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Jackson SE, Tattan-Birch H, Buss V, Shahab L, Brown J. Trends in Daily Cigarette Consumption Among Smokers: A Population Study in England, 2008-2023. Nicotine Tob Res 2024:ntae071. [PMID: 38692652 DOI: 10.1093/ntr/ntae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION This study aimed to estimate time trends in cigarette consumption among smokers in England between 2008 and 2023 and to explore differences by key potential moderators. AIMS AND METHODS We used data from 57 778 adult cigarette smokers participating in a nationally representative monthly cross-sectional survey between January 2008 and September 2023. We estimated monthly time trends in mean daily consumption of (1) any, (2) manufactured, and (3) hand-rolled cigarettes among all smokers and by main type of cigarettes smoked, smoking frequency, age, gender, occupational social grade, region, nicotine replacement therapy use, and vaping status. RESULTS Overall cigarette consumption fell from 13.6 [95% CI = 13.3 to 13.9] to 10.6 [10.5 to 10.8] per day between January 2008 and October 2019 (a 22% decrease), then remained stable up to September 2023. Over this period, the proportion mainly or exclusively smoking hand-rolled cigarettes increased (from 30.6% [29.1%-32.1%] in 2008 to 52.1% [49.7%-54.5%] in 2023). As a result, manufactured cigarette consumption fell by 47%, from 9.5 [9.2-9.8] per day in January 2008 to 5.0 [4.7-5.3] in September 2023, while hand-rolled cigarette consumption increased by 35%, from 4.2 [3.9-4.4] to 5.6 [5.3-5.9], respectively. The decline in overall cigarette consumption was observed across all subgroups, but was greater among non-daily smokers, younger smokers, and those who vaped. CONCLUSIONS Over the last 15 years, the average number of cigarettes consumed each day by smokers in England has fallen by almost a quarter, but has plateaued since October 2019. There has been a sharp decline in the number of manufactured cigarettes consumed and an increase in the number of hand-rolled cigarettes consumed, as smokers have increasingly shifted towards using hand-rolled tobacco. IMPLICATIONS While average cigarette consumption in England has fallen over the past 15 years, this declining trend has stalled (and reversed in some population groups) since 2019. The availability of cheap, hand-rolled tobacco appears to be undermining policies that aim to reduce smoking by raising the price of tobacco (eg, through taxation) and could be targeted to reignite the decline in cigarette consumption.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Vera Buss
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, Edinburgh, UK
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Zvolensky MJ, Shepherd JM, Clausen BK, de Dios M, Cano MÁ, Redmond BY. Differences in smoking behavior and beliefs about abstinence among Latinx individuals with and without depression who smoke cigarettes. J Ethn Subst Abuse 2023:1-19. [PMID: 38108308 PMCID: PMC11182888 DOI: 10.1080/15332640.2023.2293945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
There is a well-established relation between depression and smoking in the general population. However, past work focused on Latinx persons who smoke in relation to depressed affect has yielded inconsistent findings. The present investigation aimed to build on past research and evaluate differences among English-speaking Latinx adults who smoke combustible cigarettes with and without probable depression in terms of cigarette dependence, perceived barriers for quitting, severity of problems when quitting, and smoking abstinence expectancies. The current sample included 338 adult Latinx daily cigarette smokers (Mage = 35.53 years; SD = 8.65; age range 18-61; 37.3% female) that were recruited nationally throughout the US. Results indicated that among Latinx persons who smoke, those with probable depression (compared to those without) demonstrated higher levels of cigarette dependence, more severe problems when trying to quit, greater perceived barriers for quitting, and increased negative abstinence expectancies after adjusting for sociodemographic and concurrent substance use variables. Future work could build from this research to elucidate the role of depression in the maintenance and relapse of smoking among the Latinx population.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
- HEALTH Institute, University of Houston
| | | | | | - Marcel de Dios
- HEALTH Institute, University of Houston
- Department of Psychological, Health, and Learning Sciences, University of Houston
| | - Miguel Ángel Cano
- Peter O’Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center
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Gutiérrez-Torres DS, Brochier M, Stern D, Cortés-Valencia A, Hernández-Ávila JE, Morales-Carmona E, Barrientos-Gutierrez T, Inoue-Choi M, Lajous M, Freedman ND. Low-intensity daily smoking and mortality risk among Mexican women. Tob Control 2023:tc-2022-057839. [PMID: 37414526 PMCID: PMC10770292 DOI: 10.1136/tc-2022-057839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 06/19/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To examine the association between low-intensity smoking (10 or less cigarettes per day) and all-cause and cause-specific mortality risk among women who smoke and by age at cessation among women who previously smoked. METHODS In this study, 104 717 female participants of the Mexican Teachers' Cohort Study were categorised according to self-reported smoking status at baseline (2006/2008) and were followed for mortality through 2019. We estimated HRs and 95% CIs for all-cause and cause-specific mortality using multivariable Cox proportional hazards regression models with age as the underlying time metric. RESULTS Smoking as few as one to two cigarettes per day was associated with higher mortality risk for all causes (HR: 1.36; 95% CI 1.10 to 1.67) and all cancers (HR: 1.46; 95% CI 1.05 to 2.02), compared with never smoking. Similarly, slightly higher HRs were observed among participants smoking ≥3 cigarettes per day (all causes HR: 1.43; 95% CI 1.19 to 1.70; all cancers HR: 1.48; 95% CI 1.10 to 1.97; cardiovascular disease HR: 1.58; 95% CI 1.09 to 2.28). CONCLUSIONS In this large study of Mexican women, low-intensity smoking was associated with higher mortality risk for all causes and all cancers. Interventions are needed to promote cessation among women who smoke at low-intensity in Mexico, regardless of how few cigarettes they smoke per day.
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Affiliation(s)
| | - Marion Brochier
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Ciudad de México, Mexico
| | - Dalia Stern
- CONAHCyT - Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Adrian Cortés-Valencia
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Ciudad de México, Mexico
| | | | - Evangelina Morales-Carmona
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Martin Lajous
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Ciudad de México, Mexico
- Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Al-Dahshan A, Al Muraikhi H, Musa S, Joudeh A, Al Baker W, Selim N, Bougmiza I. Prevalence and predictors of smoking cessation among smokers receiving smoking cessation intervention in primary care in Qatar: a 6-month follow-up study. Front Public Health 2023; 11:1166016. [PMID: 37275499 PMCID: PMC10235512 DOI: 10.3389/fpubh.2023.1166016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Objective To estimate the rate and predictors of smoking cessation in smokers attending smoking cessation clinics in primary care settings in Qatar. Methods A cross-sectional study was conducted among 759 smokers who had attended any of the 10 smoking cessation clinics in primary health care centers from January 2019 to June 2020. The sociodemographic, clinical, and smoking-related variables were assessed. Tailored behavioral and pharmacotherapy were delivered, and patients were interviewed at 6 months to estimate the 30-day point prevalence abstinence. To identify independent factors associated with smoking cessation, a multivariable logistic regression analysis was performed. Results The mean age of participants was 40.6 (±11.3), majority being married, Arab and employed, and having a tertiary education. Almost half of the smokers (48.7%) received varenicline alone, 42.6% received NRT, and 31.8% received a combination of both. The selection of drug therapy was based on preferences, experiences, and history of previously encountered adverse effects. The overall 30-day quit rate at 6 months follow-up was 32.4%. About three-quarters (72.5%) of participants had at least one quit attempt and 12.5% had 3 or more attempts. Later age at smoking initiation, lower cigarette consumption at baseline, lower CO concentration at baseline, use of smoking cessation pharmacotherapy, having made fewer quit attempts and non-exposure to secondhand smoke among friends were identified as significant predictors of successful quitting at 6 months. Conclusion The 30-day quit rate at 6 months follow-up (32.4%) is comparable to the worldwide figure. However, further efforts should be made to plan cost-effective tobacco dependence treatment taking into account predictors and at-risk groups.
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Affiliation(s)
- Ayman Al-Dahshan
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Hissa Al Muraikhi
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Sarah Musa
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Anwar Joudeh
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Wadha Al Baker
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Nagah Selim
- Department of Community Medicine, Primary Health Care Corporation, Doha, Qatar
- Department of Public Health and Preventive Medicine, Cairo University, Giza, Egypt
| | - Iheb Bougmiza
- Department of Community Medicine, Primary Health Care Corporation, Doha, Qatar
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Ogunnaike A, Gallegos-Carrillo K, Barrientos-Gutierrez I, Arillo Santillán E, Cho YJ, Thrasher JF. Why Smoke Flavor Capsule Cigarettes? Preferences and Perceptions Among Adult Smokers in Mexico. Nicotine Tob Res 2022; 24:1635-1644. [PMID: 35244723 PMCID: PMC9575969 DOI: 10.1093/ntr/ntac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Flavor capsule cigarettes are rapidly gaining global market share, particularly in Latin America; however, little is known about consumer profiles and perceptions since the diffusion of this product innovation has become more widespread. AIMS AND METHODS This paper compares profiles and perceptions of smokers who prefer flavor capsule cigarettes and those who do not in Mexico. We analyzed data from six online surveys of adult Mexican smokers (n = 4488) from 2018-2020. Participants identified their preferred brand variety characteristics (no capsule; one capsule; two capsules), and reported perceptions of their brand varieties' flavor, smoothness, harmfulness, and whether they smoke to control their appetite. Separate multinomial logistic models regressed preferred cigarette type on sociodemographic and smoking-related variables, as well as perceived benefits on preferred cigarette type, adjusting for covariates. RESULTS Most participants preferred capsule cigarettes (single capsule = 47.5%; double capsule = 12.9%). Flavor capsule users reported that their preferred varieties mostly tasted like menthol/mint (59% of single capsule users and 23% of double capsule users), cucumber (12% and 27%, respectively) or berries (10% and 22%, respectively). Females were more likely than males to prefer either single or double capsule cigarettes (AOR = 2.26 and 2.01, respectively). Preference for flavor capsules was also higher among younger smokers, e-cigarette users, those who smoke less frequently, and those who recently tried or plan to quit. Smokers who preferred capsules were more likely than non-capsule smokers to perceive their cigarettes as smoother, less harmful, and to smoke to control their appetite. CONCLUSIONS The high prevalence of capsule use and widespread perceptions of the benefits of capsules over traditional cigarettes may help explain why tobacco control policies have not reduced smoking prevalence in Mexico. IMPLICATIONS Flavor capsules are rapidly growing in popularity in many countries around the world, including Mexico. This study found that more Mexican adult smokers prefer brand varieties with capsules (60%) than without capsules (40%), that flavor capsule use strongly correlates with menthol cigarette use, and that perceived flavors of capsules range widely. Flavor capsule smokers have more positive smoking expectancies (eg, lower risk perceptions, dietary control) than noncapsule smokers. Capsules appeal particularly to women, young adults, less frequent smokers, and those who recently tried to quit. Policies should consider banning flavors in cigarettes, including capsules and other filter innovations.
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Affiliation(s)
- Adebusola Ogunnaike
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit–Morelos, Mexican Social Security Institute, Cuernavaca, Mexico
| | - Inti Barrientos-Gutierrez
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
| | - Edna Arillo Santillán
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
| | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Evaluation and Surveys Research Center/Tobacco Research Department, National Institute of Public Health, Mexico City, Mexico
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Gallegos-Carrillo K, Barrientos-Gutiérrez I, Arillo-Santillán E, Rodríguez-Bolaños R, Cruz-Jiménez L, Desirée VP, Cho YJ, Thrasher JF. Transitions between tobacco products: Correlates of changes in cigarette smoking and e-cigarette use among exclusive adult smokers and dual users in Mexico. Prev Med Rep 2022; 29:101869. [PMID: 35911576 PMCID: PMC9326312 DOI: 10.1016/j.pmedr.2022.101869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
This study examined transitions in tobacco products use among Mexican smokers and dual users. Data were analyzed from exclusive smokers (n = 2,946) and dual users (n = 1,643) recruited from an online consumer research panel and surveyed every-four months from November 2018 to April 2021. For exclusive smokers, estimated transitions were (time "t + 1" four months after prior survey): a) remain as exclusive smokers; b) dual use; c) exclusive e-cigarette use or quit both products. Among dual users, transitions analyzed were: a) remain as dual user; b) exclusive smoker; c) exclusive e-cigarette user or quit both products. Multinomial models regressed transitions at "t + 1" on time "t" for control variables. Most exclusive smokers (81%) remained as such, 12.6% transitioned to dual use, 2.3% to exclusive e-cigarette use, and 4% quitted both products. Exclusive smokers were more likely to transition to dual use if they recently attempted to quit (AOR = 1.45) or had partners/family or friends who used e-cigarettes (AOR = 2.47 & 2.56 respectively). Most dual users (74.8%) remained as dual users, 20.4% transitioned to exclusive smoking, 1.6% transitioned to exclusive e-cigarette use, and 3.2% quitted both products. Dual users were more likely to transition to exclusive smoking if they had lower educational attainment, recently attempted to quit e-cigarettes (AOR = 1.70). Having friends who use e-cigarettes (AOR = 0.29) and higher smoking dependence (AOR = 0.55) were associated with a lower likelihood of quitting. Recent quit attempts and e-cigarette use among close social network members may explain the short-term transitions, though longer follow-up is needed to assess sustained smoking cessation.
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Affiliation(s)
- Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Morelos, Mexican Institute of Social Security, Mexico
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Lizeth Cruz-Jiménez
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Vidaña-Pérez Desirée
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James F. Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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Luo SJ, Choi E, Aredo JV, Wilkens LR, Tammemägi MC, Le Marchand L, Cheng I, Wakelee HA, Han SS. Smoking Cessation After Lung Cancer Diagnosis and the Risk of Second Primary Lung Cancer: The Multiethnic Cohort Study. JNCI Cancer Spectr 2021; 5:pkab076. [PMID: 34611582 PMCID: PMC8487318 DOI: 10.1093/jncics/pkab076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/28/2021] [Accepted: 08/18/2021] [Indexed: 12/23/2022] Open
Abstract
Background Smoking cessation reduces lung cancer mortality. However, little is known about whether diagnosis of lung cancer impacts changes in smoking behaviors. Furthermore, the effects of smoking cessation on the risk of second primary lung cancer (SPLC) have not been established yet. This study aims to examine smoking behavior changes after initial primary lung cancer (IPLC) diagnosis and estimate the effect of smoking cessation on SPLC risk following IPLC diagnosis. Methods The study cohort consisted of 986 participants in the Multiethnic Cohort Study who were free of lung cancer and active smokers at baseline (1993-1996), provided 10-year follow-up smoking data (2003-2008), and were diagnosed with IPLC in 1993-2017. The primary outcome was a change in smoking status from “current” at baseline to “former” at 10-year follow-up (ie, smoking cessation), analyzed using logistic regression. The second outcome was SPLC incidence after smoking cessation, estimated using cause-specific Cox regression. All statistical tests were 2-sided. Results Among 986 current smokers at baseline, 51.1% reported smoking cessation at 10-year follow-up. The smoking cessation rate was statistically significantly higher (80.6%) for those diagnosed with IPLC between baseline and 10-year follow-up vs those without IPLC diagnosis (45.4%) during the 10-year period (adjusted odds ratio = 5.12, 95% confidence interval [CI] = 3.38 to 7.98; P < .001). Incidence of SPLC was statistically significantly lower among the 504 participants who reported smoking cessation at follow-up compared with those without smoking cessation (adjusted hazard ratio = 0.31, 95% CI = 0.14 to 0.67; P = .003). Conclusion Lung cancer diagnosis has a statistically significant impact on smoking cessation. Quitting smoking after IPLC diagnosis may reduce the risk of developing a subsequent malignancy in the lungs.
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Affiliation(s)
- Sophia J Luo
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Eunji Choi
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Martin C Tammemägi
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Heather A Wakelee
- Stanford University School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Summer S Han
- Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.,Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA.,Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
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Mohamed R, Bullen C, Hairi FM, Nordin ASA. A systematic review of group therapy programs for smoking cessation in Asian countries. Tob Induc Dis 2021; 19:63. [PMID: 34413718 PMCID: PMC8336625 DOI: 10.18332/tid/140089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.
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Affiliation(s)
- Rashidi Mohamed
- Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Bangi, Malaysia
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,University of Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
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Sánchez-Romero LM, Zavala-Arciniega L, Reynales-Shigematsu LM, de Miera-Juárez BS, Yuan Z, Li Y, Lau YK, Fleischer NL, Meza R, Thrasher JF, Levy DT. The Mexico SimSmoke tobacco control policy model: Development of a simulation model of daily and nondaily cigarette smoking. PLoS One 2021; 16:e0248215. [PMID: 34153063 PMCID: PMC8216521 DOI: 10.1371/journal.pone.0248215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/22/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Nondaily smoking has been on the rise, especially in Mexico. While Mexico has strengthened its tobacco control policies, their effects on nondaily smokers have gone largely unexamined. We developed a simulation model to estimate the impact of tobacco control policies on daily and nondaily smoking in Mexico. METHODS A previously validated Mexico SimSmoke model that estimated overall trends in smoking prevalence from 2002 through 2013 was extended to 2018 and adapted to distinguish daily and nondaily smoking prevalence. The model was then validated using data from Mexican surveys through 2016. To gauge the potential effects of policies, we compared the trends in smoking under current policies with trends from policies kept at their 2002 levels. RESULTS Between 2002 and 2016, Mexico SimSmoke underestimated the reduction in male and female daily smoking rates. For nondaily smoking, SimSmoke predicted a decline among both males and females, while survey rates showed increasing rates in both genders, primarily among ages 15-44. Of the total reduction in smoking rates predicted by the model by 2018, tax policies account for more than 55%, followed by health warnings, cessation treatment, smoke-free air laws, and tobacco control spending. CONCLUSIONS Although Mexico SimSmoke did not successfully explain trends in daily and nondaily smoking, it helps to identify gaps in surveillance and policy evaluation for nondaily smokers. Future research should consider appropriate measures of nondaily smoking prevalence, trajectories between daily and nondaily smoking, and the separate impact of tobacco control policies on each group.
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Affiliation(s)
- Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
| | - Luis Zavala-Arciniega
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, México
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, Michigan, United States of America
| | | | | | - Zhe Yuan
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
| | - Yameng Li
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
| | - Yan Kwan Lau
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, Michigan, United States of America
| | - Nancy L. Fleischer
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, Michigan, United States of America
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, Michigan, United States of America
| | - James F. Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, México
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States of America
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10
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Zavala-Arciniega L, Reynales-Shigematsu LM, Levy DT, Lau YK, Meza R, Gutiérrez-Torres DS, Arillo-Santillán E, Fleischer NL, Thrasher J. Smoking trends in Mexico, 2002-2016: before and after the ratification of the WHO's Framework Convention on Tobacco Control. Tob Control 2020; 29:687-691. [PMID: 32019893 PMCID: PMC7398822 DOI: 10.1136/tobaccocontrol-2019-055153] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/16/2019] [Accepted: 09/02/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Mexico was the first Latin American country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004, after which it implemented some key FCTC policies (e.g., taxes, smoke-free, pictorial warnings and ad bans). This study assessed trends in the prevalence of current, daily and non-daily smoking in Mexico before and after the implementation of key FCTC policies. METHODS Data were analysed from two comparable, nationally representative surveys (i.e., the National Survey on Addictions 2002, 2011 and 2016, and the Global Adult Tobacco Survey 2009 and 2015). The pooled sample comprised 100 302 persons aged 15-65 years. Changes in the prevalence of current, daily and non-daily smoking were assessed. RESULTS From 2002 to 2016, the prevalence of current smoking fell 11% in relative terms (from 21.5% to 19.0%). The decrease was registered between 2002 and 2009, and after that, a slight increase was observed (from 16.5% in 2009 to 19% in 2016). The prevalence of daily smoking decreased by about 50% between 2002 and 2016 (from 13.5% to 7.0%) with most of the decrease occurring by 2009. Conversely, the prevalence of non-daily smoking increased by 35% between 2009 and 2016 (from 8.8% to 11.9%). CONCLUSIONS Full implementation of the FCTC is necessary to further reduce smoking. Specific interventions may be needed to target non-daily smokers, who now comprise more than half of current smokers in Mexico.
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Affiliation(s)
- Luis Zavala-Arciniega
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Luz Myriam Reynales-Shigematsu
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Tobacco Research Department, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - David T Levy
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Yan Kwan Lau
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rafael Meza
- Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniela Sarahí Gutiérrez-Torres
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Edna Arillo-Santillán
- Departamento de Investigación sobre Tabaco, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - James Thrasher
- Health Promotion, Education, & Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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11
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Gravely S, Meng G, Cummings KM, Hyland A, Borland R, Hammond D, O’Connor RJ, Goniewicz ML, Kasza KA, McNeill A, Thompson ME, Hitchman SC, Levy DT, Thrasher JF, Quah AC, Martin N, Ouimet J, Boudreau C, Fong GT. Changes in Smoking and Vaping over 18 Months among Smokers and Recent Ex-Smokers: Longitudinal Findings from the 2016 and 2018 ITC Four Country Smoking and Vaping Surveys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197084. [PMID: 32992667 PMCID: PMC7579485 DOI: 10.3390/ijerph17197084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022]
Abstract
This descriptive study of smokers (smoked at least monthly) and recent ex-smokers (quit for ≤2 years) examined transitions over an 18 month period in their smoking and vaping behaviors. Data are from Waves 1 (W1: 2016) and 2 (W2: 2018) of the ITC Four Country Smoking and Vaping Survey, a cohort study of adult (≥18+) smokers, concurrent users (smoke and vape), and recent ex-smokers from Australia, Canada, England, and the United States (US). Respondents (N = 5016) were classified according to their smoking and vaping status, which resulted in eight subgroups: (1) exclusive daily smokers (2) exclusive non-daily smokers; (3–6) concurrent users (subdivided into four groups by each combination of daily/non-daily smoking and daily/non-daily vaping); (7) ex-smokers who vape; (8) ex-smokers not vaping. The analyses focused first on describing changes between groups from W1 to W2. Second, transition outcomes were assessed based on changes in smoking and vaping between W1 and W2. Transitions focused on smoking were: no change in smoking (continued smoking at the same frequency); decreased smoking; increased smoking; discontinued smoking; relapsed (ex-smokers at W1 who were smoking at W2). Transitions focused on vaping were: initiated vaping; switched from smoking to vaping. Overall, this study found that the vast majority of smokers were smoking 18 months later. Non-daily smokers were more likely than daily smokers to have discontinued smoking (p < 0.0001) and to have switched to exclusive vaping (p = 0.034). Exclusive non-daily smokers were more likely than exclusive daily smokers to have initiated vaping (p = 0.04). Among all W1 daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers; however, concurrent users were more likely than exclusive daily smokers to have decreased to non-daily smoking (p < 0.001) or to have switched to vaping by W2 (p < 0.001). Among all W1 non-daily smokers, there were no significant differences in increased smoking or discontinued smoking between concurrent users or exclusive smokers. Most ex-smokers remained abstinent from smoking, and there was no difference in relapse back to smoking between those who vaped and those who did not.
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Affiliation(s)
- Shannon Gravely
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - K. Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Ron Borland
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Richard J. O’Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Karin A. Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA; (A.H.); (M.L.G.); (K.A.K.)
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (A.M.); (S.C.H.)
- Shaping public health policies to reduce inequalities & harm (SPECTRUM), The University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, ON N2L 3G1, Canada; (M.E.T.); (C.B.)
| | - Sara C. Hitchman
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK; (A.M.); (S.C.H.)
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA;
| | - James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
- Tobacco Research Department, Center for Population Health Research, National Institute of Public Health, Cuernavaca 62100, Mexico
| | - Anne C.K. Quah
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Nadia Martin
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, ON N2L 3G1, Canada; (M.E.T.); (C.B.)
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (S.G.); (G.M.); (A.C.K.Q.); (N.M.); (J.O.)
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
- Correspondence:
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12
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Ni K, Wang B, Link AR, Sherman SE. Does Smoking Intensity Predict Cessation Rates? A Study of Light-Intermittent, Light-Daily, and Heavy Smokers Enrolled in Two Telephone-Based Counseling Interventions. Nicotine Tob Res 2020; 22:423-430. [PMID: 30535269 DOI: 10.1093/ntr/nty257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Though many interventions have been shown to be effective in helping smokers quit, outcomes may differ between light and heavy smokers. We identified differences in baseline characteristics and post-intervention cessation rates among smoker groups at two safety-net hospitals. METHODS We retrospectively analyzed cessation rates in 1604 patients randomized to either a quitline referral (1-2 telephone counseling sessions) or intensive counseling program (seven telephone sessions). Participants were stratified into light-intermittent (smoked on ≤24 of last 30 days), light-daily (smoked on >24/30 days, 1-9 cigarettes per day [CPD]), or heavy smokers (smoked on >24/30 days, ≥10 CPD). We compared baseline characteristics between smoker types using chi-squared tests, then identified predictors of 30-day abstinence using a multivariable model. RESULTS Compared with light-daily and light-intermittent smokers, heavy smokers were more likely to be white, male, concomitant e-cigarette users, to have high-risk alcohol use, to have used quitting aids previously, to have current or lifetime substance use (excluding cannabis), and have lower confidence in quitting. However, in multivariable analysis, smoker type was not significantly associated with cessation. The statistically significant predictors of cessation at 6 months were higher confidence in quitting and enrollment in the intensive counseling intervention. CONCLUSIONS Smoker type (light-intermittent, light-daily, or heavy) does not independently predict success in a cessation program. However, smoker type is strongly associated with patients' confidence in quitting, which may be one predictor of cessation. IMPLICATIONS This study of two safety-net hospitals emphasizes that the number of cigarettes smoked per day does not independently predict smoking cessation. Additionally, heavy smokers are at highest risk for the detrimental health effects of tobacco, yet have lower confidence and motivation to quit. Confidence in quitting may be one factor that affects cessation rates; however, further study is needed to identify which other attributes predict cessation. These findings suggest that smoker type may still be a useful proxy for predicting cessation and that interventions specifically designed for and validated in heavy smokers are needed to better aid these individuals.
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Affiliation(s)
- Katherine Ni
- Department of Medicine, New York University School of Medicine, New York, NY
| | - Binhuan Wang
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Alissa R Link
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Scott E Sherman
- Department of Medicine, New York University School of Medicine, New York, NY.,Department of Population Health, New York University School of Medicine, New York, NY.,Department of Medicine, VA New York Harbor Healthcare System, New York, NY
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13
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Lozano P, Thrasher JF, Forthofer M, Hardin J, Shigematsu LMR, Arillo Santillán E, Fleischer NL. Smoking-Related Stigma: A Public Health Tool or a Damaging Force? Nicotine Tob Res 2020; 22:96-103. [PMID: 30053141 DOI: 10.1093/ntr/nty151] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/23/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Tobacco control policies and other denormalization strategies may reduce tobacco use by stigmatizing smoking. This raises an important question: Does perceived smoking-related stigma contribute to a smoker's decision to quit? The aim of this study was to evaluate if perceived smoking-related stigma was associated with smoking cessation outcomes among smokers in Mexico and Uruguay. METHODS We analyzed prospective data from a panel of adult smokers who participated in the 2008-2012 administrations of the International Tobacco Control Policy Evaluation Surveys in Mexico and Uruguay. We defined two analytic samples of participants: the quit behavior sample (n = 3896 Mexico; n = 1525 Uruguay) and the relapse sample (n = 596 Mexico). Generalized estimating equations were used to evaluate if different aspects of perceived stigma (ie, discomfort, marginalization, and negative stereotype) at baseline were associated with smoking cessation outcomes at follow-up. RESULTS We found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico. CONCLUSIONS This study suggests that perceived smoking-related stigma may be associated with more quit attempts, but less successful quitting among smokers. It is possible that once stigma is internalized by smokers, it may function as a damaging force. Future studies should evaluate the influence of internalized stigma on smoking behavior. IMPLICATIONS Although perceived smoking-related stigma may prompt smokers to quit smoking, smoking stigma may also serve as a damaging force for some individuals, making quitting more difficult. This study found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico.
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Affiliation(s)
- Paula Lozano
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Departamento de Investigación Sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Melinda Forthofer
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC
| | - James Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Edna Arillo Santillán
- Departamento de Investigación Sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Nancy L Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI
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14
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Klugman M, Hosgood HD, Hua S, Xue X, Vu THT, Perreira KM, Castañeda SF, Cai J, Pike JR, Daviglus M, Kaplan RC, Isasi CR. A longitudinal analysis of nondaily smokers: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Ann Epidemiol 2020; 49:61-67. [PMID: 32951805 DOI: 10.1016/j.annepidem.2020.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/27/2020] [Accepted: 06/18/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Nondaily smoking is increasing in the United States and common among Hispanic/Latino smokers. We characterized factors related to longitudinal smoking transitions in Hispanic/Latino nondaily smokers. METHODS The Hispanic Community Health Study/Study of Latinos is a population-based cohort study of Hispanics/Latinos aged 18-74 years. Multinomial logistic regression assessed the baseline factors (2008-2011) associated with follow-up smoking status (2014-2017) in nondaily smokers (n = 573), accounting for complex survey design. RESULTS After ∼6 years, 41% of nondaily smokers became former smokers, 22% became daily smokers, and 37% remained nondaily smokers. Factors related to follow-up smoking status were number of days smoked in the previous month, household smokers, education, income, and insurance. Those smoking 16 or more of the last 30 days had increased risk of becoming a daily smoker [vs. < 4 days; relative risk ratio (RRR) = 5.65, 95% confidence interval (95% CI) = 1.96-16.33]. Greater education was inversely associated with transitioning to daily smoking [>high school vs. <ninth grade: RRR (95% CI) = 0.30 (0.09-0.95)]. Living with smokers was associated with decreased likelihood of quitting [RRR (95% CI) = 0.45 (0.24-0.86)]. Having insurance was associated with quitting [RRR (95% CI) = 2.11 (1.18-3.76)] and becoming a daily smoker [RRR (95% CI) = 3.00 (1.39-6.48)]. CONCLUSIONS Many Hispanic/Latino nondaily smokers became daily smokers, which may increase their risk of adverse health outcomes. Addressing different smoking patterns in primary care may be useful to prevent smoking-related diseases.
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Affiliation(s)
- Madelyn Klugman
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Thanh-Huyen T Vu
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill
| | | | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - James R Pike
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Martha Daviglus
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
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15
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Cartujano-Barrera F, Rodríguez-Bolaños R, Arana-Chicas E, Gallegos-Carrillo K, N Flores Y, Pérez-Rubio G, Falfán-Valencia R, F Ellerbeck E, Reynales-Shigematsu LM, Cupertino AP. Enhancing nicotine replacement therapy usage and adherence through a mobile intervention: Secondary data analysis of a single-arm feasibility study in Mexico. Tob Induc Dis 2020; 18:36. [PMID: 32395099 PMCID: PMC7206510 DOI: 10.18332/tid/120076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/25/2020] [Accepted: 04/05/2020] [Indexed: 11/24/2022] Open
Abstract
INSTRODUCTION Nicotine Replacement Therapy (NRT) is an effective treatment for smoking cessation. However, medication usage and adherence remain a challenge that contributes to low smoking cessation rates. In Mexico, 8 in 10 smokers are interested in quitting. However, only 6% of Mexican smokers use medication for smoking cessation. The objective of this study is to assess the feasibility and acceptability of a mobile health (mHealth) intervention to increase usage and adherence of NRT in Mexico. METHODS The study involves a secondary data analysis. Forty smokers were recruited to participate in a single-arm pilot study. Participants received an mHealth intervention that uses tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. The intervention allows two-way interactivity text messaging between participants and a tobacco treatment specialist. NRT was offered to participants in accordance with practice guidelines in Mexico. Outcome measures included utilization of NRT, text messaging interactivity with the program, and biochemically verified abstinence at 12 weeks. RESULTS Thirty smokers met the criteria for use of NRT. Average age of participants was 38.1 years (SD=10.7), and they were primarily male (56.7%) with at least an undergraduate degree (60%). All participants requested NRT at baseline, and 60% requested a refill at week 4. During the 12-week intervention period, participants sent 620 messages to the program (mean=20.6, SD=18.34) of which 79 messages (12.7%) were related to NRT. Three themes were identified in the messages related to NRT: enthusiasm, instructions, and side effects. At 12 weeks, 40% of participants reported using NRT <75% of the days. Finally, 30% of participants (9/30) were biochemically verified abstinent using intention-to-treat analysis at 12 weeks. CONCLUSIONS An mHealth intervention appears to offer a promising strategy to increase usage and adherence of NRT in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
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Affiliation(s)
- Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, United States
| | | | - Evelyn Arana-Chicas
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, United States
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, United States
| | - Gloria Pérez-Rubio
- Laboratorio HLA, Instituto Nacional de Enfermedades Respiratorias, Ciudad de Mexico, Mexico
| | - Ramcés Falfán-Valencia
- Laboratorio HLA, Instituto Nacional de Enfermedades Respiratorias, Ciudad de Mexico, Mexico
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, United States
| | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, United States
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16
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Levy D, Zavala-Arciniega L, Reynales-Shigematsu LM, Fleischer NL, Yuan Z, Li Y, Romero LMS, Lau YK, Meza R, Thrasher JF. Measuring Smoking Prevalence in a Middle Income Nation: An Examination of the 100 Cigarettes Lifetime Screen. GLOBAL EPIDEMIOLOGY 2019; 1. [PMID: 33907731 DOI: 10.1016/j.gloepi.2019.100016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Introduction Public health surveillance of smoking prevalence is essential in gauging the magnitude of the problem, identifying groups most affected, and evaluating polices. However, little attention has focused on how prevalence is measured, particularly in low-and middle-income countries, where smoking patterns may not mirror those in high-income countries and where the burden of tobacco use is rapidly growing. Mexico provides a unique opportunity to gauge how the questions used to define established smokers can affect prevalence estimates. This study assesses how using the 100-cigarette lifetime question to define smoking status affects estimates of smoking prevalence. Methods We consider data from four nationally representative surveys in Mexico, from 2002 to 2016. These surveys ask about current smoking even for adults who do not indicate having smoked 100 cigarettes in their lifetime. We compare estimates of daily and nondaily smoking prevalence by age and gender with and without the 100-cigarette screen. Results The relative difference in prevalence estimates with and without the screen was greater for nondaily than daily smoking and for females than males. The difference was especially pronounced for nondaily smokers aged 15-24, where there was a 50%-75% relative difference in estimates, albeit smaller discrepancies (20-49% relative difference) were also found among older smokers. In recent years, the relative difference was greatest at lower levels of educational attainment. Conclusions With the growth in nondaily smoking, using the 100-cigarettes screen to define smoking status can have important implications regarding size of smoking population. Further research is warranted in other countries.
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Affiliation(s)
- David Levy
- Lombardi Comprehensive Cancer Center Georgetown University
| | - Luis Zavala-Arciniega
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Nancy L Fleischer
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - Zhe Yuan
- Lombardi Comprehensive Cancer Center Georgetown University
| | - Yameng Li
- Lombardi Comprehensive Cancer Center Georgetown University
| | | | - Yan Kwan Lau
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School Public Health, Ann Arbor, MI, United States of America of
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico.,Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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17
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Nargis N, Yong HH, Driezen P, Mbulo L, Zhao L, Fong GT, Thompson ME, Borland R, Palipudi KM, Giovino GA, Thrasher JF, Siahpush M. Socioeconomic patterns of smoking cessation behavior in low and middle-income countries: Emerging evidence from the Global Adult Tobacco Surveys and International Tobacco Control Surveys. PLoS One 2019; 14:e0220223. [PMID: 31490958 PMCID: PMC6730869 DOI: 10.1371/journal.pone.0220223] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 07/11/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Tobacco smoking is often more prevalent among those with lower socio-economic status (SES) in high-income countries, which can be driven by the inequalities in initiation and cessation of smoking. Smoking is a leading contributor to socio-economic disparities in health. To date, the evidence for any socio-economic inequality in smoking cessation is lacking, especially in low- and middle-income countries (LMICs). This study examined the association between cessation behaviours and SES of smokers from eight LMICs. METHODS Data among former and current adult smokers aged 18 and older came from contemporaneous Global Adult Tobacco Surveys (2008-2011) and the International Tobacco Control Surveys (2009-2013) conducted in eight LMICs (Bangladesh, Brazil, China, India, Mexico, Malaysia, Thailand and Uruguay). Adjusted odds ratios (AORs) of successful quitting in the past year by SES indicators (household income/wealth, education, employment status, and rural-urban residence) were estimated using multivariable logistic regression controlling for socio-demographics and average tobacco product prices. A random effects meta-analysis was used to combine the estimates of AORs pooled across countries and two concurrent surveys for each country. RESULTS Estimated quit rates among smokers (both daily and occasional) varied widely across countries. Meta-analysis of pooled AORs across countries and data sources indicated that there was no clear evidence of an association between SES indicators and successful quitting. The only exception was employed smokers, who were less likely to quit than their non-employed counterparts, which included students, homemakers, retirees, and the unemployed (pooled AOR≈0.8, p<0.10). CONCLUSION Lack of clear evidence of the impact of lower SES on adult cessation behaviour in LMICs suggests that lower-SES smokers are not less successful in their attempts to quit than their higher-SES counterparts. Specifically, lack of employment, which is indicative of younger age and lower nicotine dependence for students, or lower personal disposable income and lower affordability for the unemployed and the retirees, may be associated with quitting. Raising taxes and prices of tobacco products that lowers affordability of tobacco products might be a key strategy for inducing cessation behaviour among current smokers and reducing overall tobacco consumption. Because low-SES smokers are more sensitive to price increases, tobacco taxation policy can induce disproportionately larger decreases in tobacco consumption among them and help reduce socio-economic disparities in smoking and consequent health outcomes.
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Affiliation(s)
- Nigar Nargis
- American Cancer Society, Atlanta, Georgia, United States of America
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lazarous Mbulo
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Luhua Zhao
- CDC Foundation, Atlanta, Georgia, United States of America
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Ron Borland
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- VicHealth Centre for Tobacco Control, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Krishna M. Palipudi
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Gary A. Giovino
- School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, New York, United States of America
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Mohammad Siahpush
- Department of Health Promotion, Social & Behavioral Health, College of Public Health, University of Nebraska Medical Center, Nebraska, United States of America
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18
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Casado L, Thrasher JF, Perez C, Santos Thuler LC, Fong GT. Factors associated with quit attempts and smoking cessation in Brazil: findings from the International Tobacco Control Brazil Survey. Public Health 2019; 174:127-133. [PMID: 31362178 DOI: 10.1016/j.puhe.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to identify factors associated with attempting to quit and successful smoking cessation in a population-based sample of Brazilian smokers. STUDY DESIGN This is a prospective cohort study. METHODS Data came from the first two waves of the International Tobacco Control Brazil Survey, conducted in 2009 and 2012/2013 in three cities: Rio de Janeiro, São Paulo, and Porto Alegre. Data were collected from 488 adults (aged ≥18 years) who smoked at Wave 1 and who were resurveyed at Wave 2. Crude and adjusted relative risks for two outcomes (making a quit attempt between Wave 1 and Wave 2 and successfully quitting by Wave 2) were estimated. Multivariable multilevel logistic regression models were used, whereby variables were added to the models in a series of blocks. RESULTS Nearly two-thirds (65.6%) of smokers attempted to quit between waves, and 23.4% had quit at Wave 2. Intention to quit smoking at Wave 1 was the only variable associated with attempt to quit by Wave 2 (odds ratio [OR] = 2.85; 95% confidence interval [CI] 1.64-4.94; P < 0.001). Smokers of higher socio-economic status (OR high versus low = 1.80; 95% CI 1.05-3.10; P = 0.03) and lower nicotine dependence (OR low Heaviness of Smoking Index [HSI] versus high HSI = 1.94; 95% CI 1.10-3.43; P = 0.02) were more likely to successfully quit. The presence of another adult smoker at home was negatively related to successful quitting (OR = 0.50; 95% CI 0.26-0.94; P = 0.03). CONCLUSIONS These results are generally consistent with prior research and have potential to inform governmental interventions to promote tobacco cessation, particularly among disadvantaged groups.
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Affiliation(s)
- L Casado
- Coordenação de Ensino, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil.
| | - J F Thrasher
- Department of Health Promotion, Education & Behavior, University of South Carolina, Columbia, USA
| | - C Perez
- Fundação do Câncer, Rio de Janeiro, Brazil
| | - L C Santos Thuler
- Divisão de Pesquisa Clínica, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - G T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Saccone NL, Emery LS, Sofer T, Gogarten SM, Becker DM, Bottinger EP, Chen LS, Culverhouse RC, Duan W, Hancock DB, Hosgood HD, Johnson EO, Loos RJF, Louie T, Papanicolaou G, Perreira KM, Rodriquez EJ, Schurmann C, Stilp AM, Szpiro AA, Talavera GA, Taylor KD, Thrasher JF, Yanek LR, Laurie CC, Pérez-Stable EJ, Bierut LJ, Kaplan RC. Genome-Wide Association Study of Heavy Smoking and Daily/Nondaily Smoking in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Nicotine Tob Res 2019; 20:448-457. [PMID: 28520984 DOI: 10.1093/ntr/ntx107] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
Introduction Genetic variants associated with nicotine dependence have previously been identified, primarily in European-ancestry populations. No genome-wide association studies (GWAS) have been reported for smoking behaviors in Hispanics/Latinos in the United States and Latin America, who are of mixed ancestry with European, African, and American Indigenous components. Methods We examined genetic associations with smoking behaviors in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (N = 12 741 with smoking data, 5119 ever-smokers), using ~2.3 million genotyped variants imputed to the 1000 Genomes Project phase 3. Mixed logistic regression models accounted for population structure, sampling, relatedness, sex, and age. Results The known region of CHRNA5, which encodes the α5 cholinergic nicotinic receptor subunit, was associated with heavy smoking at genome-wide significance (p ≤ 5 × 10-8) in a comparison of 1929 ever-smokers reporting cigarettes per day (CPD) > 10 versus 3156 reporting CPD ≤ 10. The functional variant rs16969968 in CHRNA5 had a p value of 2.20 × 10-7 and odds ratio (OR) of 1.32 for the minor allele (A); its minor allele frequency was 0.22 overall and similar across Hispanic/Latino background groups (Central American = 0.17; South American = 0.19; Mexican = 0.18; Puerto Rican = 0.22; Cuban = 0.29; Dominican = 0.19). CHRNA4 on chromosome 20 attained p < 10-4, supporting prior findings in non-Hispanics. For nondaily smoking, which is prevalent in Hispanic/Latino smokers, compared to daily smoking, loci on chromosomes 2 and 4 achieved genome-wide significance; replication attempts were limited by small Hispanic/Latino sample sizes. Conclusions Associations of nicotinic receptor gene variants with smoking, first reported in non-Hispanic European-ancestry populations, generalized to Hispanics/Latinos despite different patterns of smoking behavior. Implications We conducted the first large-scale genome-wide association study (GWAS) of smoking behavior in a US Hispanic/Latino cohort, and the first GWAS of daily/nondaily smoking in any population. Results show that the region of the nicotinic receptor subunit gene CHRNA5, which in non-Hispanic European-ancestry smokers has been associated with heavy smoking as well as cessation and treatment efficacy, is also significantly associated with heavy smoking in this Hispanic/Latino cohort. The results are an important addition to understanding the impact of genetic variants in understudied Hispanic/Latino smokers.
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Affiliation(s)
- Nancy L Saccone
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Leslie S Emery
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Tamar Sofer
- Department of Biostatistics, University of Washington, Seattle, WA
| | | | - Diane M Becker
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Erwin P Bottinger
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | | | - Weimin Duan
- Department of Genetics, Washington University School of Medicine, St. Louis, MO
| | - Dana B Hancock
- Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Eric O Johnson
- Fellow Program and Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Tin Louie
- Department of Biostatistics, University of Washington, Seattle, WA
| | - George Papanicolaou
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Krista M Perreira
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Erik J Rodriquez
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.,Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA
| | - Claudia Schurmann
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adrienne M Stilp
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Gregory A Talavera
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC
| | - Lisa R Yanek
- GeneSTAR Research Program, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cathy C Laurie
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Eliseo J Pérez-Stable
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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20
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Cupertino AP, Cartujano-Barrera F, Ramírez M, Rodríguez-Bolaños R, Thrasher JF, Pérez-Rubio G, Falfán-Valencia R, Ellerbeck EF, Reynales-Shigematsu LM. A Mobile Smoking Cessation Intervention for Mexico (Vive sin Tabaco... ¡Decídete!): Single-Arm Pilot Study. JMIR Mhealth Uhealth 2019; 7:e12482. [PMID: 31021326 PMCID: PMC6658244 DOI: 10.2196/12482] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 01/26/2023] Open
Abstract
Background Of the 14.3 million Mexicans who smoke, only a minority take advantage of evidence-based approaches to smoking cessation. Mobile health interventions have the potential to increase the reach of effective cessation interventions in Mexico. Objective This study aimed to assess the feasibility and acceptability of an innovative, personalized, and interactive smoking cessation mobile intervention developed for Mexican smokers. Methods We recruited 40 Mexican smokers to participate in Vive sin Tabaco... ¡Decídete!, a smoking cessation program that uses a tablet-based decision support software to drive a 12-week text messaging smoking cessation program and pharmacotherapy support. Outcome measures included participant text messaging interactivity with the program, participant satisfaction, and 12-week verified abstinence using urinary cotinine testing or exhaled carbon monoxide. Results Average age of the participants was 36 years (SD 10.7), and they were primarily male (65%, 26/40) with at least an undergraduate degree (62%, 25/40). Most participants (95%, 38/40) smoked daily and were interested in quitting in the next 7 days. As an indicator of participant interactivity, participants sent an average of 21 text messages during the 12-week intervention (SD 17.62). Of the 843 messages that participants sent to the program, only 96 messages (11.3%, 96/843) used keywords. At 12 weeks, 40% (16/40) of participants were biochemically verified (87%, 35/40, follow-up rate). The majority of participants (85%, 30/35) reported being very satisfied or extremely satisfied with the program. Conclusions The Vive sin Tabaco... ¡Decídete! smoking cessation mobile intervention was accepted by participants, generated high satisfaction and high text messaging interactivity, and resulted in a noteworthy cessation rate at the end of treatment. This intervention is a promising strategy for smoking cessation in Mexico. Additional testing as a formal randomized clinical trial appears warranted.
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Affiliation(s)
- Ana Paula Cupertino
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Francisco Cartujano-Barrera
- Department of Cancer Prevention and Control, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Mariana Ramírez
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, United States
| | - Gloria Pérez-Rubio
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Laboratorio HLA, Mexico City, Mexico
| | - Ramcés Falfán-Valencia
- Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Laboratorio HLA, Mexico City, Mexico
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, United States
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21
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Thomas DP, Lyons L, Borland R. Predictors and reasons for starting and sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. Drug Alcohol Rev 2019; 38:244-253. [DOI: 10.1111/dar.12917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 01/11/2023]
Affiliation(s)
- David P. Thomas
- Tobacco Control Research, Menzies School of Health ResearchCharles Darwin University Darwin Australia
| | - Louise Lyons
- Public Health and ResearchVictorian Aboriginal Community Controlled Health Organisation Melbourne Australia
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22
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Meshefedjian GA. The smoking spectrum: review of the existing evidence and future directions. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-01009-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Zavala-Arciniega L, Reynales-Shigematsu LM, Lozano P, Rodríguez-Andrade MÁ, Arillo-Santillán E, Thrasher JF. Patterns of awareness and use of electronic cigarettes in Mexico, a middle-income country that bans them: Results from a 2016 national survey. Prev Med 2018; 116:211-218. [PMID: 30261244 PMCID: PMC6276365 DOI: 10.1016/j.ypmed.2018.09.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 09/10/2018] [Accepted: 09/22/2018] [Indexed: 12/23/2022]
Abstract
Among high-income countries, awareness and use of e-cigarettes is lower in countries with more restrictive e-cigarette regulations. Little is known about e-cigarettes in middle-income countries, many of which like Mexico, ban e-cigarette sales and marketing. The current study determined the national-level prevalence and correlates of e-cigarette awareness and consumption in Mexico. Data were analyzed from a 2016 nationally representative survey. Prevalence of e-cigarette awareness, trial and current use was estimated separately for adolescents (n = 12,436), adult nonsmokers (n = 36,966), and adult smokers (n = 7347). For each group, crude and adjusted logistic models regressed e-cigarette outcomes on sociodemographic and smoking-related variables, adjusting for the sampling design and weights. Prevalence varied across subgroups for e-cigarette awareness (adolescents = 45.3%; adult nonsmokers = 33.9%; adult smokers = 54.3%), e-cigarette trial (adolescents = 6.5%; adult nonsmokers = 2.6%; adult smokers = 18.2%) and current use of electronic cigarettes (adolescents = 1.1%; adult nonsmokers = 0.3%; adult smokers = 4.5%). Among adolescents and adults, current smoking and higher smoking frequency were significantly associated with e-cigarette awareness, trial and use. Among adolescents and nonsmokers, awareness, trial and use of e-cigarette were significantly lower among females than males. Among adult smokers, however, females were more likely to use e-cigarettes than males (AOR = 1.80; 95% CI = 1.08-3.02). Higher education and greater wealth increased the likelihood of trial of e-cigarettes among adult nonsmokers and smokers. Despite the ban on the distribution and sales of e-cigarettes, a substantial number of Mexicans, have access to e-cigarettes. Decision makers and advocates should consider e-cigarette regulations as recommended by the WHO, at the same time Mexico must invest in the infrastructure needed to enforce these regulations.
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Affiliation(s)
- Luis Zavala-Arciniega
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Paula Lozano
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | - James F Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico; Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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24
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Swayampakala K, Thrasher JF, Hardin JW, Titus AR, Liu J, Fong GT, Fleischer NL. Factors associated with changing cigarette consumption patterns among low-intensity smokers: Longitudinal findings across four waves (2008-2012) of ITC Mexico Survey. Addict Behav Rep 2018; 8:154-163. [PMID: 30364679 PMCID: PMC6197769 DOI: 10.1016/j.abrep.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background Light and intermittent smoking has become increasingly prevalent as smokers shift to lower consumption in response to tobacco control policies. We examined changes in cigarette consumption patterns over a four-year period and determined which factors were associated with smoking transitions. Methods We used data from a cohort of smokers from the 2008–2012 ITC Mexico Survey administrations to investigate transitions from non-daily (ND; n = 669), daily light (DL; ≤5 cigarettes per day (cpd); n = 643), and daily heavy (DH; >5 cpd; n = 761) smoking patterns. To identify which factors (i.e., sociodemographic measures, perceived addiction, quit behavior, social norms) were associated with smoking transitions, we stratified on smoking status at time t (ND, DL, DH) and used multinomial (ND, DL) and binomial (DH) logistic regression to examine transitions (quitting/reducing or increasing versus same level for ND and DL, quitting/reducing versus same level for DH). Results ND smokers were more likely to quit at follow-up than DL or DH smokers. DH smokers who reduced their consumption to ND were more likely to quit eventually compared to those who continued as DH. Smokers who perceived themselves as addicted had lower odds of quitting/reducing smoking consumption at follow-up compared to smokers who did not, regardless of smoking status at the prior survey. Quit attempts and quit intentions were also associated with quitting/reducing consumption. Conclusions Reducing consumption may eventually lead to cessation, even for heavier smokers. The findings that perceived addiction and quit behavior were important predictors of changing consumption for all groups may offer insights into potential interventions. Smoking transitions were evaluated in a cohort of Mexican smokers. The cohort consisted mostly of understudied light and intermittent smokers (LITS). Reductions in smoking intensity were found to facilitate smoking cessation. Greater perceived addiction inhibited cessation for smokers at all levels of intensity. LITS patterns warrant attention as number of low-intensity smokers worldwide grows.
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Affiliation(s)
- Kamala Swayampakala
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Andrea R. Titus
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Nancy L. Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Corresponding author at: Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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25
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Brewer NT, Jeong M, Mendel JR, Hall MG, Zhang D, Parada H, Boynton MH, Noar SM, Baig SA, Morgan JC, Ribisl KM. Cigarette pack messages about toxic chemicals: a randomised clinical trial. Tob Control 2018; 28:74-80. [PMID: 29654122 PMCID: PMC6186198 DOI: 10.1136/tobaccocontrol-2017-054112] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/22/2018] [Accepted: 02/20/2018] [Indexed: 11/07/2022]
Abstract
Background The USA can require tobacco companies to disclose information about harmful and potentially harmful chemicals in cigarette smoke, but the impact of these messages is uncertain. We sought to assess the effect of placing messages about toxic chemicals on smokers’ cigarette packs. Methods Participants were 719 adult cigarette smokers from California, USA, recruited from September 2016 through March 2017. We randomly assigned smokers to receive either factual messages about chemicals in cigarette smoke and their health harms (intervention) or messages about not littering cigarette butts (control) on the side of their cigarette packs for 3 weeks. The primary trial outcome was intention to quit smoking. Results In intent-to-treat analyses, smokers whose packs had chemical messages did not have higher intentions to quit smoking at the end of the trial than those whose packs had control messages (P=0.56). Compared with control messages, chemical messages led to higher awareness of the chemicals (28% vs 15%, P<0.001) and health harms (60% vs 52%, P=0.02) featured in the messages. In addition, chemical messages led to greater negative affect, thinking about the chemicals in cigarettes and the harms of smoking, conversations about the messages and forgoing a cigarette (all P<0.05). Discussion Chemical messages on cigarette packs did not lead to higher intentions to quit among smokers in our trial. However, chemical messages informed smokers of chemicals in cigarettes and harms of smoking, which directly supports their implementation and would be critical to defending the messages against cigarette company legal challenges. Trial registration number NCT02785484.
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Affiliation(s)
- Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michelle Jeong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer R Mendel
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Dongyu Zhang
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.,School of Media and Journalism, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
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Formagini TDB, Gomide HP, Perales J, Colugnati FAB. Prevalence and correlates of light and non-daily smoking in Brazil: Results from a nationwide representative survey. Drug Alcohol Depend 2017. [PMID: 28623806 DOI: 10.1016/j.drugalcdep.2017.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The research of light (≤10 cigarettes per day) and non-daily smokers in developing countries including Brazil is scarce despite the high prevalence of these groups among smokers and health risks associated to low-level smoking. OBJECTIVE To describe health and smoking characteristics of Brazilian adult light and non-daily smokers. METHODS We analyzed data from the 2013 Brazilian National Health Research survey (n=48,282). RESULTS The prevalence of current manufactured cigarette smoking in the total sample was 12.4%. Among these smokers, 12.8% were non-daily smokers (NDS), 47.4% were light smokers (LS) and 39.8% were moderate/heavy smokers (MHS). Bivariate analysis showed that non-daily smoking was associated with higher odds of poor self-rated health, binge drinking and lung diseases compared to never smokers (ORs=1.2; 5.9 and 1.9). Light smoking was associated with higher odds of poor self-rated health, binge drinking, depression, use of sleeping pills and lung diseases (ORs=1.3; 4.3; 1.4; 1.2 and 2.0). After controlling for sex and age, non-daily smoking was associated with lung disease (OR=2.2) and light smoking with depression and lung diseases (ORs=1.3 and 1.8). Smoking levels were associated with living with same-level smokers in bivariate and multivariate analyses. CONCLUSION A large proportion of smokers in Brazil are light and non-daily smokers, carrying substantial health risks related to tobacco use. Longitudinal research is needed to provide further evidence of associations found in this study. Public health policies must take the different smoking patterns into consideration to effectively target all smokers and reduce the harmful consequences of tobacco worldwide.
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Affiliation(s)
| | - Henrique Pinto Gomide
- Department of Postgraduate in Psychology, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Jaime Perales
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, KS, USA
| | - Fernando Antonio Basile Colugnati
- Department of Postgraduate in Psychology, Federal University of Juiz de Fora, Minas Gerais, Brazil; Medical School, Federal University of Juiz de Fora, Minas Gerais, Brazil.
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27
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Wang Y, Sung HY, Yao T, Lightwood J, Max W. Factors associated with short-term transitions of non-daily smokers: socio-demographic characteristics and other tobacco product use. Addiction 2017; 112:864-872. [PMID: 27886652 PMCID: PMC5382088 DOI: 10.1111/add.13700] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/29/2016] [Accepted: 11/21/2016] [Indexed: 12/01/2022]
Abstract
AIMS To examine the transitions in smoking status among non-daily smokers who transitioned to daily or former smokers or remained as non-daily smokers during a 12-month period. We analyzed factors associated with these transitions, including the use of cigars and smokeless tobacco (SLT). DESIGN Secondary data analyses using pooled data from the 2003, 2006/07 and 2010/11 Tobacco Use Supplements to the Current Population Survey (TUS-CPS). SETTING United States. PARTICIPANTS Self-respondents aged 18+ who have smoked for more than 5 years and were non-daily smokers 12 months before the interview (n = 13 673, or 14.5% of current smokers). MEASUREMENTS Multinomial logistic regression model to determine the correlates of non-daily to daily, stable non-daily and non-daily to former smoking transitions among non-daily smokers at baseline. The model controlled for socio-demographic factors and the use of cigars and SLT. FINDINGS Of the adults in our sample, 2.6% were non-daily smokers at baseline. Among these, 69.7% remained non-daily smokers (stable non-daily smokers), 18.4% became daily smokers (non-daily to daily smokers) and 11.9% quit smoking (non-daily to former smokers) after 12 months. The non-daily to daily versus stable non-daily smoking transition was less likely among those who were aged 65+ (P = 0.018), male (P < 0.001), Hispanic (P < 0.001), with an income of $25 000-49 999 or ≥$75 000 and current users of SLT (P = 0.003), but more likely among those without a college degree compared with the appropriate reference group. The non-daily to former versus stable non-daily smoking transition was less likely among those aged 25+, male (P = 0.013), non-Hispanic Asian (P = 0.032), without a college degree, widowed/divorced/separated (P = 0.013) or never married (P = 0.011) and current users of cigars (P = 0.003) compared with the appropriate reference group. CONCLUSIONS While more than two-thirds of non-daily smokers in the United States remain as such after 12 months, others become daily smokers or quit. The likelihood of remaining stable non-daily smokers and of transition from non-daily to daily and non-daily to former smokers is associated with socio-demographic factors and current use of cigars and smokeless tobacco.
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Affiliation(s)
- Yingning Wang
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - Hai-Yen Sung
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - Tingting Yao
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - James Lightwood
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA
| | - Wendy Max
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
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Brief intervention to promote smoking cessation and improve glycemic control in smokers with type 2 diabetes: a randomized controlled trial. Sci Rep 2017; 7:45902. [PMID: 28378764 PMCID: PMC5381102 DOI: 10.1038/srep45902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/06/2017] [Indexed: 12/18/2022] Open
Abstract
The aim of the study was to examine the effects of a brief stage-matched smoking cessation intervention group compared with a control group (with usual care) in type 2 diabetes mellitus patients who smoked by randomized controlled trial. There were 557 patients, randomized either into the intervention group (n = 283) who received brief (20- minute) individualized face-to-face counseling by trained nurses and a diabetes mellitus-specific leaflet, or a control group (n = 274) who received standard care. Patient follow-ups were at 1 week, 1 month, 3 months, 6 months, and 12 months via telephone, and assessment of smoking status from 2012 to 2014. Patients smoked an average of 14 cigarettes per day for more than 37 years, and more than 70% were in the precontemplation stage of quitting. The primary outcome showed that both the intervention and control groups had similar 7-day point-prevalence smoking abstinence (9.2% vs. 13.9%; p = 0.08). The secondary outcome showed that HbA1c levels with 7.95% [63 mmol/mol] vs. 8.05% [64 mmol/mol], p = 0.49 at 12 months, respectively. There was no evidence for effectiveness in promoting the brief stage-matched smoking cessation or improving glycemic control in smokers with type 2 diabetes mellitus, particularly those in the pre-contemplation stage.
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Clancy F, Prestwich A, Caperon L, O'Connor DB. Perseverative Cognition and Health Behaviors: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2016; 10:534. [PMID: 27877119 PMCID: PMC5099163 DOI: 10.3389/fnhum.2016.00534] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/10/2016] [Indexed: 12/01/2022] Open
Abstract
Recent developments in stress theory have emphasized the significance of perseverative cognition (worry and rumination) in furthering our understanding of stress-disease relationships. Substantial evidence has shown that perseverative cognition (PC) is associated with somatic outcomes and numerous physiological concomitants have been identified (i.e., cardiovascular, autonomic, and endocrine nervous system activity parameters). However, there has been no synthesis of the evidence regarding the association between PC and health behaviors. This is important given such behaviors may also directly and/or indirectly influence health and disease outcomes (triggered by PC). Therefore, the aim of the current review was to synthesize available studies that have explored the relationship between worry and rumination and health behaviors (health risk: behaviors which, if performed, would be detrimental to health; health promoting: behaviors which, if performed, would be beneficial for health). A systematic review and meta-analyses of the literature were conducted. Studies were included in the review if they reported the association between PC and health behavior. Studies identified in MEDLINE or PsycINFO (k = 7504) were screened, of which 19 studies met the eligibility criteria. Random-effects meta-analyses suggested increased PC was generally associated with increased health risk behaviors but not health promoting behaviors. Further analyses indicated that increases in rumination (r = 0.122), but not reflection (r = −0.080), or worry (r = 0.048) were associated with health risk behaviors. In conclusion, these results showed that increases in PC are associated with increases in health risk behaviors (substance use, alcohol consumption, unhealthy eating, and smoking) that are driven primarily through rumination. These findings provide partial support for our hypothesis that in Brosschot et al.'s (2006) original perseverative cognition hypothesis, there may be scope for additional routes to pathogenic disease via poorer health behaviors.
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Affiliation(s)
- Faye Clancy
- School of Psychology, University of Leeds Leeds, UK
| | | | - Lizzie Caperon
- Leeds Institute of Health Sciences, University of Leeds Leeds, UK
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Lozano P, Fleischer NL, Moore S, Shigematsu LMR, Santillán EA, Thrasher JF. Does neighborhood social cohesion modify the relationship between neighborhood social norms and smoking behaviors in Mexico? Health Place 2016; 40:145-52. [PMID: 27318174 DOI: 10.1016/j.healthplace.2016.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/15/2016] [Accepted: 05/25/2016] [Indexed: 11/30/2022]
Abstract
The aim of this study was to examine the separate and combined relationships of neighborhood social norms and neighborhood social cohesion with smoking behavior in a cohort of adult Mexican smokers. Neighborhood anti-smoking norms were measured as the proportion of residents in each neighborhood who believed that society disapproves of smoking. Perceived social cohesion was measured using a 5-item cohesion scale and aggregated to the neighborhood level. Higher neighborhood anti-smoking norms were associated with less successful quitting. Neighborhood social cohesion modified the relationship between neighborhood social norms and two smoking behaviors: smoking intensity and quit attempts. Residents of neighborhoods with weaker anti-smoking norms and higher social cohesion had lower smoking intensity and more quit attempts than residents living in other areas. Social cohesion may help buffer smoking behavior in areas with weak social norms.
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Affiliation(s)
- Paula Lozano
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Nancy L Fleischer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Spencer Moore
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Edna Arillo Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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Differences in cigarette design and metal content across five countries: results from the International Tobacco Control (ITC) Project. TOB REGUL SCI 2016; 2:166-175. [PMID: 32864393 DOI: 10.18001/trs.2.2.7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives The current study examines physical cigarette design characteristics and tobacco metal content of cigarettes obtained from 5 countries to determine how these properties vary for cigarette brands, both within and across countries with different dominant manufacturers. Methods Cigarette packs were collected from International Tobacco Control Policy Evaluation Survey (ITC) participants in the U.S., the U.K., Mauritius, Mexico, and Thailand. Cigarettes were assessed for physical and design properties (eg, ventilation, pressure drop, rod density, weight) by published methods, and for metal content (As, Cd, Ni, Pb) by X-ray fluorescence spectrometry. Results Significant differences in cigarette design and toxic metal concentrations were observed between countries and between manufacturers within countries. Filter ventilation, which is strongly predictive of machine-measured tar and nicotine levels, varied most widely across countries. Ni and Cd were highest in Thailand (2.23ug/g and 1.64ug/g, respectively); As was highest in Mexico (0.29ug/g) and Pb was highest in the U.K. (0.43 ug/g). Conclusions Parties to the FCTC should consider the adoption of uniform product standards related to cigarette design, emissions, and tobacco content that would reduce population health risks.
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Fleischer NL, Thrasher JF, Reynales-Shigematsu LM, Cummings KM, Meza R, Zhang Y, Levy DT. Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico. Glob Public Health 2016; 12:830-845. [PMID: 26837721 DOI: 10.1080/17441692.2015.1123749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
- Nancy L Fleischer
- a Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health , University of Michigan , Ann Arbor , MI , USA
| | - James F Thrasher
- b Department of Health Promotion, Education, and Behavior, Arnold School of Public Health , University of South Carolina , Columbia , SC , USA.,c Department of Tobacco Research, Center for Population Health Research , National Institute of Public Health , Cuernavaca , Mexico
| | - Luz Myriam Reynales-Shigematsu
- c Department of Tobacco Research, Center for Population Health Research , National Institute of Public Health , Cuernavaca , Mexico
| | - K Michael Cummings
- d Department of Psychiatry & Behavioral Sciences , Medical University of South Carolina , Charleston , SC , USA
| | - Rafael Meza
- e Department of Epidemiology , University of Michigan , Ann Arbor , MI , USA
| | - Yian Zhang
- f Department of Oncology , Georgetown University , Washington , DC , USA
| | - David T Levy
- g Lombardi Comprehensive Cancer Center , Georgetown University , Washington , DC , USA
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Fleischer NL, Lozano P, Santillán EA, Shigematsu LMR, Thrasher JF. The impact of neighbourhood violence and social cohesion on smoking behaviours among a cohort of smokers in Mexico. J Epidemiol Community Health 2015; 69:1083-90. [PMID: 26043898 PMCID: PMC5062743 DOI: 10.1136/jech-2014-205115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 05/20/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent increases in violent crime may impact a variety of health outcomes in Mexico. We examined relationships between neighbourhood-level violence and smoking behaviours in a cohort of Mexican smokers from 2011 to 2012, and whether neighbourhood-level social cohesion modified these relationships. METHODS Data were analysed from adult smokers and recent ex-smokers who participated in waves 5 and 6 of the International Tobacco Control Mexico survey. Self-reported neighbourhood violence and social cohesion were asked of wave 6 survey participants (n=2129 current and former smokers, n=150 neighbourhoods). Neighbourhood-level averages for violence and social cohesion (ranges 4-14 and 10-25, respectively) were assigned to individuals. We used generalised estimating equations to determine associations between neighbourhood indicators and individual-level smoking intensity, quit behaviours and relapse. RESULTS Higher neighbourhood violence was associated with higher smoking intensity (risk ratio (RR)=1.17, 95% CI 1.02 to 1.33), and fewer quit attempts (RR=0.72, 95% CI 0.61 to 0.85). Neighbourhood violence was not associated with successful quitting or relapse. Higher neighbourhood social cohesion was associated with more quit attempts and more successful quitting. Neighbourhood social cohesion modified the association between neighbourhood violence and smoking intensity: in neighbourhoods with higher social cohesion, as violence increased, smoking intensity decreased and in neighbourhoods with lower social cohesion, as violence increased, so did smoking intensity. CONCLUSIONS In the context of recent increased violence in Mexico, smokers living in neighbourhoods with more violence may smoke more cigarettes per day and make fewer quit attempts than their counterparts in less violent neighbourhoods. Neighbourhood social cohesion may buffer the impact of violence on smoking intensity.
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Affiliation(s)
- Nancy L. Fleischer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Paula Lozano
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edna Arillo Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | | | - James F. Thrasher
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Robertson L, Iosua E, McGee R, Hancox RJ. Nondaily, Low-Rate Daily, and High-Rate Daily Smoking in Young Adults: A 17-Year Follow-Up. Nicotine Tob Res 2015; 18:943-9. [PMID: 26246050 DOI: 10.1093/ntr/ntv167] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 07/28/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION While overall tobacco consumption is declining in many countries, patterns of low-frequency smoking-such as nondaily and low-rate daily smoking-appear to be increasing. We aimed firstly to describe differences in demographic, smoking- and quitting-related characteristics between nondaily and daily smokers in young adults; secondly, to determine the proportion of low-frequency smokers who transition to a higher rate of smoking by age 38 and factors associated with this. METHODS We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972-1973, at regular intervals from age 21 to age 38 years. Smokers were categorized as either nondaily, low-rate daily (ie, defined as five or less cigarettes per day) or high-rate daily smokers (six or more cigarettes per day). Descriptive statistics, linear and logistic regression were used. RESULTS Nondaily smokers at age 21 tended to self-identify as nonsmokers. Both nondaily smokers and low-rate daily smokers reported higher readiness and confidence in quitting compared to high-rate daily smokers. Around 40% of the age 21 low-rate daily smokers reported smoking daily at age 38, compared to 13% of the nondaily smokers and 4% of the nonsmokers. Nondaily smoking at age 21 was associated with increased odds of being a daily smoker by age 38 (OR: 3.6; 95% CI = 1.7% to 7.8%) compared to nonsmokers. CONCLUSIONS Different patterns of smoking are associated with differences in readiness to quit and confidence in quitting ability. For a considerable proportion of smokers, low-frequency smoking in young adulthood develops into daily smoking by adulthood. IMPLICATIONS Low-frequency smoking, including nondaily smoking, in early adulthood is a significant risk factor for being a daily smoker in the long-term. Cessation interventions should be tailored to low-frequency smokers, taking into account differences between them and heavier smokers in terms of smoking motivation and quitting-related cognitions.
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Affiliation(s)
- Lindsay Robertson
- Cancer Society of New Zealand Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand;
| | - Ella Iosua
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rob McGee
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Robert J Hancox
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Daoud N, Hayek S, Sheikh Muhammad A, Abu-Saad K, Osman A, Thrasher JF, Kalter-Leibovici O. Stages of change of the readiness to quit smoking among a random sample of minority Arab male smokers in Israel. BMC Public Health 2015; 15:672. [PMID: 26178347 PMCID: PMC4607270 DOI: 10.1186/s12889-015-1950-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite advanced smoking prevention and cessation policies in many countries, the prevalence of cigarette smoking among indigenous and some ethnic minorities continues to be high. This study examined the stages of change (SOC) of the readiness to quit smoking among Arab men in Israel shortly after new regulations of free-of-charge smoking cessation workshops and subsidized medications were introduced through primary health care clinics. METHODS We conducted a countrywide study in Israel between 2012-2013. Participants, 735 current smokers; 18-64 years old; were recruited from a stratified random sample and interviewed face-to-face using a structured questionnaire in Arabic. We used ordered regression to examine the contribution of socio-economic position (SEP), health status, psychosocial attributes, smoking-related factors, and physician advice to the SOC of the readiness to quit smoking (pre-contemplation, contemplation and preparation). RESULTS Of the current smokers, 61.8% were at the pre-contemplation stage, 23.8% were at the contemplation stage, and only 14.4% were at the preparation stage. In the multinomial analysis, factors significantly (P < 0.05) contributing to contemplation stage compared to pre-contemplation stage included [odds ratio (OR), 95% confidence interval (CI)]: chronic morbidity [0.52, (0.31-0.88)], social support [1.35, (1.07-1.70)], duration of smoking for 11-21 years [1.94, (1.07-3.50)], three or more previous attempts to quit [2.27, (1.26-4.01)], knowledge about smoking hazards [1.75, (1.29-2.35)], positive attitudes toward smoking prevention [1.44, (1.14-1.82)], and physician advice to quit smoking [1.88, (1.19-2.97)]. The factors significantly (P < 0.05) contributing to preparation stage compared to pre-contemplation stage were [OR, (95 % CI)]: chronic morbidity [0.36, (0.20-0.67)], anxiety [1.07, (1.01-1.13)], social support [1.34, (1.01-1.78)], duration of smoking 5 years or less [2.93, (1.14-7.52)], three or more previous attempts to quit [3.16, (1.60-6.26)], knowledge about smoking hazards [1.57, (1.10-2.21)], and positive attitudes toward smoking prevention [1.34, (1.00-1.82)]. CONCLUSIONS Most Arab men who currently smoke are in the pre-contemplation stage, indicating low readiness to quit smoking. New policies of free-of-charge smoking-cessation group sessions and subsidized medications introduced through primary health care clinics in Israel may be less effective among Arab men. For these policies to promote cessation more successfully, tailored interventions and campaigns may be needed to increase the readiness to quit smoking in this population, especially for those at the pre-contemplation stage.
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Affiliation(s)
- Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva, 84015, Israel.
| | - Samah Hayek
- School of Public Health. University of Haifa, Haifa, Israel.
| | - Ahmad Sheikh Muhammad
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva, 84015, Israel.
| | - Kathleen Abu-Saad
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, 52621, Israel.
| | - Amira Osman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC, 29208, USA.
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC, 29208, USA.
| | - Ofra Kalter-Leibovici
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, 52621, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Hall MG, Fleischer NL, Reynales-Shigematsu LM, Arillo-Santillán E, Thrasher JF. Increasing availability and consumption of single cigarettes: trends and implications for smoking cessation from the ITC Mexico Survey. Tob Control 2014; 24 Suppl 3:iii64-iii70. [PMID: 25192772 DOI: 10.1136/tobaccocontrol-2014-051690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 08/19/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Determine (1) trends in single cigarette availability and purchasing in Mexico and (2) the association between neighbourhood access to singles and cessation behaviour among adult Mexican smokers. METHODS We analysed data from Wave 4 (2010), Wave 5 (2011) and Wave 6 (2012) of the Mexican International Tobacco Control Policy Evaluation Survey. We used data from all three waves to examine time trends in singles availability and purchasing. To explore the association between neighbourhood access to singles and cessation behaviour, we used data from participants who were smokers at Wave 5 and followed up at Wave 6 (n=1272). FINDINGS The percentage of participants who saw singles sold daily (45.2% in 2010; 51.4% in 2011; 64.9% in 2012), who bought singles at least once a week (22.3% in 2010; 29.1% in 2011; 29.1% in 2012) and whose last cigarette purchase was a single (16.6% in 2010; 20.7% in 2011; 25.8% in 2012) increased significantly from 2010 to 2012 (all p<0.001). The average percentage of residents who reported seeing singles sold daily in their neighbourhood in 2012 was 60% (SD=25%). In adjusted analyses, smokers living in neighbourhoods with higher access to singles were less likely to make a quit attempt (risk ratio (RR)=0.72; 95% CI 0.46 to 1.12), and more likely to relapse (RR=1.30; CI 0.94 to 1.82), but these results were not statistically significant. CONCLUSIONS Single cigarettes appear widely accessible in Mexico and growing in availability. Future research should explore potential explanations, consequences and effective methods for reducing the availability of single cigarettes.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nancy L Fleischer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | | | - Edna Arillo-Santillán
- Tobacco Control Research Department, National Institute of Public Health Mexico, Cuernavaca, Mexico
| | - James F Thrasher
- Tobacco Control Research Department, National Institute of Public Health Mexico, Cuernavaca, Mexico Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina
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Fleischer NL, Thrasher JF, Sáenz de Miera Juárez B, Reynales-Shigematsu LM, Arillo-Santillán E, Osman A, Siahpush M, Fong GT. Neighbourhood deprivation and smoking and quit behaviour among smokers in Mexico: findings from the ITC Mexico Survey. Tob Control 2014; 24 Suppl 3:iii56-iii63. [PMID: 25170022 DOI: 10.1136/tobaccocontrol-2013-051495] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 08/08/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND In high-income countries (HICs), higher neighbourhood socioeconomic deprivation is associated with higher levels of smoking. Few studies in low-income and middle-income countries (LMICs) have investigated the role of the neighbourhood environment on smoking behaviour. OBJECTIVE To determine whether neighbourhood socioeconomic deprivation is related to smoking intensity, quit attempts, quit success and smoking relapse among a cohort of smokers in Mexico from 2010 to 2012. METHODS Data were analysed from adult smokers and recent ex-smokers who participated in waves 4-6 of the International Tobacco Control (ITC) Mexico Survey. Data were linked to the Mexican government's composite index of neighbourhood socioeconomic deprivation, which is based on 2010 Mexican Census data. We used generalised estimating equations to determine associations between neighbourhood deprivation and individual smoking behaviours. FINDINGS Contrary to past findings in HICs, higher neighbourhood socioeconomic deprivation was associated with lower smoking intensity. Quit attempts showed a U-shaped pattern whereby smokers living in high/very high deprivation neighbourhoods and smokers living in very low deprivation neighbourhoods were more likely to make a quit attempt than smokers living in other neighbourhoods. We did not find significant differences in neighbourhood deprivation on relapse or successful quitting, with the possible exception of people living in medium-deprivation neighbourhoods having a higher likelihood of successful quitting than people living in very low deprivation neighbourhoods (p=0.06). CONCLUSIONS Neighbourhood socioeconomic environments in Mexico appear to operate in an opposing manner to those in HICs. Further research should investigate whether rapid implementation of strong tobacco control policies in LMICs, as occurred in Mexico during the follow-up period, avoids the concentration of tobacco-related disparities among socioeconomically disadvantaged groups.
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Affiliation(s)
- Nancy L Fleischer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | | | | | - Edna Arillo-Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Amira Osman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Mohammad Siahpush
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada School of Public health and Health Systems, University of Waterloo, Ontario, Canada Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Kaplan RC, Bangdiwala SI, Barnhart JM, Castañeda SF, Gellman MD, Lee DJ, Pérez-Stable EJ, Talavera GA, Youngblood ME, Giachello AL. Smoking among U.S. Hispanic/Latino adults: the Hispanic community health study/study of Latinos. Am J Prev Med 2014; 46:496-506. [PMID: 24745640 PMCID: PMC5794209 DOI: 10.1016/j.amepre.2014.01.014] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 01/08/2014] [Accepted: 01/23/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Prior national surveys capture smoking behaviors of the aggregated U.S. Hispanic/Latino population, possibly obscuring subgroup variation. PURPOSE To describe cigarette use among Hispanic/Latino adults across subgroups of age, gender, national background, SES, birthplace, and degree of acculturation to the dominant U.S. culture. METHODS A cross-sectional survey of 16,322 participants in the Hispanic Community Health Study/Study of Latinos aged 18-74 years, recruited in Bronx NY, Chicago IL, Miami FL, and San Diego CA, was conducted during 2008-2011. RESULTS Prevalence of current smoking was highest among Puerto Ricans (men, 35.0%; women, 32.6%) and Cubans (men, 31.3%; women, 21.9%), with particularly high smoking intensity noted among Cubans as measured by pack-years and cigarettes/day. Dominicans had the lowest smoking prevalence (men, 11.0%; women, 11.7%). Individuals of other national backgrounds had a smoking prevalence that was intermediate between these groups, and typically higher among men than women. Non-daily smoking was common, particularly although not exclusively among young men of Mexican background. Persons of low SES were more likely to smoke, less likely to have quit smoking, and less frequently used over-the-counter quit aids compared to those with higher income and education levels. Smoking was more common among individuals who were born in the U.S. and had a higher level of acculturation to the dominant U.S. culture, particularly among women. CONCLUSIONS Smoking behaviors vary widely across Hispanic/Latino groups in the U.S., with a high prevalence of smoking among population subgroups with specific, readily identifiable characteristics.
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Affiliation(s)
- Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
| | - Shrikant I Bangdiwala
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Janice M Barnhart
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Sheila F Castañeda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Marc D Gellman
- Department of Psychology, University of Miami, Miami, Florida
| | - David J Lee
- Department of Epidemiology and Public Health, University of Miami, Miami, Florida
| | - Eliseo J Pérez-Stable
- Division of General Internal Medicine, Department of Medicine, University of California-San Francisco Medical Center
| | - Gregory A Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Marston E Youngblood
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Aida L Giachello
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Jasek JP, Johns M, Mbamalu I, Auer K, Kilgore EA, Kansagra SM. One cigarette is one too many: evaluating a light smoker-targeted media campaign. Tob Control 2014; 24:362-8. [PMID: 24610054 DOI: 10.1136/tobaccocontrol-2013-051348] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 02/01/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Light smokers represent an increasing share of adult smokers in various parts of the world including New York City (NYC). Since 2007, the NYC Department of Health and Mental Hygiene has aired hard-hitting antitobacco media campaigns paired with time-limited nicotine replacement therapy (NRT) giveaways. We evaluated an original antitobacco media campaign, developed to increase awareness of smoking risks and encourage cessation service use among light smokers in NYC. METHODS We compared cessation service request volume during the campaign to historical periods without ads targeting light smokers. We used a cross-sectional online panel survey to assess the ad's perceived effectiveness and its impact on learning something new, quit intentions and concern for smoking-related health risks among non-daily, light daily and heavy daily smokers. RESULTS The proportion of light smokers among smokers requesting cessation services increased 50% (from 13% to 20%) relative to previous time-limited NRT giveaways. Compared to heavy daily smokers, non-daily (aOR: 1.95, p<0.05) and light daily (aOR: 2.27, p<0.05) smokers were more likely to express increased concern about smoking-related health risks after viewing the ad. Perceived effectiveness of the ad did not differ by smoker type. CONCLUSIONS This study provides evidence that light smokers were receptive to a targeted antitobacco message encouraging use of cessation services. The campaign appears to have been particularly effective in increasing smoking-related health concerns in this group. The lack of difference in perceived ad effectiveness by smoker type suggests the potential to develop such ads without sacrificing broad impact.
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Affiliation(s)
- John P Jasek
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | - Michael Johns
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | - Ijeoma Mbamalu
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | - Kari Auer
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | - Elizabeth A Kilgore
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
| | - Susan M Kansagra
- New York City Department of Health and Mental Hygiene, Bureau of Chronic Disease Prevention and Tobacco Control, Long Island City, New York, USA
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