Home matters: work and household predictors of smoking and cessation among blue-collar workers

Environment and social support for smoking cessation among community smokers in Beijing, China

INTRODUCTION

This study investigated the relationship between environment support, social support and smoking cessation, to provide suggestions for the construction of environment and social support for tobacco control.

METHODS

This was a secondary analysis based on two cross-sectional surveys of adult smokers who participated in the six-month community smoking cessation intervention projects in Beijing. The study subjects were divided into a successful group (n=159) and an unsuccessful group (n=253). The status of the environment support, community tobacco exposure, and social support were compared between groups. A structural equation model (SEM) was established for Confirmatory Factor Analysis.

RESULTS

The univariate analysis showed that there were differences in smoking cessation outcomes among smokers with different home tobacco regulations, workplace tobacco regulations and number of smokers in the family. Differences in 6-month smoking reduction were also found with different promotion levels of anti-tobacco messaging and the frequency of smoking events at home. The logistic regression analysis indicated that home tobacco regulations (OR=1.30; 95% CI: 1.00-1.69), workplace tobacco regulations (OR=1.27; 95% CI: 1.05- 1.54), and frequency of smoking events at home (OR=1.15; 95% CI: 1.02-1.29), were associated with smoking cessation. The results of the SEM showed that environment support (β=0.39; 95% CI: 0.05-0.73, p=0.026) and social support (β=0.37; 95% CI: 0.05-0.68, p=0.022) had influence on smoking cessation.

CONCLUSIONS

Environment support and social support are related to smoking cessation. Attention should be paid to the smoking regulations at home and workplace, anti-tobacco messaging, and social support by the family.

TRIAL REGISTRATION

The study was registered on the official website of the China Clinical Trial Registration Center. Identifier: ChiCTR1900024991.

Smoking cessation: Exploration of perceived technology-related information value

This study describes a unique approach to information transfer affecting the perceived value of this information and related impact on smoker behavior. Data were collected via survey, sampling approximately 120 participants. An online survey tool was used for the survey creation, data collection and monitoring. Another online tool was used by participants to create short animation videos as a means of increasing their engagement with information in an experiential fashion. Study findings included that the process experienced by the test group was influential and facilitated participants' change of mind regarding enrollment in a smoking cessation workshop. This was partly attributable to the IKEA effect. The study provides evidence that a change in habits crucial to improve health and enhance positive lifestyle choices can be stimulated through active engagement with artifact creation in a technology-mediated environment.

Prevalence and Correlates of Current and Former Smoking among Urban Transit Workers

Transit workers constitute a blue-collar occupational group that have elevated smoking rates relative to other sectors of employed adults in the United States. This study analyzed cross-sectional tobacco survey data from 935 workers (60% African American; 37% female) employed at an urban public transit agency in California. Prevalence of current and former smoking was 20.3% and 20.6%, respectively. Younger workers were less likely than older workers to be current or former smokers. Having a complete home smoking ban was associated with decreased likelihood of being a smoker [odds ratio (OR) = 0.04, 95% confidence interval (CI) = 0.01–0.17], as were neutral views about whether it is easy for a smoker to take a smoking break during their shift (OR = 0.50, 95% CI 0.28–0.88). Current smoking among the sample is > 50% higher than the adult statewide prevalence. Potential points of intervention identified in this study include perceived ease of worksite smoking breaks and establishing home smoking bans. Tailored cessation efforts focusing on older transit workers more likely to smoke are needed to reduce tobacco-related disparities in this workforce.

Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study

OBJECTIVES

The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California.

METHODS

Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment.

RESULTS

In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status.

CONCLUSIONS

Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.

Predictors of cessation in smokers suspected of TB: Secondary analysis of data from a cluster randomized controlled trial

BACKGROUND

Smoking cessation services are rarely found within health services in low income countries. Given the interactions between Tuberculosis (TB) and tobacco, including cessation support within TB programs offers a promising cost-effective solution. We conducted secondary analysis of data from a cluster randomized controlled trial of smoking cessation in health centers in Pakistan to identify predictors of continuous and short-term abstinence in smokers suspected of TB using cigarettes or hookah.

METHODS

Predictor variables of those continuously abstinent at 5 and 25 weeks post quit-date (continuous abstinence) and those abstinent only at 5 weeks (short-term abstinence) were compared with those who continued smoking and with each other. Self-reported abstinence at both time points was confirmed biochemically.

RESULTS

Data obtained from 1955 trial participants were analyzed. The factors that predicted continued smoking when compared to continuous abstinence were: being older RR 0.97 (0.95 to 0.98), smoking higher quantities of tobacco RR 0.975 (0.97 to 0.98) and sharing a workplace with other smokers RR 0.88 (0.77 to 0.99). Those with a confirmed TB diagnosis were more likely to remain continuously abstinent than those without RR 1.27 (1.10-1.47).

CONCLUSIONS

Those diagnosed with TB are more likely to be abstinent than those diagnosed with other respiratory conditions. Beyond this, predictors of continued smoking in Pakistan are similar to those in high income contexts. Taking advantage of the 'teachable moment' that a TB diagnosis provides is an efficient means for resource-poor TB programs in low income settings to increase tobacco cessation and improve health outcomes.

Prevalence of chronic obstructive pulmonary disease among US working adults aged 40 to 70 years. National Health Interview Survey data 2004 to 2011

OBJECTIVE

To estimate the prevalence and prevalence odds ratios of chronic obstructive pulmonary disease (COPD) among US workers by major occupational groups.

METHODS

The 2004 to 2011 National Health Interview Survey data for working adults 40 to 70 years old was analyzed to estimate the prevalence of COPD by major occupational groups. Logistic regression models were used to evaluate the associations between COPD (chronic bronchitis or emphysema) and occupations.

RESULTS

The estimated overall COPD prevalence was 4.2% (95% CI, 4.0 to 4.3). The odds of COPD were highest among workers in health care support occupations (prevalence odds ratio, 1.64; 95% CI, 1.25 to 2.14) followed by food preparation and serving-related occupations (prevalence odds ratio, 1.57; 95% CI, 1.20 to 2.06).

CONCLUSIONS

Prevalence varied by occupations, suggesting workplace exposures may contribute to COPD. Preventive measures such as interventions to reduce smoking may reduce the prevalence of COPD.

Interplay of genetic risk (CHRNA5) and environmental risk (partner smoking) on cigarette smoking reduction

BACKGROUND

This study tests whether the genetic predictor (CHRNA5 nicotine receptor gene variants) and an environmental risk factor (partner smoking) interact in the prediction of smoking reduction.

METHODS

Subjects were from a community-based, longitudinal study of women (n=1856) who smoked before pregnancy, and a randomized comparative effectiveness smoking cessation trial (n=1065). Smoking reduction was defined as the trajectory of self-reported smoking quantities over time in the observational study, and as the trajectory of alveolar CO levels in the cessation trial.

RESULTS

In the pregnancy study, rs16969968 genotype and partner smoking status interacted such that the smoking reduction was lowest for expectant mothers with high genetic risk and partner smoking, and highest for those with high genetic risk but not partner smoking (interaction of genotype×partner smoking on smoking quantity trajectory slope β=0.071, 95%CI=0.013, 0.13, p=0.017). In the clinical trial, a similar interaction was found (interaction β=0.20, 95%CI=0.049, 0.36, p=0.010). Furthermore, these associations were moderated by pharmacotherapy such that the interactive relation of genetic and environmental factors occurred in the placebo group, but not in the active pharmacotherapy group (interaction of genotype×partner smoking×pharmacotherapy on CO trajectory slope β=-0.25, 95%CI=-0.42, -0.091, p=0.0023).

CONCLUSIONS

The CHRNA5 genetic risk synergized the effect of partner smoking, producing an especially low likelihood of successful smoking reduction in two complementary studies. This suggests that the genetic vulnerability may be mitigated by altering environmental factors. In addition, cessation pharmacotherapy neutralizes the increase in cessation failure associated with combined genetic and environmental risks, which has possible relevance to treatment algorithms.

BINGE DRINKING, SMOKING AND MARIJUANA USE: THE ROLE OF WOMEN's LABOR FORCE PARTICIPATION

This study analyzed the role of women's labor force participation in relation to binge drinking, smoking and marijuana use among employment age married/cohabiting women. The sample consisted of 956 women who were employed as construction workers (n=104), or were unemployed (n=101), homemakers (n=227) or employed in non-physically demanding occupations (n=524). Results of multivariate logistic regression analyses showed that women construction workers were at elevated risk for smoking and monthly binge drinking; unemployed women were more likely to use marijuana. Women in both categories were at risk for polysubstance use. Additional research is needed to explicate how labor force participation influences women's substance use.

The association of spousal smoking status with the ability to quit smoking: the Atherosclerosis Risk in Communities Study

Smoking is the leading cause of preventable death in the United States. Studies have shown that smoking status tends to be concordant within spouse pairs. This study aimed to estimate the association of spousal smoking status with quitting smoking in US adults. We analyzed data from 4,500 spouse pairs aged 45-64 years from the Atherosclerosis Risk in Communities Study cohort, sampled from 1986 to 1989 from 4 US communities and followed up every 3 years for a total of 9 years. Logistic regression with generalized estimating equations was used to calculate the odds ratio of quitting smoking given that one's spouse is a former smoker or a current smoker compared to a never smoker. Among men and women, being married to a current smoker decreased the odds of quitting smoking (for men, odds ratio (OR) = 0.37, 95% confidence interval (CI): 0.29, 0.46; for women, OR = 0.54, 95% CI: 0.43, 0.68). Among women only, being married to a former smoker increased the odds of quitting smoking (OR = 1.26, 95% CI: 1.04, 1.53). In conclusion, spouses of current smokers are less likely to quit, whereas women married to former smokers are more likely to quit. Smoking cessation programs and clinical advice should consider targeting couples rather than individuals.

Smoke-free homes, strength of smoke-free law, and children in the home

INTRODUCTION

Secondhand smoke (SHS) is a leading cause of childhood illness and premature death, especially in rural areas. The study examined the relationship of having a smoke-free home, strength of smoke-free law (SFL) in the county of residence, having one or more minor children in the home, rural/urban location, and demographics.

METHODS

An Internet-based panel survey was administered to Kentucky residents from 2007 to 2012. Sample size ranged from 400 to 513 per year; N = 2,653 total. Most were female, aged 35-54, had at least some college education, and lived in a smoke-free home. Almost half lived in a county with a comprehensive SFL; 14% lived in a county with a moderate or weak law.

RESULTS

Multivariate logistic regression revealed that the significant predictors of a smoke-free home included having education beyond high school, being a nonsmoker, living in an urban county, and having a year of participation in the survey. Controlling for smoking status and other personal characteristics, those who responded to the survey in the last 2 years of administration were more likely to have a smoke-free home compared to the reference year of 2007. Respondents living in urban counties were nearly 2 times more likely to report a smoke-free home than rural dwellers.

CONCLUSIONS

Smoke-free homes in urban areas, where SFLs may be the norm, may be more typical than in rural communities. Public awareness campaigns and education about the benefits of smoke-free homes is needed, especially in rural areas, targeting smokers, those with less education, and those with children living in the home.