calculated and extrapolated to a scenario in which all indoor work areas were smoke-free. RESULTS: Of the 19 studies, 18 reported declines in daily smoking rates, and 17 reported declines in smoking prevalence. Smoke-free workplaces are currently responsible for an annual reduction of some 602 million cigarettes, or 1.8% of all cigarettes that might otherwise be consumed, in Australia, and an annual reduction of 9.7 billion cigarettes (2%) in the United States. Approximately 22.3% of the 2.7 billion decrease in cigarette consumption in Australia between 1988 and 1995 can be attributed to smoke-free workplaces, as can 12.7% of the 76.5 billion decrease in the United States between 1988 and 1994. CONCLUSIONS: If workplaces were universally smoke-free, the number of cigarettes forgone annually would increase to 1.14 billion (3.4%) in Australia and 20.9 billion (4.1%) in the United States. PMID:10394309

Organisational justice and smoking: the Finnish Public Sector Study.

PubMed

Kouvonen, Anne; Vahtera, Jussi; Elovainio, Marko; Cox, Sara J; Cox, Tom; Linna, Anne; Virtanen, Marianna; Kivimäki, Mika

2007-05-01

To examine the extent to which the justice of decision-making procedures and interpersonal relationships is associated with smoking. 10 municipalities and 21 hospitals in Finland. Cross-sectional data derived from the Finnish Public Sector Study were analysed with logistic regression analysis models with generalised estimating equations. Analyses of smoking status were based on data provided by 34,021 employees. Separate models for heavy smoking (> or = 20 cigarettes/day) were calculated for 6295 current smokers. After adjustment for age, education, socioeconomic position, marital status, job contract and negative affectivity, smokers who reported low procedural justice were about 1.4 times more likely to smoke > or = 20 cigarettes/day compared with their counterparts who reported high levels of justice. In a similar way, after adjustments, low levels of justice in interpersonal treatment was significantly associated with an increased prevalence of heavy smoking (OR 1.35, 95% CI 1.03 to 1.77 for men and OR 1.41, 95% CI 1.09 to 1.83 for women). Further adjustment for job strain and effort-reward imbalance had little effect on these results. No associations were observed between justice components and smoking status or ex-smoking. The extent to which employees are treated with justice in the workplace seems to be associated with smoking intensity independently of established stressors at work.

Lifetime smoking habits among Norwegian men and women born between 1890 and 1994: a cohort analysis using cross-sectional data.

PubMed

Lund, Ingeborg; Lund, Karl Erik

2014-10-17

Providing lifetime smoking prevalence data and gender-specific cigarette consumption data for use in epidemiological studies of tobacco-induced cancer in Norway. Characterising smoking patterns in birth cohorts is essential for evaluating the impact of tobacco control interventions and predicting smoking-related mortality. Norway. Previously analysed annual surveys of smoking habits from 1954 to 1992, and individual lifetime smoking histories collected in 1965 from a sample of people born in 1893-1927, were supplemented with new annual surveys of smoking habits from 1993 to 2013. Age range 15-74 years. Current smoking proportions in 5-year gender-and-birth cohorts of people born between 1890 and 1994. The proportion of smokers increased in male cohorts until the 1950s, when the highest proportion of male smokers (76-78%) was observed among those born in 1915-1934. Among women, the peak (52%) occurred 20 years later, in women born in 1940-1949. After 1970 smoking has declined in all cohorts of men and women. In the 1890-1894 cohorts, male smoking prevalence was several times higher than female, but the gap declined until no gender difference was present among those born after 1950. Gender-specific per capita consumption was even more skewed, and men have consumed over 70% of all cigarettes since 1930. The incidence of lung cancer for men peaked at around 2000, with the highest incidence rate estimated at ca. 38%. The incidence of lung cancer for women is still increasing, and estimated incidence rate for 2011 was 25.2%. In an epidemiological perspective, men have had a longer and more intense exposure to cigarettes than women. The gender-specific incidence of lung cancer reflects the gender difference in consumption over time. 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.

smokeSALUD: exploring the effect of demographic change on the smoking prevalence at municipality level in Austria.

PubMed

Tomintz, Melanie; Kosar, Bernhard; Clarke, Graham

2016-10-07

Reducing the smoking population is still high on the policy agenda, as smoking leads to many preventable diseases, such as lung cancer, heart disease, diabetes, and more. In Austria, data on smoking prevalence only exists at the federal state level. This provides an interesting overview about the current health situation, but for regional planning authorities these data are often insufficient as they can hide pockets of high and low smoking prevalence in certain municipalities. This paper presents a spatial-temporal change of estimated smokers for municipalities from 2001 and 2011. A synthetic dataset of smokers is built by combining individual large-scale survey data and small area census data using a deterministic spatial microsimulation approach. Statistical analysis, including chi-square test and binary logistic regression, are applied to find the best variables for the simulation model and to validate its results. As no easy-to-use spatial microsimulation software for non-programmers is available yet, a flexible web-based spatial microsimulation application for health decision support (called simSALUD) has been developed and used for these analyses. The results of the simulation show in general a decrease of smoking prevalence within municipalities between 2001 and 2011 and differences within areas are identified. These results are especially valuable to policy decision makers for future planning strategies. This case study shows the application of smokeSALUD to model the spatial-temporal changes in the smoking population in Austria between 2001 and 2011. This is important as no data on smoking exists at this geographical scale (municipality). However, spatial microsimulation models are useful tools to estimate small area health data and to overcome these problems. The simulations and analysis should support health decision makers to identify hot spots of smokers and this should help to show where to spend health resources best in order to reduce health inequalities.

[Smoking tobacco in Costa Rica: susceptibility, consumption and dependence].

PubMed

Fonseca-Chaves, Sandra; Méndez-Muñoz, Jesús; Bejarano-Orozco, Julio; Guerrero-López, Carlos Manuel; Reynales-Shigematsu, Luz Myriam

2017-01-01

To identify factors associated with susceptibility, tobacco use and addiction in young people from 13 to 15 years of age, to determine conditions of risk and identify possible correlates to the development of public policies on smoking in Costa Rica. Information available from the four rounds of the Global Youth Tobacco Survey (GYTS) Costa Rica was used. It was based on a sample size of 11 540 youngsters from public and private schools. Indicators of interest and logistic regression models for smoking, susceptibility and addiction were estimated. The prevalence of current consumption shows a significant decrease over the 14 years of the study (17.3% in 1999 and 5.0% in 2013) and, to a lesser intensity, in the index of smoking susceptibility (19.3% in 1999 and 12.4% in 2013). The proportion of young people with addiction has shown a significant increase in the same period. The conditions that explained the significant reduction in smoking prevalence and less susceptibility must be maintained and deepened to achieve full compliance of the MPower measures.

[Smoking cessation interventions in Mexico: analysis of the willingness to pay for an effective method to quit].

PubMed

Serván-Mori, Edson E; Heredia-Pi, Ileana B; Reynales-Shigematsu, Luz Myriam; Bautista-Arredondo, Sergio

2012-06-01

To identify environmental, demographic and socioeconomic factors associated with the desire to quit, estimate the willingness to pay (WTP) for smoking cessation treatments (SCT) and to identify associated factors with this valuation. Using the Global Adult Tobacco Survey, Mexico 2009, we characterized 1 626 smokers. Logistic and multiple lineal regression models allowed to identify associated factors with the desire to quit and the WTP for SCT. 82.2 % of the current smokers who did not want to quit were men. Between those who wanted to quit, 49.8 % had been consuming tobacco every day, for more than 16 years, 57 % had made cessation attempts in the past, and around 10% knew about the existence of centers to help quit smoking. Average WTP was 2 708 Mexican pesos (MXP), with differences by educational and socioeconomic levels. This evidence supports policymakers in the design of smoking cessation interventions improving national health system interventions for quit smoking.

Workplace smoking related absenteeism and productivity costs in Taiwan

PubMed Central

Tsai, S; Wen, C; Hu, S; Cheng, T; Huang, S

2005-01-01

Objective: To estimate productivity losses and financial costs to employers caused by cigarette smoking in the Taiwan workplace. Methods: The human capital approach was used to calculate lost productivity. Assuming the value of lost productivity was equal to the wage/salary rate and basing the calculations on smoking rate in the workforce, average days of absenteeism, average wage/salary rate, and increased risk and absenteeism among smokers obtained from earlier research, costs due to smoker absenteeism were estimated. Financial losses caused by passive smoking, smoking breaks, and occupational injuries were calculated. Results: Using a conservative estimate of excess absenteeism from work, male smokers took off an average of 4.36 sick days and male non-smokers took off an average of 3.30 sick days. Female smokers took off an average of 4.96 sick days and non-smoking females took off an average of 3.75 sick days. Excess absenteeism caused by employee smoking was estimated to cost US$178 million per annum for males and US$6 million for females at a total cost of US$184 million per annum. The time men and women spent taking smoking breaks amounted to nine days per year and six days per year, respectively, resulting in reduced output productivity losses of US$733 million. Increased sick leave costs due to passive smoking were approximately US$81 million. Potential costs incurred from occupational injuries among smoking employees were estimated to be US$34 million. Conclusions: Financial costs caused by increased absenteeism and reduced productivity from employees who smoke are significant in Taiwan. Based on conservative estimates, total costs attributed to smoking in the workforce were approximately US$1032 million. PMID:15923446

Workplace smoking related absenteeism and productivity costs in Taiwan.

PubMed

Tsai, S P; Wen, C P; Hu, S C; Cheng, T Y; Huang, S J

2005-06-01

To estimate productivity losses and financial costs to employers caused by cigarette smoking in the Taiwan workplace. The human capital approach was used to calculate lost productivity. Assuming the value of lost productivity was equal to the wage/salary rate and basing the calculations on smoking rate in the workforce, average days of absenteeism, average wage/salary rate, and increased risk and absenteeism among smokers obtained from earlier research, costs due to smoker absenteeism were estimated. Financial losses caused by passive smoking, smoking breaks, and occupational injuries were calculated. Using a conservative estimate of excess absenteeism from work, male smokers took off an average of 4.36 sick days and male non-smokers took off an average of 3.30 sick days. Female smokers took off an average of 4.96 sick days and non-smoking females took off an average of 3.75 sick days. Excess absenteeism caused by employee smoking was estimated to cost USD 178 million per annum for males and USD 6 million for females at a total cost of USD 184 million per annum. The time men and women spent taking smoking breaks amounted to nine days per year and six days per year, respectively, resulting in reduced output productivity losses of USD 733 million. Increased sick leave costs due to passive smoking were approximately USD 81 million. Potential costs incurred from occupational injuries among smoking employees were estimated to be USD 34 million. Financial costs caused by increased absenteeism and reduced productivity from employees who smoke are significant in Taiwan. Based on conservative estimates, total costs attributed to smoking in the workforce were approximately USD 1032 million.

Performance and Cost-Effectiveness of Computed Tomography Lung Cancer Screening Scenarios in a Population-Based Setting: A Microsimulation Modeling Analysis in Ontario, Canada.

PubMed

Ten Haaf, Kevin; Tammemägi, Martin C; Bondy, Susan J; van der Aalst, Carlijn M; Gu, Sumei; McGregor, S Elizabeth; Nicholas, Garth; de Koning, Harry J; Paszat, Lawrence F

2017-02-01

The National Lung Screening Trial (NLST) results indicate that computed tomography (CT) lung cancer screening for current and former smokers with three annual screens can be cost-effective in a trial setting. However, the cost-effectiveness in a population-based setting with >3 screening rounds is uncertain. Therefore, the objective of this study was to estimate the cost-effectiveness of lung cancer screening in a population-based setting in Ontario, Canada, and evaluate the effects of screening eligibility criteria. This study used microsimulation modeling informed by various data sources, including the Ontario Health Insurance Plan (OHIP), Ontario Cancer Registry, smoking behavior surveys, and the NLST. Persons, born between 1940 and 1969, were examined from a third-party health care payer perspective across a lifetime horizon. Starting in 2015, 576 CT screening scenarios were examined, varying by age to start and end screening, smoking eligibility criteria, and screening interval. Among the examined outcome measures were lung cancer deaths averted, life-years gained, percentage ever screened, costs (in 2015 Canadian dollars), and overdiagnosis. The results of the base-case analysis indicated that annual screening was more cost-effective than biennial screening. Scenarios with eligibility criteria that required as few as 20 pack-years were dominated by scenarios that required higher numbers of accumulated pack-years. In general, scenarios that applied stringent smoking eligibility criteria (i.e., requiring higher levels of accumulated smoking exposure) were more cost-effective than scenarios with less stringent smoking eligibility criteria, with modest differences in life-years gained. Annual screening between ages 55-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago yielded an incremental cost-effectiveness ratio of $41,136 Canadian dollars ($33,825 in May 1, 2015, United States dollars) per life-year gained (compared to annual screening between ages 60-75 for persons who smoked ≥40 pack-years and who currently smoke or quit ≤10 y ago), which was considered optimal at a cost-effectiveness threshold of $50,000 Canadian dollars ($41,114 May 1, 2015, US dollars). If 50% lower or higher attributable costs were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $38,240 ($31,444 May 1, 2015, US dollars) or $48,525 ($39,901 May 1, 2015, US dollars), respectively. If 50% lower or higher costs for CT examinations were assumed, the incremental cost-effectiveness ratio of this scenario was estimated to be $28,630 ($23,542 May 1, 2015, US dollars) or $73,507 ($60,443 May 1, 2015, US dollars), respectively. This scenario would screen 9.56% (499,261 individuals) of the total population (ever- and never-smokers) at least once, which would require 4,788,523 CT examinations, and reduce lung cancer mortality in the total population by 9.05% (preventing 13,108 lung cancer deaths), while 12.53% of screen-detected cancers would be overdiagnosed (4,282 overdiagnosed cases). Sensitivity analyses indicated that the overall results were most sensitive to variations in CT examination costs. Quality of life was not incorporated in the analyses, and assumptions for follow-up procedures were based on data from the NLST, which may not be generalizable to a population-based setting. Lung cancer screening with stringent smoking eligibility criteria can be cost-effective in a population-based setting.

The Effect of Smoking on the Risk of Sciatica: A Meta-analysis.

PubMed

Shiri, Rahman; Falah-Hassani, Kobra

2016-01-01

The role of smoking in sciatica is unknown. This study aimed to estimate the effect of smoking on lumbar radicular pain and clinically verified sciatica. Comprehensive literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar, and ResearchGate databases from 1964 through March 2015. We used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses with regard to study design, methodological quality of included studies, and publication bias. Twenty-eight (7 cross-sectional [n = 20,111 participants], 8 case control [n = 10,815], and 13 cohort [n = 443,199]) studies qualified for a meta-analysis. Current smokers had an increased risk of lumbar radicular pain or clinically verified sciatica (pooled adjusted odds ratio [OR] 1.46; 95% confidence interval [CI], 1.30-1.64, n = 459,023). Former smokers had only slightly elevated risk compared with never smokers (pooled adjusted OR 1.15; 95% CI, 1.02-1.30, n = 387,196). For current smoking the pooled adjusted OR was 1.64 (95% CI, 1.24-2.16, n = 10,853) for lumbar radicular pain, 1.35 (95% CI, 1.09-1.68, n = 110,374) for clinically verified sciatica, and 1.45 (95% CI, 1.16-1.80, n = 337,796) for hospitalization or surgery due to a herniated lumbar disc or sciatica. The corresponding estimates for past smoking were 1.57 (95% CI, 0.98-2.52), 1.09 (95% CI, 1.00-1.19), and 1.10 (95% CI, 0.96-1.26). The associations did not differ between men and women, and they were independent of study design. Moreover, there was no evidence of publication bias, and the observed associations were not due to selection or detection bias, or confounding factors. Smoking is a modest risk factor for lumbar radicular pain and clinically verified sciatica. Smoking cessation appears to reduce, but not entirely eliminate, the excess risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Neighbourhood crime and smoking: the role of objective and perceived crime measures

PubMed Central

2011-01-01

Background Smoking is a major public health problem worldwide. Research has shown that neighbourhood of residence is independently associated with the likelihood of individuals' smoking. However, a fine comprehension of which neighbourhood characteristics are involved and how remains limited. In this study we examine the relative contribution of objective (police-recorded) and subjective (resident-perceived) measures of neighbourhood crime on residents' smoking behaviours. Methods Data from 2,418 men and women participating in the 2007/8 sweep of the West of Scotland Twenty-07 Study were analyzed. Smoking status and perceived crime were collected through face-to-face interviews with participants. Police-recorded crime rates were obtained from the Scottish Neighbourhood Statistics website at the datazone scale. Adjusted odds ratios and 95% confidence intervals were estimated for the likelihood of current smoking using logistic regression models. Adjusted mean daily amount smoked and F statistics were calculated using general linear models. Analyses were conducted for all respondents and stratified by sex and age cohort. Results Compared to individuals living in low crime areas, those residing in an area characterized by high police-recorded crime rates or those perceiving high crime in their neighbourhood were more likely to be current smokers, after controlling for individual characteristics. The association with smoking was somewhat stronger for police-recorded crime than for perceived crime. Associations were only slightly attenuated when adjusting for either the objective or subjective crime measures, suggesting that these indicators may exert an independent influence on the risk of smoking. Stronger effects were observed for women compared to men. Police-recorded crime rates were more strongly related to smoking status among older respondents than among the younger cohort, whereas the strongest effect for perceived crime was observed among younger participants. Conclusions Our findings highlight the relevance of paying attention to both objective and perceived neighbourhood crime measures when aiming to prevent smoking. PMID:22168151

Space-based Observational Constraints for 1-D Plume Rise Models

NASA Technical Reports Server (NTRS)

Martin, Maria Val; Kahn, Ralph A.; Logan, Jennifer A.; Paguam, Ronan; Wooster, Martin; Ichoku, Charles

2012-01-01

We use a space-based plume height climatology derived from observations made by the Multi-angle Imaging SpectroRadiometer (MISR) instrument aboard the NASA Terra satellite to evaluate the ability of a plume-rise model currently embedded in several atmospheric chemical transport models (CTMs) to produce accurate smoke injection heights. We initialize the plume-rise model with assimilated meteorological fields from the NASA Goddard Earth Observing System and estimated fuel moisture content at the location and time of the MISR measurements. Fire properties that drive the plume-rise model are difficult to estimate and we test the model with four estimates for active fire area and four for total heat flux, obtained using empirical data and Moderate Resolution Imaging Spectroradiometer (MODIS) re radiative power (FRP) thermal anomalies available for each MISR plume. We show that the model is not able to reproduce the plume heights observed by MISR over the range of conditions studied (maximum r2 obtained in all configurations is 0.3). The model also fails to determine which plumes are in the free troposphere (according to MISR), key information needed for atmospheric models to simulate properly smoke dispersion. We conclude that embedding a plume-rise model using currently available re constraints in large-scale atmospheric studies remains a difficult proposition. However, we demonstrate the degree to which the fire dynamical heat flux (related to active fire area and sensible heat flux), and atmospheric stability structure influence plume rise, although other factors less well constrained (e.g., entrainment) may also be significant. Using atmospheric stability conditions, MODIS FRP, and MISR plume heights, we offer some constraints on the main physical factors that drive smoke plume rise. We find that smoke plumes reaching high altitudes are characterized by higher FRP and weaker atmospheric stability conditions than those at low altitude, which tend to remain confined below the BL, consistent with earlier results. We propose two simplified parameterizations for computing injection heights for fires in CTMs and discuss current challenges to representing plume injection heights in large scale atmospheric models.

Does film smoking promote youth smoking in middle-income countries?: A longitudinal study among Mexican adolescents

PubMed Central

Thrasher, James F.; Sargent, James D.; Huang, Liling; Arillo-Santillán, Edna; Dorantes-Alonso, Ana; Pérez-Hernández, Rosaura

2013-01-01

Objective To determine whether exposure to smoking imagery in films predicts smoking onset among never-smoking Mexican adolescents. Methods The analytic sample was comprised of 11- to 14-year old secondary school students who reported never having tried smoking at baseline, 83% (1741/2093) of whom were successfully followed up after one year. Exposure to 42 popular films that contained smoking was assessed at baseline, whereas smoking behavior and risk factors were assessed at baseline and follow up. Logistic regression was used to estimate bivariate and adjusted relative risks of trying smoking and current smoking at follow up. Results At follow up, 36% reported having tried smoking and 8% reported having smoked in the previous month. Students who were successfully followed up were exposed to an average of 43.8 minutes of smoking in the films they reported viewing at baseline. Adjusted relative risks (ARRs) indicated that students in the two highest levels of exposure to film smoking were more than twice as likely to have smoked in the previous 30 days at follow up (ARR3v1=2.44, 95%CI 1.31, 4.55; ARR4v1=2.23, 95% CI 1.19, 4.17). The adjusted relative risk of having tried smoking by follow up reached statistical significance only when comparing the 3rd highest to the lowest exposure group (ARR3v1=1.54, 95%CI 1.01, 2.64). Having a parent or best friend who smoked at baseline were the only other variables that independently predicted both outcomes. Conclusions Exposure to movie smoking is a risk factor for smoking onset among Mexican youth. PMID:19959694

[Tobacco consumption, mortality and fiscal policy in Mexico].

PubMed

Guerrero-López, Carlos Manuel; Muños-Hernández, José Alberto; Sáenz de Miera-Juárez, Belén; Reynales-Shigematsu, Luz Myriam

2013-01-01

To analyze tobacco consumption in the last 12 years, its impact on chronic diseases mortality and the potential benefits of fiscal policy in Mexico. Through the analysis of national health surveys (ENSA, ENSANUT), records of mortality and economic surveys between 2000 and 2012, smoking prevalence, chronic diseases mortality and consumption were estimated. In 2012, 9.2% and 19% of Mexican youths and adults were current smokers. Between 2000 and 2012, smoking prevalence did not change. However, the average consumption among adolescents and adults declined whilst the special tobacco tax has being increased. Mortality attributable to tobacco consumption for four diseases was estimated in 60 000 in 2010. Tobacco consumption remains the leading cause of preventable death. Increasing taxes on tobacco products could deter the tobacco epidemic and consequently chronic diseases mortality in Mexico.

Electronic cigarette: use and perceptions among French military nurses in 2013.

PubMed

Guillet, Sébastien; Sicard, Sébastien; Meynard, Jean-Baptiste; Mayet, Aurélie

2015-01-01

Paramedical personnel are exposed to tobacco smoking. Electronic cigarettes (e-cigarettes) may be considered as a lower-risk substitute for cigarettes. The aim of the study was to estimate the prevalence of e-cigarette use, the motives for use and the perceptions among French military nurses. A cross-sectional survey, using self-administered questionnaires, was conducted in 2013 among 300 students and instructors of the French school of military paramedical personnel. Prevalences of e-cigarette use among smokers and nonsmokers were compared using logistic regressions adjusted on age and gender. The prevalence of smoking was 40% among the 200 responders. E-cigarette current use prevalence was 25% (6% daily users), without significant difference according to gender and age. Tobacco smokers reported significantly more e-cigarette current use (51% vs7%). Motives for e-cigarette use reported by smokers were curiosity (48%), intention to reduce tobacco consumption (43%) or to quit smoking (8%). Among users of both tobacco and e-cigarettes, 48% reported a significant decrease in tobacco consumption following e-cigarette initiation (average decrease of 5-10 cigarettes smoked per day; p <0.001). Both tobacco smokers and nonsmokers (88%) estimated that e-cigarette use was potentially harmful for health, but it was perceived as less harmful than tobacco by 46%. E-cigarette use among military nurses follows the trends observed in the general population in terms of prevalence and motives. E-cigarettes, which are seen as an attractive alternative to cigarettes, may contribute to a reduction in tobacco use among healthcare workers.

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.

A duration analysis of the role of cigarette prices on smoking initiation and cessation in developing countries.

PubMed

Kostova, Deliana; Chaloupka, Frank J; Shang, Ce

2015-04-01

This study evaluates the impact of cigarette prices on smoking initiation and cessation among adults in two pooled samples of 6 low- to lower-middle income countries (LMICs) and 8 upper-middle income countries (UMICs). We find that, while higher prices reduce smoking across the board, this reduction occurs through different behavioral mechanisms in lower versus higher income countries. Specifically, cigarette prices reduce smoking rates by deterring initiation in LMICs while in UMICs they act primarily by promoting cessation. Because current smoking rates are relatively lower in LMICs and relatively higher in UMICs, this differential mechanism underscores the adaptability of tobacco prices as a tool for regulating tobacco use across countries at different levels of development; it shows that prices can be used to sustain the relatively low rates of smoking in LMICs by preventing entry of new smokers, and can reduce the relatively high rates of smoking in UMICs by encouraging exit of existing smokers. Using split-population duration models and controlling for fixed and time-varying unobserved country characteristics, we estimate that the price elasticity of initiation in LMICs is -0.74 and the price elasticity of cessation in UMICs is 0.51.

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

Augmentation index (AI) in a dose–response relationship with smoking habits in males

PubMed Central

Tsuru, Tomoko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Kumagai, Eita; Nakamura, Sachiko; Nohara, Yume; Kono, Shoko; Nakao, Erika; Sakaue, Akiko; Morikawa, Nagisa; Fukumoto, Yoshihiro

2016-01-01

Abstract We investigated the relationship between augmentation index (AI) and smoking habits in community-dwelling Japanese. This cross-sectional study enrolled 1926 subjects (769 males and 1157 females) aged 40 to 95 years who underwent a health check-up in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town in Kyushu Island in 2009. The subjects’ medical history, alcohol intake, smoking habit, and current medications for hypertension, dyslipidemia, and diabetes were ascertained by questionnaire. Radial arterial pressure wave analysis was used to obtain AI. We analyzed the data stratified by gender. Age-adjusted means of AI in males showed a clear dose–response relationship in 4 categories of smoking habits (P = 0.010). There was no significant relationship between AI and smoking habits in females (P = 0.127). The significant dose–response relationship (P = 0.036) in males between AI and 4 categories of smoking habits still remained even after adjustment for age, body mass index, systolic blood pressure, estimated glomerular filtration rate, glucose, hypertensive medication, and alcohol intake. The present study demonstrated that AI values were significantly associated with smoking habits in a dose-dependent manner in Japanese males. PMID:28002323

Augmentation index (AI) in a dose-response relationship with smoking habits in males: The Tanushimaru study.

PubMed

Tsuru, Tomoko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Kumagai, Eita; Nakamura, Sachiko; Nohara, Yume; Kono, Shoko; Nakao, Erika; Sakaue, Akiko; Morikawa, Nagisa; Fukumoto, Yoshihiro

2016-12-01

We investigated the relationship between augmentation index (AI) and smoking habits in community-dwelling Japanese.This cross-sectional study enrolled 1926 subjects (769 males and 1157 females) aged 40 to 95 years who underwent a health check-up in a Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town in Kyushu Island in 2009. The subjects' medical history, alcohol intake, smoking habit, and current medications for hypertension, dyslipidemia, and diabetes were ascertained by questionnaire. Radial arterial pressure wave analysis was used to obtain AI. We analyzed the data stratified by gender.Age-adjusted means of AI in males showed a clear dose-response relationship in 4 categories of smoking habits (P = 0.010). There was no significant relationship between AI and smoking habits in females (P = 0.127). The significant dose-response relationship (P = 0.036) in males between AI and 4 categories of smoking habits still remained even after adjustment for age, body mass index, systolic blood pressure, estimated glomerular filtration rate, glucose, hypertensive medication, and alcohol intake.The present study demonstrated that AI values were significantly associated with smoking habits in a dose-dependent manner in Japanese males.

Smoking may modify the association between neoadjuvant chemotherapy and survival from ovarian cancer.

PubMed

Kelemen, Linda E; Warren, Graham W; Koziak, Jennifer M; Köbel, Martin; Steed, Helen

2016-01-01

Tobacco smoking by cancer patients is associated with increased mortality. Less is known of the impact of smoking on recurrence risk and interaction with chemotherapy treatment. We examined these associations in ovarian cancer. Patients were identified from the Alberta Cancer Registry between 1978 and 2010 and were oversampled for less-common histologic ovarian tumor types. Medical records were abstracted for 678 eligible patients on lifestyle, medical and cancer treatment, and review of pathology slides was performed for 605 patients. We estimated hazard ratios (HR) and 95% confidence intervals (CI) using Cox proportional hazard models adjusted for age at diagnosis, race, stage and residual disease. Among patients receiving adjuvant chemotherapy (N=432), current smoking was significantly associated with shorter duration of overall (OS; HR, 8.56; 95% CI, 1.50-48.7) and progression-free (PFS; HR, 5.74; 95% CI, 1.05-31.4) survival from mucinous ovarian cancer only. There was no significant association between neoadjuvant chemotherapy and survival. However, among patients receiving neoadjuvant chemotherapy (N=44), current smokers had shorter PFS (HR, 4.32; 95% CI, 1.36-13.8; N=32 progressed/9 censored events) compared to never smokers, but the HRs were not statistically different across smoking categories (P interaction=0.87). Adverse associations were observed between smoking status and OS or PFS among patients with mucinous ovarian cancer receiving adjuvant chemotherapy. No significant effect was found from neoadjuvant chemotherapy on PFS overall; however, smoking may modify this association. Although needing replication, these findings suggest that patients may benefit from smoking cessation interventions prior to treatment with chemotherapy. Copyright © 2015 Elsevier Inc. All rights reserved.

Smoking, socioeconomic factors, and age-related cataract: The Singapore Malay Eye study.

PubMed

Wu, Renyi; Wang, Jie Jin; Mitchell, Paul; Lamoureux, Ecosse L; Zheng, Yingfeng; Rochtchina, Elena; Tan, Ava G; Wong, Tien Yin

2010-08-01

To describe the relationship of smoking, sex, and socioeconomic factors with age-related cataract in Malay adults in Singapore. In a population-based study, 3280 Malay individuals aged 40 to 80 years participated (78.7% response rate). All had interviews, systemic examination, and laboratory investigations. Lens opacity was graded from slitlamp and retroillumination photographs using the Wisconsin Cataract Grading System. Smoking-cataract associations were compared with the Blue Mountains Eye Study in Australia. Of 2927 participants (89.2%) with gradable lens photographs, 1338 (45.7%) had cataract. After adjusting for age, sex, body mass index, hypertension, and diabetes, current smokers had a higher prevalence of nuclear cataract (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.46-2.98), cortical cataract (OR, 1.33; 95% CI, 1.02-1.74), posterior subcapsular cataract (OR, 1.39; 95% CI, 1.02-1.91), or any cataract (OR, 1.48; 95% CI, 1.10-1.99). These associations were not seen in the Blue Mountains Eye Study. Primary or lower education (OR, 1.67; 95% CI, 1.06-2.64) and low monthly income (OR, 1.43; 95% CI, 1.09-1.87) were both associated with nuclear cataract, while small-sized public housing was associated with posterior subcapsular cataract (OR, 1.70; 95% CI, 1.28-2.25). Among men, 43.5% currently smoked compared with only 3.2% of women. The population attributable risk of nuclear cataract due to smoking was estimated to be 17.6% in men. Smoking and indicators of low socioeconomic status were associated with cataract in Malay persons, with 1 in 6 nuclear cataract cases in men attributable to smoking. Smoking-cataract associations were stronger in Malay than in white persons.

Unemployment Rate, Smoking in China: Are They Related?

PubMed Central

Wang, Qing; Shen, Jay J.; Cochran, Chris

2016-01-01

Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. Results: A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent for those who smoked including a 2.9% increase for those who smoked 1–10 cigarettes per day; a 2.8% increase for those who smoked 11–20 cigarettes per day; and a 3.4% increase for those who smoked 20 cigarettes or more per day. The effects were stronger for those who were employed. Non-drinkers were more likely to engage in smoking with increased unemployment rate. 2SLS estimation revealed the same association. Conclusions: The unemployment rate was positively associated with smoking behavior. Smoking control and intervention strategies should focus on both the individual′s characteristics and the physical environment in which unemployment rate tend to rise. PMID:26761019

Impact of Smoking on the Risk of Pancreatitis: A Systematic Review and Meta-Analysis

PubMed Central

Ye, Xiaohua; Lu, Guangrong; Huai, Jiaping; Ding, Jin

2015-01-01

Background and objective Cigarette smoking may increase the risk of developing pancreatic cancer, although its impact on pancreatitis has only been discerned in recent years. However, the results of previous studies differ. We performed a meta-analysis to provide a quantitative pooled risk estimate of the association of cigarette smoking with pancreatitis. Method A literature search of the MEDLINE and Embase databases was conducted, and studies were selected that investigated the association of cigarette smoking with pancreatitis. Summary relative risks (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Results Twenty-two studies were included. The summary RRs (95% CI) associated with ever, current and former smokers for acute and chronic pancreatitis (AP/CP) were as follows: 1.51 (1.10, 2.07)/3.00 (1.46, 6.17), 1.42 (1.08, 1.87)/2.72 (1.74, 4.24), and 1.22 (0.99, 1.52)/1.27 (1.00, 1.62), respectively. Moreover, studies that analyzed both AP and CP were also summarized: 1.73 (1.18, 2.54) for ever smokers, 1.67 (1.03, 2.68) for current smokers and 1.56 (1.16, 2.11) for former smokers, respectively. There was no evidence of publication bias across the studies. Conclusion The evidence suggests a positive association of cigarette smoking with the development of pancreatitis. It is possible that smoking cessation may be a useful strategy for the management of pancreatitis. PMID:25879541

Impact of smoking on the risk of pancreatitis: a systematic review and meta-analysis.

PubMed

Ye, Xiaohua; Lu, Guangrong; Huai, Jiaping; Ding, Jin

2015-01-01

Cigarette smoking may increase the risk of developing pancreatic cancer, although its impact on pancreatitis has only been discerned in recent years. However, the results of previous studies differ. We performed a meta-analysis to provide a quantitative pooled risk estimate of the association of cigarette smoking with pancreatitis. A literature search of the MEDLINE and Embase databases was conducted, and studies were selected that investigated the association of cigarette smoking with pancreatitis. Summary relative risks (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Twenty-two studies were included. The summary RRs (95% CI) associated with ever, current and former smokers for acute and chronic pancreatitis (AP/CP) were as follows: 1.51 (1.10, 2.07)/3.00 (1.46, 6.17), 1.42 (1.08, 1.87)/2.72 (1.74, 4.24), and 1.22 (0.99, 1.52)/1.27 (1.00, 1.62), respectively. Moreover, studies that analyzed both AP and CP were also summarized: 1.73 (1.18, 2.54) for ever smokers, 1.67 (1.03, 2.68) for current smokers and 1.56 (1.16, 2.11) for former smokers, respectively. There was no evidence of publication bias across the studies. The evidence suggests a positive association of cigarette smoking with the development of pancreatitis. It is possible that smoking cessation may be a useful strategy for the management of pancreatitis.

Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS)

PubMed Central

Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira

2015-01-01

Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women). PMID:26670238

Waterpipe Tobacco Smoking in Turkey: Policy Implications and Trends from the Global Adult Tobacco Survey (GATS).

PubMed

Erdöl, Cevdet; Ergüder, Toker; Morton, Jeremy; Palipudi, Krishna; Gupta, Prakash; Asma, Samira

2015-12-08

Waterpipe tobacco smoking (WTS) is an emerging tobacco product globally, especially among adolescents and young adults who may perceive WTS as a safe alternative to smoking cigarettes. Monitoring the use of WTS in Turkey in relation to the tobacco control policy context is important to ensure that WTS does not become a major public health issue in Turkey. The Global Adult Tobacco Survey (GATS) was conducted in Turkey in 2008 and was repeated in 2012. GATS provided prevalence estimates on current WTS and change over time. Other indicators of WTS were also obtained, such as age of initiation and location of use. Among persons aged 15 and older in Turkey, the current prevalence of WTS decreased from 2.3% in 2008 to 0.8% in 2012, representing a 65% relative decline. Among males, WTS decreased from 4.0% to 1.1% (72% relative decline). While the overall smoking prevalence decreased among females, there was no change in the rate of WTS (0.7% in 2008 vs. 0.5% in 2012), though the WTS prevalence rate was already low in 2008. Comprehensive tobacco control efforts have been successful in reducing the overall smoking prevalence in Turkey, which includes the reduction of cigarette smoking and WTS. However, it is important to continue monitoring the use of waterpipes in Turkey and targeting tobacco control efforts to certain groups that may be vulnerable to future WTS marketing (e.g., youth, women).

Peer, parent and media influences on adolescent smoking by developmental stage.

PubMed

Villanti, Andrea; Boulay, Marc; Juon, Hee-Soon

2011-01-01

Previous studies of social influences on adolescent smoking have focused on peers and parents, using data collected prior the 1998 Master Settlement Agreement. This study used the 2004 wave of the National Youth Tobacco Survey to examine associations between peer smoking, smoking at home, tobacco-related media exposure, and smoking behavior during early and middle adolescence. Findings indicate that peer smoking and smoking at home remain strongly associated with current smoking among early and middle adolescents, controlling for gender, race/ethnicity and exposure to tobacco industry and anti-tobacco media. The magnitude of the association between peer smoking and current smoking decreases from early adolescence to middle adolescence while the association between smoking at home and current smoking is static across developmental stage. Exposure to tobacco-related media is associated with increased current and former smoking in both early and middle adolescence. Copyright © 2010 Elsevier Ltd. All rights reserved.

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.

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.

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): the case for Lebanon.

PubMed

Saade, Georges; Warren, Charles W; Jones, Nathan R; Asma, Samira; Mokdad, Ali

2008-09-01

The purpose of this paper is to use data collected in the 2001 and 2005 Lebanon Global Youth Tobacco Survey (GYTS) to monitor articles in the WHO Framework Convention on Tobacco Control (WHO FCTC). This information is necessary to enhance the capacity of the Ministry of Health and relevant organizations to design, implement, and evaluate tobacco control and prevention programs in Lebanon, especially among adolescents. The GYTS is a school-based survey which uses a two-stage sample design to produce representative, independent, cross-sectional estimates. The GYTS was conducted in 2001 and 2005 in Lebanon to produce representative national estimates. Data in this report are limited to students aged 13-15 years. In total, 5035 students from 50 schools participated in 2001; and 3341 students from 50 schools participated in 2005. The data in this report show that, in 2005, 8.6% of the students currently smoked cigarettes, but 33.9% currently smoked narguileh. Half of current smokers wanted to stop smoking and 6 in 10 have tried to stop during the past year but have failed. In 2005, exposure to SHS at home (78.4%) and in public places (74.4%) was very high; while 85.2% thought smoking should be banned in public places. Nearly 9 in 10 students who usually buy their cigarettes in stores were not refused purchase because of their age. Overall, only half of the students in Lebanon reported that during the past school year they had been taught about the dangers of smoking. Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Health with particular attention to youth. The key for the Lebanese parliament is to develop, endorse, implement and enforce these new tobacco control laws and use the data from GYTS to monitor progress toward achieving the goals of the WHO FCTC. One key component of tobacco control needs to be the monitoring of Narguileh use among youth, a new emergency.

Native American ancestry, lung function, and COPD in Costa Ricans.

PubMed

Chen, Wei; Brehm, John M; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R; Bruse, Shannon; Tesfaigzi, Yohannes; Celedón, Juan C

2014-04-01

Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC.

Native American Ancestry, Lung Function, and COPD in Costa Ricans

PubMed Central

Chen, Wei; Brehm, John M.; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R.; Bruse, Shannon; Tesfaigzi, Yohannes

2014-01-01

Background: Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. Methods: We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. Results: The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. Conclusions: NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC. PMID:24306962

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.

Socioeconomic Impact on the Prevalence of Cardiovascular Risk Factors in Wallonia, Belgium: A Population-Based Study.

PubMed

Streel, Sylvie; Donneau, Anne-Françoise; Hoge, Axelle; Majerus, Sven; Kolh, Philippe; Chapelle, Jean-Paul; Albert, Adelin; Guillaume, Michèle

2015-01-01

Background. Monitoring the epidemiology of cardiovascular risk factors (CRFs) and their determinants is important to develop appropriate recommendations to prevent cardiovascular diseases in specific risk groups. The NESCaV study was designed to collect standardized data to estimate the prevalence of CRFs in relation to socioeconomic parameters among the general adult population in the province of Liège, Wallonia, Belgium. Methods. A representative stratified random sample of 1017 subjects, aged 20-69 years, participated in the NESCaV study (2010-2012). A self-administered questionnaire, a clinical examination, and laboratory tests were performed on participants. CRFs included hypertension, dyslipidemia, global obesity, abdominal obesity, diabetes, current smoking, and physical inactivity. Covariates were education and subjective and objective socioeconomic levels. Data were analyzed by weighted logistic regression. Results. The prevalence of hypertension, abdominal obesity, global obesity, current smoking, and physical inactivity was higher in subjects with low education and who considered themselves "financially in need." Living below poverty threshold also increased the risk of global and abdominal obesity, current smoking, and physical inactivity. Conclusion. The study shows that socioeconomic factors impact the prevalence of CRFs in the adult population of Wallonia. Current public health policies should be adjusted to reduce health inequalities in specific risk groups.

Parental smoking and childhood obesity: higher effect estimates for maternal smoking in pregnancy compared with paternal smoking--a meta-analysis.

PubMed

Riedel, Christina; Schönberger, Katharina; Yang, Seungmi; Koshy, Gibby; Chen, Yang-Ching; Gopinath, Bamini; Ziebarth, Stephanie; von Kries, Rüdiger

2014-10-01

Some studies reported similar effect estimates for the impact of maternal smoking in pregnancy and paternal smoking on childhood obesity, whereas others suggested higher effects for maternal smoking. We performed a meta-analysis to compare the effect of in utero exposure to maternal smoking and that of paternal or household smoking exposure in utero or after birth with mutual adjustment. Meta-analysis of observational studies identified in MEDLINE, EMBASE and Web of Knowledge published in 1900-2013. Study inclusion criterion was assessment of the association of maternal smoking during pregnancy and paternal or household smoking (anyone living in the household who smokes) at any time with childhood overweight and obesity. The analyses were based on all studies with mutually adjusted effect estimates for maternal and paternal/household smoking applying a random-effects model. Data for 109,838 mother/child pairs were reported in 12 studies. The pooled odds ratios (ORs) for overweight 1.33 [95% confidence interval (CI) 1.23;1.44] (n=6, I2=0.00%) and obesity 1.60 (95% CI 1.37;1.88) (n=4, I2=32.47%) for maternal smoking during pregnancy were higher than for paternal smoking: 1.07 (95% CI 1.00;1.16) (n=6, I2=41.34%) and 1.23 (95% CI 1.10;1.38) (n=4, I2=14.61%), respectively. Similar estimates with widely overlapping confidence limits were found for maternal smoking during pregnancy and childhood overweight and obesity: 1.35 (95% CI 1.20;1.51) (n=3, I2=0.00%) and 1.28 (95% CI 1.07;1.54) (n=3, I2=0.00%) compared with household smoking 1.22 (95% CI 1.06;1.39) (n=3, I2=72.14%) and 1.31 (95% CI 1.15;1.50)] (n=3, I2=0.00%). Higher effect estimates for maternal smoking in pregnancy compared with paternal smoking in mutually adjusted models may suggest a direct intrauterine effect. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Blending Model Output with satellite-based and in-situ observations to produce high-resolution estimates of population exposure to wildfire smoke

NASA Astrophysics Data System (ADS)

Lassman, William

In the western US, emissions from wildfires and prescribed fire have been associated with degradation of regional air quality. Whereas atmospheric aerosol particles with aerodynamic diameters less than 2.5 mum (PM2.5) have known impacts on human health, there is uncertainty in how particle composition, concentrations, and exposure duration impact the associated health response. Due to changes in climate and land-management, wildfires have increased in frequency and severity, and this trend is expected to continue. Consequently, wildfires are expected to become an increasingly important source of PM2.5 in the western US. While composition and source of the aerosol is thought to be an important factor in the resulting human health-effects, this is currently not well-understood; therefore, there is a need to develop a quantitative understanding of wildfire-smoke-specific health effects. A necessary step in this process is to determine who was exposed to wildfire smoke, the concentration of the smoke during exposure, and the duration of the exposure. Three different tools are commonly used to assess exposure to wildfire smoke: in-situ measurements, satellite-based observations, and chemical-transport model (CTM) simulations, and each of these exposure-estimation tools have associated strengths and weakness. In this thesis, we investigate the utility of blending these tools together to produce highly accurate estimates of smoke exposure during the 2012 fire season in Washington for use in an epidemiological case study. For blending, we use a ridge regression model, as well as a geographically weighted ridge regression model. We evaluate the performance of the three individual exposure-estimate techniques and the two blended techniques using Leave-One-Out Cross-Validation. Due to the number of in-situ monitors present during this time period, we find that predictions based on in-situ monitors were more accurate for this particular fire season than the CTM simulations and satellite-based observations, so blending provided only marginal improvements above the in-situ observations. However, we show that in hypothetical cases with fewer surface monitors, the two blending techniques can produce substantial improvement over any of the individual tools.

An Updated Global Picture of Cigarette Smoking Persistence among Adults

PubMed Central

Troost, Jonathan P.; Barondess, David A.; Storr, Carla L.; Wells, J. Elisabeth; Al-Hamzawi, Ali Obaid; Andrade, Laura Helena; Bromet, Evelyn; Bruffaerts, Ronny; Florescu, Silvia; de Girolamo, Giovanni; de Graaf, Ron; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Huang, Yueqin; Karam, Aimee N.; Kessler, Ronald C.; Lepine, Jean-Pierre; Matschinger, Herbert; Medina-Mora, Maria Elena; O'Neill, Siobhan; Posada-Villa, Jose; Sagar, Rajesh; Takeshima, Tadashi; Tomov, Toma; Williams, David R.; Anthony, James C.

2012-01-01

Background Cross-national variance in smoking prevalence is relatively well documented. The aim of this study is to estimate levels of smoking persistence across 21 countries with a hypothesized inverse relationship between country income level and smoking persistence. Methods Data from the World Health Organization World Mental Health Survey Initiative were used to estimate cross-national differences in smoking persistence–the proportion of adults who started to smoke and persisted in smoking by the date of the survey. Result There is large variation in smoking persistence from 25% (Nigeria) to 85% (China), with a random-effects meta-analytic summary estimate of 55% with considerable cross-national variation. (Cochran's heterogeneity Q statistic=6,845; p<0.001). Meta-regressions indicated observed differences are not attributable to differences in country income level, age distribution of smokers, or how recent the onset of smoking began within each country. Conclusion While smoking should remain an important public health issue in any country where smokers are present, this report identifies several countries with higher levels of smoking persistence (namely, China and India). PMID:23626929

Attempt Quit Smoking 24+ Hours Maps and Data of Model-Based Small Area Estimates - Small Area Estimates

Cancer.gov

Attempt Quit Smoking 24+ Hours is defined as a person 18 years of age or older who must have reported smoking at least 100 cigarettes in his/her life, and now does not smoke at all but it has been less than 365 days since completely stopped smoking cigarettes, or now smoke everyday or some days but reported that have made attempt of quitting for more than 24 hours in the past 12 months.

Ethnic differences in current smoking and former smoking in the Netherlands and the contribution of socioeconomic factors: a cross-sectional analysis of the HELIUS study

PubMed Central

Brathwaite, Rachel; Smeeth, Liam; Addo, Juliet; Kunst, Anton E; Peters, Ron J G; Snijder, Marieke B; Derks, Eske M; Agyemang, Charles

2017-01-01

Objectives Data exploring how much of the ethnic differences in smoking prevalence and former smoking are explained by socioeconomic status (SES) are lacking. We therefore assessed ethnic differences in smoking prevalence and former smoking and the contribution of both educational level and occupational-related SES to the observed ethnic differences in smoking behaviour. Methods Data of 22 929 participants (aged 18–70 years) from the multiethnic cross-sectional Healthy Life in an Urban Setting study in the Netherlands were analysed. Poisson regression models with a robust variance were used to estimate prevalence ratios. Results Compared with the Dutch, after adjustment for age and marital status, smoking prevalence was higher in men of Turkish (prevalence ratio 1.69, 95% CI 1.54 to 1.86), African Surinamese (1.55, 95% CI 1.41 to 1.69) and South-Asian Surinamese origin (1.53, 95% CI 1.40 to 1.68), whereas among women, smoking prevalence was higher in Turkish, similar in African Surinamese but lower in all other ethnic origin groups. All ethnic minority groups, except Ghanaians, had a significantly lower smoking cessation prevalence than the Dutch. Socioeconomic gradients in smoking (higher prevalence among those lower educated and with lower level employment) were observed in all groups except Ghanaian women (a higher prevalence was observed in the higher educated). Ethnic differences in smoking prevalence and former smoking are largely, but not completely, explained by socioeconomic factors. Conclusions Our findings imply that antismoking policies designed to target smoking within the lower socioeconomic groups of ethnic minority populations may substantially reduce ethnic inequalities in smoking particularly among men and that certain groups may benefit from targeted smoking cessation interventions. PMID:28698339

A study of the growth and decay of cigarette smoke NOx in ambient air under controlled conditions

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

Rickert, W.S.; Robinson, J.C.; Collishaw, N.E.

The amount of NO{sub 2} and NO produced by the machine smoking of cigarettes was determined for 15 commercial Canadian brands. Average yield of NO was 1.44 {mu}moles or about 13% of the average reported for American cigarettes. Levels of NO{sub 2} were all less than 12% of NO and were probably due to the oxidation of NO. In order to assess the contribution of tobacco smoke to levels of NO in ambient air, 5 brands of cigarettes were smoked in a 27 cubic meter controlled environment room. Ventilation conditions were either 2.5 or 5.0 air changes per hour (ACH)more » and each experiment was replicated 3 times for a total of 30 experiments. Ventilation rates of 0.3 and 1.5 ACH were also selected in a second series of experiments in which only one brand of cigarette was smoked. Least squares estimates for the effective ventilation rates were obtained in the usual manner after linearizing the decay portion of the NO time curve. In each of the experiments, the regression explained at least 95% of the variation in the levels of NO with time. Loss of NO due to factors other than ventilation appeared to be constant within experimental error and averaged 2.22 ACH. Equilibrium values for NO were grossly underestimated when results from currently accepted procedures for smoke analysis were used in modeling the growth and decay of NO. Goodness-of-fit was improved when equilibrium values were estimated based on observed levels in ambient air.« less

Welfare analysis of a zero-smoking policy - A case study in Japan.

PubMed

Nakamura, Yuuki; Takahashi, Kenzo; Nomura, Marika; Kamei, Miwako

2018-03-19

Smoking cessation efforts in Japan reduce smoking rates. A future zero-smoking policy would completely prohibit smoking (0% rate). We therefore analyzed the social welfare of smokers and non-smokers under a hypothetical zero-smoking policy. The demand curve for smoking from 1990 to 2014 was estimated by defining quantity as the number of cigarettes smoked and price as total tobacco sales/total cigarettes smoked by the two-stage least squares method using the tax on tobacco as the instrumental variable. In the estimation equation (calculated using the ordinary least squares method), the price of tobacco was the dependent variable and tobacco quantity the explanatory variable. The estimated constant was 31.90, the estimated coefficient of quantity was - 0.0061 (both, p < 0.0004), and the determinant coefficient was 0.9187. Thus, the 2015 consumer surplus was 1.08 trillion yen (US$ 9.82 billion) (95% confidence interval (CI), 889 billion yen (US$ 8.08 billion) - 1.27 trillion yen (US$ 11.6 billion)). Because tax revenue from tobacco in 2011 was 2.38 trillion yen (US$ 21.6 billion), the estimated deadweight loss if smoking were prohibited in 2014 was 3.31 trillion yen (US$ 30.2 billion) (95% CI, 3.13 trillion yen (US$ 28.5 billion) - 3.50 trillion yen (US$ 31.8 billion)), representing a deadweight loss about 0.6 trillion yen (US$ 5.45 billion) below the 2014 disease burden (4.10-4.12 trillion yen (US$ 37.3-37.5 billion)). We conclude that a zero-smoking policy would improve social welfare in Japan.

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

Application of an Original Wildfire Smoke Health Cost Benefits Transfer Protocol to the Western US, 2005-2015

NASA Astrophysics Data System (ADS)

Jones, Benjamin A.; Berrens, Robert P.

2017-11-01

Recent growth in the frequency and severity of US wildfires has led to more wildfire smoke and increased public exposure to harmful air pollutants. Populations exposed to wildfire smoke experience a variety of negative health impacts, imposing economic costs on society. However, few estimates of smoke health costs exist and none for the entire Western US, in particular, which experiences some of the largest and most intense wildfires in the US. The lack of cost estimates is troublesome because smoke health impacts are an important consideration of the overall costs of wildfire. To address this gap, this study provides the first time series estimates of PM2.5 smoke costs across mortality and several morbidity measures for the Western US over 2005-2015. This time period includes smoke from several megafires and includes years of record-breaking acres burned. Smoke costs are estimated using a benefits transfer protocol developed for contexts when original health data are not available. The novelty of our protocol is that it synthesizes the literature on choices faced by researchers when conducting a smoke cost benefit transfer. On average, wildfire smoke in the Western US creates 165 million in annual morbidity and mortality health costs.

Application of an Original Wildfire Smoke Health Cost Benefits Transfer Protocol to the Western US, 2005-2015.

PubMed

Jones, Benjamin A; Berrens, Robert P

2017-11-01

Recent growth in the frequency and severity of US wildfires has led to more wildfire smoke and increased public exposure to harmful air pollutants. Populations exposed to wildfire smoke experience a variety of negative health impacts, imposing economic costs on society. However, few estimates of smoke health costs exist and none for the entire Western US, in particular, which experiences some of the largest and most intense wildfires in the US. The lack of cost estimates is troublesome because smoke health impacts are an important consideration of the overall costs of wildfire. To address this gap, this study provides the first time series estimates of PM2.5 smoke costs across mortality and several morbidity measures for the Western US over 2005-2015. This time period includes smoke from several megafires and includes years of record-breaking acres burned. Smoke costs are estimated using a benefits transfer protocol developed for contexts when original health data are not available. The novelty of our protocol is that it synthesizes the literature on choices faced by researchers when conducting a smoke cost benefit transfer. On average, wildfire smoke in the Western US creates $165 million in annual morbidity and mortality health costs.

Tobacco control and the reduction in smoking-related premature deaths in the United States, 1964-2012.

PubMed

Holford, Theodore R; Meza, Rafael; Warner, Kenneth E; Meernik, Clare; Jeon, Jihyoun; Moolgavkar, Suresh H; Levy, David T

2014-01-08

January 2014 marks the 50th anniversary of the first surgeon general's report on smoking and health. This seminal document inspired efforts by governments, nongovernmental organizations, and the private sector to reduce the toll of cigarette smoking through reduced initiation and increased cessation. To model reductions in smoking-related mortality associated with implementation of tobacco control since 1964. Smoking histories for individual birth cohorts that actually occurred and under likely scenarios had tobacco control never emerged were estimated. National mortality rates and mortality rate ratio estimates from analytical studies of the effect of smoking on mortality yielded death rates by smoking status. Actual smoking-related mortality from 1964 through 2012 was compared with estimated mortality under no tobacco control that included a likely scenario (primary counterfactual) and upper and lower bounds that would capture plausible alternatives. National Health Interview Surveys yielded cigarette smoking histories for the US adult population in 1964-2012. Number of premature deaths avoided and years of life saved were primary outcomes. Change in life expectancy at age 40 years associated with change in cigarette smoking exposure constituted another measure of overall health outcomes. In 1964-2012, an estimated 17.7 million deaths were related to smoking, an estimated 8.0 million (credible range [CR], 7.4-8.3 million, for the lower and upper tobacco control counterfactuals, respectively) fewer premature smoking-related deaths than what would have occurred under the alternatives and thus associated with tobacco control (5.3 million [CR, 4.8-5.5 million] men and 2.7 million [CR, 2.5-2.7 million] women). This resulted in an estimated 157 million years (CR, 139-165 million) of life saved, a mean of 19.6 years for each beneficiary (111 million [CR, 97-117 million] for men, 46 million [CR, 42-48 million] for women). During this time, estimated life expectancy at age 40 years increased 7.8 years for men and 5.4 years for women, of which tobacco control is associated with 2.3 years (CR, 1.8-2.5) (30% [CR, 23%-32%]) of the increase for men and 1.6 years (CR, 1.4-1.7) (29% [CR, 25%-32%]) for women. Tobacco control was estimated to be associated with avoidance of 8 million premature deaths and an estimated extended mean life span of 19 to 20 years. Although tobacco control represents an important public health achievement, efforts must continue to reduce the effect of smoking on the nation's death toll.

Smoking prevalence: a comparison of two American surveys.

PubMed

Rodu, B; Cole, P

2009-09-01

To compare smoking prevalence estimates from two nationally representative surveys in the USA. Smoking prevalence estimates derived from the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH) for the period 1998-2005. Comparisons according to age (18-34 or 35+ years) and according to smoking frequency (every day or some days). In 1998, the prevalence of smoking in both surveys was nearly identical at 24%. From 1999 to 2005, a divergence occurred in smoking prevalence found by the NSDUH and the NHIS. By 2005, NHIS prevalence had declined to 20.9% [95% confidence interval (CI) 20.3-21.5], but the NSDUH estimate was 25.4% (95%CI 24.6-26.2), amounting to 9.1 million more smokers. In 1999, prevalence among 18-34 year olds in the NSDUH was only 18% (95%CI 13-22) higher than that in the NHIS, but that difference had doubled by 2005, when smoking prevalence among 18-34 year olds was 36% (95%CI 30-41) higher in the NSDUH than in the NHIS. NSDUH and NHIS prevalence among 35+ year olds were similar in 1999 and 2001, but the difference was 13% (95%CI 9-18) in 2005. Higher smoking prevalence estimates in the NSDUH were largely due to much higher estimates for some-day smoking in that survey, although every-day smoking prevalence among 18-34 year-olds was also higher in the NSDUH than in the NHIS. These results raise doubt about the recent decline in smoking prevalence described by the NHIS. Further investigation of the NSDUH/NHIS discrepancy may lead to better surveys and to a clearer picture of smoking trends in the USA.

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.

Modification of claims-based measures improves identification of comorbidities in non-elderly women undergoing mastectomy for breast cancer: a retrospective cohort study.

PubMed

Nickel, Katelin B; Wallace, Anna E; Warren, David K; Ball, Kelly E; Mines, Daniel; Fraser, Victoria J; Olsen, Margaret A

2016-08-16

Accurate identification of underlying health conditions is important to fully adjust for confounders in studies using insurer claims data. Our objective was to evaluate the ability of four modifications to a standard claims-based measure to estimate the prevalence of select comorbid conditions compared with national prevalence estimates. In a cohort of 11,973 privately insured women aged 18-64 years with mastectomy from 1/04-12/11 in the HealthCore Integrated Research Database, we identified diabetes, hypertension, deficiency anemia, smoking, and obesity from inpatient and outpatient claims for the year prior to surgery using four different algorithms. The standard comorbidity measure was compared to revised algorithms which included outpatient medications for diabetes, hypertension and smoking; an expanded timeframe encompassing the mastectomy admission; and an adjusted time interval and number of required outpatient claims. A χ2 test of proportions was used to compare prevalence estimates for 5 conditions in the mastectomy population to national health survey datasets (Behavioral Risk Factor Surveillance System and the National Health and Nutrition Examination Survey). Medical record review was conducted for a sample of women to validate the identification of smoking and obesity. Compared to the standard claims algorithm, use of the modified algorithms increased prevalence from 4.79 to 6.79 % for diabetes, 14.75 to 24.87 % for hypertension, 4.23 to 6.65 % for deficiency anemia, 1.78 to 12.87 % for smoking, and 1.14 to 6.31 % for obesity. The revised estimates were more similar, but not statistically equivalent, to nationally reported prevalence estimates. Medical record review revealed low sensitivity (17.86 %) to capture obesity in the claims, moderate negative predictive value (NPV, 71.78 %) and high specificity (99.15 %) and positive predictive value (PPV, 90.91 %); the claims algorithm for current smoking had relatively low sensitivity (62.50 %) and PPV (50.00 %), but high specificity (92.19 %) and NPV (95.16 %). Modifications to a standard comorbidity measure resulted in prevalence estimates that were closer to expected estimates for non-elderly women than the standard measure. Adjustment of the standard claims algorithm to identify underlying comorbid conditions should be considered depending on the specific conditions and the patient population studied.

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.

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

Trend differences in men and women in rural and urban U.S. settings.

PubMed

Cepeda-Benito, A; Doogan, N J; Redner, R; Roberts, M E; Kurti, A N; Villanti, A C; Lopez, A A; Quisenberry, A J; Stanton, C A; Gaalema, D E; Keith, D R; Parker, M A; Higgins, S T

2018-04-05

Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women. Copyright © 2018 Elsevier Inc. All rights reserved.

Smoking among American adolescents: a risk and protective factor analysis.

PubMed

Scal, Peter; Ireland, Marjorie; Borowsky, Iris Wagman

2003-04-01

Cigarette smoking remains a substantial threat to the current and future health of America's youth. The purpose of this study was to identify the risk and protective factors for cigarette smoking among US adolescents. Data from the National Longitudinal Study of Adolescent Health was used, comparing the responses of all non-smokers at Time 1 for their ability to predict the likelihood of smoking at Time 2, one year later. Data was stratified into four gender by grade group cohorts. Cross-cutting risk factors for smoking among all four cohorts were: using alcohol, marijuana, and other illicit drugs; violence involvement; having had sex; having friends who smoke and learning problems. Having a higher grade point average and family connectedness were protective across all cohorts. Other gender and grade group specific risk and protective factors were identified. The estimated probability of initiating smoking decreased by 19.2% to 54.1% both in situations of high and low risk as the number of protective factors present increased. Of the factors that predict or protect against smoking some are influential across all gender and grade group cohorts studied, while others are specific to gender and developmental stage. Prevention efforts that target both the reduction of risk factors and enhancement of protective factors at the individual, family, peer group and community are likely to reduce the likelihood of smoking initiation.

Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: race and gender differences.

PubMed

Lee, Chien-Ti; Clark, Trenette T; Kollins, Scott H; McClernon, F Joseph; Fuemmeler, Bernard F

2015-03-01

This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed. A subsample of 9719 youth (54.5% female) was drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Cohort sequential design and zero-inflated Poisson (ZIP) latent growth modeling were used to estimate the relationship between ADHD directionality and severity on smoking development. ADHD severity's effect on the likelihood of ever smoking cigarettes at the intercept (age 13) had a greater impact on White males than other groups. ADHD severity also had a stronger influence on the initial number of cigarettes smoked at age 13 among Hispanic participants. The relationships between ADHD directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) and a higher number of cigarettes smoked at the intercept were stronger among Hispanic males than others. Gender differences manifested only among Whites. ADHD severity and directionality had unique effects on smoking trajectories. Our results also highlight that the risk of ADHD symptoms may differ by race and gender. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Exposure to environmental tobacco smoke in the workplace and the impact of away-from-work exposure

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

LaKind, J.S.; Graves, C.G.; Tardiff, R.G.

Concentrating on exposure in workplaces where smoking occurs, the authors examined environmental tobacco smoke (ETS)-related concentration data from the 16-City Study. This study involved a large population of nonsmokers, used personal monitors, and encompassed a wide selection of ETS-related constituents. This first article in a series of three describes the 16-City Study, considers the impact of demographic variables, and concludes that these variables did not explain differences in exposure to ETS. The authors compared 16-City Study concentrations obtained in the workplace to previously reported workplace concentrations and determined that data from this study were representative of current ETS exposure inmore » nonmanufacturing workplaces where smoking occurs. Considering factors other than demographic factors, they found that, not surprisingly, the number of cigarettes observed in the workplace had an impact on exposure concentrations. Finally, they compared people from homes where smoking occurs with people from nonsmoking homes and found that people from smoking homes observed more smoking in the workplace and experienced higher concentrations of ETS-related compounds in the workplace, even when they observed the same number of cigarettes being smoked in the workplace. In two subsequent articles in this series, they discuss relationships between various ETS markers and provide estimates of distributions of doses to nonsmoking workers employed in workplaces where smoking occurs.« less

Organisational justice and smoking: the Finnish public sector study

PubMed Central

Kouvonen, Anne; Vahtera, Jussi; Elovainio, Marko; Cox, Sara J; Cox, Tom; Linna, Anne; Virtanen, Marianna; Kivimäki, Mika

2007-01-01

Objective To examine the extent to which the justice of decision‐making procedures and interpersonal relationships is associated with smoking. Setting 10 municipalities and 21 hospitals in Finland. Design and participants Cross‐sectional data derived from the Finnish Public Sector Study were analysed with logistic regression analysis models with generalised estimating equations. Analyses of smoking status were based on data provided by 34 021 employees. Separate models for heavy smoking (⩾20 cigarettes/day) were calculated for 6295 current smokers. Results After adjustment for age, education, socioeconomic position, marital status, job contract and negative affectivity, smokers who reported low procedural justice were about 1.4 times more likely to smoke ⩾20 cigarettes/day compared with their counterparts who reported high levels of justice. In a similar way, after adjustments, low levels of justice in interpersonal treatment was significantly associated with an increased prevalence of heavy smoking (OR 1.35, 95% CI 1.03 to 1.77 for men and OR 1.41, 95% CI 1.09 to 1.83 for women). Further adjustment for job strain and effort–reward imbalance had little effect on these results. No associations were observed between justice components and smoking status or ex‐smoking. Conclusions The extent to which employees are treated with justice in the workplace seems to be associated with smoking intensity independently of established stressors at work. PMID:17435210

Descriptive Summaries of the Research Development Test & Evaluation Army Appropriation FY 1983. Supporting Data FY 1983, Budget Estimate Submitted to Congress February 1982. Volume III.

DTIC Science & Technology

1982-02-01

11-17 TACTICAL PROGRAMS 2.37.24.A HEAVY ANTITAIg/ASSAULT WEAPON SYSTEM (TOW...AIRBORNE,4) DIO SYSTEM (SINCGARS)................................ 11-328 6.37.47.A SOLDIER SUPPORT/SURVIVABILITY...enhanced illumination over the current 81mm mortar. The current smoke cartridges for the 81mm mortar and 4.2" battalion heavy mortar, in use since the

Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.

PubMed

Levy, David; Mohlman, Mary Katherine; Zhang, Yian

2016-05-01

Numerous studies document the causal relationship between prenatal smoking and adverse maternal and child health (MCH) outcomes. Studies also reveal the impact that tobacco control policies have on prenatal smoking. The purpose of this study is to estimate the effect of tobacco control policies on prenatal smoking prevalence and adverse MCH outcomes. The US SimSmoke simulation model was extended to consider adverse MCH outcomes. The model estimates prenatal smoking prevalence and, applying standard attribution methods, uses estimates of MCH prevalence and relative smoking risks to estimate smoking-attributable MCH outcomes over time. The model then estimates the effect of tobacco control policies on adverse birth outcomes averted. Different tobacco control policies have varying impacts on the number of smoking-attributable adverse MCH birth outcomes. Higher cigarette taxes and comprehensive marketing bans individually have the biggest impact with a 5% to 10% reduction across all outcomes for the period from 2015 to 2065. The policies with the lowest impact (2%-3% decrease) during this period are cessation treatment, health warnings, and complete smoke-free laws. Combinations of all policies with each tax level lead to 23% to 28% decreases across all outcomes. Our findings demonstrate the substantial impact of strong tobacco control policies for preventing adverse MCH outcomes, including long-term health implications for children exposed to low birth weight and preterm birth. These benefits are often overlooked in discussions of tobacco control. © 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.

Estimation of fire emissions from satellite-based measurements

NASA Astrophysics Data System (ADS)

Ichoku, C. M.; Kaufman, Y. J.

2004-12-01

Biomass burning is a worldwide phenomenon affecting many vegetated parts of the globe regularly. Fires emit large quantities of aerosol and trace gases into the atmosphere, thus influencing the atmospheric chemistry and climate. Traditional methods of fire emissions estimation achieved only limited success, because they were based on peripheral information such as rainfall patterns, vegetation types and changes, agricultural practices, and surface ozone concentrations. During the last several years, rapid developments in satellite remote sensing has allowed more direct estimation of smoke emissions using remotely-sensed fire data. However, current methods use fire pixel counts or burned areas, thereby depending on the accuracy of independent estimations of the biomass fuel loadings, combustion efficiency, and emission factors. With the enhanced radiometric range of its 4-micron fire channel, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor, which flies aboard both of the Earth Observing System (EOS) Terra and Aqua Satellites, is able to measure the rate of release of fire radiative energy (FRE) in MJ/s (something that older sensors could not do). MODIS also measures aerosol distribution. Taking advantage of these new resources, we have developed a procedure combining MODIS fire and aerosol products to derive FRE-based smoke emission coefficients (Ce in kg/MJ) for different regions of the globe. These coefficients are simply used to multiply FRE from MODIS to derive the emitted smoke aerosol mass. Results from this novel methodology are very encouraging. For instance, it was found that the smoke total particulate mass emission coefficient for the Brazilian Cerrado ecosystem (approximately 0.022 kg/MJ) is about twice the value for North America or Australia, but about 50 percent lower than the value for Zambia in southern Africa.

Estimation of Fire Emissions from Satellite-Based Measurements

NASA Technical Reports Server (NTRS)

Ichoku, Charles; Kaufman, Yoram J.

2004-01-01

Biomass burning is a worldwide phenomenon affecting many vegetated parts of the globe regularly. Fires emit large quantities of aerosol and trace gases into the atmosphere, thus influencing the atmospheric chemistry and climate. Traditional methods of fire emissions estimation achieved only limited success, because they were based on peripheral information such as rainfall patterns, vegetation types and changes, agricultural practices, and surface ozone concentrations. During the last several years, rapid developments in satellite remote sensing has allowed more direct estimation of smoke emissions using remotely-sensed fire data. However, current methods use fire pixel counts or burned areas, thereby depending on the accuracy of independent estimations of the biomass fuel loadings, combustion efficiency, and emission factors. With the enhanced radiometric range of its 4-micron fire channel, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor, which flies aboard both of the Earth Observing System EOS) Terra and Aqua Satellites, is able to measure the rate of release of fire radiative energy (FRE) in MJ/s (something that older sensors could not do). MODIS also measures aerosol distribution. Taking advantage of these new resources, we have developed a procedure combining MODIS fire and aerosol products to derive FRE-based smoke emission coefficients (C(e), in kg/MJ) for different regions of the globe. These coefficients are simply used to multiply FRE from MODIS to derive the emitted smoke aerosol mass. Results from this novel methodology are very encouraging. For instance, it was found that the smoke total particulate mass emission coefficient for the Brazilian Cerrado ecosystem (approximately 0.022 kg/MJ) is about twice the value for North America, Western Europe, or Australia, but about 50% lower than the value for southern Africa.

Social networks and smoking: exploring the effects of peer influence and smoker popularity through simulations.

PubMed

Schaefer, David R; Adams, Jimi; Haas, Steven A

2013-10-01

Adolescent smoking and friendship networks are related in many ways that can amplify smoking prevalence. Understanding and developing interventions within such a complex system requires new analytic approaches. We draw on recent advances in dynamic network modeling to develop a technique that explores the implications of various intervention strategies targeted toward micro-level processes. Our approach begins by estimating a stochastic actor-based model using data from one school in the National Longitudinal Study of Adolescent Health. The model provides estimates of several factors predicting friendship ties and smoking behavior. We then use estimated model parameters to simulate the coevolution of friendship and smoking behavior under potential intervention scenarios. Namely, we manipulate the strength of peer influence on smoking and the popularity of smokers relative to nonsmokers. We measure how these manipulations affect smoking prevalence, smoking initiation, and smoking cessation. Results indicate that both peer influence and smoking-based popularity affect smoking behavior and that their joint effects are nonlinear. This study demonstrates how a simulation-based approach can be used to explore alternative scenarios that may be achievable through intervention efforts and offers new hypotheses about the association between friendship and smoking.

Social Networks and Smoking: Exploring the Effects of Influence and Smoker Popularity through Simulations

PubMed Central

Schaefer, David R.; adams, jimi; Haas, Steven A.

2015-01-01

Adolescent smoking and friendship networks are related in many ways that can amplify smoking prevalence. Understanding and developing interventions within such a complex system requires new analytic approaches. We draw upon recent advances in dynamic network modeling to develop a technique that explores the implications of various intervention strategies targeted toward micro-level processes. Our approach begins by estimating a stochastic actor-based model using data from one school in the National Longitudinal Study of Adolescent Health. The model provides estimates of several factors predicting friendship ties and smoking behavior. We then use estimated model parameters to simulate the co-evolution of friendship and smoking behavior under potential intervention scenarios. Namely, we manipulate the strength of peer influence on smoking and the popularity of smokers relative to nonsmokers. We measure how these manipulations affect smoking prevalence, smoking initiation, and smoking cessation. Results indicate that both peer influence and smoking-based popularity affect smoking behavior, and that their joint effects are nonlinear. This study demonstrates how a simulation-based approach can be used to explore alternative scenarios that may be achievable through intervention efforts and offers new hypotheses about the association between friendship and smoking. PMID:24084397

Cigarette Smoking and Sociodemographic, Military, and Health Characteristics of Operation Enduring Freedom and Operation Iraqi Freedom Veterans: 2009-2011 National Health Study for a New Generation of US Veterans.

PubMed

Cypel, Yasmin S; Hamlett-Berry, Kim; Barth, Shannon K; Christofferson, Dana E; Davey, Victoria J; Eber, Stephanie; Schneiderman, Aaron I; Bossarte, Robert M

2016-09-01

We examined the sociodemographic, military, and health characteristics of current cigarette smokers, former smokers, and nonsmokers among Operation Enduring Freedom (OEF) / Operation Iraqi Freedom (OIF) veterans and estimated smoking prevalence to better understand cigarette use in this population. We analyzed data from the US Department of Veterans Affairs (VA) 2009-2011 National Health Study for a New Generation of US Veterans. On the basis of a stratified random sample of 60 000 OEF/OIF veterans, we sought responses to a 72-item questionnaire via mail, telephone, or Internet. Cigarette smoking status was based on self-reported cigarette use in the past year. We used multinomial logistic regression to evaluate associations between smoking status and sociodemographic, military, and health characteristics. Among 19 911 veterans who provided information on cigarette smoking, 5581 were current smokers (weighted percentage: 32.5%, 95% confidence interval [CI]: 31.7-33.2). Current smokers were more likely than nonsmokers or former smokers to be younger, to have less education or income, to be separated/divorced or never married/single, and to have served on active duty or in the army. Comparing current smokers and nonsmokers, some significant associations from adjusted analyses included the following: having a Mental Component Summary score (a measure of overall mental health) above the mean of the US population relative to below the mean (adjusted odds ratio [aOR] = 0.81, 95% CI: 0.73-0.90); having physician-diagnosed depression (aOR = 1.52, 95% CI: 1.33-1.74), respiratory conditions (aOR = 1.16, 95% CI: 1.04-1.30), or repeated seizures/blackouts/convulsions (aOR = 1.80, 95% CI: 1.22-2.67); heavy alcohol use vs never use (aOR = 5.49, 95% CI: 4.57-6.59); a poor vs excellent perception of overall health (aOR = 3.79, 95% CI: 2.60-5.52); and being deployed vs nondeployed (aOR = 0.87, 95% CI: 0.78-0.96). Using health care services from the VA protected against current smoking. Mental and physical health, substance use, and military service characteristics shape cigarette-smoking patterns in OEF/OIF veterans.

Prevalence and characteristics of young adult smokers in the U.S. in the precontemplation stage of smoking cessation.

PubMed

Andrews, Mary E; Sabado, Melanie; Choi, Kelvin

2018-09-01

The precontemplation stage of smoking cessation refers to having no intention to quit smoking in the next six months. We aimed to estimate the prevalence of and characteristics associated with the precontemplation stage of smoking cessation among U.S. young adult smokers to inform the development of targeted interventions. We analyzed data in 2017 from the 2013-2014 National Adult Tobacco Survey. Young adult (18-29 years old) daily and non-daily smokers were included (n = 1809). We applied weighted multiple logistic regression models to examine the associations between demographics, tobacco use behaviors, exposure to pro- and anti-tobacco messages, and the precontemplation stage of smoking cessation. 59.0% of U.S. young adult smokers are in the precontemplation stage of smoking cessation. Unemployment was positively associated with being in the precontemplation stage of smoking cessation (AOR = 1.42 95% CI = 1.05, 1.91). Smoking every day (vs. some days), more cigarettes smoked per day, using roll-your-own cigarettes (vs. manufactured cigarettes only), currently smoking cigars, and signing up for promotional offers were positively associated with being in the precontemplation stage of smoking cessation (p < 0.05). Non-Hispanic Black was negatively associated with precontemplation stage (AOR = 0.40, 95% CI = 0.27, 0.59). Not smoking after viewing a health warning on a cigarette pack was negatively associated with the precontemplation stage of smoking cessation (AOR = 0.36, 95% CI = 0.25, 0.51). Many U.S. young adult smokers classify as being in the precontemplation stage of smoking cessation. Interventions to motivate these smokers to quit smoking with considerations of their specific characteristics (e.g., being unemployed) are warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

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.

Lung Cancer Mortality Associated With Smoking and Smoking Cessation Among People Living With HIV in the United States.

PubMed

Reddy, Krishna P; Kong, Chung Yin; Hyle, Emily P; Baggett, Travis P; Huang, Mingshu; Parker, Robert A; Paltiel, A David; Losina, Elena; Weinstein, Milton C; Freedberg, Kenneth A; Walensky, Rochelle P

2017-11-01

Lung cancer has become a leading cause of death among people living with human immunodeficiency virus (HIV) (PLWH). Over 40% of PLWH in the United States smoke cigarettes; HIV independently increases the risk of lung cancer. To project cumulative lung cancer mortality by smoking exposure among PLWH in care. Using a validated microsimulation model of HIV, we applied standard demographic data and recent HIV/AIDS epidemiology statistics with specific details on smoking exposure, combining smoking status (current, former, or never) and intensity (heavy, moderate, or light). We stratified reported mortality rates attributable to lung cancer and other non-AIDS-related causes by smoking exposure and accounted for an HIV-conferred independent risk of lung cancer. Lung cancer mortality risk ratios (vs never smokers) for male and female current moderate smokers were 23.6 and 24.2, respectively, and for those who quit smoking at age 40 years were 4.3 and 4.5. In sensitivity analyses, we accounted for nonadherence to antiretroviral therapy (ART) and for a range of HIV-conferred risks of death from lung cancer and from other non-AIDS-related diseases (eg, cardiovascular disease). Cumulative lung cancer mortality by age 80 years (stratified by sex, age at entry to HIV care, and smoking exposure); total expected lung cancer deaths, accounting for nonadherence to ART. Among 40-year-old men with HIV, estimated cumulative lung cancer mortality for heavy, moderate, and light smokers who continued to smoke was 28.9%, 23.0%, and 18.8%, respectively; for those who quit smoking at age 40 years, it was 7.9%, 6.1%, and 4.3%; and for never smokers, it was 1.6%. Among women, the corresponding mortality for current smokers was 27.8%, 20.9%, and 16.6%; for former smokers, it was 7.5%, 5.2%, and 3.7%; and for never smokers, it was 1.2%. ART-adherent individuals who continued to smoke were 6 to 13 times more likely to die from lung cancer than from traditional AIDS-related causes, depending on sex and smoking intensity. Due to greater AIDS-related mortality risks, individuals with incomplete ART adherence had higher overall mortality but lower lung cancer mortality. Applying model projections to the approximately 644 200 PLWH aged 20 to 64 in care in the United States, 59 900 (9.3%) are expected to die from lung cancer if smoking habits do not change. Those PLWH who adhere to ART but smoke are substantially more likely to die from lung cancer than from AIDS-related causes.

Cannabis Smoking and Diabetes Mellitus: Results from Meta-Analysis with Eight Independent Replication Samples

PubMed Central

Alshaarawy, Omayma; Anthony, James C.

2016-01-01

Background In preclinical animal studies, evidence links cannabis smoking (CS) with hyperphagia, obesity, and insulin resistance. Nonetheless, in humans, CS might protect against type 2 diabetes mellitus (DM). Here, we offer epidemiological estimates from eight independent replications from (1) the National Health and Nutrition Examination Surveys, and (2) the National Surveys on Drug Use and Health (2005-12). Methods For each national survey participant, computer-assisted self-interviews assess CS and physician-diagnosed DM; NHANES provides additional biomarker values and a composite DM diagnosis. Regression analyses produce estimates of CS-DM associations. Meta-analyses summarize the replication estimates. Results Recently active CS and DM are inversely associated. The meta-analytic summary odds ratio is 0.7 (95% CI = 0.6, 0.8). Conclusions Current evidence is too weak for causal inference, but there now is a more stable evidence base for new lines of clinical translational research on a possibly protective (or spurious) CS-DM association suggested in prior research. PMID:25978795

Lung Cancer Risk and Demographic Characteristics of Current 20-29 Pack-year Smokers: Implications for Screening.

PubMed

Pinsky, Paul F; Kramer, Barnett S

2015-11-01

Based on current recommendations, 30+ pack-years of smoking are required for eligibility for low-dose CT (LDCT) lung cancer screening; former smokers must have quit within 15 years. We investigated whether current smokers with 20 to 29 pack-years have similar lung cancer risks as eligible former smokers and also whether they have a different demographic profile. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) was a randomly assigned screening trial of subjects age 55 to 74 years with chest radiographs (CXR) used for lung cancer. Subjects completed a baseline questionnaire containing smoking history questions. Cox proportional hazards models, adjusted for age and sex, were utilized to estimate hazard ratios (HRs) for various smoking history groups. Next, we utilized the National Health Interview Survey (NHIS), which inquired about smoking history and race/ethnicity, to analyze the demographic profiles of various high-risk smoking history categories. All statistical tests were two-sided. The PLCO cohort included 18 114 former and 12 243 current LDCT-eligible smokers, plus 2283 20- to 29-pack-year current smokers. The hazard ratio for 20- to 29-pack-year current smokers compared with eligible (30+ pack-year) former smokers was 1.07 (95% confidence interval [CI] = 0.75 to 1.5). Based on the NHIS, 10 million persons in the United States are currently LDCT eligible; an additional 1.6 million (16%, 95% CI = 13.6% to 19.0%) are 20- to 29-pack-year current smokers. The percentage increase in eligibles if 20- to 29-pack-year current smokers were included was substantially greater for women than men (22.2%, 95% CI = 17.9% to 26.7%; vs 12.2%, 95% CI = 9.3% to 15.3%, P < .001) and for minorities than non-Hispanic whites (30.0%, 95% CI = 24.2% to 36.0%; vs 14.1%, 95% CI = 11.1% to 17.0%, P < .001). The potential benefits and harms of recommending LDCT screening for 20 to 29-pack-year current smokers should be assessed. Published by Oxford University Press 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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.

Budgetary Impact Analysis of Reimbursement Varenicline for the Smoking-Cessation Treatment in Patients with Cardiovascular Diseases, Chronic Obstructive Pulmonary Disease or Type-2 Diabetes Mellitus: A National Health System Perspective.

PubMed

Cedillo, Sergio; Sicras-Mainar, Antoni; Jiménez-Ruiz, Carlos A; Fernández de Bobadilla, Jaime; Rejas-Gutiérrez, Javier

2017-01-01

The study aimed to assess the budgetary impact (BI) of reimbursing varenicline in patients with chronic obstructive pulmonary disease (COPD), type-2 diabetes mellitus (t2-DM) or cardiovascular diseases (CVD). The BI was estimated comparing the current non-reimbursed scenario versus a projected reimbursed scenario using the Spanish National Health System (SNHS) perspective. A hybrid model was developed using epidemiological data and Markov chains to estimate smoking cessation rates with varenicline during a 5-year horizon. Costs of cessation were considered in the reimbursement scenario only. Efficacy, expressed as a 1-year continuous abstinence rate, was derived from clinical trials. Cost savings due to smoking cessation were extracted from local cost-of-illness studies. Results are shown as incremental cost savings. Univariate sensitivity analysis was also applied. A total of 68,684 patients stopped smoking in the reimbursed scenario compared with 15,208 without reimbursement. In the reimbursed scenario, total savings accounted for €36.3 million, showing 14.6 million accumulated additional savings compared with the scenario without reimbursement. Sensitivity analyses showed results to be robust with monetary savings starting in the third year of modeling. Reimbursement of varenicline in smoking cessation is a cost-effective health policy in the SNHS in COPD, t2-DM or CVD, and could produce cost savings starting in the third year of implementation. © 2016 S. Karger AG, Basel.

Air quality, mortality, and economic benefits of a smoke - free workplace law for non-smoking Ontario bar workers.

PubMed

Repace, J; Zhang, B; Bondy, S J; Benowitz, N; Ferrence, R

2013-04-01

We estimated the impact of a smoke-free workplace bylaw on non-smoking bar workers' health in Ontario, Canada. We measured bar workers' urine cotinine before (n = 99) and after (n = 91) a 2004 smoke-free workplace bylaw. Using pharmacokinetic and epidemiological models, we estimated workers' fine-particle (PM2.5 ) air pollution exposure and mortality risks from workplace secondhand smoke (SHS). workers' pre-law geometric mean cotinine was 10.3 ng/ml; post-law dose declined 70% to 3.10 ng/ml and reported work hours of exposure by 90%. Pre-law, 97% of workers' doses exceeded the 90th percentile for Canadians of working age. Pre-law-estimated 8-h average workplace PM2.5 exposure from SHS was 419 μg/m(3) or 'Very Poor' air quality, while outdoor PM2.5 levels averaged 7 μg/m(3) , 'Very Good' air quality by Canadian Air Quality Standards. We estimated that the bar workers' annual mortality rate from workplace SHS exposure was 102 deaths per 100000 persons. This was 2.4 times the occupational disease fatality rate for all Ontario workers. We estimated that half to two-thirds of the 10620 Ontario bar workers were non-smokers. Accordingly, Ontario's smoke-free law saved an estimated 5-7 non-smoking bar workers' lives annually, valued at CA $50 million to $68 million (US $49 million to $66 million). © 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

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

The Effects of Workplace Clean Indoor Air Law Coverage on Workers' Smoking-Related Outcomes.

PubMed

Cheng, Kai-Wen; Liu, Feng; Gonzalez, MariaElena; Glantz, Stanton

2017-02-01

This study investigated the effects of workplace clean indoor air law (CIAL) coverage on worksite compliance with CIALs, smoking participation among indoor workers, and secondhand smoke (SHS) exposure among nonsmoker indoor workers. This study improved on previous research by using the probability of a resident in a county covered by workplace CIALs, taking into account the state, county, and city legislation. The county-level probability of being covered by a CIAL is merged into two large nationally representative US surveys on smoking behaviors: Tobacco Use Supplement of the Current Population Survey (2001-2010) and Behavioral Risk Factor Surveillance System (2000-2006) based on the year of the survey and respondent's geographic location to identify respondents' CIAL coverage. This study estimated several model specifications of including and not including state or county fixed effects, and the effects of workplace CIALs are consistent across models. Increased coverage by workplace CIALs significantly increased likelihood of reporting a complete smoking restriction by 8% and 10% for the two different datasets, decreased smoking participation among indoor workers by 12%, and decreased SHS exposure among nonsmokers by 28%. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

The Effects of Workplace Clean Indoor Air Law Coverage on Workers’ Smoking-Related Outcomes

PubMed Central

Cheng, Kai-Wen; Liu, Feng; Gonzalez, MariaElena; Glantz, Stanton

2015-01-01

This study investigated the effects of workplace clean indoor air law (CIAL) coverage on worksite compliance with CIALs, smoking participation among indoor workers, and secondhand smoke (SHS) exposure among non-smoker indoor workers. This study improved on previous research by using the probability of a resident in a county covered by workplace CIALs taking into account the state, county, and city legislation. The county-level probability of being covered by a CIAL is merged into two large nationally representative US surveys on smoking behaviors: Tobacco Use Supplement of the Current Population Survey (2001–2010) and Behavioral Risk Factor Surveillance System (2000–2006) based on the year of the survey and respondent’s geographic location to identify respondents’ CIAL coverage. This study estimated several model specifications of including and not including state or county fixed effects, and the effects of workplace CIALs are consistent across models. Increased coverage by workplace CIALs significantly increased likelihood of reporting a complete smoking restriction by 8% and 10% for the two different datasets, decreased smoking participation among indoor workers by 12%, and decreased SHS exposure among non-smokers by 28%. PMID:26639369

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

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

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.

Smoking and cutaneous melanoma: findings from The QSkin Sun and Health cohort study.

PubMed

Dusingize, Jean Claude; Olsen, Catherine M; Pandeya, Nirmala; Thompson, Bridie S; Webb, Penelope M; Green, Adèle C; Neale, Rachel E; Whiteman, David C

2018-05-22

Previous studies suggest that smokers have lower risks of cutaneous melanoma than non-smokers, but data from population-based prospective studies are scarce. We investigated associations between smoking and melanoma in a cohort study purpose-designed to investigate skin cancer outcomes. Participants with no prior history of melanoma (n=38,697) completed a risk factor survey at baseline (2011). Patients were followed through linkage to the cancer registry. We estimated hazard ratios and 95% confidence intervals for associations between smoking (including intensity, duration, time since quitting) and melanoma using multivariate Cox proportional hazards regression, accounting for death as a competing event. During a mean follow-up of 3.5 years, invasive melanomas developed in 247 participants. Compared with never smokers, former smokers (but not current smokers) had lower risks of invasive melanoma (HR: 0.76; 95%CI 0.57-1.01). Among former smokers, risks were lower with greater quantity of cigarettes smoked (HR: 0.75; 95%CI 0.56-0.98 per 10 cigarettes/day). No association was observed with duration of smoking while longer time since quitting was associated with a relative risk of melanoma that was not significantly different from the null (HR: 1.18; 95%CI: 0.91-1.51, for every 10 years since quitting). We observed complex associations between smoking and melanoma, with some suggestion that former smokers had lower risks than never or current smokers. The apparent inverse association among former smokers may be due to residual confounding, although surveillance bias or biological effects cannot be excluded entirely. Smoking does not increase the risk of cutaneous melanoma. Copyright ©2018, American Association for Cancer Research.

Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging

PubMed Central

Rodgers, A; Corbett, T; Bramley, D; Riddell, T; Wills, M; Lin, R; Jones, M

2005-01-01

Objectives: To determine the effectiveness of a mobile phone text messaging smoking cessation programme. Design: Randomised controlled trial Setting: New Zealand Participants: 1705 smokers from throughout New Zealand who wanted to quit, were aged over 15 years, and owned a mobile phone were randomised to an intervention group that received regular, personalised text messages providing smoking cessation advice, support, and distraction, or to a control group. All participants received a free month of text messaging; starting for the intervention group on their quit day to assist with quitting, and starting for the control group at six months to encourage follow up. Follow up data were available for 1624 (95%) at six weeks and 1265 (74%) at six months. Main outcome measures: The main trial outcome was current non-smoking (that is, not smoking in the past week) six weeks after randomisation. Secondary outcomes included current non-smoking at 12 and 26 weeks. Results: More participants had quit at six weeks in the intervention compared to the control group: 239 (28%) v 109 (13%), relative risk 2.20 (95% confidence interval 1.79 to 2.70), p < 0.0001. This treatment effect was consistent across subgroups defined by age, sex, income level, or geographic location (p homogeneity > 0.2). The relative risk estimates were similar in sensitivity analyses adjusting for missing data and salivary cotinine verification tests. Reported quit rates remained high at six months, but there was some uncertainty about between group differences because of incomplete follow up. Conclusions: This programme offers potential for a new way to help young smokers to quit, being affordable, personalised, age appropriate, and not location dependent. Future research should test these findings in different settings, and provide further assessment of long term quit rates. PMID:16046689

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.

Survival Bias When Assessing Risk Factors for Age-Related Macular Degeneration: A Tutorial with Application to the Exposure of Smoking.

PubMed

McGuinness, Myra B; Karahalios, Amalia; Kasza, Jessica; Guymer, Robyn H; Finger, Robert P; Simpson, Julie A

2017-08-01

We illustrate the effect of survival bias when investigating risk factors for eye disease in elderly populations for whom death is a competing risk. Our investigation focuses on the relationship between smoking and late age-related macular degeneration (AMD) in an observational study impacted by censoring due to death. Statistical methodology to calculate the survivor average causal effect (SACE) as a sensitivity analysis is described, including example statistical computing code for Stata and R. To demonstrate this method, we examine the causal effect of smoking history at baseline (1990-1994) on the presence of late AMD at the third study wave (2003-2007) using data from the Melbourne Collaborative Cohort Study. Of the 40,506 participants eligible for inclusion, 38,092 (94%) survived until the start of the third study wave, 20,752 (51%) were graded for AMD (60% female, aged 47-85 years, mean 65 ± 8.7 years). Late AMD was detected in 122 participants. Logistic regression showed strong evidence of an increased risk of late AMD for current smokers compared to non-smokers (adjusted naïve odds ratio 2.99, 95% confidence interval, CI, 1.74-5.13). Among participants expected to be alive at the start of follow-up regardless of their smoking status, the estimated SACE odds ratio comparing current smokers to non-smokers was at least 3.42 (95% CI 1.57-5.15). Survival bias can attenuate associations between harmful exposures and diseases of aging. Estimation of the SACE using a sensitivity analysis approach should be considered when conducting epidemiological research within elderly populations.

Worksite safety climate, smoking, and the use of protective equipment by blue collar building workers enrolled in the MassBUILT smoking cessation trial

PubMed Central

Dutra, Lauren M; Kim, Seung-Sup; Williams, David R; Kawachi, Ichiro; Okechukwu, Cassandra A

2014-01-01

Objective In order to assess potential contributors to high injury rates and smoking prevalence among construction workers, we investigated the association of safety climate with personal protective equipment (PPE) use, and smoking behaviors. Methods Logistic regression models estimated risk ratios for PPE use and smoking using data from participants in MassBUILT smoking cessation intervention (n=1,725). Results Contractor safety climate was negatively associated with use of dust masks (RR=0.88,95%CI:0.83–0.94); respirators (RR=0.82,95%CI:0.75–0.89); general equipment (RR=0.98,95%CI:0.95–1.00); and fall protection (RR=0.94,95%CI:0.91–0.98) and positively associated with current smoking (RR=1.12,95%CI:1.01–1.25) but not smoking cessation. Coworker safety climate was negatively associated with use of dust masks (RR=0.87,95%CI:0.82–0.92); respirators (RR=0.80,95%CI:0.74–0.87); general equipment (RR=0.96,95%CI:0.94–0.98); fall (RR=0.92,95%CI:0.89–0.96) and hearing (RR=0.88,95%CI:0.83–0.93) protection but not smoking. Conclusions Worksite safety climate may be important for PPE use and smoking, but further research is needed. PMID:25285831

Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries.

PubMed

Oberg, Mattias; Jaakkola, Maritta S; Woodward, Alistair; Peruga, Armando; Prüss-Ustün, Annette

2011-01-08

Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004. The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specific relative risk estimates and area-specific estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004. Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379,000 deaths from ischaemic heart disease, 165,000 from lower respiratory infections, 36,900 from asthma, and 21,400 from lung cancer. 603,000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to second-hand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5,939,000), ischaemic heart disease in adults (2,836,000), and asthma in adults (1,246,000) and children (651,000). These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide. Swedish National Board of Health and Welfare and Bloomberg Philanthropies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Simulation-based estimates of effectiveness and cost-effectiveness of smoking cessation in patients with chronic obstructive pulmonary disease.

PubMed

Atsou, Kokuvi; Chouaid, Christos; Hejblum, Gilles

2011-01-01

The medico-economic impact of smoking cessation considering a smoking patient with chronic obstructive pulmonary disease (COPD) is poorly documented. Here, considering a COPD smoking patient, the specific burden of continuous smoking was estimated, as well as the effectiveness and the cost-effectiveness of smoking cessation. A multi-state Markov model adopting society's perspective was developed. Simulated cohorts of English COPD patients who are active smokers (all severity stages combined or patients with the same initial severity stage) were compared to identical cohorts of patients who quit smoking at cohort initialization. Life expectancy, quality adjusted life-years (QALY), disease-related costs, and incremental cost-effectiveness ratio (ICER: £/QALY) were estimated, considering smoking cessation programs with various possible scenarios of success rates and costs. Sensitivity analyses included the variation of model key parameters. At the horizon of a smoking COPD patient's remaining lifetime, smoking cessation at cohort intitialization, relapses being allowed as observed in practice, would result in gains (mean) of 1.27 life-years and 0.68 QALY, and induce savings of -1824 £/patient in the disease-related costs. The corresponding ICER was -2686 £/QALY. Smoking cessation resulted in 0.72, 0.69, 0.64 and 0.42 QALY respectively gained per mild, moderate, severe, and very severe COPD patient, but was nevertheless cost-effective for mild to severe COPD patients in most scenarios, even when hypothesizing expensive smoking cessation intervention programmes associated with low success rates. Considering a ten-year time horizon, the burden of continuous smoking in English COPD patients was estimated to cost a total of 1657 M£ while 452516 QALY would be simultaneously lost. The study results are a useful support for the setting of smoking cessation programmes specifically targeted to COPD patients.

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

ERICA: smoking prevalence in Brazilian adolescents

PubMed Central

Figueiredo, Valeska Carvalho; Szklo, André Salem; Costa, Letícia Casado; Kuschnir, Maria Cristina C; da Silva, Thiago Luiz Nogueira; Bloch, Katia Vergetti; Szklo, Moyses

2016-01-01

ABSTRACT OBJECTIVE To estimate the prevalences of tobacco use, tobacco experimentation, and frequent smoking among Brazilian adolescents. METHODS We evaluated participants of the cross-sectional, nation-wide, school-based Study of Cardiovascular Risks in Adolescents (ERICA), which included 12- to 17-year-old adolescents from municipalities of over 100 thousand inhabitants. The study sample had a clustered, stratified design and was representative of the whole country, its geographical regions, and all 27 state capitals. The information was obtained with self-administered questionnaires. Tobacco experimentation was defined as having tried cigarettes at least once in life. Adolescents who had smoked on at least one day over the previous 30 days were considered current cigarette smokers. Having smoked cigarettes for at least seven consecutive days was an indicator for regular consumption of tobacco. Considering the complex sampling design, prevalences and 95% confidence intervals were estimated according to sociodemographic and socio-environmental characteristics. RESULTS We evaluated 74,589 adolescents. Among these, 18.5% (95%CI 17.7-19.4) had smoked at least once in life, 5.7% (95%CI 5.3-6.2) smoked at the time of the research, and 2.5% (95%CI 2.2-2.8) smoked often. Adolescents aged 15 to 17 years had higher prevalences for all indicators than those aged 12 to 14 years. The prevalences did not differ significantly between sexes. The highest prevalences were found in the South region and the lowest ones, in the Northeast region. Regardless of sex, the prevalences were found to be higher for adolescents who had had paid jobs, who lived with only one parent, and who reported having been in contact with smokers either inside or outside their homes. Female public school adolescents were found to smoke more than the ones from private schools. CONCLUSIONS Tobacco use among adolescents is still a challenge. Intending to reduce the prevalence of tobacco use among young people, especially the ones under socioeconomic vulnerability conditions, Brazil must consolidate and increase effective public health care measures. PMID:26910545

Cost-effectiveness of a community anti-smoking campaign targeted at a high risk group in London.

PubMed

Stevens, Warren; Thorogood, Margaret; Kayikki, Seher

2002-03-01

Surveys of Turkish speaking people in London found 74% of men and 45% of women were smokers, and knowledge of the health effects of smoking was low. Camden and Islington Health Authority has a substantial Turkish community. We report an economic evaluation of a community smoking cessation intervention, aimed at the Turkish community, undertaken by Camden and Islington Health Promotion Agency. The intervention aimed to highlight the dangers of smoking, and to reduce the amount smoked and the number of current smokers. It included a play, a poster and media campaign, and purpose-designed leaflets. A panel survey of the Turkish population determined smoking habits, attitudes to smoking and knowledge about the health effects at baseline and 12 months. The intervention effect was estimated from the changes between baseline and final surveys. To allow for the non-response to the second survey we analysed effectiveness in two ways: first by assuming that the responders represented the true situation, and secondly by making a more pessimistic assumption that there was no change in the non-responders. Fifty-seven per cent of the Turkish population were smokers at baseline, compared with 39% in the general population of Camden and Islington. Levels were particularly high in younger women. At follow-up there was a net reduction in smokers of 6.4% [95% confidence interval (CI) 0-13.6%] in responders. When all study subjects were included the net reduction was 2.9% (CI 0-6.3%). Most quitters were light smokers to start with. At follow-up, 51% of respondents recognized at least one of the Turkish language interventions. The estimated cost-effectiveness of this intervention was 105 pound (range 33-391 pound) per life year gained. Campaigns targeted at groups with high smoking prevalence may be more cost-effective than general population campaigns.

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

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.

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

Comparison of wildfire smoke estimation methods and associations with cardiopulmonary-related hospital admissions.

PubMed

Gan, Ryan W; Ford, Bonne; Lassman, William; Pfister, Gabriele; Vaidyanathan, Ambarish; Fischer, Emily; Volckens, John; Pierce, Jeffrey R; Magzamen, Sheryl

2017-03-01

Climate forecasts predict an increase in frequency and intensity of wildfires. Associations between health outcomes and population exposure to smoke from Washington 2012 wildfires were compared using surface monitors, chemical-weather models, and a novel method blending three exposure information sources. The association between smoke particulate matter ≤2.5 μm in diameter (PM 2.5 ) and cardiopulmonary hospital admissions occurring in Washington from 1 July to 31 October 2012 was evaluated using a time-stratified case-crossover design. Hospital admissions aggregated by ZIP code were linked with population-weighted daily average concentrations of smoke PM 2.5 estimated using three distinct methods: a simulation with the Weather Research and Forecasting with Chemistry (WRF-Chem) model, a kriged interpolation of PM 2.5 measurements from surface monitors, and a geographically weighted ridge regression (GWR) that blended inputs from WRF-Chem, satellite observations of aerosol optical depth, and kriged PM 2.5 . A 10 μg/m 3 increase in GWR smoke PM 2.5 was associated with an 8% increased risk in asthma-related hospital admissions (odds ratio (OR): 1.076, 95% confidence interval (CI): 1.019-1.136); other smoke estimation methods yielded similar results. However, point estimates for chronic obstructive pulmonary disease (COPD) differed by smoke PM 2.5 exposure method: a 10 μg/m 3 increase using GWR was significantly associated with increased risk of COPD (OR: 1.084, 95%CI: 1.026-1.145) and not significant using WRF-Chem (OR: 0.986, 95%CI: 0.931-1.045). The magnitude (OR) and uncertainty (95%CI) of associations between smoke PM 2.5 and hospital admissions were dependent on estimation method used and outcome evaluated. Choice of smoke exposure estimation method used can impact the overall conclusion of the study.

Studies of emotional instability in smoke from fires: Decrease of thinking powers and of memory in fire smoke

NASA Astrophysics Data System (ADS)

Jin, T.

The effect and degree of smoke concentration on the reduction in thinking and memory was studied. The change in memory and thinking power was estimated by the change in correction ratio for mental calculation in various smoke concentrations. The reduction of memory in a smokey environment estimated by the correction ratio for remembering the order of four color panels which were shown before smoke exposure. It is found that it is difficult to evaluate the relationship between the reduction in thinking power against smoke concentration, and relationship between the reductions of memory against smoke concentration.

Exposure to secondhand smoke in Italian non-smokers 5 years after the Italian smoking ban.

PubMed

Martínez-Sánchez, Jose M; Gallus, Silvano; Zuccaro, Piergiorgio; Colombo, Paolo; Fernández, Esteve; Manzari, Marco; La Vecchia, Carlo

2012-10-01

No data on secondhand smoke (SHS) exposure are available on a national level in Italy. To assess the prevalence of exposure to SHS in indoor public places, home and cars in non-smoking Italian population, we conducted a survey 5 years after the national smoking ban. In 2010, we conducted a survey on a representative sample of the Italian population aged≥15 years. Analyses were conducted on 2365 non-smokers. Current (during the previous week) self-reported exposure to SHS was assessed in public places, at home and in private cars. The prevalence of SHS exposure in any setting (excluding workplaces) was 31.2%. SHS exposure was 10.2% in public places, 15.6% at home and 17.9% in cars. The corresponding estimates among the young (15-24 years) were 54.2% in any setting, 21.4% in public places, 27.1% at home and 32.9% in cars. By multivariate analysis, males, the young, subjects from southern Italy and former smokers were more frequently exposed in any setting. The Italian smoking ban substantially decreased SHS exposure. However, specific subpopulations, including the young, are still frequently exposed both in public and private places. We observed a relatively high SHS exposure in private vehicles. Thus, further control to improve compliance with the smoking ban and an extension of the smoke-free legislation to motor vehicles are needed.

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.

Cigarette smoking and cigarette marketing exposure among students in selected African countries: Findings from the Global Youth Tobacco Survey.

PubMed

Zhao, Luhua; Palipudi, Krishna M; Ramanandraibe, Nivo; Asma, Samira

2016-10-01

To investigate cigarette smoking prevalence and exposure to various forms of cigarette marketing among students in 10 African countries. We used data collected during 2009-2011 from the Global Youth Tobacco Survey (GYTS), a school-based cross-sectional survey of students aged 13-15years, to measure the prevalence of cigarette smoking and exposure to cigarette marketing; comparisons to estimates from 2005 to 2006 were conducted for five countries where data were available. Current cigarette smoking ranged from 3.4% to 13.6% among students aged 13-15 in the 10 countries studied, although use of tobacco products other than cigarettes was more prevalent in all countries except in Cote D'Ivoire. Cigarette smoking was higher among boys than girls in seven out of the 10 countries. Among the five countries with two rounds of surveys, a significant decrease in cigarette smoking prevalence was observed in Mauritania and Niger; these two countries also experienced a decline in three measures of cigarette marketing exposure. It is also possible that smoking prevalence might have risen faster among girls than boys. Cigarette smoking among youth was noticeable in 10 African countries evaluated, with the prevalence over 10% in Cote D'Ivoire, Mauritania, and South Africa. Cigarette marketing exposure varied by the types of marketing; traditional venues such as TV, outdoor billboards, newspapers, and magazines were still prominent. Published by Elsevier Inc.

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.

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.

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.

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.

What factors influence smoking prevalence and smoke free policy enactment across the European Union Member States.

PubMed

Bogdanovica, Ilze; McNeill, Ann; Murray, Rachael; Britton, John

2011-01-01

Smoking prevention should be a primary public health priority for all governments, and effective preventive policies have been identified for decades. The heterogeneity of smoking prevalence between European Union (EU) Member States therefore reflects, at least in part, a failure by governments to prioritise public health over tobacco industry or possibly other financial interests, and hence potentially government corruption. The aims of this study were to test the hypothesis that smoking prevalence is higher in countries with high levels of public sector corruption, and explore the ecological association between smoking prevalence and a range of other national characteristics in current EU Member States. Ecological data from 27 EU Member States were used to estimate univariate and multivariate correlations between smoking prevalence and the Transparency International Corruption Perceptions Index, and a range of other national characteristics including economic development, social inclusion, quality of life and importance of religion. We also explored the association between the Corruption Perceptions Index and measures of the extent to which smoke-free policies have been enacted and are enforced. In univariate analysis, smoking prevalence was significantly higher in countries with higher scores for corruption, material deprivation, and gender inequality; and lower in countries with higher per capita Gross Domestic Product, social spending, life satisfaction and human development scores. In multivariate analysis, only the corruption perception index was independently related to smoking prevalence. Exposure to tobacco smoke in the workplace was also correlated with corruption, independently from smoking prevalence, but not with the measures of national smoke-free policy implementation. Corruption appears to be an important risk factor for failure of national tobacco control activity in EU countries, and the extent to which key tobacco control policies have been implemented. Further research is needed to assess the causal relationships involved.

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 prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study

PubMed Central

Brathwaite, Rachel; Addo, Juliet; Kunst, Anton E.; Agyemang, Charles; Owusu-Dabo, Ellis; de-Graft Aikins, Ama; Beune, Erik; Meeks, Karlijn; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Mockenhaupt, Frank P.; Amoah, Stephen; Galbete, Cecilia; Schulze, Matthias B.; Danquah, Ina; Smeeth, Liam

2017-01-01

Background Although the prevalence of smoking is low in Ghana, little is known about the effect of migration on smoking. Comparing Ghanaians living in their country of origin to those living in Europe offers an opportunity to investigate smoking by location of residence and the associations between smoking behaviours and migration-related factors. Methods Data on a relatively homogenous group of Ghanaians living in London (n = 949), Amsterdam (n = 1400), Berlin (n = 543), rural Ghana (n = 973) and urban Ghana (n = 1400) from the cross-sectional RODAM (Research on Obesity & Diabetes in African Migrants) study were used. Age-standardized prevalence rates of smoking by location of residence and factors associated with smoking among Ghanaian men were estimated using prevalence ratios (PR: 95% CIs). Results Current smoking was non-existent among women in rural and urban Ghana and London but was 3.2% and 3.3% in women in Amsterdam and Berlin, respectively. Smoking prevalence was higher in men in Europe (7.8%) than in both rural and urban Ghana (4.8%): PR 1.91: 95% CI 1.27, 2.88, adjusted for age, marital status, education and employment. Factors associated with a higher prevalence of smoking among Ghanaian men included European residence, being divorced or widowed, living alone, Islam religion, infrequent attendance at religious services, assimilation (cultural orientation), and low education. Conclusion Ghanaians living in Europe are more likely to smoke than their counterparts in Ghana, suggesting convergence to European populations, although prevalence rates are still far below those in the host populations. PMID:28475620

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

Changes in prevalence of tobacco use and the factors that may affect use among Uganda youth: the Global Youth Tobacco Survey (GYTS) 2007-2011.

PubMed

Kadobera, Daniel; Chaussard, Martine; Lee, Kyung Ah; Ayebazibwe, Nicholas; Ndyanabangi, Sheila

2016-01-01

To assess changes from 2007 to 2011 in the prevalence of tobacco use and tobacco-related indicators in Uganda by examining results from the Global Youth Tobacco Survey (GYTS). Both the 2007 (n=2,251) and 2011 (n=2,026) Uganda GYTS were conducted among students in primary seven, secondary one, two, and three. A two-stage cluster sample design was used to generate a representative sample of students for the surveys. Stata 12 software was used to provide weighted prevalence estimates and logistic regression models were developed to examine the relationship between factors that influence tobacco use and current tobacco use. The percentage of students who had ever smoked a cigarette, even just one or two puffs, declined from 15.6% in 2007 to 10.9% in 2011 (p=0.03). From 2007 to 2011, neither the percentage of current use of any tobacco (16.6% to 17.3%, p=0.75), nor the percentage of current (past 30 day) cigarette smoking (5.5% to 4.8%,p=0.59) changed significantly. Following adjustment, having parents [Adjusted Odds Ratio (AOR):1.9, 95% Confidence Interval (CI):1.3-2.8] and friends [AOR 2.5, 95% CI: 1.5-4.0)] who smoke, and having seen tobacco advertisements in print media [AOR 1.8(1.3-2.4)], were associated with greater odds of current tobacco use among students in 2007.Having parents who smoke [AOR;1.8, 95% CI: 1.1-3.0] was associated with greater odds of current tobacco use among students in 2011. From 2007 to 2011, no significant change occurred in the prevalence of current tobacco use or cigarette smoking among youth in Uganda. These findings underscore the importance of implementing effective population-level public health interventions, as outlined in the articles of the World Health Organization's Framework Convention on Tobacco Control, to prevent and reduce the use of tobacco among youth in Uganda.

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.

Quantitative estimation of dust fall and smoke particles in Quetta Valley*

PubMed Central

Sami, Muhammad; Waseem, Amir; Akbar, Sher

2006-01-01

Tightening of air quality standards for populated urban areas has led to increasing attention to assessment of air quality management areas, where violation of air quality standards occurs, and development of control strategies to eliminate such violation of air quality standards. The Quetta urban area is very densely built and has heavy motorized traffic. The increase of emissions mainly from traffic and industry are responsible for the increase in atmospheric pollution levels during the last years. The dust examined in the current study was collected by both deposit gauge and Petri dish methods at various sites of Quetta Valley. Smoke particles were obtained by bladder method from the exhausts of various types of motor vehicles. The concentration of lead found in the smoke ranged from 1.5×10−6 to 4.5×10−6. PMID:16773727

Smoking, mental illness and socioeconomic disadvantage: analysis of the Australian National Survey of Mental Health and Wellbeing

PubMed Central

2013-01-01

Background High rates of smoking and lower rates of smoking cessation are known to be associated with common mental disorders such as anxiety and depression, and with individual and community measures of socioeconomic status. It is not known to what extent mental illness and socioeconomic status might be jointly associated with smoking behaviour. We set out to examine the relationship between mental illness, measures of socioeconomic disadvantage and both current smoking and smoking cessation rates. Methods We used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between mental illness, socioeconomic status and both current smoking and smoking cessation. We used cross-classified tables and logistic regression to examine the relationship between psychosocial and sociodemographic predictors and current smoking. We also used proportional hazards regression to examine the relationship between the factors and smoking cessation. Results Both mental illness and socioeconomic status were independently associated with current smoking and with lower likelihood of smoking cessation, with gradients in smoking by mental health status being observed within levels of socioeconomic indicators and vice versa. Having a mental illness in the past 12 months was the most prevalent factor strongly associated with smoking, affecting 20.0% of the population, associated with increased current smoking (OR 2.43; 95% CI: 1.97-3.01) and reduced likelihood of smoking cessation (HR: 0.77; 95% CI: 0.65-0.91). Conclusions The association between mental illness and smoking is not explained by the association between mental illness and socioeconomic status. There are strong socioeconomic and psychosocial gradients in both current smoking and smoking cessation. Incorporating knowledge of the other adverse factors in smokers’ lives may increase the penetration of tobacco control interventions in population groups that have historically benefitted less from these activities. PMID:23663362

Workplace and home smoking restrictions and racial/ethnic variation in the prevalence and intensity of current cigarette smoking among women by poverty status, TUS‐CPS 1998–1999 and 2001–2002

PubMed Central

Shavers, Vickie L; Fagan, Pebbles; Alexander, Linda A Jouridine; Clayton, Richard; Doucet, Jennifer; Baezconde‐Garbanati, Lourdes

2006-01-01

Study objective Recognition of the health consequences of exposure to environmental tobacco smoke has led government agencies and many employers to establish policies that restrict cigarette smoking in public and workplaces. This cross sectional study examines the association of workplace smoking policies and home smoking restrictions with current smoking among women. Design Participants were employed US women ages 18–64 who were self respondents to the 1998–1999 or 2000–2001 tobacco use supplement to the current population survey supplements. Cross tabulations and multivariate logistic regression analyses examine the association of selected demographic characteristics, occupation, income, workplace and home smoking policies/restrictions with current smoking, consumption patterns, and quit attempts among women by poverty level for five race/ethnic groups. Main results The prevalence of either having an official workplace or home smoking policy that completely banned smoking increased with increased distance from the poverty level threshold. A complete ban on home smoking was more frequently reported by African American and Hispanic women although Hispanic women less frequently reported an official workplace smoking policy. In general, policies that permitted smoking in the work area or at home were associated with a higher prevalence of current smoking but this varied by poverty level and race/ethnicity. Home smoking policies that permitted smoking were associated with lower adjusted odds of having a least one quit attempt for nearly all poverty level categories but there was no association between having one quit attempt and workplace policies. Conclusion Home smoking policies were more consistently associated with a lower prevalence of current smoking irrespective of poverty status or race/ethnicity than workplace policies. These findings underscore the importance of examining tobacco control policies in multiple domains (work and home) as well as by race/ethnicity and socioeconomic position. PMID:17708009

Workplace and home smoking restrictions and racial/ethnic variation in the prevalence and intensity of current cigarette smoking among women by poverty status, TUS-CPS 1998-1999 and 2001-2002.

PubMed

Shavers, Vickie L; Fagan, Pebbles; Alexander, Linda A Jouridine; Clayton, Richard; Doucet, Jennifer; Baezconde-Garbanati, Lourdes

2006-09-01

Recognition of the health consequences of exposure to environmental tobacco smoke has led government agencies and many employers to establish policies that restrict cigarette smoking in public and workplaces. This cross sectional study examines the association of workplace smoking policies and home smoking restrictions with current smoking among women. Participants were employed US women ages 18-64 who were self respondents to the 1998-1999 or 2000-2001 tobacco use supplement to the current population survey supplements. Cross tabulations and multivariate logistic regression analyses examine the association of selected demographic characteristics, occupation, income, workplace and home smoking policies/restrictions with current smoking, consumption patterns, and quit attempts among women by poverty level for five race/ethnic groups. The prevalence of either having an official workplace or home smoking policy that completely banned smoking increased with increased distance from the poverty level threshold. A complete ban on home smoking was more frequently reported by African American and Hispanic women although Hispanic women less frequently reported an official workplace smoking policy. In general, policies that permitted smoking in the work area or at home were associated with a higher prevalence of current smoking but this varied by poverty level and race/ethnicity. Home smoking policies that permitted smoking were associated with lower adjusted odds of having a least one quit attempt for nearly all poverty level categories but there was no association between having one quit attempt and workplace policies. Home smoking policies were more consistently associated with a lower prevalence of current smoking irrespective of poverty status or race/ethnicity than workplace policies. These findings underscore the importance of examining tobacco control policies in multiple domains (work and home) as well as by race/ethnicity and socioeconomic position.

Inclusion of mobile telephone numbers into an ongoing population health survey in New South Wales, Australia, using an overlapping dual-frame design: impact on the time series.

PubMed

Barr, Margo L; Ferguson, Raymond A; Steel, David G

2014-08-12

Since 1997, the NSW Population Health Survey (NSWPHS) had selected the sample using random digit dialing of landline telephone numbers. When the survey began coverage of the population by landline phone frames was high (96%). As landline coverage in Australia has declined and continues to do so, in 2012, a sample of mobile telephone numbers was added to the survey using an overlapping dual-frame design. Details of the methodology are published elsewhere. This paper discusses the impacts of the sampling frame change on the time series, and provides possible approaches to handling these impacts. Prevalence estimates were calculated for type of phone-use, and a range of health indicators. Prevalence ratios (PR) for each of the health indicators were also calculated using Poisson regression analysis with robust variance estimation by type of phone-use. Health estimates for 2012 were compared to 2011. The full time series was examined for selected health indicators. It was estimated from the 2012 NSWPHS that 20.0% of the NSW population were mobile-only phone users. Looking at the full time series for overweight or obese and current smoking if the NSWPHS had continued to be undertaken only using a landline frame, overweight or obese would have been shown to continue to increase and current smoking would have been shown to continue to decrease. However, with the introduction of the overlapping dual-frame design in 2012, overweight or obese increased until 2011 and then decreased in 2012, and current smoking decreased until 2011, and then increased in 2012. Our examination of these time series showed that the changes were a consequence of the sampling frame change and were not real changes. Both the backcasting method and the minimal coverage method could adequately adjust for the design change and allow for the continuation of the time series. The inclusion of the mobile telephone numbers, through an overlapping dual-frame design, did impact on the time series for some of the health indicators collected through the NSWPHS, but only in that it corrected the estimates that were being calculated from a sample frame that was progressively covering less of the population.

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.

Acrylamide content in cigarette mainstream smoke and estimation of exposure to acrylamide from tobacco smoke in Poland.

PubMed

Mojska, Hanna; Gielecińska, Iwona; Cendrowski, Andrzej

2016-09-01

Acrylamide is a "probably human carcinogen" monomer that can form in heated starchy food as a result of a reaction between asparagine and reducing sugars via Maillard reaction. The main source of acrylamide in human diet are potato products, cereal products and coffee. Tobacco smoke may be another significant source of exposure to acrylamide. The aim of our study was to determine acrylamide content in cigarettes available on the Polish market and to estimate the exposure to acrylamide originating from tobacco smoke in smokers in Poland. The material was cigarettes of the top five brands bought in Poland and tobacco from non-smoked cigarettes. Acrylamide content in cigarettes mainstream smoke was determined by LC-MS/MS. Exposure assessment was carried out using analytical data of acrylamide content in cigarettes and the mean quantity of cigarettes smoked daily by smokers in Poland, assuming body weight at 70 kg. The mean content of acrylamide was 679.3 ng/cigarette (range: 455.0 - 822.5 ng/cigarette). The content of acrylamide was evidenced to correlate positively with total particulate matter (TPM) content in cigarettes. The estimated average exposure to acrylamide from tobacco smoke in adult smokers in Poland is 0.17 μg/kg b.w./day. Our results demonstrate that tobacco smoke is a significant source of acrylamide and total exposure to acrylamide in the population of smokers, on average, is higher by more than 50% in comparison with non-smokers. Our estimation of exposure to acrylamide from tobacco smoke is the first estimation taking into account the actual determined acrylamide content in the cigarettes available on the market.

Cigarette Graphic Warning Labels and Smoking Prevalence in Canada: A Critical Examination and Reformulation of the FDA Regulatory Impact Analysis

PubMed Central

Huang, Jidong; Chaloupka, Frank J.; Fong, Geoffrey T.

2014-01-01

Background The estimated effect of cigarette graphic warning labels (GWLs) on smoking rates is a key input to FDA's regulatory impact analysis (RIA), required by law as part of its rulemaking process. However, evidence on the impact of GWLs on smoking prevalence is scarce. Objective The goal of this paper is to critically analyze FDA's approach to estimating the impact of GWLs on smoking rates in its RIA, and to suggest a path forward to estimating the impact of the adoption of GWLs in Canada on Canadian national adult smoking prevalence. Methods A quasi-experimental methodology was employed to examine the impact of adoption of GWLs in Canada in 2000, using the U.S. as a control. Findings We found a statistically significant reduction in smoking rates after the adoption of GWLs in Canada in comparison to the U.S. Our analyses show that implementation of GWLs in Canada reduced smoking rates by 2.87 to 4.68 percentage points, a relative reduction of 12.1 to 19.6% — 33 to 53 times larger than FDA's estimates of a 0.088 percentage point reduction. We also demonstrated that FDA's estimate of the impact was flawed because it is highly sensitive to the changes in variable selection, model specification, and the time period analyzed. Conclusions Adopting GWLs on cigarette packages reduces smoking prevalence. Applying our analysis of the Canadian GWLs, we estimate that if the U.S. had adopted GWLs in 2012, the number of adult smokers in the U.S. would have decreased by 5.3 to 8.6 million in 2013. Our analysis demonstrates that FDA's approach to estimating the impact of GWLs on smoking rates is flawed. Rectifying these problems before this approach becomes the norm is critical for FDA's effective regulation of tobacco products. PMID:24218057

Health assessment of future PM2.5 exposures from indoor, outdoor, and secondhand tobacco smoke concentrations under alternative policy pathways in Ulaanbaatar, Mongolia

PubMed Central

Edwards, Rufus; Turner, Jay R.; Argo, Yuma D.; Olkhanud, Purevdorj B.; Odsuren, Munkhtuul; Guttikunda, Sarath; Ochir, Chimedsuren; Smith, Kirk R.

2017-01-01

Introduction Winter air pollution in Ulaanbaatar, Mongolia is among the worst in the world. The health impacts of policy decisions affecting air pollution exposures in Ulaanbaatar were modeled and evaluated under business as usual and two more-strict alternative emissions pathways through 2024. Previous studies have relied on either outdoor or indoor concentrations to assesses the health risks of air pollution, but the burden is really a function of total exposure. This study combined projections of indoor and outdoor concentrations of PM2.5 with population time-activity estimates to develop trajectories of total age-specific PM2.5 exposure for the Ulaanbaatar population. Indoor PM2.5 contributions from secondhand tobacco smoke (SHS) were estimated in order to fill out total exposures, and changes in population and background disease were modeled. The health impacts were derived using integrated exposure-response curves from the Global Burden of Disease Study. Results Annual average population-weighted PM2.5 exposures at baseline (2014) were estimated at 59 μg/m3. These were dominated by exposures occurring indoors, influenced considerably by infiltrated outdoor pollution. Under current control policies, exposures increased slightly to 60 μg/m3 by 2024; under moderate emissions reductions and under a switch to clean technologies, exposures were reduced from baseline levels by 45% and 80%, respectively. The moderate improvement pathway decreased per capita annual disability-adjusted life year (DALY) and death burdens by approximately 40%. A switch to clean fuels decreased per capita annual DALY and death burdens by about 85% by 2024 with the relative SHS contribution increasing substantially. Conclusion This study demonstrates a way to combine estimated changes in total exposure, background disease and population levels, and exposure-response functions to project the health impacts of alternative policy pathways. The resulting burden analysis highlights the need for aggressive action, including the elimination of residential coal burning and the reduction of current smoking rates. PMID:29088256

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.

Community reductions in youth smoking after raising the minimum tobacco sales age to 21.

PubMed

Kessel Schneider, Shari; Buka, Stephen L; Dash, Kim; Winickoff, Jonathan P; O'Donnell, Lydia

2016-05-01

Raising the tobacco sales age to 21 has gained support as a promising strategy to reduce youth cigarette access, but there is little direct evidence of its impact on adolescent smoking. Using regional youth survey data, we compared youth smoking trends in Needham, Massachusetts--which raised the minimum purchase age in 2005--with those of 16 surrounding communities. The MetroWest Adolescent Health Survey is a biennial census survey of high school youth in communities west of Boston; over 16,000 students participated at each of four time points from 2006 to 2012. Using these pooled cross-section data, we used generalised estimating equation models to compare trends in current cigarette smoking and cigarette purchases in Needham relative to 16 comparison communities without similar ordinances. To determine whether trends were specific to tobacco, we also examined trends in youth alcohol use over the same time period. From 2006 to 2010, the decrease in 30-day smoking in Needham (from 13% to 7%) was significantly greater than in the comparison communities (from 15% to 12%; p<.001). This larger decline was consistent for both genders, Caucasian and non-Caucasian youth, and grades 10, 11 and 12. Cigarette purchases among current smokers also declined significantly more in Needham than in the comparison communities during this time. In contrast, there were no comparable differences for current alcohol use. Our results suggest that raising the minimum sales age to 21 for tobacco contributes to a greater decline in youth smoking relative to communities that did not pass this ordinance. These findings support local community-level action to raise the tobacco sales age to 21. 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/

The Cost of Smoking in California.

PubMed

Max, Wendy; Sung, Hai-Yen; Shi, Yanling; Stark, Brad

2016-05-01

The economic impact of smoking, including healthcare costs and the value of lost productivity due to illness and mortality, was estimated for California for 2009. Smoking-attributable healthcare costs were estimated using a series of econometric models that estimate expenditures for hospital care, ambulatory care, prescriptions, home health care, and nursing home care. Lost productivity due to illness was estimated using an econometric model predicting how smoking status affects the number of days lost from work or other activities. The value of lives lost from premature mortality due to smoking was estimated using an epidemiological approach. Almost 4 million Californians still smoke, including 146 000 adolescents. The cost of smoking in 2009 totaled $18.1 billion, including $9.8 billion in healthcare costs, $1.4 billion in lost productivity from illness, and $6.8 billion in lost productivity from premature mortality. This amounts to $487 per California resident and $4603 per smoker. Costs were greater for men than for women. Hospital costs comprised 44% of healthcare costs. Despite extensive efforts at tobacco control in California, healthcare and lost productivity costs attributable to smoking remain high. Compared to costs for 1999, the total cost was 15% greater in 2009. However, after adjusting for inflation, real costs have fallen by 13% over the past decade, indicating that efforts have been successful in reducing the economic burden of smoking in the state. © 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.

A Cross-sectional Examination of What Smokers Perceive to be Important and Their Willingness to Pay for Tobacco Cessation Medications.

PubMed

Dube, Shanta R; Pesko, Michael F; Xu, Xin

2016-01-01

Tobacco smoking is the leading cause of preventable morbidity and mortality in the United States, and smoking cessation has multiple health benefits. The purpose of this study was to assess cigarette smokers' perceived importance toward characteristics of tobacco cessation medications using a willingness-to-pay approach. Cross-sectional analysis of data from the 2008 HealthStyles survey, a mail-based probability sample of 5399 adults aged 18 years and older.Point estimates and 95% confidence intervals were calculated overall and by sociodemographic and smoking behavior characteristics. Multivariate Probit regression analysis was used to evaluate smokers' willingness to pay in relation to perceived importance of 3 cessation medication characteristics: convenience of use, over-the-counter availability, and efficiency to help quit. All models controlled for sociodemographic characteristics, smoking behavior characteristics, and US regional fixed effects. A total of 914 current cigarette smokers. Interest in quitting, interest in using cessation medications, and willingness to pay for 6 types of cessation medications. Approximately 68.4% of current cigarette smokers were interested in quitting. Among these individuals, 45.6% indicated that they were interested in using cessation medications, and of these, 47.3% indicated that they were willing to pay $150 or more out-of-pocket for these medications. Convenience of use and the effectiveness of these medications to help quit were positively associated with current smokers' willingness to pay for $300 or more (P < .05); however, no association was observed for over-the-counter availability. Self-reported exposure to telephone quitline advertisements was also positively associated with the willingness to pay. Approximately 68% of current smokers are interested in quitting, and about half of those smokers interested in quitting are also interested in using cessation medications. Convenience of use and the medication's effectiveness are important characteristics of cessation medication for smokers with quit intentions. Understanding preferences for these cessation medication characteristics may help inform smoking cessation efforts.

Public opinion about smoking and smoke free legislation in a district of North India.

PubMed

Goel, S; Singh, R J; D, Sharma; A, Singh

2014-01-01

Context: A growing number of cities, districts, counties and states across the globe are going smoke-free. While an Indian national law namely Cigarettes and Other Tobacco Products Act (COTPA) exists since 2003 and aims at protecting all the people in our country; people still smoke in public places. Aim: This study assessed knowledge and perceptions about smoking, SHS and their support for Smoke-free laws among people residing in Mohali district, Punjab. Materials and Methods: This cross-sectional study was conducted in Mohali district of Punjab, India. A sample size of 1600 people was obtained. Probability Proportional to Size technique was used for selecting the number of individuals to be interviewed from each block and also from urban and rural population. Statistical Analysis Used: We estimated proportions and tested for significant differences by residence, smoking status, literacy level and employment level by means of the chi-square statistics. Statistical software SPSS for Windows version 20 was used for analysing data . Results: The overall prevalence of current smoking among study participants was 25%. Around 96% were aware of the fact that smoking is harmful to health, 45% viewed second-hand smoke to be equally harmful as active smoking, 84.2% knew that smoking is prohibited in public places and 88.3% wanted the government to take strict actions to control the menace of public smoking. Multivariate logistic regression analysis showed that people aged 20 years and above, unemployed, urban, literate and non-smokers had significantly better perception towards harms of smoking. The knowledge about smoke free provisions of COTPA was significantly better among males, employed individuals, urban residents, and literate people. Conclusions: There was high knowledge about deleterious multi-dimensional effects of smoking among residents and a high support for implementation of COTPA. Efforts should be taken to make Mohali a "smoke-free district".

Exposure of Secondary School Adolescents from Argentina and Mexico to Smoking Scenes in Movies: a Population-based Estimation.

PubMed

Salgado, María V; Pérez, Adriana; Abad-Vivero, Erika N; Thrasher, James F; Sargent, James D; Mejía, Raúl

2016-04-01

Smoking scenes in movies promote adolescent smoking onset; thus, the analysis of the number of images of smoking in movies really reaching adolescents has become a subject of increasing interest. The aim of this study was to estimate the level of exposure to images of smoking in movies watched by adolescents in Argentina and Mexico. First-year secondary school students from Argentina and Mexico were surveyed. One hundred highest-grossing films from each year of the period 2009-2013 (Argentina) and 2010-2014 (Mexico) were analyzed. Each participant was assigned a random sample of 50 of these movies and was asked if he/she had watched them. The total number of adolescents who had watched each movie in each country was estimated and was multiplied by the number of smoking scenes (occurrences) in each movie to obtain the number of gross smoking impressions seen by secondary school adolescents from each country. Four-hundred and twenty-two movies were analyzed in Argentina and 433 in Mexico. Exposure to more than 500 million smoking impressions was estimated for adolescents in each country, averaging 128 and 121 minutes of smoking scenes seen by each Argentine and Mexican adolescent, respectively. Although 15, 16 and 18-rated movies had more smoking scenes in average, movies rated for younger teenagers were responsible for the highest number of smoking scenes watched by the students (67.3% in Argentina and 54.4% in Mexico) due to their larger audience. At the population level, movies aimed at children are responsible for the highest tobacco burden seen by adolescents.

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.

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

[Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults].

PubMed

Shen, Q; Zhu, N B; Yu, C Q; Guo, Y; Bian, Z; Tan, Y L; Pei, P; Chen, J S; Chen, Z M; Lyu, J; Li, L M

2018-01-10

Objective: To examine the sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults. Methods: The present analysis included 487 373 participants from the China Kadoorie Biobank after excluding those with cancer, heart diseases, stroke at baseline survey. The baseline survey was conducted from June 2004 to July 2008. The number of follow-up years was calculated from the time that the participants completed baseline survey to the time of any event: CVD incidence, death, loss of follow-up, or December 31, 2015, whichever occurred first. We used Cox proportional hazards regression models to estimate the HR s and 95% CI of incident cardiovascular diseases with tobacco smoking. Results: During a median follow-up of 8.9 years(a total of 4.1 million person years), we documented 33 947 cases of ischemic heart diseases, 6 048 cases of major coronary diseases, 7 794 cases of intracerebral hemorrhage, and 31 722 cases of cerebral infarction. The prevalence of smoking was much higher in men (67.9%) than in women (2.7%). Smoking increased risk of all subtypes of cardiovascular diseases. Compared with nonsmokers, the multivariable-adjusted HR s (95% CI ) for current smokers were 1.54 (1.43-1.66) for major coronary event, 1.28 (1.24-1.32) for ischemic heart disease, 1.18 (1.14-1.22) for cerebral infarction, and 1.07 (1.00-1.15) for intracerebral hemorrhage, respectively. Female smokers tended to have greater risk of developing major coronary event associated with amount of tobacco smoked daily (interaction P =0.006) and age when smoking started (interaction P =0.011). There was no sex difference in these two effects for ischemic heart diseases, intracerebral hemorrhage and cerebral infarction (all interaction P >0.05). Conclusions: This prospective study confirmed increased risk of all subtypes of cardiovascular diseases in current smokers. Smoking was more harmful to women than to men for major coronary event.

Patient-reported recall of smoking cessation interventions from a health professional.

PubMed

King, Brian A; Dube, Shanta R; Babb, Stephen D; McAfee, Timothy A

2013-11-01

To determine the prevalence and characteristics of current cigarette smokers who report receiving health care provider interventions ('5A's': ask, advise, assess, assist, arrange) for smoking cessation. Data came from the 2009-2010 National Adult Tobacco Survey, a telephone survey of United States adults aged ≥ 18 years. Among current cigarette smokers who reported visiting a health professional in the past year (n=16,542), estimates were calculated overall and by sex, age, race/ethnicity, education, income, health insurance coverage, and sexual orientation. Among smokers who visited a health professional (75.2%), 87.9% were asked if they used tobacco, 65.8% were advised to quit, and 42.6% were asked if they wanted to quit. Among those wanting to quit, 78.2% were offered assistance and 17.5% had follow-up arranged. Receipt of the 'ask' component was lower among males and uninsured individuals. Receipt of the 'advise' and 'assess' components was lower among those aged 18-24 and uninsured individuals. Receipt of the 'assist' component was lower among non-Hispanic blacks. No differences were observed for the 'arrange' component. Many current smokers report receiving health care provider interventions for smoking cessation. Continued efforts to educate, encourage, and support all health professionals to provide effective, comprehensive tobacco cessation interventions to their patients may be beneficial. © 2013.

Prevalence of tobacco use among power loom workers - a cross-sectional study.

PubMed

Ansari, Zaki Anwar; Bano, S Nafees; Zulkifle, M

2010-01-01

Tobacco use is a major public health problem globally. According to the World Health Organization (WHO), tobacco is the second most important cause of death in the world. It is currently estimated to be responsible for about 5 million deaths each year worldwide. In India, it is responsible for over 8 lakh deaths every year. To estimate the prevalence of tobacco use among power loom workers in Mau Aima Town, District Allahabad, UP. Five hundred power loom workers were randomly chosen. Out of them 448 workers were interviewed through a questionnaire survey during May-June 2007. Data on demographics, education, and type of work were collected along with details regarding tobacco use and smoking status, duration of the habit, and daily consumption. Prevalence of tobacco chewing and/or bidi and cigarette smoking, and their sociodemographic correlates, were examined. The overall prevalence of tobacco use was 85.9%; the prevalence of smoking and tobacco chewing were 62.28% and 66.07%, respectively. Statistical analysis showed that smoking is more common in the elderly, while chewing gutka (a type of chewing tobacco) is popular among the younger age-groups. The prevalence of tobacco use among power loom workers is very high compared to that in general population. Immediate intervention programs are warranted to reduce the future burden of tobacco-related morbidity among these workers who are already exposed to the highly polluted environment in power loom factories.

Smoking, healthcare cost, and loss of productivity in Sweden 2001.

PubMed

Bolin, Kristian; Lindgren, Björn

2007-01-01

Objectives were (a) to estimate healthcare cost and productivity losses due to smoking in Sweden 2001 and (b) to compare the results with studies for Sweden 1980, Canada 1991, Germany 1996, and the USA 1998. Published estimates on relative risks and Swedish smoking patterns were used to calculate attributable risks for smokers and former smokers. These were applied to cost estimates for smoking-related diseases based on data from public Swedish registers. The estimated total cost for Sweden 2001 was US 804 million dollars; COPD and cancer of the lung accounted for 43%. Healthcare cost accounted for 26% of the total cost. The estimated costs per smoker were US 3,200 dollars in the USA 1998; 1,600 in Canada 1991; 1,100 in Germany 1996; 600 in Sweden 2001; and 300 in Sweden 1980 (all in 2001 US dollar prices). To reduce the prevalence of smoking is an issue worthwhile pursuing in its own right. In order to reduce the cost of smoking, however, policy-makers should also explore and influence the factors that determine the cost per smoker. Sweden seems to have been more successful than comparable countries in pursuing both these objectives.

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.

Effects of cigarette smoking on lexical decision-making.

PubMed

Hale, C R; Gentry, M V; Meliska, C J

1999-02-01

10 habitual smokers, aged 19-25 yr., were randomly assigned to smoke either a very low nicotine "Placebo" cigarette (.05-mg nicotine delivery as estimated by the FTC method) or a Nicotine cigarette (.7-mg estimated nicotine delivery). Each participant was asked to abstain from smoking for 4 to 7 hr. prior to testing. After completing a presmoking test of lexical decision-making, participants smoked either a Nicotine or Placebo cigarette and were then retested for reaction times and accuracy on the lexical decision test. When presented the most difficult lexical decisions, participants responded significantly faster after smoking a Nicotine cigarette than they did before smoking; smoking a Placebo cigarette did not affect reaction times. Response accuracy was unaffected by smoking either kind of cigarette. These results suggest that smoking a nicotine cigarette may improve attention or memory retrieval after several hours of smoking abstinence.

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.

Smoking habits and leukocyte telomere length dynamics among older adults: Results from the ESTHER cohort.

PubMed

Müezzinler, Aysel; Mons, Ute; Dieffenbach, Aida Karina; Butterbach, Katja; Saum, Kai-Uwe; Schick, Matthias; Stammer, Hermann; Boukamp, Petra; Holleczek, Bernd; Stegmaier, Christa; Brenner, Hermann

2015-10-01

Leukocyte telomere length (LTL) shortens with age and short LTL has been associated with increased mortality and increased risk for some age-related outcomes. This study aims to analyse the associations of smoking habits with LTL and rate of LTL change per year in older adults. LTL was measured by quantitative PCR at baseline in 3600 older adults, who were enrolled in a population-based cohort study in Germany. For longitudinal analyses, measurements were repeated in blood samples obtained at 8-year follow-up from 1000 participants. Terminal Restriction Fragment analysis was additionally performed in a sub-sample to obtain absolute LTL in base pairs. Multivariate linear regression models were used to estimate associations of smoking habits with baseline LTL and changes in LTL over time. LTL was inversely associated with age (r=-0.090, p<0.0001). Women had longer LTL than men (p<0.0001). Smoking was inversely associated with LTL. On average, current smokers had 73 base pairs (BP) shorter LTL compared to never smokers. Smoking intensity and pack-years of smoking were also inversely associated with LTL, and a positive association was observed with years since smoking cessation. Slower LTL attrition rates were observed in ever smokers over 8years of follow-up. Our cross-sectional analysis supports suggestions that smoking might contribute to shortening of LTL but this relationship could not be shown longitudinally. The overall rather small effect sizes observed for smoking-related variables suggest that LTL reflects smoking-related health hazards only to a very limited extent. Copyright © 2015 Elsevier Inc. All rights reserved.

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

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy

PubMed Central

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-wei

2016-01-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at −0.879, −0.853, and −1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue. PMID:27358905

The Demand for Cigarettes in Tanzania and Implications for Tobacco Taxation Policy.

PubMed

Kidane, Asmerom; Mduma, John; Naho, Alexis; Ngeh, Ernest Tingum; Hu, Teh-Wei

2015-10-01

The study attempts to estimate the demand for cigarettes in Tanzania and presents simulation results on the effect of the cigarette excise tax on smoking participation, government revenue, and related topics. After briefly summarizing the magnitude and spread of cigarette consumption in the country, the paper reviews some empirical estimates from African and other countries. The 2008 Tanzanian household budget survey was used to estimate the demand for cigarettes in Tanzania. The descriptive statistics suggest that the smoking prevalence for Tanzania is 15.35 percent with low variability across expenditure (income) groups. Smoking intensity and per capita consumption were estimated at 7.08 cigarettes and 1.33 cigarettes, respectively, a relatively low value. A two-part demand equation model was used to estimate various elasticities. For the overall equation, the price elasticities of smoking participation, smoking intensity, and total elasticity were estimated at -0.879, -0.853, and -1.732, respectively. Compared to similar results in other developing countries, the estimates appear quite high. When estimated by expenditure (income) groups, the magnitude of the elasticity appears higher among high expenditure groups than among low expenditure groups. Two simulation exercises were undertaken. First, the effect of different excise rates on smoking participation rate, cigarette consumption, tax revenue, and related responses was estimated and highlighted. Second, the same exercise was undertaken to determine the effect of a given increase in the cigarette excise tax on various expenditure groups. The overall results suggest that an increase in the excise tax on cigarettes in Tanzania would reduce cigarette consumption and increase government tax revenue.

Ethnic differences in current smoking and former smoking in the Netherlands and the contribution of socioeconomic factors: a cross-sectional analysis of the HELIUS study.

PubMed

Brathwaite, Rachel; Smeeth, Liam; Addo, Juliet; Kunst, Anton E; Peters, Ron J G; Snijder, Marieke B; Derks, Eske M; Agyemang, Charles

2017-07-10

Data exploring how much of the ethnic differences in smoking prevalence and former smoking are explained by socioeconomic status (SES) are lacking. We therefore assessed ethnic differences in smoking prevalence and former smoking and the contribution of both educational level and occupational-related SES to the observed ethnic differences in smoking behaviour. Data of 22 929 participants (aged 18-70 years) from the multiethnic cross-sectional Healthy L i fe in an Urban Setting study in the Netherlands were analysed. Poisson regression models with a robust variance were used to estimate prevalence ratios. Compared with the Dutch, after adjustment for age and marital status, smoking prevalence was higher in men of Turkish (prevalence ratio 1.69, 95% CI 1.54 to 1.86), African Surinamese (1.55, 95% CI 1.41 to 1.69) and South-Asian Surinamese origin (1.53, 95% CI 1.40 to 1.68), whereas among women, smoking prevalence was higher in Turkish, similar in African Surinamese but lower in all other ethnic origin groups. All ethnic minority groups, except Ghanaians, had a significantly lower smoking cessation prevalence than the Dutch. Socioeconomic gradients in smoking (higher prevalence among those lower educated and with lower level employment) were observed in all groups except Ghanaian women (a higher prevalence was observed in the higher educated). Ethnic differences in smoking prevalence and former smoking are largely, but not completely, explained by socioeconomic factors. Our findings imply that antismoking policies designed to target smoking within the lower socioeconomic groups of ethnic minority populations may substantially reduce ethnic inequalities in smoking particularly among men and that certain groups may benefit from targeted smoking cessation interventions. © 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.

Comparing the effects of entertainment media and tobacco marketing on youth smoking in Germany.

PubMed

Sargent, James D; Hanewinkel, Reiner

2009-05-01

To examine differential effects of smoking in films and tobacco advertising on adolescent smoking. We hypothesize that movie smoking will have greater effects on smoking initiation, whereas tobacco advertising receptivity will primarily affect experimentation. Longitudinal observational study of adolescents. School-based surveys conducted in Schleswig-Holstein, Germany. A total of 4384 adolescents age 11-15 years at baseline and re-surveyed 1 year later; ever smoking prevalence was 38% at time 1. The main outcome variable combined two items assessing life-time and current smoking (alpha = 0.87). Baseline never smokers were analyzed separately from those who had tried smoking (ever smokers). Exposure to smoking in 398 internationally distributed US movies was modeled as a continuous variable, with 0 corresponding to the 5th percentile and 1 to the 95th percentile of exposure. Tobacco marketing receptivity consisted of naming a brand for a favorite tobacco advertisement. Ordinal logistic regressions controlled for socio-demographics, other social influences, personality characteristics of the adolescent and parenting style. Whereas 34% of ever smokers were receptive to tobacco marketing at time 1, only 6% of never smokers were. Among time 1 never smokers, exposure to movie smoking was a significantly stronger predictor of higher time 2 smoking level [adjusted proportional odds ratio = 2.76, 95% confidence interval (1.84, 4.15)] than was tobacco marketing receptivity (1.53 [1.07, 2.20]). Among time 1 ever smokers, both tobacco marketing receptivity and exposure to movie smoking predicted higher levels of time 2 smoking [2.17 (1.78, 2.63) and 1.62 (1.18, 2.23), respectively], and the two estimates were not significantly different. In this longitudinal study, exposure to movie smoking was a stronger predictor of smoking initiation than tobacco marketing receptivity, which was more common among ever smokers. The results suggest that entertainment media smoking should be emphasized in programs aimed at preventing onset, and both exposures should be emphasized in programs aimed at experimental smokers.

Socioeconomic inequalities in smoking in The Netherlands before and during the Global Financial Crisis: a repeated cross-sectional study.

PubMed

Benson, Fiona E; Kuipers, Mirte A G; Nierkens, Vera; Bruggink, Jan-Willem; Stronks, Karien; Kunst, Anton E

2015-05-06

The Global Financial Crisis (GFC) increased levels of financial strain, especially in those of low socioeconomic status (SES). Financial strain can affect smoking behaviour. This study examines socioeconomic inequalities in current smoking and smoking cessation in The Netherlands before and during the Global Financial Crisis (GFC). Participants were 66,960 Dutch adults (≥ 18 years) who took part in the annual national Health Survey (2004-2011). Period was dichotomised: 'pre-' and 'during-GFC'. SES measures used were income, education and neighbourhood deprivation. Outcomes were current smoking rates (smokers/total population) and smoking cessation ratios (former smokers/ever smokers). Multilevel logistic regression models controlled for individual characteristics and tested for interaction between period and SES. In both periods, high SES respondents (in all indicators) had lower current smoking levels and higher cessation ratios than those of middle or low SES. Inequalities in current smoking increased significantly in poorly educated adults of 45-64 years of age (Odds Ratio (OR) low educational level compared with high: 2.00[1.79-2.23] compared to pre-GFC 1.67[1.50-1.86], p for interaction = 0.02). Smoking cessation inequalities by income in 18-30 year olds increased with borderline significance during the GFC (OR low income compared to high income: 0.73[0.58-0.91]) compared to pre-GFC (OR: 0.98[0.80-1.20]), p for interaction = 0.051). Overall, socioeconomic inequalities in current smoking and smoking cessation were unchanged during the GFC. However, current smoking inequalities by education, and smoking cessation inequalities by income, increased in specific age groups. Increased financial strain caused by the crisis may disproportionately affect smoking behaviour in some disadvantaged groups.

Cigarette Smoking Among Inmates by Race/Ethnicity: Impact of Excluding African American Young Adult Men From National Prevalence Estimates.

PubMed

Kennedy, Sara M; Sharapova, Saida R; Beasley, Derrick D; Hsia, Jason

2016-04-01

Cigarette smoking prevalence is more than two times greater among incarcerated adults, a population usually excluded from national health surveys. African American young adult (18-25) men are less likely to smoke cigarettes than their white counterparts. However, they are two and a-half-times more likely to be incarcerated. This study estimated smoking prevalence with noninstitutionalized and incarcerated samples combined to determine if excluding incarcerated adults impacts smoking prevalence for certain populations. The Bureau of Justice Statistics last fielded the Survey of Inmates in State and Federal Correction Facilities in 2003-2004. We combined data from Survey of Inmates in State and Federal Correction Facilities (n = 17 910) and the 2003 and 2004 National Health Interview Survey (n = 61 470) to calculate combined cigarette smoking estimates by race/ethnicity, sex, and age. Inmates represented the greatest proportion of smokers among African American men. Among African American young adult men, inmates represented 15.2% of all smokers in the combined population, compared to 2.0% among white young adult men. Cigarette smoking prevalence was 17.6% in the noninstitutionalized population of young adult African American men and 19.7% in the combined population. Among white young adult men, cigarette smoking prevalence was 29.8% in the noninstitutionalized population, and 30.2% in the combined population. There was little difference in estimates among women. The exclusion of incarcerated African American young adult men may result in a small underestimation of cigarette smoking prevalence in this population. Increasing access to smoking cessation support among inmates may reduce smoking prevalence in disproportionately incarcerated segments of the US population. The exclusion of incarcerated adults from national survey data should be considered when examining differences in cigarette smoking prevalence estimates between African American and white young adult men. Approximately one in six African American young adult men who smoke were incarcerated. Increasing access to smoking cessation support among inmates may reduce smoking prevalence among disproportionately incarcerated segments of the population. © 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.

The risk of coronary artery disease estimated non-invasively in patients with essential hypertension environmentally exposed to cigarette smoke.

PubMed

Gać, Paweł; Jaźwiec, Przemysław; Poręba, Małgorzata; Mazur, Grzegorz; Pawlas, Krystyna; Sobieszczańska, Małgorzata; Poręba, Rafał

2017-12-01

The relationship between environmental exposure of non-smokers to cigarette smoke and the coronary artery calcium scores has not been sufficiently documented. The aim of the study was to identify the relationship between environmental exposure to cigarette smoke and the risk of coronary artery disease (CAD) estimated non-invasively through measurement of coronary artery calcium score by computed tomography in patients with essential hypertension. The study was conducted on 67 patients with essential hypertension, non-smokers environmentally exposed to cigarette smoke (group A) and on 67 patients with essential hypertension, non-smokers not exposed to cigarette smoke (group B), selected using the case to case. Environmental exposure to cigarette smoke was evaluated using a questionnaire. The risk of development of coronary artery disease was estimated non-invasively through measurement of coronary artery calcium score (CA CS ) by computed tomography. Group A was characterised by significantly higher CA CS and left anterior descending (LAD CS ) calcium scores than group B. Compared to group B, group A had significantly higher percentage of patients with significant risk of CAD estimated on the basis of CA CS values, and significantly lower percentage of patients with practically no risk of CAD estimated with the same method. Advanced age, peripheral artery diseases and environmental exposure to cigarette smoke are independent risk factors associated with increased CA CS and LAD CS values. In addition, higher BMI and hypercholesterolemia are independent risk factors for increased values of LAD CS . In patients with essential hypertension environmental exposure to cigarette smoke may result in elevated risk of coronary artery disease estimated non-invasively through measurement of coronary artery calcium score by computed tomography. Copyright © 2017 Elsevier B.V. All rights reserved.

Future respiratory hospital admissions from wildfire smoke under climate change in the Western US

NASA Astrophysics Data System (ADS)

Coco Liu, Jia; Mickley, Loretta J.; Sulprizio, Melissa P.; Yue, Xu; Peng, Roger D.; Dominici, Francesca; Bell, Michelle L.

2016-12-01

Background. Wildfires are anticipated to be more frequent and intense under climate change. As a result, wildfires may emit more air pollutants that can harm health in communities in the future. The health impacts of wildfire smoke under climate change are largely unknown. Methods. We linked projections of future levels of fine particulate matter (PM2.5) specifically from wildfire smoke under the A1B climate change scenario using the GEOS-Chem model for 2046-2051, present-day estimates of hospital admission impacts from wildfire smoke, and future population projections to estimate the change in respiratory hospital admissions for persons ≥65 years by county (n = 561) from wildfire PM2.5 under climate change in the Western US. Results. The increase in intense wildfire smoke days from climate change would result in an estimated 178 (95% confidence interval: 6.2, 361) additional respiratory hospital admissions in the Western US, accounting for estimated future increase in the elderly population. Climate change is estimated to impose an additional 4990 high-pollution smoke days. Central Colorado, Washington and southern California are estimated to experience the highest percentage increase in respiratory admissions from wildfire smoke under climate change. Conclusion. Although the increase in number of respiratory admissions from wildfire smoke seems modest, these results provide important scientific evidence of an often-ignored aspect of wildfire impact, and information on their anticipated spatial distribution. Wildfires can cause serious social burdens such as property damage and suppression cost, but can also raise health problems. The results provide information that can be incorporated into development of environmental and health policies in response to climate change. Climate change adaptation policies could incorporate scientific evidence on health risks from natural disasters such as wildfires.

[The cost of tobacco-related diseases for Brazil's Unified National Health System].

PubMed

Pinto, Márcia; Ugá, Maria Alicia Domínguez

2010-06-01

This study aimed to identify the direct costs of hospitalizations due to three smoking-related groups of diseases - cancer and circulatory and respiratory diseases - in Brazil's Unified National Health System (SUS) in 2005. For cancer, the cost of chemotherapy was also included. The study derived cost estimates using administrative databases, relative risks, smoking prevalence, and smoking-attributable fraction. According to the estimates, smoking- attributable medical expenditures for the three disease groups amounted to R$338,692,516.02 (approximately U$185 million), accounting for 27.6% of total medical expenditures. Considering all hospitalizations and chemotherapy provided by the National Health System, tobacco-related diseases accounted for 7.7% of total medical expenditures. These costs also represented 0.9% of expenditures by federally funded public health services. This study provides a conservative estimate of smoking-related costs and suggests the need for continued research on comprehensive approaches to measure the total burden of smoking for society.

Factors predicting high estimated 10-year stroke risk: thai epidemiologic stroke study.

PubMed

Hanchaiphiboolkul, Suchat; Puthkhao, Pimchanok; Towanabut, Somchai; Tantirittisak, Tasanee; Wangphonphatthanasiri, Khwanrat; Termglinchan, Thanes; Nidhinandana, Samart; Suwanwela, Nijasri Charnnarong; Poungvarin, Niphon

2014-08-01

The purpose of the study was to determine the factors predicting high estimated 10-year stroke risk based on a risk score, and among the risk factors comprising the risk score, which factors had a greater impact on the estimated risk. Thai Epidemiologic Stroke study was a community-based cohort study, which recruited participants from the general population from 5 regions of Thailand. Cross-sectional baseline data of 16,611 participants aged 45-69 years who had no history of stroke were included in this analysis. Multiple logistic regression analysis was used to identify the predictors of high estimated 10-year stroke risk based on the risk score of the Japan Public Health Center Study, which estimated the projected 10-year risk of incident stroke. Educational level, low personal income, occupation, geographic area, alcohol consumption, and hypercholesterolemia were significantly associated with high estimated 10-year stroke risk. Among these factors, unemployed/house work class had the highest odds ratio (OR, 3.75; 95% confidence interval [CI], 2.47-5.69) followed by illiterate class (OR, 2.30; 95% CI, 1.44-3.66). Among risk factors comprising the risk score, the greatest impact as a stroke risk factor corresponded to age, followed by male sex, diabetes mellitus, systolic blood pressure, and current smoking. Socioeconomic status, in particular, unemployed/house work and illiterate class, might be good proxy to identify the individuals at higher risk of stroke. The most powerful risk factors were older age, male sex, diabetes mellitus, systolic blood pressure, and current smoking. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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.

The association between smoking and blood pressure in men: a cross-sectional study.

PubMed

Li, Guoju; Wang, Hailing; Wang, Ke; Wang, Wenrui; Dong, Fen; Qian, Yonggang; Gong, Haiying; Hui, Chunxia; Xu, Guodong; Li, Yanlong; Pan, Li; Zhang, Biao; Shan, Guangliang

2017-10-10

Cigarette smoking is a known risk factor for cardiovascular disease (CVD), but the association between smoking and blood pressure is unclear. Thus, the current study examined the association between cigarette smoking and blood pressure in men. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) were examined using digital blood pressure measuring device, and smoking status was determined with China National Health Survey. The ANCOVA showed that the adjusted DBP and MAP were lower in current smokers versus nonsmokers and the adjusted SBP was lower in current smokers versus former smokers (P < 0.05). Additionally, the adjusted PP tend to be decreased steadily as the pack·years increased in current smokers. In a fully adjusted logistic regression model, former smokers had increased ORs (95% CI) of 1.48 (1.01, 2.18) of hypertension and current smokers had not increased ORs (95% CI) of 0.83 (0.61, 1.12), compared with never smokers. The findings revealed that the adjusted blood pressure were lower in current smokers versus nonsmokers and former smokers. No significant dose-dependent effect of current smoking on blood pressure indices except PP was observed. Smoking cessation was significantly associated with an increased risk of hypertension. However, current smoking was not a risk factor of hypertension.

Future healthy life expectancy among older adults in the US: a forecast based on cohort smoking and obesity history.

PubMed

Cao, Bochen

2016-01-01

In the past three decades, the elderly population in the United States experienced increase in life expectancy (LE) and disability-free life expectancy (LE(ND)), but decrease in life expectancy with disability (LE(D)). Smoking and obesity are two major risk factors that had negative impacts on these trends. While smoking prevalence continues to decline in recent decades, obesity prevalence has been growing and is currently at a high level. This study aims to forecast the healthy life expectancy for older adults aged 55 to 85 in the US from 2011 to 2040, in relation to their smoking and obesity history. First, population-level mortality data from the Human Mortality Database (HMD) and individual-level disability data from the US National Health Interview Survey (NHIS) were used to estimate the transition rates between different health states from 1982 to 2010, using a multi-state life table (MSLT) model. Second, the estimated transition rates were fitted and projected up to 2040, using a modified Lee-Carter model that incorporates cohort smoking and obesity history from NHIS. Mortality and morbidity for both sexes will continue to decline in the next decades. Relative to 2010, men are expected to have 3.2 years gain in LE(ND) and 0.8 years loss in LE(D). For women, there will be 1.8 years gain in LE(ND) and 0.8 years loss in LE(D). By 2040, men and women are expected to spend respectively 80 % and 75 % of their remaining life expectancy between 55 and 85 disability-free. Smoking and obesity have independent negative impacts on both the survival and disability of the US older population in the coming decades, and are responsible for the present and future gender disparity in mortality and morbidity. Overall, the US older population is expected to enjoy sustained health improvements and compression of disability, largely due to decline in smoking.

[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.

Estimating fuel consumption during prescribed fires in Arkansas

Treesearch

Virginia L. McDaniel; James M. Guldin; Roger W. Perry

2012-01-01

While prescribed fire is essential to maintaining numerous plant communities, fine particles produced in smoke can impair human health and reduce visibility in scenic areas. The Arkansas Smoke Management Program was established to mitigate the impacts of smoke from prescribed fires. This program uses fuel loading and consumption estimates from standard fire-behavior...

[Modelling of the costs of productivity losses due to smoking in Germany for the year 2005].

PubMed

Prenzler, A; Mittendorf, T; von der Schulenburg, J M

2007-11-01

The aim of this study was to estimate disease-related productivity costs attributable to smoking in the year 2005 in Germany. The calculation was based on the updated relative smoking-related disease risk found in the US Cancer Prevention Study II combined with data on smoking prevalence for Germany. With this, smoking-attributable cases resulting in premature mortality, invalidity, and temporal disability to work could be estimated. Neoplasms, diseases of the circulatory and the respiratory systems as well as health problems in children younger than one year were considered in the analysis. The human capital approach was applied to calculate years of potential work loss and productivity costs as a result of smoking. Various sensitivity analyses were conducted to test for robustness of the underlying model. Based on the assumptions within the model, 107,389 deaths, 14,112 invalidity cases, and 1.19 million cases of temporary disability to work were found to be due to smoking in 2005 in Germany, respectively. As a result, productivity costs of 9.6 billion were caused by smoking. The model showed that smoking has a high financial effect. Even so, further analyses are necessary to estimate an overall impact of smoking on the German society.

Survival of macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking in patients with type 2 diabetes: BioBank Japan cohort.

PubMed

Yokomichi, Hiroshi; Nagai, Akiko; Hirata, Makoto; Kiyohara, Yutaka; Muto, Kaori; Ninomiya, Toshiharu; Matsuda, Koichi; Kamatani, Yoichiro; Tamakoshi, Akiko; Kubo, Michiaki; Nakamura, Yusuke; Yamagata, Zentaro

2017-03-01

The number of patients with diabetes is increasing worldwide. Macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking frequently accompany type 2 diabetes. Few data are available related to mortality of Asians with diabetes associated with these serious comorbidities. The present study aimed to quantify the excess mortality risks of type 2 diabetic patients with comorbidities. We analysed the available records of 30,834 Japanese patients with type 2 diabetes from the BioBank Japan Project between 2003 and 2007. Men and women were followed up for median 8.03 and 8.30 years, respectively. We applied Cox proportional hazard model and Kaplan-Meier estimates for survival curves to evaluate mortality in diabetic patients with or without macrovascular disease, chronic respiratory disease, chronic kidney disease, cancer and smoking. Adjusted hazard ratios (HRs) for mortality were 1.39 (95% CI, 1.09-1.78) for male sex, 2.01 (95% CI, 1.78-2.26) per 10-year increment of age. Adjusted HRs of primary interest were 1.77 (95% CI, 1.42-2.22), macrovascular disease; 1.58 (95% CI, 1.08-2.31), chronic respiratory disease; 2.03 (95% CI, 1.67-2.47), chronic kidney disease; 1.16 (95% CI, 0.86-1.56), cancer; and 1.74 (95% CI, 1.30-2.31), current smoking. Diabetic patients with a past or current history of chronic kidney, macrovascular or respiratory diseases or smoking habit have exhibited the highest risk of mortality. Data were limited to those of survivors of comorbidities but we propose the need to improve comorbidities and terminate cigarette smoking for better prognosis in patients with diabetes. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

The contribution of smoking to inequalities in mortality by education varies over time and by sex: two national cohort studies, 1981-84 and 1996-99.

PubMed

Blakely, Tony; Wilson, Nick

2005-10-01

The contributions of tobacco smoking to overall mortality and socioeconomic inequalities in mortality vary between populations and over time. We determined how these contributions varied by sex and over time in two national New Zealand cohort studies. Poisson regression and modelling were conducted on linked census-mortality cohorts for people aged 45-74 years in 1981-84 and 1996-99 (2.0 and 2.7 million person-years, respectively). Contribution to socioeconomic inequalities in mortality. Adjusting for current and former smoking reduced the all-cause mortality rate ratios for men with nil educational qualifications compared with men with post-school qualifications from 1.34 to 1.29 in 1981-84 and from 1.31 to 1.25 in 1996-99, or 16 and 21% reductions in relative inequalities. Equivalent results for women were 1.42-1.41 in 1981-84 and 1.42-1.37 in 1996-99, or 3 and 11% reductions in relative inequalities. Contribution to overall mortality. Using 1996-99 data, we estimated that if all current smokers quit and became ex-smokers, mortality rates would reduce by 11% for men and 5% for women. If everyone was a never smoker (i.e. a historically smoke-free society), mortality rates would have been 26% lower for men and 25% lower for women. The contribution of smoking to educational inequalities in mortality was greater for males, and increased over time for both males and females, reflecting the historically differential phasing of the tobacco epidemic by sex and socioeconomic position. Complete cessation of smoking in contemporary New Zealand would reduce both overall mortality and educational inequalities in mortality.

Youth tobacco surveillance--United States, 2001-2002.

PubMed

Marshall, LaTisha; Schooley, Michael; Ryan, Heather; Cox, Patrick; Easton, Alyssa; Healton, Cheryl; Jackson, Kat; Davis, Kevin C; Homsi, Ghada

2006-05-19

Cigarette smoking is the leading preventable cause of death in the United States, accounting for approximately 440,000 deaths each year. The prevalence of cigarette smoking nationwide among high school students (grades 9-12) increased during the 1990s, peaking during 1996-1997, and then declined. Approximately 80% of tobacco users initiate use before age 18 years. An estimated 6.4 million children aged <18 years who are living today will die prematurely as adults because they began to smoke cigarettes during adolescence. The annual health-related economic cost associated with tobacco use exceeds 167 billion dollars. 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. This report covers data collected during January 2001-December 2002. The National Youth Tobacco Survey (NYTS) and state youth tobacco surveys (YTS) were developed to provide states with data to support the design, implementation, and evaluation of comprehensive tobacco-control programs. NYTS is representative of middle and high school students in the 50 states and the District of Columbia. During spring 2002, a total of 26,149 students in 246 schools completed NYTS questionnaires. Weighted data for the YTS were achieved by 13 states in 2001 and by 20 states in 2002; state sample sizes varied (range: 982-38,934). This report summarizes data from the 2002 NYTS and the 2001 and 2002 YTS. Findings from the 2002 NYTS indicate that current use of any tobacco product ranged from 13.3% among middle school students to 28.2% among high school students. Cigarette smoking was the most prevalent form of tobacco use, with 9.8% of middle school students and 22.5% of high school students reporting that they currently smoke cigarettes. Cigar smoking was the second most prevalent form of tobacco use, with 6.0% of middle school students and 11.6% of high school students reporting that they currently smoke cigars. Among current cigarette smokers, 41.8% of middle school students and 52.0% of high school students reported that they usually smoke Marlboro cigarettes. Black middle school and high school students who smoke were more likely to smoke Newport cigarettes than any other brand (58.3% and 66.8%, respectively). Among middle school students aged <18 years, 75.9% were not asked to show proof of age when they bought or tried to buy cigarettes, and 63.4% were not refused purchase because of their age. Among high school students aged <18 years, 58.5% were not asked to show proof of age when they bought or tried to buy cigarettes, and 60.6% were not refused purchase because of their age. Nearly half (49.6%) of middle school students and 62.1% of high school students who smoke reported a desire to stop smoking cigarettes, with 55.4% of middle school students and 53.1% of high school students reported having made at least one cessation attempt during the 12 months preceding the survey. Among students who have never smoked cigarettes, 21.3% of middle school students and 22.9% of high school students were susceptible to initiating cigarette smoking in the next year. Exposure to secondhand smoke (i.e., environmental tobacco smoke) was high. During the week before the survey, 1) 88.3% of middle school students and 91.4% of high school students who currently smoke cigarettes and 47.1% of middle school students and 53.3% of high school students who have never smoked cigarettes were in the same room with someone who was smoking cigarettes; 2) 81.7% of middle school students and 83.7% of high school students who currently smoke cigarettes and 31.5% of middle school students and 29.1% of high school students who have never smoked cigarettes rode in a car with someone who was smoking cigarettes; and 3) 71.5% of middle school students and 57.5% of high school students who currently smoke cigarettes and 33.3% of middle school students and 29.9% of high school students who have never smoked cigarettes lived in a home in which someone else smoked cigarettes. Media and advertising influence was also noted, with 58.1% of middle school students and 54.9% of high school students who currently use tobacco and 11.0% of middle school students and 13.7% of high school students who have never used tobacco reporting that they would wear or use an item with a tobacco company name or logo on it. Although 84.6% of middle school students and 91.2% of high school students had seen or heard antismoking commercials on television or radio, 89.9% of middle school students and 91.3% of high school students also had seen actors using tobacco on television or in the movies. Health and education officials use YTS and NYTS data to plan, evaluate, and improve national and state programs to prevent and control youth tobacco use. States can use these data in presentations to their state legislators to demonstrate the need for funding comprehensive tobacco-control programs, including tobacco cessation and prevention programs for youth.

Exposure of Secondary School Adolescents from Argentina and Mexico to Smoking Scenes in Movies: a Population-based Estimation

PubMed Central

SALGADO, MARÍA V.; PÉREZ, ADRIANA; ABAD-VIVERO, ERIKA N.; THRASHER, JAMES F.; SARGENT, JAMES D.; MEJÍA, RAÚL

2016-01-01

Background Smoking scenes in movies promote adolescent smoking onset; thus, the analysis of the number of images of smoking in movies really reaching adolescents has become a subject of increasing interest. Objective The aim of this study was to estimate the level of exposure to images of smoking in movies watched by adolescents in Argentina and Mexico. Methods First-year secondary school students from Argentina and Mexico were surveyed. One hundred highest-grossing films from each year of the period 2009-2013 (Argentina) and 2010-2014 (Mexico) were analyzed. Each participant was assigned a random sample of 50 of these movies and was asked if he/she had watched them. The total number of adolescents who had watched each movie in each country was estimated and was multiplied by the number of smoking scenes (occurrences) in each movie to obtain the number of gross smoking impressions seen by secondary school adolescents from each country. Results Four-hundred and twenty-two movies were analyzed in Argentina and 433 in Mexico. Exposure to more than 500 million smoking impressions was estimated for adolescents in each country, averaging 128 and 121 minutes of smoking scenes seen by each Argentine and Mexican adolescent, respectively. Although 15, 16 and 18-rated movies had more smoking scenes in average, movies rated for younger teenagers were responsible for the highest number of smoking scenes watched by the students (67.3% in Argentina and 54.4% in Mexico) due to their larger audience. Conclusion At the population level, movies aimed at children are responsible for the highest tobacco burden seen by adolescents. PMID:27354756

The Role of Public Policies in Reducing Smoking Prevalence in California: Results from the California Tobacco Policy Simulation Model

PubMed Central

Levy, David T.; Hyland, Andrew; Higbee, Cheryl; Remer, Lillian; Compton, Christine

2009-01-01

Summary Tobacco control policies are examined utilizing a simulation model for California, the state with the longest running comprehensive program. We assess the impact of the California Tobacco Control Program (CTCP) and surrounding price changes on smoking prevalence and smoking-attributable deaths. Modeling begins in 1988 and progresses chronologically to 2004, and considers four types of policies (taxes, mass media, clean air laws, and youth access policies) independently and as a package. The model is validated against existing smoking prevalence estimates. The difference in trends between predicted smoking rates from the model and other commonly used estimates of smoking prevalence for the overall period were generally small. The model also predicted some important changes in trend, which occurred with changes in policy. The California SimSmoke model estimates that tobacco control policies reduced smoking rates in California by an additional 25% relative to the level that they would have been if policies were kept at their 1988 level. By 2004, the model attributes over 60% of the reduction to price increases, over 25% of the overall effect to media policies, 10% to clean air laws, and only a small percent to youth access policies. The model estimates that over 5,000 lives will be saved in the year 2010 alone as a result of the CTCP and industry-initiated price increases, and that over 50,000 lives were saved over the period 1988-2010. Tobacco control policies implemented as comprehensive tobacco control strategies have significantly impacted smoking rates. Further tax increases should lead to additional lives saved, and additional policies may result in further impacts on smoking rates, and consequently on smoking-attributable health outcomes in the population. PMID:17055104

Parental migration and smoking behavior of left-behind children: evidence from a survey in rural Anhui, China.

PubMed

Yang, Tingting; Li, Cuicui; Zhou, Chengchao; Jiang, Shan; Chu, Jie; Medina, Alexis; Rozelle, Scott

2016-08-05

Parental migration is most an important factor affecting children's behaviors. Few studies have addressed the association between parental migration and children's smoking behavior in China. This study aims to estimate the current smoking prevalence among children, evaluate the association of parental migration and the smoking behavior of children and identify factors associated with smoking behavior among left-behind children (LBC). A cross-sectional study was conducted in 6 cities in Anhui province during July and August, 2012. All participants were interviewed face-to-face using a standardized questionnaire. Only children 10 to 14 years old that live in rural villages for at least 6 months during the previous year were included in the study. A total of 1343 children met the sampling criteria and participated in the study. Of these, 56 % are LBC and 44 % live with both parents. The average rate of smoking is 3.4 %. The rate of smoking is statistically higher for LBC with both parents out (rate = 6.1 %; OR = 5.59, P < 0.001) than for children living with both parents (1.4 %). Similarly, the rate of LBC with father home only (rate = 5.0 %; OR = 5.60, P = 0.005) is also statistically higher than for children living with both parents when controlling other variables. Factors affecting the smoking behavior of LBC, include gender (i.e., boys), (perceived) school performance and primary caregiver. Parental migration is associated with a significant increase in smoking behavior among children. Intervention studies that target LBC would help to develop strategies to reduce smoking among rural children. Gender-specific strategies and anti-smoking education also appears to be needed to reduce tobacco use among rural LBC.

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.

Characterizing Internet Searchers of Smoking Cessation Information

PubMed Central

Graham, Amanda L

2006-01-01

Background The Internet is a viable channel to deliver evidence-based smoking cessation treatment that has the potential to make a large population impact on reducing smoking prevalence. There is high demand for smoking cessation information and support on the Internet. Approximately 7% (10.2 million) of adult American Internet users have searched for information on quitting smoking. Little is known about these individuals, their smoking status, what type of cessation services they are seeking on the Internet, or how frequently these searches for cessation information are conducted. Objective The primary goal of this study was to characterize individuals who search for smoking cessation information on the Internet to determine appropriate triage and treatment strategies. The secondary goal was to estimate the incidence of searches for cessation information using publicly available search engine data. Methods We recruited individuals who clicked on a link to a leading smoking cessation website (QuitNet) from within the results of a search engine query. Individuals were “intercepted” before seeing the QuitNet home page and were invited to participate in the study. Those accepting the invitation were routed to an online survey about demographics, smoking characteristics, preferences for specific cessation services, and Internet search patterns. To determine the generalizability of our sample, national datasets on search engine usage patterns, market share, and keyword rankings were examined. These datasets were then used to estimate the number of queries for smoking cessation information each year. Results During the 10-day study period, 2265 individuals were recruited and 29% (N = 655) responded. Of these, 59% were female and overall tended to be younger than the previously characterized general Internet population. Most (76%) respondents were current smokers; 17% had quit within the last 7 days, and 7% had quit more than 7 days ago. Slightly more than half of active smokers (53%) indicated that they were planning to quit in the next 30 days. Smokers were more likely to seek information on how to quit and on medications; former smokers were more interested in how to cope with withdrawal. All participants rated withdrawal information and individually tailored information as being more useful, while displaying little interest in telephone counseling, expert support, or peer support. Publicly available data from large search engines suggest that 4 million Americans search for resources on smoking cessation each year. Conclusions This study adds to the limited data available on individuals who search for smoking cessation information on the Internet, supports the prior estimates of the size of the population, and indicates that these individuals are in appropriate stages for both active cessation interventions and aggressive relapse prevention efforts. Continued development and evaluation of online interventions is warranted, and organizations seeking to promote cessation should carefully evaluate the Internet as a possible modality for treatment and as a gateway to other traditional programs. PMID:17032633

Comparison of wildfire smoke estimation methods and associations with cardiopulmonary-related hospital admissions

PubMed Central

Gan, Ryan W.; Ford, Bonne; Lassman, William; Pfister, Gabriele; Vaidyanathan, Ambarish; Fischer, Emily; Volckens, John; Pierce, Jeffrey R.; Magzamen, Sheryl

2017-01-01

Climate forecasts predict an increase in frequency and intensity of wildfires. Associations between health outcomes and population exposure to smoke from Washington 2012 wildfires were compared using surface monitors, chemical-weather models, and a novel method blending three exposure information sources. The association between smoke particulate matter ≤2.5 μm in diameter (PM2.5) and cardiopulmonary hospital admissions occurring in Washington from 1 July to 31 October 2012 was evaluated using a time-stratified case-crossover design. Hospital admissions aggregated by ZIP code were linked with population-weighted daily average concentrations of smoke PM2.5 estimated using three distinct methods: a simulation with the Weather Research and Forecasting with Chemistry (WRF-Chem) model, a kriged interpolation of PM2.5 measurements from surface monitors, and a geographically weighted ridge regression (GWR) that blended inputs from WRF-Chem, satellite observations of aerosol optical depth, and kriged PM2.5. A 10 μg/m3 increase in GWR smoke PM2.5 was associated with an 8% increased risk in asthma-related hospital admissions (odds ratio (OR): 1.076, 95% confidence interval (CI): 1.019–1.136); other smoke estimation methods yielded similar results. However, point estimates for chronic obstructive pulmonary disease (COPD) differed by smoke PM2.5 exposure method: a 10 μg/m3 increase using GWR was significantly associated with increased risk of COPD (OR: 1.084, 95%CI: 1.026–1.145) and not significant using WRF-Chem (OR: 0.986, 95%CI: 0.931–1.045). The magnitude (OR) and uncertainty (95%CI) of associations between smoke PM2.5 and hospital admissions were dependent on estimation method used and outcome evaluated. Choice of smoke exposure estimation method used can impact the overall conclusion of the study. PMID:28868515

Estimating Economic Burden of Cancer Deaths Attributable to Smoking in Iran.

PubMed

Rezaei, Satar; Akbari Sari, Ali; Arab, Mohammad; Majdzadeh, Reza; Mohammadpoorasl, Asghar

2015-01-01

There is a broad consensus among health policy-makers that smoking has a significant impact on both heath system and society. The purpose of this study was to estimate the economic burden of major cancer deaths caused by smoking in Iran in 2012. Number of major cancer deaths due to smoking by sex and age groups in 2012 was obtained from GLOBCAN database. The life expectancy and retirement age were used to estimate years of potential life lost (YPLL) and cost of productive lost attributable to smoking, respectively. Data on prevalence of smoking, relative risk of smoking, life expectancy table, annual wage and employment rate were extracted from the various resources such as previous studies, WHO database and Iranian statistic centers. The data analysis was conducted by Excel software. Smoking was responsible for 4,623 cancer deaths, 80808 YPLL and $US 83,019,583 cost of productivity lost. Lung cancer accounts for largest proportion of total cancer deaths, YPLL and cost of productivity lost attributable to smoking. Males account for 86.6% of cancer deaths, 82.6% of YPLL and 85.3% of cost of productivity lost caused by smoking. Smoking places a high economic burden on health system and society as a whole. In addition, if no one had been smokers in Iran, approximately two out of ten cancer deaths could be prevented.

The cost-effectiveness of smoking cessation support delivered by mobile phone text messaging: Txt2stop.

PubMed

Guerriero, Carla; Cairns, John; Roberts, Ian; Rodgers, Anthony; Whittaker, Robyn; Free, Caroline

2013-10-01

The txt2stop trial has shown that mobile-phone-based smoking cessation support doubles biochemically validated quitting at 6 months. This study examines the cost-effectiveness of smoking cessation support delivered by mobile phone text messaging. The lifetime incremental costs and benefits of adding text-based support to current practice are estimated from a UK NHS perspective using a Markov model. The cost-effectiveness was measured in terms of cost per quitter, cost per life year gained and cost per QALY gained. As in previous studies, smokers are assumed to face a higher risk of experiencing the following five diseases: lung cancer, stroke, myocardial infarction, chronic obstructive pulmonary disease, and coronary heart disease (i.e. the main fatal or disabling, but by no means the only, adverse effects of prolonged smoking). The treatment costs and health state values associated with these diseases were identified from the literature. The analysis was based on the age and gender distribution observed in the txt2stop trial. Effectiveness and cost parameters were varied in deterministic sensitivity analyses, and a probabilistic sensitivity analysis was also performed. The cost of text-based support per 1,000 enrolled smokers is £16,120, which, given an estimated 58 additional quitters at 6 months, equates to £278 per quitter. However, when the future NHS costs saved (as a result of reduced smoking) are included, text-based support would be cost saving. It is estimated that 18 LYs are gained per 1,000 smokers (0.3 LYs per quitter) receiving text-based support, and 29 QALYs are gained (0.5 QALYs per quitter). The deterministic sensitivity analysis indicated that changes in individual model parameters did not alter the conclusion that this is a cost-effective intervention. Similarly, the probabilistic sensitivity analysis indicated a >90 % chance that the intervention will be cost saving. This study shows that under a wide variety of conditions, personalised smoking cessation advice and support by mobile phone message is both beneficial for health and cost saving to a health system.

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.

Estimating Cotinine Associations and a Saliva Cotinine Level to Identify Active Cigarette Smoking in Alaska Native Pregnant Women

PubMed Central

Robinson, Renee F.; Khan, Burhan A.; Sosnoff, Connie S.; Dillard, Denise A.

2017-01-01

Studies indicate nicotine metabolism varies by race and can change during pregnancy. Given high rates of tobacco use and limited studies among Alaska Native (AN) women, we estimated associations of saliva cotinine levels with cigarette use and second-hand smoke (SHS) exposure and estimated a saliva cotinine cutoff to distinguish smoking from non-smoking pregnant AN women. Using questionnaire data and saliva cotinine, we utilized multivariable linear regression (n = 370) to estimate cotinine associations with tobacco use, SHS exposure, demographic, and pregnancy-related factors. Additionally, we estimated an optimal saliva cotinine cutoff for indication of active cigarette use in AN pregnant women using receiver operating characteristic (ROC) curve analysis (n = 377). Saliva cotinine significantly decreased with maternal age and significantly increased with cigarettes smoked per day, SHS exposure, and number of previous full term pregnancies. Using self-reported cigarette use in the past 7 days as indication of active smoking, the area under the ROC curve was 0.975 (95 % CI: 0.960–0.990). The point closest to 100 % specificity and sensitivity occurred with a cotinine concentration of 1.07 ng/mL, which corresponded to sensitivity of 94 % and specificity of 94 %. We recommend using a saliva cotinine cutoff of 1 ng/mL to distinguish active smoking in pregnant AN women. This cutoff is lower than used in other studies with pregnant women, most likely due to high prevalence of light or intermittent smoking in the AN population. Continued study of cotinine levels in diverse populations is needed. PMID:23423858

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

Socio-economic disparities in tobacco consumption in rural India: evidence from a health and demographic surveillance system.

PubMed

Barik, Anamitra; Rai, Rajesh Kumar; Gorain, Ashoke; Majumdar, Saikat; Chowdhury, Abhijit

2016-09-01

India houses over 275 million tobacco users, with 164 million users of only smokeless tobacco, 69 million exclusive smokers, and 42 million users of both smoking and smokeless tobacco. This study aims to examine the socio-economic factors associated with types of tobacco use in a selected rural Indian population. A cross-sectional study was conducted with surveillance data from the Birbhum Population Project (BIRPOP). Total respondents of 29,783 individuals (16,038 men and 13,745 women) aged ≥15 years were surveyed between October 2010 and January 2011. Apart from bivariate analyses, a binary logistic regression was applied to estimate the adjusted odds ratio for socio-economic factors (religion, social group, education, occupation, and wealth quintile) associated with current tobacco use, current smokeless tobacco use, and current bidi use among men and women. Nearly 22% of men and 26% of women were using smokeless tobacco. While 46% of men were smoking bidi, only 4% of women reported smoking bidi. Overall, men are more likely to use tobacco. Irrespective of gender, with increasing years of education, people are less inclined to use tobacco, and unemployed people are less likely to use tobacco. With increasing income, the odds of smokeless tobacco use and the odds of smoking bidi are higher among women and men, respectively. The BIRPOP study indicates that irrespective of gender and income, raising the level of awareness through household-based health education could be an effective intervention to minimise the level of tobacco use. © Royal Society for Public Health 2015.

Effects of the truth FinishIt brand on tobacco outcomes.

PubMed

Evans, W Douglas; Rath, Jessica M; Hair, Elizabeth C; Snider, Jeremy Williams; Pitzer, Lindsay; Greenberg, Marisa; Xiao, Haijun; Cantrell, Jennifer; Vallone, Donna

2018-03-01

Since 2000, the truth campaign has grown as a social marketing brand. Back then, truth employed branding to compete directly with the tobacco industry. In 2014, the launch of truth FinishIt reflected changes in the brand's strategy, the tobacco control environment, and youth/young adult behavior. Building on a previous validation study, the current study examined brand equity in truth FinishIt , as measured by validated multi-dimensional scales, and tobacco related attitudes, beliefs, and behavior based on two waves of the Truth Longitudinal Cohort data from 2015 and 2016. A fixed effects logistic regression was used to estimate the change in brand equity between panel survey waves 3 and 4 on past 30-day smoking among ever and current smokers. Additional models determined the effects of brand equity predicting tobacco attitudes/use at follow up among the full sample. All analyses controlled for demographic factors. A one-point increase in the brand equity scale between the two waves was associated with a 66% greater chance of not smoking among ever smokers (OR 1.66, CI 1.11-2.48, p  < 0.05) and an 80% greater chance of not smoking among current smokers (OR 1.80, CI 1.05-3.10, p  < 0.05). Higher overall truth brand equity at wave 3 predicted less smoking at wave 4 and more positive anti-tobacco attitudes. Being male, younger, and non-white predicted some of the tobacco related attitudes. Future research should examine long-term effects of brand equity on tobacco use and how tobacco control can optimize the use of branding in campaigns.

Satellite Estimates of the Direct Radiative Forcing of Biomass Burning Aerosols Over South America and Africa

NASA Technical Reports Server (NTRS)

Christopher, Sundar A.; Wang, Min; Kliche, Donna V.; Berendes, Todd; Welch, Ronald M.; Yang, S.K.

1997-01-01

Atmospheric aerosol particles, both natural and anthropogenic are important to the earth's radiative balance. Therefore it is important to provide adequate validation information on the spatial, temporal and radiative properties of aerosols. This will enable us to predict realistic global estimates of aerosol radiative effects more confidently. The current study utilizes 66 AVHRR LAC (Local Area Coverage) and coincident Earth Radiation Budget Experiment (ERBE) images to characterize the fires, smoke and radiative forcings of biomass burning aerosols over four major ecosystems of South America.

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.

Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal Demographic and Health Survey-2006.

PubMed

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Harsha Kumar, Hn; Sathian, Brijesh; Arokiasamy, John T

2011-12-20

Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use. A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant. Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas. Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions.

Chronic illness histories of adults entering treatment for co-occurring substance abuse and other mental health disorders.

PubMed

Chesher, Nicholas J; Bousman, Chad A; Gale, Maiken; Norman, Sonya B; Twamley, Elizabeth W; Heaton, Robert K; Everall, Ian P; Judd, Patricia A

2012-01-01

Little is known about the medical status of individuals entering treatment for co-occurring substance abuse and other mental disorders (COD). We analyzed the medical histories of 169 adults entering outpatient treatment for CODs, estimating lifetime prevalence of chronic illness and current smoking, comparing these rates to the general population, and examining psychiatric and substance-related correlates of chronic illness. Results revealed significantly higher prevalence of hypertension, asthma, arthritis, and smoking compared to the general US population, and showed an association between chronic illness and psychiatric symptom distress and substance use severity. Findings support integration of chronic illness management into COD treatment.  Copyright © American Academy of Addiction Psychiatry.

Measuring visual exposure to smoking behaviours: a viewshed analysis of smoking at outdoor bars and cafés across a capital city's downtown area.

PubMed

Pearson, Amber L; Nutsford, Daniel; Thomson, George

2014-04-06

The influence of visual exposure to health-related behaviours, such as smoking, is increasingly acknowledged in the public health literature. Social contagion or normalisation is thought to operate through the visibility of those behaviours. There has been a lack of systematic and comprehensive approaches to quantifying visual exposure to these behaviours over a relatively large geographic area. We describe the novel application of a geographic tool, viewshed analysis, to estimate visual exposure to smoking outside bars/cafés across a downtown area. Smoking was observed for different times and days of the week at 14 outdoor areas of bars/cafés throughout downtown Wellington, New Zealand. We used these data to extrapolate to other bars/cafés with outdoor seating. We then conducted viewshed analyses to estimate visual exposure to smoking at bars/cafés for all public outdoor spaces. We observed a smoking point prevalence of 16%. Visibility analyses indicated that estimated visible smoking was highest in the evenings (7-8 pm), where the average values across Wednesday and Friday ranged from zero up to 92 visible smokers (mean=1.44). Estimated visible smoking at midday ranged from zero to 13 (mean=0.27). Values were also higher at the end of the week compared with midweek in the evening. Maps indicate that streets with high levels of retail shops and hospitality areas had high values of estimated visible smokers, particularly in the evening where numbers were consistently above 50. This paper highlights a useful method for measuring the extent of visual exposure to smoking behaviours across relatively large areas using a geospatial approach. Applying this method in other locations would require consideration of place-specific characteristics which impact on visibility and could be improved through more sophisticated extrapolation of observational data across the study area. The findings of this and similar research could ultimately support the expansion of smokefree public spaces.

[Mortality cost of smoking in Spain].

PubMed

Cobacho Tornel, Ma Belén; López Nicolás, Angel; Ramos Parreño, José María

2010-01-01

Public policies are crucial for smoking prevention and improving health among the population. Despite the positive impact in Spain of the law for smoking prevention in 2006, there is room for further improvement in this area of public policy. The estimate of the mortality cost per pack of cigarretes is a crucial factor in cost-benefit analysis for policies aimed to reducing smoking induced mortality. The aim of this paper is twofold. First, we estimate the Value of Statistical Life (VSL) among Spanish smokers. Secondly, we quantify the mortality cost of smoking. We use a hedonic wage model to quantify the marginal value of an increase in the mortality risk in monetary terms. We estimate the model for the Spanish labour market using the European Community Household Data and the Encuesta de Accidentes de Trabajo from the Ministerio de Trabajo e Inmigración. We estimate a VSL of 3.78 million Euros for Spanish smokers. Using this value, in conjunction with the increase in the mortality risk over the life cycle due to smoking, the private mortality cost of smoking is 78 Euros per pack for men, and 54 Euros per pack for women (in 2000 Euros). The mortality cost per pack of cigarettes is highly above its market price.

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.

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.

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.

[Application of Competing Risks Model in Predicting Smoking Relapse Following Ischemic Stroke].

PubMed

Hou, Li-Sha; Li, Ji-Jie; Du, Xu-Dong; Yan, Pei-Jing; Zhu, Cai-Rong

2017-07-01

To determine factors associated with smoking relapse in men who survived from their first stroke. Data were collected through face to face interviews with stroke patients in the hospital, and then repeated every three months via telephone over the period from 2010 to 2014. Kaplan-Meier method and competing risk model were adopted to estimate and predict smoking relapse rates. The Kaplan-Meier method estimated a higher relapse rate than the competing risk model. The four-year relapse rate was 43.1% after adjustment of competing risk. Exposure to environmental tobacco smoking outside of home and workplace (such as bars and restaurants) ( P =0.01), single ( P <0.01), and prior history of smoking at least 20 cigarettes per day ( P =0.02) were significant predictors of smoking relapse. When competing risks exist, competing risks model should be used in data analyses. Smoking interventions should give priorities to those without a spouse and those with a heavy smoking history. Smoking ban in public settings can reduce smoking relapse in stroke patients.

Smoking in Movies and Increased Smoking Among Young Adults

PubMed Central

Song, Anna V.; Ling, Pamela M.; Neilands, Torsten B.; Glantz, Stanton A.

2010-01-01

Objective This study assessed whether smoking in the movies was associated with smoking in young adults. Methods A national web-enabled cross-sectional survey of 1528 young adults, aged 18–25, was performed between September and November 2005. Logistic regression and path analysis using probit regression were used to assess relationships between exposure to smoking in the movies and smoking behavior. Analysis was completed in December 2006. Results Exposure to smoking in the movies predicted current smoking. The adjusted odds of current smoking increased by a factor of 1.21 for each quartile increase in exposure to smoking (p<0.01) in the movies, reaching 1.77 for the top exposure quartile. The unadjusted odds of established smoking (100+ cigarettes with current smoking) increased by 1.23 per quartile (p<0.001) of exposure, reaching 1.86 for the top quartile. This effect on established smoking was mediated by two factors related to smoking in the movies: positive expectations about smoking and exposure to friends and relatives who smoked, with positive expectations accounting for about two thirds of the effect. Conclusions The association between smoking in the movies and young adult smoking behavior exhibited a dose–response relationship; the more a young adult was exposed to smoking in the movies, the more likely he or she would have smoked in the past 30 days or have become an established smoker. PMID:17950405

Smoking in movies and increased smoking among young adults.

PubMed

Song, Anna V; Ling, Pamela M; Neilands, Torsten B; Glantz, Stanton A

2007-11-01

This study assessed whether smoking in the movies was associated with smoking in young adults. A national web-enabled cross-sectional survey of 1528 young adults, aged 18-25, was performed between September and November 2005. Logistic regression and path analysis using probit regression were used to assess relationships between exposure to smoking in the movies and smoking behavior. Analysis was completed in December 2006. Exposure to smoking in the movies predicted current smoking. The adjusted odds of current smoking increased by a factor of 1.21 for each quartile increase in exposure to smoking (p<0.01) in the movies, reaching 1.77 for the top exposure quartile. The unadjusted odds of established smoking (100+ cigarettes with current smoking) increased by 1.23 per quartile (p<0.001) of exposure, reaching 1.86 for the top quartile. This effect on established smoking was mediated by two factors related to smoking in the movies: positive expectations about smoking and exposure to friends and relatives who smoked, with positive expectations accounting for about two thirds of the effect. The association between smoking in the movies and young adult smoking behavior exhibited a dose-response relationship; the more a young adult was exposed to smoking in the movies, the more likely he or she would have smoked in the past 30 days or have become an established smoker.

Comparison of the effects of the US Clean Air Act and of smoking prevention and cessation efforts on the risk of acute myelogenous leukemia.

PubMed

Goldstein, Bernard D; Liu, Yan; Wu, Felicia; Lioy, Paul

2011-12-01

We used 2 approaches based on published information to compare the impacts on leukemia incidence and benzene exposure of the 1990 US Clean Air Act (CAA) amendments and smoking prevention and cessation efforts. We extrapolated leukemia mortality related to community air pollution levels and to cigarette smoking from data from the US Environmental Protection Agency and the US Surgeon General. We also estimated relative decline in total exposures to benzene (a known human leukemogen) owing to the CAA amendments and to smoking prevention and cessation efforts. We estimated that because of the CAA, there will be approximately 300 fewer leukemia deaths in the United States during the period 2000 through 2020. During the closest comparable period (1987-2007), we estimated that decline in cigarette smoking led to 7120 fewer leukemia deaths, of which 1282 to 3702 were attributable to benzene. Similarly, the decline in smoking led to about a tenfold greater decrease in total-population benzene exposure than did the 1990 CAA amendments. Both the CAA and smoking cessation activities contribute to a decrease in leukemia incidence. Smoking cessation activities have had a greater effect in the past.

The economic burden of smoking-related disease in Thailand: a prevalence-based analysis.

PubMed

Leartsakulpanitch, Jittrakul; Nganthavee, Wimol; Salole, Eugene

2007-09-01

To estimate the direct out-of-pocket medical costs of treating major diseases attributable to smoking in Thailand in 2006. A prevalence-based, disease-specific, approach was used to estimate the direct medical costs of treating lung cancer, chronic obstructive pulmonary disease (COPD), and coronary heart disease (CHD) attributable to smoking. Epidemiological parameters were obtained from the literature; historical out-of-pocket cost data were used to estimate 2006 expenditure. The number of cases attributable to smoking in 2006 was 5,299 for lung cancer, 624,309 for COPD, and 52,605 for CHD. The out-of-pocket expenditures for treatment were 368.49 million baht for lung cancer, 7,714.88 million baht for COPD, and 1,773.65 million baht for CHD. Total smoking-attributable out-of-pocket medical costs amounted to 9,857.02 million baht, 0.48% of GDP in 2006. The prevalence-based, disease-specific, analysis described here shows that the health and economic impact of smoking in Thailand are substantial, and should be reduced by implementing smoking-cessation and related tobacco control policies of the types found effective in reducing the prevalence of smoking in other countries.

Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in Lima, Peru

PubMed Central

2012-01-01

Background Tobacco smoking is an important public health concern worldwide leading to both chronic disease and early death. In Latin America, smoking prevalence is estimated at approximately 30% and prior studies suggest that the prevalence in Peru is 22% to 38%. We sought to determine the prevalence of daily smoking in a poor peri-urban community in Lima, Peru. Methods We conducted a cross-sectional survey in a random sample of adults ≥40 years of age living in Pampas de San Juan de Miraflores, Lima, Peru. We asked participants to respond to a survey that included questions on sociodemographics, tobacco use and dependence. Results We enrolled 316 participants. Average monthly household income was ≤ 400 USD and nearly all homes had running water, sewage, and electricity. Most individuals had not completed high school. Smoking prevalence was 16% overall, yet daily smoking prevalence was 1.9%. Former daily smokers comprised 3.8% of current nonsmokers and 9.1% current occasional smokers. Average scores for the Fagerstrom Test for Nicotine Dependence for daily smokers and occasional smokers were 1.5 and 0, respectively. Conclusions Daily use of tobacco is uncommon among adults in peri-urban communities of Lima, Peru, unlike their counterparts in Lima and other Latin American capital cities. Tobacco dependence is also low. Hence, efforts aimed at primary prevention are of utmost importance in these communities. This study provides an accurate baseline using an internationally recognized assessment tool (Global Adult Tobacco Survey), allowing for accurate assessment of tobacco control interventions over time. PMID:22429737

Epidemiology of tobacco use and dependence in adults in a poor peri-urban community in Lima, Peru.

PubMed

Weygandt, Paul Logan; Vidal-Cardenas, Elisa; Gilman, Robert H; Avila-Tang, Erika; Cabrera, Lilia; Checkley, William

2012-03-19

Tobacco smoking is an important public health concern worldwide leading to both chronic disease and early death. In Latin America, smoking prevalence is estimated at approximately 30% and prior studies suggest that the prevalence in Peru is 22% to 38%. We sought to determine the prevalence of daily smoking in a poor peri-urban community in Lima, Peru. We conducted a cross-sectional survey in a random sample of adults ≥40 years of age living in Pampas de San Juan de Miraflores, Lima, Peru. We asked participants to respond to a survey that included questions on sociodemographics, tobacco use and dependence. We enrolled 316 participants. Average monthly household income was ≤ 400 USD and nearly all homes had running water, sewage, and electricity. Most individuals had not completed high school. Smoking prevalence was 16% overall, yet daily smoking prevalence was 1.9%. Former daily smokers comprised 3.8% of current nonsmokers and 9.1% current occasional smokers. Average scores for the Fagerstrom Test for Nicotine Dependence for daily smokers and occasional smokers were 1.5 and 0, respectively. Daily use of tobacco is uncommon among adults in peri-urban communities of Lima, Peru, unlike their counterparts in Lima and other Latin American capital cities. Tobacco dependence is also low. Hence, efforts aimed at primary prevention are of utmost importance in these communities. This study provides an accurate baseline using an internationally recognized assessment tool (Global Adult Tobacco Survey), allowing for accurate assessment of tobacco control interventions over time.

The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep.

PubMed

Sabanayagam, Charumathi; Shankar, Anoop

2011-01-01

Studies have shown that cigarette smoking is associated with sleep disorders in the general population. But studies examining the association between smokeless tobacco use, second-hand smoke exposure and insufficient rest/sleep are limited. We examined the association between smoking, smokeless tobacco use (n=83,072), second-hand smoke exposure (n=28,557) and insufficient rest/sleep among adults aged ≥20 years in the state-based 2008 Behavioral Risk Factor Surveillance System. Exposure to second-hand smoke was defined as >1 day of exposure to cigarette smoking either at home or in the workplace in the preceding 7 days. Insufficient rest/sleep was defined as not getting enough rest/sleep everyday in the preceding 30 days. Compared to never smokeless tobacco users, the odds ratio (OR; 95% confidence interval [CI]) of insufficient rest/sleep was 1.16 (1.00-1.36) and 1.74 (1.37-2.22) among former and current users. Compared to non-smokers/non-smokeless tobacco users, the OR (95% CI) of insufficient rest/sleep for those who were both current smokers and current smokeless tobacco users was 2.21 (1.66-2.94). Regarding second-hand smoke exposure among non-smokers, those with second-hand smoke exposure had higher odds for insufficient rest/sleep than those without. In contrast, the odds of insufficient rest/sleep were similar among current smokers with or without second-hand smoke exposure. In a multiethnic sample of US adults, compared to non-smokers/non-smokeless tobacco users, those who were both current smokers and current smokeless tobacco users had twice the odds of insufficient sleep. Second-hand smoke exposure was associated with insufficient rest/sleep among non-smokers. Copyright © 2010 Elsevier B.V. All rights reserved.

Socioeconomic and Geographic Patterning of Smoking Behaviour in Canada: A Cross-Sectional Multilevel Analysis

PubMed Central

Corsi, Daniel J.; Lear, Scott A.; Chow, Clara K.; Subramanian, S. V.; Boyle, Michael H.; Teo, Koon K.

2013-01-01

Objective To describe the socioeconomic and geographic distribution of smoking behaviour in Canada among 19,383 individuals (51% women) aged 15–85 years. Methods Current smoking and quitting were modeled using standard and multilevel logistic regression. Markers of socioeconomic status (SES) were education and occupation. Geography was defined by Canadian Provinces. Results The adjusted prevalence of current smoking was 20.2% (95% confidence interval [CI]: 18.8–21.7) and 63.7% (95% CI: 61.1–66.3) of ever smokers had quit. Current smoking decreased and quitting increased with increasing SES. The adjusted prevalence of current smoking was 32.8% (95% CI: 28.4–37.5) among the least educated compared to 11.0% (95% CI: 8.9–13.4) for the highest educated. Among the least educated, 53.0% (95% CI: 46.8–59.2) had quit, rising to 68.7% (95% CI: 62.7–74.1) for the most educated. There was substantial variation in current smoking and quitting at the provincial level; current smoking varied from 17.9% in British Columbia to 26.1% in Nova Scotia, and quitting varied from 57.4% in Nova Scotia to 67.8% in Prince Edward Island. Nationally, increasing education and occupation level were inversely associated with current smoking (odds ratio [OR] 0.64, 95% CI: 0.60–0.68 for education; OR 0.82, 95% CI: 0.77–0.87 for occupation) and positively associated with quitting (OR 1.27, 95% CI: 1.16–1.40 for education; OR 1.20, 95% CI: 1.12–1.27 for occupation). These associations were consistent in direction across provinces although with some variability in magnitude. Conclusion Our findings indicate that socioeconomic inequalities in smoking have persisted in Canada; current smoking was less likely and quitting was more likely among the better off groups and in certain provinces. Current prevention and cessation policies have not been successful in improving the situation for all areas and groups. Future efforts to reduce smoking uptake and increase cessation in Canada will need consideration of socioeconomic and geographic factors to be successful. PMID:23469038

What factors are associated with current smokers using or stopping e-cigarette use?

PubMed

Simonavicius, Erikas; McNeill, Ann; Arnott, Deborah; Brose, Leonie S

2017-04-01

While some smokers use e-cigarettes and stop smoking, a substantial proportion try e-cigarettes and later discontinue or use them concurrently with smoking (current dual users). The aim was to assess factors associated with ongoing e-cigarette use and discontinuation among smokers. Secondary analysis of data of 1489 currently smoking adults, 18 and above, from a GB population-based online survey conducted in March 2016. A multivariable logistic regression assessed motivation to stop smoking among never e-cigarette users, past triers (

Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010–2012)

PubMed Central

Yu, Bin; Chen, Xinguang; Varma, Deepthi S; Li, Juanjuan; Zhao, Jiang; Ruan, Yuan; Han, Xingmeng; Min, Xiangdong; Liu, Zhitao

2018-01-01

Objective This study aims to understand the age patterns of smoking initiation during adolescence and young adulthood in South-West China, where the prevalence of tobacco use is reported as the highest in the country. Design A cross-sectional study. Setting The data were derived from the China National Nutrition and Health Survey in Yunnan Province, South-West China (2010–2012). Participants A total of 4801 participants aged 15–65 years were included. Primary outcome measures A survival model was used to estimate the hazard of smoking initiation by age and log-rank test was used to compare the hazard curves across subgroups (men/women, urban/rural, Han Chinese/ethnic minority). Results The prevalence of current smoking among men and women were 60.4% (95% CI 58.2% to 62.6%) and 5.1% (95% CI 4.3% to 5.9%), respectively. Smoking was more prevalent among men and women of lower education and less income, as well as rural and ethnic minority women. Among the current smokers, cigarette (80.7%) was the most commonly used tobacco product, followed by waterpipe (10.8%) and pipe tobacco (8.5%). The hazards of smoking initiation were low for both men and women before the age of 15 years (1% for men and 0.05% for women); and the hazards increased quickly from age 15 years and peaked at 19years (21.5% for men and 1.0% for women). Rural and ethnic minority women were at higher risk of smoking initiation than their counterparts between 15 years and 19 years of age (χ2=44.8, p<0.01; χ2=165.2, p<0.01) and no such difference was found in men. Conclusions Findings of this study underscore the importance to implement tobacco prevention interventions among older teens and young adults in South-West China, especially for rural and ethnic minority women. PMID:29858407

The association between exposure to tobacco coupons and predictors of smoking behaviors among US youth

PubMed Central

Choi, Kelvin

2015-01-01

Introduction A recent report showed that 13.1% of US middle and high school students were exposed to tobacco coupons in the past 30 days in 2012. The current study reanalyzed data from the National Youth Tobacco Survey 2012 to examine the associations between exposure to tobacco coupons in the past 30 days and predictors of smoking among US youth by smoking status. Methods 24658 middle and high school students were asked if and where they had received tobacco coupons in the past 30 days. Demographics, smoking behaviors, smoking-related beliefs, susceptibility to smoking, and confidence in quitting smoking were assessed. Analyses were stratified by smoking status (never smokers, experimenters, and current smokers). Data were weighted to be representative of US youth. Results Exposure to tobacco coupons was associated with lower likelihood of denying the social benefits of cigarette smoking and believing all tobacco products are dangerous, higher likelihood of being susceptible to smoking (among non-smokers), lower likelihood to feel confident in quitting cigarettes completely (among current smokers) and higher likelihood to intend to purchase cigarettes in the next 30 days (among experimenters and current smokers; p < 0.05). Conclusions Tobacco coupons may promote smoking and hinder smoking cessation among youth. Regulating tobacco coupons may reduce youth smoking in the US. Further research is needed to determine the effect of tobacco coupons on youth tobacco use globally. PMID:25882686

Carboxyhaemoglobin levels and inhaling habits in cigarette smokers.

PubMed Central

Wald, N; Idle, M; Bailey, A

1978-01-01

In 520 men who currently smoked only cigarettes, carboxyhaemoglobin (COHb) levels were measured as a method of estimating the extent to which cigarette smoke was inhaled and the results were compared with the smokers' own assessment of their inhaling habits. The mean COHb level after standardising for the number of cigarettes smoked before the blood test on the day of the test was 4.0% in self-described non-inhalers. This was much higher than the mean level of 0.7% in 1891 similar non-smokers, but not very different from the standardised mean levels of 5.2%, 5.3%, and 5.6% in men who said they inhaled slightly, moderately, or deeply, respectively. The increasing trend in the COHb levels of men in the four self-described inhaling categories (nil to deep) was small but statistically highly significant. The data from this study may help to explain some of the anomalous epidemiological results regarding the relationship between self-described inhaling habits and the development of diseases associated with smoking, such as coronary heart disease and lung cancer. PMID:663879

Cigarette smoking and telomere length: A systematic review of 84 studies and meta-analysis.

PubMed

Astuti, Yuliana; Wardhana, Ardyan; Watkins, Johnathan; Wulaningsih, Wahyu

2017-10-01

Cigarette smoking is a risk factor for ageing-related disease, but its association with biological ageing, indicated by telomere length, is unclear. We systematically reviewed evidence evaluating association between smoking status and telomere length. Searches were performed in MEDLINE (Ovid) and EMBASE (Ovid) databases, combining variation of keywords "smoking" and "telomere". Data was extracted for study characteristics and estimates for association between smoking and telomere length. Quality of studies was assessed with a risk of bias score, and publication bias was assessed with a funnel plot. I 2 test was used to observe heterogeneity. Meta-analysis was carried out to compare mean difference in telomere length by smoking status, and a dose-response approach was carried out for pack-years of smoking and telomere length. A sensitivity analysis was carried out to examine sources of heterogeneity. A total of 84 studies were included in the review, and 30 among them were included in our meta-analysis. Potential bias was addressed in half of included studies, and there was little evidence of small study bias. Telomere length was shorter among ever smokers compared to never smokers (summary standard mean difference [SMD]: -0.11 (95% CI -0.16 to -0.07)). Similarly, shorter telomere length was found among smokers compared to non-smokers, and among current smokers compared to never or former smokers. Dose-response meta-analysis suggested an inverse trend between pack-years of smoking and telomere length. However, heterogeneity among some analyses was observed. Shorter telomeres among ever smokers compared to those who never smoked may imply mechanisms linking tobacco smoke exposure to ageing-related disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Are tobacco control policies effective in reducing young adult smoking?

PubMed

Farrelly, Matthew C; Loomis, Brett R; Kuiper, Nicole; Han, Beth; Gfroerer, Joseph; Caraballo, Ralph S; Pechacek, Terry F; Couzens, G Lance

2014-04-01

We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. We use a natural experimental design approach that uses the variation in tobacco control policies across states and over time to understand their influence on tobacco outcomes. We combine individual outcome data with annual state-level policy data to conduct multivariable logistic regression models, controlling for an extensive set of sociodemographic factors. The participants are 18- to 25-year-olds from the 2002-2009 National Surveys on Drug Use and Health. The three main outcomes are past-year smoking initiation, and current and established smoking. A current smoker was one who had smoked on at least 1 day in the past 30 days. An established smoker was one who had smoked 1 or more cigarettes in the past 30 days and smoked at least 100 cigarettes in his or her lifetime. Higher levels of tobacco control program funding and greater smoke-free-air law coverage were both associated with declines in current and established smoking (p < .01). Greater coverage of smoke-free air laws was associated with lower past year initiation with marginal significance (p = .058). Higher cigarette prices were not associated with smoking outcomes. Had smoke-free-air law coverage and cumulative tobacco control funding remained at 2002 levels, current and established smoking would have been 5%-7% higher in 2009. Smoke-free air laws and state tobacco control programs are effective strategies for curbing young adult smoking. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Are Tobacco Control Policies Effective in Reducing Young Adult Smoking?

PubMed Central

Farrelly, Matthew C.; Loomis, Brett R.; Kuiper, Nicole; Han, Beth; Gfroerer, Joseph; Caraballo, Ralph S.; Pechacek, Terry F.; Couzens, G. Lance

2015-01-01

Purpose We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. Methods We use a natural experimental design approach that uses the variation in tobacco control policies across states and over time to understand their influence on tobacco outcomes. We combine individual outcome data with annual state-level policy data to conduct multivariable logistic regression models, controlling for an extensive set of sociodemographic factors. The participants are 18- to 25-year-olds from the 2002–2009 National Surveys on Drug Use and Health. The three main outcomes are past-year smoking initiation, and current and established smoking. A current smoker was one who had smoked on at least 1 day in the past 30 days. An established smoker was one who had smoked 1 or more cigarettes in the past 30 days and smoked at least 100 cigarettes in his or her lifetime. Results Higher levels of tobacco control program funding and greater smoke-free-air law coverage were both associated with declines in current and established smoking (p < .01). Greater coverage of smoke-free air laws was associated with lower past year initiation with marginal significance (p = .058). Higher cigarette prices were not associated with smoking outcomes. Had smoke-free-air law coverage and cumulative tobacco control funding remained at 2002 levels, current and established smoking would have been 5%–7% higher in 2009. Conclusions Smoke-free air laws and state tobacco control programs are effective strategies for curbing young adult smoking. PMID:24268360

Little Cigars and Cigarillos Use Among Young Adult Cigarette Smokers in the United States: Understanding Risk of Concomitant Use Subtypes

PubMed Central

Fryer, Craig S.; Pagano, Ian; Fagan, Pebbles

2016-01-01

Introduction: In 2016, the Food and Drug Administration announced that it would regulate little cigars and cigarillos (LCCs) and expressed concern about the concomitant use of combustible tobacco products. To understand LCC use among socially-disadvantaged cigarette smokers, we assessed (1) the prevalence of concomitant use of subtypes of LCCs: LCC-tobacco, LCC-blunt, and LCC- poly use, which includes use of both LCC-tobacco and LCC-blunt and (2) and its association with sociodemographic factors and substance use behaviors using race/ethnicity and gender stratified models. Methods: In 2015, a web-based survey was administered to a national probability sample of black/African American, Hispanic/Latino, and white cigarette smokers aged 18–44 (n = 1018). Weighted estimates were used to assess current LCC-tobacco, LCC-blunt, and LCC-poly use. Multinomial regression models assessed sociodemographic, other tobacco and substance use correlates associated with LCC user subtypes. Results: Of cigarette smokers, 63% did not smoke LCCs; 15.1% were LCC-tobacco users; 11.1% were LCC-blunt users; and 10.5% were LCC-poly users. Black/African American and Hispanic/Latino cigarette smokers had higher odds of LCC-tobacco, LCC-blunt, and LCC-poly use compared to white cigarette smokers. Blacks/African Americans who initiated cigarette smoking before age 18 and smoked other tobacco products had greater odds of LCC-tobacco use than whites. Male cigarette smokers who smoked other tobacco products and females who had early onset of cigarette use also had greater odds of LCC-tobacco use. Conclusions: Over 30% of cigarette smokers concomitantly used LCCs, which may prolong smoking. Accurate estimates of diverse LCC use behaviors may increase our understanding of the potential harms of concomitant use. Implications: Aggregate measures of LCC smoking do not distinguish subtypes of use among socially-disadvantaged cigarette smokers (ie, young adults, blacks/African Americans, Hispanics/Latinos), who may engage in these unique smoking behaviors. We document the prevalence of young adult cigarette smokers who dual use LCC-tobacco and LCC-blunts and are poly users of LCC-tobacco + LCC-blunts, and identify sociodemographic groups at risk for use. The Food and Drug Administration is concerned about concomitant behavior, which may increase chronic disease risk and addiction. Accurate estimates of LCC smoking behaviors may increase our understanding of the harms of concomitant use; which can inform prevention programs that specifically target LCC subtypes. PMID:27613889

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

Prevalence of invehicle smoking and secondhand smoke exposure in Uruguay.

PubMed

Llambi, Laura; Barros, Mary; Parodi, Carolina; Pippo, Antonella; Nunez, Virginia; Colomar, Mercedes; Ciganda, Alvaro; Cavalleri, Fiorella; Goyeneche, Juan J; Aleman, Alicia

2018-01-19

Protection from secondhand smoke (SHS) is one of the fundamental principles of the WHO Framework Convention for Tobacco Control. Objective data on SHS exposure in vehicles in South America is scarce. This study aimed to estimate prevalence of smoking inside vehicles. The point prevalence of smoking in vehicles was observed, and a method for estimating smoking prevalence was piloted. We observed 10 011 vehicles. In 219 (2.2%; 95% CI 1.91 to 2.49) of them, smoking was observed, and in 29.2% of these, another person was exposed to SHS. According to the 'expansion factor' we constructed, direct observation detected one of six to one to nine vehicles in which smoking occurred. The observed prevalence of smoking in vehicles (2.2%) could reflect a real prevalence between 12% and 19%. In 29.2% (95% CI 23.6 to 35.5) and 4.6% (95% CI 2.2 to 8.3) of vehicles in which smoking was observed, another adult or a child, respectively, was exposed to SHS. Smoking was estimated to occur in 12%-19% of vehicles, with involuntary exposure in one of three of vehicles observed. These data underscore a need for new public policies to eliminate SHS in vehicles to protect public health. © 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.

Cognitive dissonance towards the smoking habit among nursing and physiotherapy students at the University of Balearic Islands in Spain.

PubMed

Pericas, J; González, S; Bennasar, M; De Pedro, J; Aguiló, A; Bauzá, L

2009-03-01

To estimate the prevalence of tobacco smoking among physiotherapy and nursing students at the University of the Balearic Islands in Spain and to describe their perceptions, attitude and behaviour towards smoking and towards the Spanish Smoking Prevention Act. Active smoking is the first avoidable cause of death in the world while passive smoking is the third. The tobacco epidemic kills 5.4 million people a year from lung cancer, heart disease and other related illnesses. In Europe, around one-third of the Community population are smokers, with about 650,000 smoking-related deaths per year in the Community. In Spain, 56,000 people a year are estimated to die from tobacco-related illnesses. An observational, cross-sectional, descriptive study, with a sample of 345 out of 645 students (53.5% participation rate) who completed an anonymous, self-administered, standardized survey devised by the World Health Organization. The study revealed a 26.1% prevalence of tobacco smoking (26.9% among women and 22.6% among men), which is similar to percentages of students at other Spanish universities. Smokers and non-smokers reported many differences in attitude and behaviour, some of which have potential repercussions in their career, such as in estimating the harmful effects of tobacco smoke or the status of health professionals as role models in the society they serve. The results of this study will contribute to develop an anti-smoking programme at the university and to establish smoking-prevention campaigns.

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.

Smoke and Mirrors: The Perceived Benefits of Continued Tobacco use Among Current Smokers

PubMed Central

Klein, Hugh; Sterk, Claire E.; Elifson, Kirk W.

2014-01-01

Despite 50+ years of public health efforts to reduce smoking rates in the United States, approximately one-fifth of the adults living in this country continue to smoke cigarettes. Previous studies have examined smokers’ risk perceptions of cigarette smoking, as well as the perceived benefits of quitting smoking. Less research has focused on the perceived benefits of smoking among current cigarette smokers. The latter is the main focus of the present paper. Questionnaire-based interviews were conducted with a community-based sample of 485 adult current cigarette smokers recruited from the Atlanta, Georgia, metropolitan area between 2004 and 2007. Active and passive recruiting approaches were used, along with a targeted sampling strategy. Results revealed that most current cigarette smokers perceive themselves to experience benefits as a result of their cigarette use, including (among others) increased relaxation, diminished nervousness in social situations, enjoyment of the taste of cigarettes when smoking, and greater enjoyment of parties when smoking. Perceiving benefits from cigarette smoking was associated with a variety of tobacco use measures, such as smoking more cigarettes, an increased likelihood of chain smoking, and overall negative attitude toward quitting smoking, among others. Several factors were associated with the extent to which smokers perceived themselves to benefit from their tobacco use, including education attainment, the age of first purchasing cigarettes, the proportion of friends who smoked, hiding smoking from others, being internally-oriented regarding locus of control, and self-esteem. PMID:26973934

What Factors Influence Smoking Prevalence and Smoke Free Policy Enactment across the European Union Member States

PubMed Central

Bogdanovica, Ilze; McNeill, Ann; Murray, Rachael; Britton, John

2011-01-01

Background Smoking prevention should be a primary public health priority for all governments, and effective preventive policies have been identified for decades. The heterogeneity of smoking prevalence between European Union (EU) Member States therefore reflects, at least in part, a failure by governments to prioritise public health over tobacco industry or possibly other financial interests, and hence potentially government corruption. The aims of this study were to test the hypothesis that smoking prevalence is higher in countries with high levels of public sector corruption, and explore the ecological association between smoking prevalence and a range of other national characteristics in current EU Member States. Methods Ecological data from 27 EU Member States were used to estimate univariate and multivariate correlations between smoking prevalence and the Transparency International Corruption Perceptions Index, and a range of other national characteristics including economic development, social inclusion, quality of life and importance of religion. We also explored the association between the Corruption Perceptions Index and measures of the extent to which smoke-free policies have been enacted and are enforced. Results In univariate analysis, smoking prevalence was significantly higher in countries with higher scores for corruption, material deprivation, and gender inequality; and lower in countries with higher per capita Gross Domestic Product, social spending, life satisfaction and human development scores. In multivariate analysis, only the corruption perception index was independently related to smoking prevalence. Exposure to tobacco smoke in the workplace was also correlated with corruption, independently from smoking prevalence, but not with the measures of national smoke-free policy implementation. Conclusions Corruption appears to be an important risk factor for failure of national tobacco control activity in EU countries, and the extent to which key tobacco control policies have been implemented. Further research is needed to assess the causal relationships involved. PMID:21909375

Determinants of smoking-induced deprivation in China

PubMed Central

Yao, Tingting; Huang, Jidong; Sung, Hai-Yen; Ong, Michael K; Mao, Zhengzhong; Jiang, Yuan; Fong, Geoffrey T; Max, Wendy

2015-01-01

Objective Spending on cigarettes may deprive households of other items like food. The goal of this study was to examine the prevalence of and factors associated with this smoking-induced deprivation among adult smokers in China. Methods The data came from waves 1–3 of the International Tobacco Control (ITC) China Survey, conducted from 2006 to 2009 among urban adults aged 18 years or older in China. We focus on the samples of current smokers from six cities (N=7981). Smoking-induced deprivation was measured with the survey question, “In the last six months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?” We examined whether sociodemographic factors, smoking intensity and price paid per pack of cigarettes were associated with smoking-induced deprivation using generalised estimating equations modelling. Findings 7.3% of smokers reported smoking-induced deprivation due to purchasing cigarettes. Low-income and middle-income smokers were more likely to have smoking-induced deprivation compared with high-income smokers (adjusted OR (AOR)=2.06, 95% CI 1.32 to 2.31; AOR=1.44, 95% CI 1.10 to 1.69); smokers living in Shenyang (AOR=1.68, 95% CI 1.25 to 2.24) and Yinchuan (AOR=2.50, 95% CI 1.89 to 3.32) were more likely to have smoking-induced deprivation compared with smokers living in Beijing. Retired smokers were less likely to have smoking-induced deprivation compared with employed smokers (AOR=0.67, 95% CI 0.52 to 0.87). There was no statistically significant relationship between smoking intensity, price paid per pack of cigarettes and smoking-induced deprivation. Conclusions Our findings indicate that certain groups of smokers in China acknowledge spending money on cigarettes that could be better spent on household essentials. Tobacco control policies that reduce smoking in China may improve household living standards by reducing smoking-induced deprivation. PMID:24827978

Tobacco consumption among pediatric residents in Argentina. Current prevalence and trend over the past 10 years.

PubMed

Gigliotti, Emiliano; Ferrero, Fernando; Castaños, Claudio; Blengini, María Teresa; Durán, Pablo; Moreno, Laura

2013-01-01

Pediatricians are in a strategic position to prevent smoking. To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients' or their parents' smoking were evaluated; results were compared to those obtained in 2002. Out of 448 surveyed physicians, 20.1% smoked. There were no significant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95% CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95% CI: 0.34-0.96; p = 0.03). Only 18.1% referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4% versus 26.1%; p < 0.01) and warned them against smoking (37.7% versus 18.6%; p < 0.01), and of those who received information on this topic during their training (63.6% versus 39.8%; p < 0.01). Among resident pediatricians, 20.1% were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of official policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.

The Disproportionate Cost of Smoking for African Americans in California

PubMed Central

Sung, Hai-Yen; Tucker, Lue-Yen; Stark, Brad

2010-01-01

Objectives. We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality. Methods. We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models. Results. Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49 000 years of life and $784 million in productivity. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars. Conclusions. Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community. PMID:19965569

The impact of taxation on tobacco consumption in Mexico.

PubMed

Jiménez-Ruiz, J A; Sáenz de Miera, B; Reynales-Shigematsu, L M; Waters, H R; Hernández-Avila, M

2008-04-01

The price of cigarettes to consumers in Mexico, and Latin America in general, remains low in comparison with other regions of the world. In Mexico, taxes represented 59% of the total price of cigarettes in 2006, compared to 75% or more in many high-income countries. The feasibility of raising taxes on cigarettes in Mexico--to both discourage consumption and increase revenues--is an important policy question. Using household survey data, we undertake a pooled cross-sectional analysis of the demand for cigarettes in Mexico. We use a two-part model to estimate the price elasticity of cigarettes. This model controls for the selection effect that arises from the fact that the impact of price on the decision to smoke or not is estimated using all households in the dataset. The results indicate that price is a significant factor in household decisions concerning smoking and the number of cigarettes smoked. Holding other factors constant, our simulations show that a 10% increase in the cigarette tax in Mexico--calculated as a percentage of the price--yields a 12.4% increase in the price to the consumer, a 6.4% decrease in consumption of cigarettes and a 15.7% increase in the revenue yielded by the tax. In Mexico, there are strong arguments for increasing cigarette taxes. Revenue raised could be used to further prevent tobacco consumption and to finance current funding shortages for the treatment of diseases related to smoking.

Smoking status and associated factors among male Chinese restaurant workers in metropolitan Sydney.

PubMed

Jiang, Wei; Leung, Brenda; Tam, Nancy; Xu, Huilan; Gleeson, Suzanne; Wen, Li Ming

2017-03-01

Issue addressed The smoking rate among male Chinese migrants in Australia is higher than among the general population. This study investigated the smoking rate of male Chinese restaurant workers in metropolitan Sydney, and explored factors associated with smoking and quitting. Methods A self-administered questionnaire survey was completed by Chinese workers in selected Chinese restaurants in metropolitan Sydney from October-December 2012. Eighty-nine Chinese restaurants were approached and 54 (61%) took part in the study. The questionnaire asked participants about their smoking status, knowledge of and attitudes to smoking and quitting as well as socio-demographic information. Multivariable logistic regression was built to assess the associated factors. Results Of the 382 participants who completed the survey, 171 (45%) were current smokers and 50% of current smokers wanted to quit smoking. Participants who spoke Mandarin, had lower English proficiency, did not realise environmental smoke harms children, did not prefer a smoke-free environment or had more than 50% of relatives or friends who smoked were more likely to be current smokers. Participants who were aged 18-29 years, did not understand the benefits of quitting smoking or did not prefer a smoke-free environment were less likely to want to quit. Conclusions Nearly 50% of male Chinese restaurant workers surveyed in this study were current smokers. Key factors associated with the participants' smoking or quitting status are: aged 18-29 years; speaking Mandarin; lower English literacy; and not knowing the dangers of smoking. So what? Tobacco control programs targetted at male Chinese restaurant workers that raise awareness of the harm caused by smoking and the benefits of quitting smoking are required to enhance intention to quit smoking within this population.

Current Tobacco Smoking and Desire to Quit Smoking Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 61 Countries, 2012-2015.

PubMed

Arrazola, René A; Ahluwalia, Indu B; Pun, Eugene; Garcia de Quevedo, Isabel; Babb, Stephen; Armour, Brian S

2017-05-26

Tobacco use is the world's leading cause of preventable morbidity and mortality, resulting in nearly 6 million deaths each year (1). Smoked tobacco products, such as cigarettes and cigars, are the most common form of tobacco consumed worldwide (2), and most tobacco smokers begin smoking during adolescence (3). The health benefits of quitting are greater for persons who stop smoking at earlier ages; however, quitting smoking at any age has health benefits (4). CDC used the Global Youth Tobacco Survey (GYTS) data from 61 countries across the six World Health Organization (WHO) regions from 2012 to 2015 to examine the prevalence of current tobacco smoking and desire to quit smoking among students aged 13-15 years. Across all 61 countries, the median current tobacco smoking prevalence among students aged 13-15 years was 10.7% (range = 1.7%, Sri Lanka to 35.0%, Timor-Leste). By sex, the median current tobacco smoking prevalence was 14.6% among males (range = 2.9%, Tajikistan to 61.4%, Timor-Leste) and 7.5% among females (range = 1.6%, Tajikistan to 29.0%, Bulgaria). In the majority of countries assessed, the proportion of current tobacco smokers who desired to quit smoking exceeded 50%. These findings could be used by country level tobacco control programs to inform strategies to prevent and reduce youth tobacco use (1,4).

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.

OLFACTORY DYSFUNCTION IN PARKINSON’S DISEASE: POSITIVE EFFECT OF CIGARETTE SMOKING

PubMed Central

Sharer, James D.; Leon-Sarmiento, Fidias E.; Morley, James F.; Weintraub, Daniel; Doty, Richard L.

2014-01-01

Background There is compelling evidence from over 60 epidemiological studies that smoking significantly reduces the risk of Parkinson’s disease (PD). In general, those who currently smoke cigarettes, as well as those with a past history of such smoking, have a reduced risk of PD compared to those who have never smoked. Recently it has been suggested that a cardinal non-motor sensory symptom of PD, olfactory dysfunction, may be less severe in PD patients who smoke than in PD patients who do not, in contrast to the negative effect of smoking on olfaction described in the general population. Methods We evaluated University of Pennsylvania Smell Identification Test (UPSIT) scores from 323 Parkinson’s patients and 323 controls closely matched individually on age, sex, and smoking history (never, past, current). Results The patients exhibited much lower UPSIT scores than did the controls (P<0.0001). The relative decline in dysfunction of the current PD smokers was less than that of the never- and past-PD smokers (respective Ps=0.0005 & 0.0019). The female PD patients outperformed their male counterparts by a larger margin than did the female controls (3.66 vs. 1.07 UPSIT points; respective Ps < 0.0001 & 0.06). Age-related declines in UPSIT scores were generally present (P < 0.0001). No association between the olfactory measure and smoking dose, as indexed by pack years, was evident. Conclusions PD patients who currently smoke do not exhibit the smoking-related decline in olfaction observed in non-PD control subjects who currently smoke. The physiologic basis of this phenomenon is yet to be defined. PMID:25545729

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.

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

Biopsychosocial Characteristics of Community-dwelling Older Adults with Limited Ability to Walk ¼ Mile

PubMed Central

Hardy, Susan E.; McGurl, David J.; Studenski, Stephanie A.; Degenholtz, Howard B.

2010-01-01

Objectives To establish nationally representative estimates of the prevalence of self-reported difficulty and inability to walk ¼ mile among older adults and to identify the characteristics independently associated with difficulty or inability to walk ¼ mile. Design Cross-sectional analysis of data from the 2003 Cost and Use Medicare Current Beneficiary Survey. Setting Community. Participants 9563 community-dwelling Medicare beneficiaries aged 65 years or older, representing an estimated total population of 34.2 million older adults. Measurements Self-reported ability to walk ¼ mile, sociodemographics, chronic conditions, body mass index, smoking, and functional status. Results In 2003, an estimated 9.5 million aged Medicare beneficiaries had difficulty walking ¼ mile and 5.9 million were unable. Among the 20.2 million older adults with no difficulty in basic or instrumental activities of daily living (ADL), an estimated 4.3 million (21%) had limited ability to walk ¼ mile. Having difficulty or being unable to walk ¼ mile was independently associated with older age, female sex, non-Hispanic ethnicity, lower educational level, Medicaid entitlement, most chronic medical conditions, current smoking, and being overweight or obese. Conclusion Almost half of older adults, and 20% of those reporting no ADL limitations, report limited ability to walk ¼ mile. Among functionally independent older adults, reported ability to walk ¼ mile can identify vulnerable older adults with greater medical problems and fewer resources, and may be a valuable clinical marker in planning their care. Future work is needed to determine the association between ¼ mile walk ability and subsequent functional decline and healthcare utilization. PMID:20210817

Satellite measurements of large-scale air pollution - Measurements of forest fire smoke

NASA Technical Reports Server (NTRS)

Ferrare, Richard A.; Kaufman, Yoram J.; Fraser, Robert S.

1990-01-01

The transport, optical properties, total mass, and removal of smoke produced by forest fires in western Canada during late July and early August 1982 are studied using NOAA 7 AVHRR data. Color composite imagery is produced to track the movement of the smoke over Canada and the U.S. as the smoke traveled thousands of km from the source region. Smoke optical thickness, particle size, and single scattering albedo are computed using radiances measured by AVHRR bands 1 and 2. Results show that smoke optical thickness ranged from less that 0.1 to greater than 3.7 and the geometric mean mass radii ranged from 300 to 900 nm. The smoke single scattering albedo ranged from 0.9 to nearly 1.0. The total smoke mass over the eastern U.S. ranged from 0.1 to 0.5 Tg, which is close to the 0.5 Tg estimated from the forest fuel content. The smoke lifetime is estimated to be between 15 and 20 days.

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.

The prevalence of and factors associated with current smoking among College of Health Sciences students, Mekelle University in northern Ethiopia.

PubMed

Eticha, Tadele; Kidane, Feven

2014-01-01

Tobacco smoking is one of the greatest causes of preventable morbidity and mortality globally, and is responsible for many causes of untimely deaths. This survey was aimed to determine prevalence and factors associated with current smoking among the students of College of Health Sciences, Mekelle University, Ethiopia. A cross-sectional study was employed using a structured self-administered questionnaire among College of Health Sciences students in March 2013. A stratified random sampling method was employed to select study participants. Data were entered and analysed using of Statistical Package for Social Sciences (SPSS) version 20.0. Of the 193 students, 57 (29.5%) of the students were current smokers. Most of the current smokers (89.4%) smoked between 1-10 sticks of cigarette per day. The two main reasons cited for smoking cigarettes were peer pressure (43.9%) and to relieve stress (36.8%). Being female (adjusted OR [AOR] = 0.49; 95% CI: 0.25, 0.95) and Tigre by ethnicity (AOR = 0.32; 95% CI: 0.14, 0.74) were significantly less associated with current smoking. On the other hand, being second year students (AOR = 3.84; 95% CI: 1.41, 10.46), khat chewing (AOR = 8.36; 95% CI: 2.60, 26.85) and taking illicit drugs (AOR = 10.59; 95% CI: 2.77, 40.51) were positively associated with current smoking cigarettes. The current smoking prevalence among students in College of Health Sciences, Mekelle University is high and therefore, effective smoking prevention and cessation intervention programs are required to reduce smoking among university students.

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.

The contribution of benzene to smoking-induced leukemia.

PubMed

Korte, J E; Hertz-Picciotto, I; Schulz, M R; Ball, L M; Duell, E J

2000-04-01

Cigarette smoking is associated with an increased risk of leukemia; benzene, an established leukemogen, is present in cigarette smoke. By combining epidemiologic data on the health effects of smoking with risk assessment techniques for low-dose extrapolation, we assessed the proportion of smoking-induced total leukemia and acute myeloid leukemia (AML) attributable to the benzene in cigarette smoke. We fit both linear and quadratic models to data from two benzene-exposed occupational cohorts to estimate the leukemogenic potency of benzene. Using multiple-decrement life tables, we calculated lifetime risks of total leukemia and AML deaths for never, light, and heavy smokers. We repeated these calculations, removing the effect of benzene in cigarettes based on the estimated potencies. From these life tables we determined smoking-attributable risks and benzene-attributable risks. The ratio of the latter to the former constitutes the proportion of smoking-induced cases attributable to benzene. Based on linear potency models, the benzene in cigarette smoke contributed from 8 to 48% of smoking-induced total leukemia deaths [95% upper confidence limit (UCL), 20-66%], and from 12 to 58% of smoking-induced AML deaths (95% UCL, 19-121%). The inclusion of a quadratic term yielded results that were comparable; however, potency models with only quadratic terms resulted in much lower attributable fractions--all < 1%. Thus, benzene is estimated to be responsible for approximately one-tenth to one-half of smoking-induced total leukemia mortality and up to three-fifths of smoking-related AML mortality. In contrast to theoretical arguments that linear models substantially overestimate low-dose risk, linear extrapolations from empirical data over a dose range of 10- to 100-fold resulted in plausible predictions.

The economic impact of smoke-free laws on restaurants and bars in 9 States.

PubMed

Loomis, Brett R; Shafer, Paul R; van Hasselt, Martijn

2013-08-01

Smoke-free air laws in restaurants and bars protect patrons and workers from involuntary exposure to secondhand smoke, but owners often express concern that such laws will harm their businesses. The primary objective of this study was to estimate the association between local smoke-free air laws and economic outcomes in restaurants and bars in 8 states without statewide smoke-free air laws: Alabama, Indiana, Kentucky, Mississippi, Missouri, South Carolina, Texas, and West Virginia. A secondary objective was to examine the economic impact of a 2010 statewide smoke-free restaurant and bar law in North Carolina. Using quarterly data from 2000 through 2010, we estimated dynamic panel data models for employment and sales in restaurants and bars. The models controlled for smoke-free laws, general economic activity, cigarette sales, and seasonality. We included data from 216 smoke-free cities and counties in the analysis. During the study period, only North Carolina had a statewide law banning smoking in restaurants or bars. Separate models were estimated for each state. In West Virginia, smoke-free laws were associated with a significant increase of approximately 1% in restaurant employment. In the remaining 8 states, we found no significant association between smoke-free laws and employment or sales in restaurants and bars. Results suggest that smoke-free laws did not have an adverse economic impact on restaurants or bars in any of the states studied; they provided a small economic benefit in 1 state. On the basis of these findings, we would not expect a statewide smoke-free law in Alabama, Indiana, Kentucky, Missouri, Mississippi, South Carolina, Texas, or West Virginia to have an adverse economic impact on restaurants or bars in those states.

The Economic Impact of Smoke-Free Laws on Restaurants and Bars in 9 States

PubMed Central

Shafer, Paul R.; van Hasselt, Martijn

2013-01-01

Introduction Smoke-free air laws in restaurants and bars protect patrons and workers from involuntary exposure to secondhand smoke, but owners often express concern that such laws will harm their businesses. The primary objective of this study was to estimate the association between local smoke-free air laws and economic outcomes in restaurants and bars in 8 states without statewide smoke-free air laws: Alabama, Indiana, Kentucky, Mississippi, Missouri, South Carolina, Texas, and West Virginia. A secondary objective was to examine the economic impact of a 2010 statewide smoke-free restaurant and bar law in North Carolina. Methods Using quarterly data from 2000 through 2010, we estimated dynamic panel data models for employment and sales in restaurants and bars. The models controlled for smoke-free laws, general economic activity, cigarette sales, and seasonality. We included data from 216 smoke-free cities and counties in the analysis. During the study period, only North Carolina had a statewide law banning smoking in restaurants or bars. Separate models were estimated for each state. Results In West Virginia, smoke-free laws were associated with a significant increase of approximately 1% in restaurant employment. In the remaining 8 states, we found no significant association between smoke-free laws and employment or sales in restaurants and bars. Conclusion Results suggest that smoke-free laws did not have an adverse economic impact on restaurants or bars in any of the states studied; they provided a small economic benefit in 1 state. On the basis of these findings, we would not expect a statewide smoke-free law in Alabama, Indiana, Kentucky, Missouri, Mississippi, South Carolina, Texas, or West Virginia to have an adverse economic impact on restaurants or bars in those states. PMID:23906328

Chinese and Vietnamese adult male smokers' perspectives regarding facilitators of tobacco cessation behavior.

PubMed

Spigner, Clarence; Yip, Mei-Po; Huang, Bu; Tu, Shin Ping

2007-01-01

National surveys show a low prevalence of tobacco cigarette smoking within the Asian American/Pacific Islander population. However, smoking rates loom higher when data is disaggregated by ethnicity and gender. Nevertheless, few data are available on how smokers in this population quit smoking. The aim of this study was to collect first-hand perspectives from adult male Chinese and Vietnamese current and former smokers who were patients at a community clinic in Seattle, Washington, in order to understand the facilitators toward smoking cessation and the methods that they might use to quit smoking. A telephone survey was administered to age-eligible male Chinese and Vietnamese clinic patients who were current or former smokers. A total of 196 Chinese and 198 Vietnamese (N=394) adult male current and former smokers were contacted from a pool culled from the clinic database. Descriptive analysis using SPSS software revealed ethnicity-specific differences between current and former smokers regarding influences on smoking cessation behavior as well as uptake and endorsement of cessation methods. Family encouragement and physician recommendations were significant facilitators on the cessation process. Will power and self-determination were frequently mentioned by both Vietnamese and Chinese smokers as helpful methods to quit smoking. Vietnamese smokers were more resourceful than Chinese smokers in their use of smoking cessation methods. Even with access to cessation classes at a health clinic, half of current smokers indicated that they had no intention to quit. Such attitudes underscore the need for promotion of effective smoking cessation programs as well as successful strategies for reaching smokers. These conclusions are particularly important for Chinese smokers, who were comparatively less resourceful in their use of smoking cessation methods. Future studies should explore integrating the concept of will power with current mainstream state-of-the-art smoking cessation programs.

Risk Perceptions of Little Cigar and Cigarillo Smoking Among Adult Current Cigarette Smokers.

PubMed

Sterling, Kymberle L; Majeed, Ban A; Nyman, Amy; Eriksen, Michael

2017-11-01

Few studies have examined the perceptions of risk of little cigar and cigarillo (LCC) smoking among cigarette smokers, which is important for expanding regulatory policies and developing prevention programs. We examined current cigarette smokers' perceived harm of LCC smoking, and determined whether these perceptions were associated with susceptibility and intention to continue smoking LCCs. Data were from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 US adults. Data were analyzed for a subsample of 1191 current cigarette smokers who were stratified into three groups: (1) dual current cigarette smokers who had ever used LCCs, (2) current smokers susceptible to LCC smoking, and (3) current smokers who were not susceptible to LCC smoking. Overall, 47.2% of participants were dual smokers, 12.7% were susceptible to LCC smoking, and 40.1% were not susceptible. Perceptions of risk of LCCs varied across the groups. Dual smokers were more likely to perceive that daily LCC smoking is "very risky" (OR = 1.64, 95% CI = 1.08, 2.41) while occasional LCC smoking is only "somewhat risky" (OR = 1.71, 95% CI = 1.02, 2.87). Of the dual smokers, 20.7% intended to continue smoking LCCs in the future. Perceptions of addiction and risk of daily LCC smoking significantly predicted intention to continue LCC smoking. Addiction perceptions also significantly predicted susceptibility to initiate LCC smoking. Perceptions about harms from and addiction to LCCs could predict future LCC smoking. Health communication campaigns need to address the harms of LCCs. Our data suggest that perceptions of risk about the addictiveness of LCCs and frequency of use are important determinants of the LCC smoking susceptibility among some cigarette smokers and intended continued use among cigarette smokers with a history of LCC use. Health communication campaigns should address misperceptions related to LCCs. © 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.

How rapidly does the excess risk of lung cancer decline following quitting smoking? A quantitative review using the negative exponential model.

PubMed

Fry, John S; Lee, Peter N; Forey, Barbara A; Coombs, Katharine J

2013-10-01

The excess lung cancer risk from smoking declines with time quit, but the shape of the decline has never been precisely modelled, or meta-analyzed. From a database of studies of at least 100 cases, we extracted 106 blocks of RRs (from 85 studies) comparing current smokers, former smokers (by time quit) and never smokers. Corresponding pseudo-numbers of cases and controls (or at-risk) formed the data for fitting the negative exponential model. We estimated the half-life (H, time in years when the excess risk becomes half that for a continuing smoker) for each block, investigated model fit, and studied heterogeneity in H. We also conducted sensitivity analyses allowing for reverse causation, either ignoring short-term quitters (S1) or considering them smokers (S2). Model fit was poor ignoring reverse causation, but much improved for both sensitivity analyses. Estimates of H were similar for all three analyses. For the best-fitting analysis (S1), H was 9.93 (95% CI 9.31-10.60), but varied by sex (females 7.92, males 10.71), and age (<50years 6.98, 70+years 12.99). Given that reverse causation is taken account of, the model adequately describes the decline in excess risk. However, estimates of H may be biased by factors including misclassification of smoking status. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

[Smoking and changes in body weight: can physiopathology and genetics explain this association?].

PubMed

Chatkin, Raquel; Chatkin, José Miguel

2007-01-01

Tobacco use is the leading preventable cause of death in most countries, including Brazil. Smoking cessation is an important strategy for reducing the morbidity and mortality associated with tobacco-related diseases. An inverse relationship between nicotine use and body weight has been reported, in which body weight tends to be lower among smokers than among nonsmokers. Smoking abstinence results in an increase in body weight for both males and females. On average, sustained quitters gain from 5 to 6 kg, although approximately 10% gain more than 10 kg. Pharmacological treatment for smoking cessation attenuates weight gain. The importance of smoking cessation as a contributing cause of the current obesity epidemic has been little studied. In the USA, the rate of obesity attributable to smoking cessation has been estimated at approximately 6.0 and 3.2% for males and females, respectively. Although the mechanisms are unclear, there is evidence that dopamine and serotonin are appetite suppressants. The administration of nicotine, regardless of the delivery system, acutely raises the levels of these neurotransmitters in the brain, reducing the need for energy intake and consequently suppressing appetite. In addition, nicotine has a direct effect on adipose tissue metabolism, influencing the rate of weight gain following smoking cessation. Leptin, ghrelin and neuropeptide Y are substances that might constitute factors involved in the inverse relationship between nicotine and body mass index, although their roles as determinants or consequences of this relationship have yet to be determined.

Estimating the causal effects of smoking.

PubMed

Rubin, D B

An important application of statistics in recent years has been to address the causal effects of smoking. There is little doubt that there are health risks associated with smoking. However, more general issues concern the causal effects due to the alleged misconduct of the tobacco industry or due to programmes designed to curtail tobacco use. To address any such causal question, assumptions must be made. Although some of the issues are well known in the statistical and epidemiological literature, there does not appear to be a unified treatment that provides prescriptive guidance on the estimation of these causal effects with explication of the needed assumptions. A 'conduct attributable fraction' is derived, which allows for arbitrary changes in smoking and non-smoking health care expenditure related factors in a counterfactual world without the alleged misconduct, and therefore generalizes the traditional 'smoking attributable fraction'. The formulation presented here, although described for the problem of estimating excess health care expenditures due to the alleged misconduct of the tobacco industry, is more general. It can be applied to any outcome, such as mortality, morbidity, or income from excise taxes, as well as to any situation in which consequences due to alleged misconduct (for example, of two entities, such as the tobacco and the asbestos industries) or due to hypothetical programmes (for example, extra smoking reduction initiatives) are to be estimated. Copyright 2001 John Wiley & Sons, Ltd.

Smoking and hemorrhagic stroke mortality in a prospective cohort study of older Chinese.

PubMed

Xu, Lin; Schooling, Catherine Mary; Chan, Wai Man; Lee, Siu Yin; Leung, Gabriel M; Lam, Tai Hing

2013-08-01

Hemorrhagic stroke is more common in non-Western settings and does not always share risk factors with other cardiovascular diseases. The association of smoking with hemorrhagic stroke subtypes has not been established. We examined the association of cigarette smoking with hemorrhagic stroke, by subtype (intracerebral hemorrhage and subarachnoid hemorrhage), in a large cohort of older Chinese from Hong Kong. Multivariable Cox regression analysis was used to assess the adjusted associations of smoking at baseline with death from hemorrhagic stroke and its subtypes, using a population-based prospective cohort of 66 820 Chinese aged>65 years enrolled from July 1998 to December 2001 at all the 18 Elderly Health Centers of the Hong Kong Government Department of Health and followed until May 31, 2012. After follow-up for an average of 10.9 years (SD=3.1), 648 deaths from hemorrhagic stroke had occurred, of which 530 (82%) were intracerebral hemorrhage. Current smoking was associated with a higher risk of hemorrhagic stroke (hazard ratio, 2.19; 95% confidence interval, 1.49-3.22), intracerebral hemorrhage (1.94; 1.25-3.01), and subarachnoid hemorrhage (3.58; 1.62-7.94), adjusted for age, sex, education, public assistance, housing type, monthly expenditure, alcohol use, and exercise. Further adjustment for hypertension and body mass index slightly changed the estimates. Smoking is strongly associated with hemorrhagic stroke mortality, particularly for subarachnoid hemorrhage.

The Influence of the National truth campaign on smoking initiation.

PubMed

Farrelly, Matthew C; Nonnemaker, James; Davis, Kevin C; Hussin, Altijani

2009-05-01

States and national organizations spend millions annually on antismoking campaigns aimed at youth. Much of the evidence for their effectiveness is based on cross-sectional studies. This study was designed to evaluate the effectiveness of a prominent national youth smoking-prevention campaign in the U.S. known as truth that was launched in February 2000. A nationally representative cohort of 8904 adolescents aged 12-17 years who were interviewed annually from 1997 to 2004 was analyzed in 2008. A quasi-experimental design was used to relate changes in smoking initiation to variable levels of exposure to antismoking messages over time and across 210 media markets in the U.S. A discrete-time hazard model was used to quantify the influence of media market delivery of TV commercials on smoking initiation, controlling for confounding influences. Based on the results of the hazard model, the number of youth nationally who were prevented from smoking from 2000 through 2004 was estimated. Exposure to the truth campaign is associated with a decreased risk of smoking initiation (relative risk=0.80, p=0.001). Through 2004, approximately 450,000 adolescents were prevented from trying smoking nationwide. Factors negatively associated with initiation include African-American race (relative risk=0.44, p<0.001), Hispanic ethnicity (relative risk=0.74, p<0.001), completing high school (relative risk=0.69, p<0.001), and living with both parents at baseline (OR=0.79, p<0.001). The current study strengthens the available evidence for antismoking campaigns as a viable strategy for preventing youth smoking.

Prevalence of and attitudes to waterpipe smoking among Saudi Arabian physicians.

PubMed

Al Ghobain, Mohammed; Ahmed, Anwar; Abdrabalnabi, Zynab; Mutairi, Wjdan; Al Khathaami, Ali

2018-06-10

Tobacco smoking kills more than 5 million people annually and it is the most important cause of preventable death. Waterpipe smoking is common in the Middle East and is prevalent among young people. There is a misconception that it is less harmful than cigarette smoking. Physicians are considered role models in the community and their behaviours and attitudes towards smoking can have direct effects on cessation. The aim of this study was to estimate current prevalence, attitudes and associated factors in regard to waterpipe smoking among Saudi Arabian physicians. Using a self-administered questionnaire, we conducted a cross-sectional study among 454 male and female physicians from 3 specialties, and of various levels of training working in 4 hospitals in Riyadh. The prevalence of waterpipe smoking was 45%, greater in men than in women (58% vs 18%; P ≤ 0.001) and in surgical than in medical specialists (58% vs 38%; P ≤ 0.001). More non-smokers than smokers believed that physicians should serve as role models (79% vs 60%; P ≤ 0.001). Physicians who were waterpipe non-smokers had received more formal training about cessation than smokers (50% vs 36%; P ≤ 0.001). Waterpipe smoking among Saudi Arabian physicians is frequent and is associated with low exposure to information about the hazards and cessation during medical education. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Cigarette smoking and endometrial carcinoma risk: the role of effect modification and tumor heterogeneity

PubMed Central

Yang, Hannah P.; Gierach, Gretchen L.; Park, Yikyung; Brinton, Louise A.

2014-01-01

Purpose The inverse relationship between cigarette smoking and endometrial carcinoma risk is well established. We examined effect modification of this relationship and associations with tumor characteristics in the National Institutes of Health–AARP Diet and Health Study. Methods We examined the association between cigarette smoking and endometrial carcinoma risk among 110,304 women. During 1,029,041 person years of follow-up, we identified 1,476 incident endometrial carcinoma cases. Multivariable Cox proportional hazards regression models were used to estimate relative risks (RRs) and 95 % confidence intervals (CIs) for the association between smoking status, years since smoking cessation, and endometrial carcinoma risk overall and within strata of endometrial carcinoma risk factors. Effect modification was assessed using likelihood ratio test statistics. Smoking associations by histologic subtype/grade and stage at diagnosis were also evaluated. Results Reduced endometrial carcinoma risk was evident among former (RR 0.89, 95 % CI 0.80, 1.00) and current (RR 0.65, 95 % CI 0.55, 0.78) smokers compared with never smokers. Smoking cessation 1–4 years prior to baseline was significantly associated with endometrial carcinoma risk (RR 0.65, 95 % CI 0.48, 0.89), while cessation ≥10 years before baseline was not. The association between smoking and endometrial carcinoma risk was not significantly modified by any endometrial carcinoma risk factor, nor did we observe major differences in risk associations by tumor characteristics. Conclusion The cigarette smoking–endometrial carcinoma risk relationship was consistent within strata of important endometrial carcinoma risk factors and by clinically relevant tumor characteristics. PMID:24487725

Factors affecting commencement and cessation of smoking behaviour in Malaysian adults

PubMed Central

2012-01-01

Background Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs. Methods Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios. Results Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01). Conclusions Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation. PMID:22429627

Positive and negative affect as predictors of urge to smoke: temporal factors and mediational pathways.

PubMed

Leventhal, Adam M; Greenberg, Jodie B; Trujillo, Michael A; Ameringer, Katherine J; Lisha, Nadra E; Pang, Raina D; Monterosso, John

2013-03-01

Elucidating interrelations between prior affective experience, current affective state, and acute urge to smoke could inform affective models of addiction motivation and smoking cessation treatment development. This study tested the hypothesis that prior levels of positive (PA) and negative (NA) affect predict current smoking urge via a mediational pathway involving current state affect. We also explored if tobacco deprivation moderated affect-urge relations and compared the effects of PA and NA on smoking urge to one another. At a baseline session, smokers reported affect experienced over the preceding few weeks. At a subsequent experimental session, participants were randomly assigned to 12-hr tobacco deprived (n = 51) or nondeprived (n = 69) conditions and reported state affect and current urge. Results revealed a mediational pathway whereby prior NA reported at baseline predicted state NA at the experimental session, which in turn predicted current urge. This mediational pathway was found primarily for an urge subtype indicative of urgent need to smoke and desire to smoke for NA relief, was stronger in the deprived (vs. nondeprived) condition, and remained significant after controlling for PA. Prior PA and current state PA were inversely associated with current urge; however, these associations were eliminated after controlling for NA. These results cohere with negative reinforcement models of addiction and with prior research and suggest that: (a) NA plays a stronger role in smoking motivation than PA; (b) state affect is an important mechanism linking prior affective experience to current urge; and (c) affect management interventions may attenuate smoking urge in individuals with a history of affective disturbance. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

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.

The impact of the mode of survey administration on estimates of daily smoking for mobile phone only users.

PubMed

Hanna, Joseph; Cordery, Damien V; Steel, David G; Davis, Walter; Harrold, Timothy C

2017-04-20

Over the past decade, there have been substantial changes in landline and mobile phone ownership, with a substantial increase in the proportion of mobile-only households. Estimates of daily smoking rates for the mobile phone only (MPO) population have been found to be substantially higher than the rest of the population and telephone surveys that use a dual sampling frame (landline and mobile phones) are now considered best practice. Smoking is seen as an undesirable behaviour; measuring such behaviours using an interviewer may lead to lower estimates when using telephone based surveys compared to self-administered approaches. This study aims to assess whether higher daily smoking estimates observed for the mobile phone only population can be explained by administrative features of surveys, after accounting for differences in the phone ownership population groups. Data on New South Wales (NSW) residents aged 18 years or older from the NSW Population Health Survey (PHS), a telephone survey, and the National Drug Strategy Household Survey (NDSHS), a self-administered survey, were combined, with weights adjusted to match the 2013 population. Design-adjusted prevalence estimates and odds ratios were calculated using survey analysis procedures available in SAS 9.4. Both the PHS and NDSHS gave the same estimates for daily smoking (12%) and similar estimates for MPO users (20% and 18% respectively). Pooled data showed that daily smoking was 19% for MPO users, compared to 10% for dual phone owners, and 12% for landline phone only users. Prevalence estimates for MPO users across both surveys were consistently higher than other phone ownership groups. Differences in estimates for the MPO population compared to other phone ownership groups persisted even after adjustment for the mode of collection and demographic factors. Daily smoking rates were consistently higher for the mobile phone only population and this was not driven by the mode of survey collection. This supports the assertion that the use of a dual sampling frame addresses coverage issues that would otherwise be present in telephone surveys that only made use of a landline sampling frame.

Developing small-area predictions for smoking and obesity prevalence in the United States for use in Environmental Public Health Tracking.

PubMed

Ortega Hinojosa, Alberto M; Davies, Molly M; Jarjour, Sarah; Burnett, Richard T; Mann, Jennifer K; Hughes, Edward; Balmes, John R; Turner, Michelle C; Jerrett, Michael

2014-10-01

Globally and in the United States, smoking and obesity are leading causes of death and disability. Reliable estimates of prevalence for these risk factors are often missing variables in public health surveillance programs. This may limit the capacity of public health surveillance to target interventions or to assess associations between other environmental risk factors (e.g., air pollution) and health because smoking and obesity are often important confounders. To generate prevalence estimates of smoking and obesity rates over small areas for the United States (i.e., at the ZIP code and census tract levels). We predicted smoking and obesity prevalence using a combined approach first using a lasso-based variable selection procedure followed by a two-level random effects regression with a Poisson link clustered on state and county. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1991 to 2010 to estimate the model. We used 10-fold cross-validated mean squared errors and the variance of the residuals to test our model. To downscale the estimates we combined the prediction equations with 1990 and 2000 U.S. Census data for each of the four five-year time periods in this time range at the ZIP code and census tract levels. Several sensitivity analyses were conducted using models that included only basic terms, that accounted for spatial autocorrelation, and used Generalized Linear Models that did not include random effects. The two-level random effects model produced improved estimates compared to the fixed effects-only models. Estimates were particularly improved for the two-thirds of the conterminous U.S. where BRFSS data were available to estimate the county level random effects. We downscaled the smoking and obesity rate predictions to derive ZIP code and census tract estimates. To our knowledge these smoking and obesity predictions are the first to be developed for the entire conterminous U.S. for census tracts and ZIP codes. Our estimates could have significant utility for public health surveillance. Copyright © 2014. Published by Elsevier Inc.

Pharmacokinetics and pharmacodynamics of smoked heroin.

PubMed

Jenkins, A J; Keenan, R M; Henningfield, J E; Cone, E J

1994-10-01

Despite the current popularity of smoking as a route of drug self-administration, there have been few human studies characterizing the pharmacokinetics and pharmacodynamics of smoked drugs of abuse. A variety of technological difficulties are encountered in the design of smoking studies, such as delivering reproducible doses and limiting the amount of pyrolysis of parent drug. As part of a concerted research effort to deliver precise, smoked doses of drug, a computer-assisted smoking device was utilized that delivered single puffs of heroin vapor to human subjects under controlled clinical conditions. Recovery studies indicated that the smoking device delivered approximately 89% of parent heroin to subjects. Although only two qualified heroin smokers could be identified as eligible volunteers, their participation provided the unique opportunity to study the pharmacokinetics and pharmacodynamics of smoked heroin. The two subjects were administered four smoked heroin doses in ascending order. In addition, four intravenous doses of heroin were administered for comparison of effects and estimation of bioavailability. Concurrent physiological, behavioral, and performance measures were collected along with blood samples. Blood was analyzed for heroin, 6-acetylmorphine, and morphine by solid-phase extraction gas chromatography-mass spectrometry. Heroin appeared rapidly in blood after administration and peaked 1-5 minutes after smoking, which is similar to that observed following intravenous administration. Heroin concentrations declined rapidly to the limit of detection (1.0 ng/mL) by 30 minutes. 6-Acetylmorphine blood concentrations also peaked and declined rapidly after smoked heroin with peak concentrations occurring at 1-2 minutes after smoking. Morphine levels rose and decayed more slowly. Mean elimination half-lives for heroin, 6-acetylmorphine, and morphine were 3.3 min, 5.4 min, and 18.8 min, respectively, by the smoked route. The bioavailability of smoked heroin was highly variable. Physiological measures such as pupil diameter demonstrated a counterclockwise hysteresis compared with heroin blood levels. The rapid onset of pharmacological effects together with the early appearance of heroin and metabolites in blood following smoked heroin demonstrated the effectiveness of this route of drug administration. It is evident that the smoking route enables individuals to obtain similar pharmacological effects as are produced by intravenous administration of heroin.

Comparing the effects of entertainment media and tobacco marketing on youth smoking in Germany

PubMed Central

Sargent, James D.; Hanewinkel, Reiner

2013-01-01

Aims To examine differential effects of smoking in films and tobacco advertising on adolescent smoking. We hypothesize that movie smoking will have greater effects on smoking initiation, whereas tobacco advertising receptivity will primarily affect experimentation. Design Longitudinal observational study of adolescents. Setting School-based surveys conducted in Schleswig-Holstein, Germany. Participants A total of 4384 adolescents age 11–15 years at baseline and re-surveyed 1 year later; ever smoking prevalence was 38% at time 1. Measurements The main outcome variable combined two items assessing life-time and current smoking (alpha = 0.87). Baseline never smokers were analyzed separately from those who had tried smoking (ever smokers). Exposure to smoking in 398 internationally distributed US movies was modeled as a continuous variable, with 0 corresponding to the 5th percentile and 1 to the 95th percentile of exposure. Tobacco marketing receptivity consisted of naming a brand for a favorite tobacco advertisement. Ordinal logistic regressions controlled for socio-demographics, other social influences, personality characteristics of the adolescent and parenting style. Findings Whereas 34% of ever smokers were receptive to tobacco marketing at time 1, only 6% of never smokers were. Among time 1 never smokers, exposure to movie smoking was a significantly stronger predictor of higher time 2 smoking level [adjusted proportional odds ratio = 2.76, 95% confidence interval (1.84, 4.15)] than was tobacco marketing receptivity (1.53 [1.07, 2.20]). Among time 1 ever smokers, both tobacco marketing receptivity and exposure to movie smoking predicted higher levels of time 2 smoking [2.17 (1.78, 2.63) and 1.62 (1.18, 2.23), respectively], and the two estimates were not significantly different. Conclusions In this longitudinal study, exposure to movie smoking was a stronger predictor of smoking initiation than tobacco marketing receptivity, which was more common among ever smokers. The results suggest that entertainment media smoking should be emphasized in programs aimed at preventing onset, and both exposures should be emphasized in programs aimed at experimental smokers. PMID:19413793

Occupational risk factors for male bladder cancer: results from a population based case cohort study in the Netherlands.

PubMed

Zeegers, M P; Swaen, G M; Kant, I; Goldbohm, R A; van den Brandt, P A

2001-09-01

This study was conducted to estimate risk of bladder cancer associated with occupational exposures to paint components, polycyclic aromatic hydrocarbons (PAHs), diesel exhausts, and aromatic amines among the general population in The Netherlands. A prospective cohort study was conducted among 58,279 men. In September 1986, the cohort members (55-69 years) completed a self administered questionnaire on risk factors for cancer including job history. Follow up for incident bladder cancer was established by linkage to cancer registries until December 1992. A case-cohort approach was used based on 532 cases and 1630 subcohort members. A case by case expert assessment was carried out to assign to the cases and subcohort members a cumulative probability of occupational exposure for each carcinogenic exposure. Men in the highest tertiles of occupational exposure to paint components, PAHs, aromatic amines, and diesel exhaust had non-significantly higher age and smoking adjusted incident rate ratios (RRs) of bladder cancer than men with no exposure: 1.29 (95% confidence interval (95% CI) 0.71 to 2.33), 1.24 (95% CI 0.68 to 2.27), 1.32 (95% CI 0.41 to 4.23) and 1.21 (95% CI 0.78 to 1.88), respectively. The associations between paint components and PAHs and risk of bladder cancer were most pronounced for current smokers. Among former smokers it seemed that for cumulative probability of exposure to paint components and PAHs, men who had smoked more than 15 cigarettes a day had RRs below unity compared with men who had smoked less than 15 cigarettes a day, whereas among current smokers the opposite was found. Exposure to diesel exhaust was positively associated with risk of bladder cancer among current and former smokers who had smoked more than 15 cigarettes a day. This study provided only marginal evidence for an association between occupational exposure to paint components, PAHs, aromatic amines, and bladder cancer. Despite the small proportion of exposed subjects, an interaction with cigarette smoking was found, specifically for paint components, suggesting that the carcinogenic effect on the bladder might decrease after stopping smoking.