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Kwon B, Lee G. Association between chronotype, tobacco use or alcohol use, and high-risk drinking by age group: The Seventh Korea National Health and Nutrition Examination Survey (VII: 2016-2017). Sleep Health 2022; 8:491-497. [PMID: 35927179 DOI: 10.1016/j.sleh.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/07/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To analyze the association between chronotype, tobacco use or alcohol use, and high-risk drinking by age group and examine the differences across groups. METHODS A cross-sectional descriptive study design was adopted. Data from 12,189 participants aged ≥ 12 years from 2016 to 2017, excluding shift workers, were gathered from the Korea Disease Control and Prevention Agency's Seventh Korea National Health and Nutrition Examination Survey. A general linear model was used to determine the aforementioned associations and differences across age groups. Chronotype was measured using the Munich Chronotype Questionnaire. It was divided into quintiles. We used current tobacco use, monthly alcohol use, and high-risk drinking as indexes of tobacco use and alcohol use. These data were extracted from the national representative data. RESULTS Among adolescents and adults, both tobacco use and alcohol use showed a linear increasing trend, although it was greatest among adolescents. In older adults, tobacco use showed a linear increasing trend with delayed chronotype. When the chronotypes of all age groups were aggregated, high-risk drinking was higher in both extreme types, Quintiles 1 and 5. CONCLUSIONS Tobacco use and alcohol use were mostly associated with delayed chronotype. Therefore, interventions to address delayed chronotype at all ages are needed. As the trend of increase in tobacco use and alcohol use in adolescents was higher than in other age groups, a special strategy is required aimed at this population. Moreover, both extreme chronotypes should be considered risk factors for high-risk drinking.
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Affiliation(s)
- Boram Kwon
- Department of Nursing Science, Catholic Kwandong University, Gangneung-si, South Korea
| | - Gyungjoo Lee
- College of Nursing, The Catholic University of Korea, Seoul, South Korea.
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Abstract
AbstractIntroductionThe US Navy utilizes numerous resources to encourage smoking cessation. Despite these efforts, cigarette smoking among service members remains high. Electronic cigarettes (EC) have provided an additional cessation resource. Little is known regarding the utilization efficacy of these cessation resources in the US Navy.AimsThis study sought to explore the utilization and efficacy of ECs and other smoking cessation resources.MethodsAn anonymous cross-sectional survey was conducted at a military clinic from 2015 to 2016. Participants were active duty in the US Navy and reported demographics, smoking behaviors, and utilization of cessation resources.ResultsOf the 977 participants in the study, 14.9% were current and 39.4% were former smokers. Most current smokers (83.6%) previously attempted cessation, smoked an average of 2–5 cigarettes per day (34.7%), and smoked every day of the month (26.4%). The number of daily cigarettes smoked and number of days cigarettes were smoked per month was not significantly different between cigarette-only smokers and EC dual users (p = 0.92, p = 0.75, respectively). Resources used by current and former smokers include: ‘cold turkey’ (44.6%, 57.1%, respectively), ECs (22.3%, 24.7%), nicotine patch (8.3%, 1.3%), medicine (6.6%, 3.9%), nicotine gum (5.8%, 10.4%), and quit programs (2.5%, 2.6).ConclusionCurrent and former cigarette smokers utilized similar resources to quit smoking. Electronic cigarettes are being used for cessation but do not significantly reduce the number of cigarettes smoked on a daily or monthly basis. Future studies may benefit from exploring the use of cessation resources and ECs within the military as a whole.
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Brown JM, Anderson Goodell EM, Williams J, Bray RM. Socioecological Risk and Protective Factors for Smoking Among Active Duty U.S. Military Personnel. Mil Med 2018; 183:e231-e239. [PMID: 29697835 PMCID: PMC6027073 DOI: 10.1093/milmed/usx021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 06/12/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Cigarette smoking can have negative consequences in military populations including injury, reduced physical endurance, higher frequency of sick days, and reduced combat readiness. This study used the socioecological model to understand individual, interpersonal, and organizational influences on cigarette smoking among military members. Materials and Methods The sample for this secondary analysis was drawn from personnel at 24 large U.S. military installations, six from each service branch. Analyses included 4,728 personnel who were classified as current cigarette smokers. Generalized linear mixed models were used to estimate the associations among risk and protective factors from multiple ecological levels for smoking intensity and nicotine dependence. Results Smoking to fit in with one's unit, being in the Army, smoking as a reaction to stress, and work-related stressors were all related to increased intensity of smoking and nicotine dependence. More active coping was associated with lower nicotine dependence and reduced smoking intensity. Conclusion Results based on the socioecological model identify influencing factors and suggest possible interventions for smoking cessation. Reducing tobacco use in the military will require coordinated interventions that address multilevel determinants of use and improve military health. This is important to the strategic alignment of policy and services across the continuum of health care needs.
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Affiliation(s)
| | | | | | - Robert M Bray
- RTI International, Research Triangle Park, Durham NC
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Zarka S, Levine H, Rozhavski V, Sela T, Bar-Ze'ev Y, Molina-Hazan V, Rosen LJ. Smoking Behavior Change During Compulsory Military Service in Israel, 1987-2011. Nicotine Tob Res 2017; 19:1322-1329. [PMID: 28115500 DOI: 10.1093/ntr/ntw285] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/20/2016] [Indexed: 11/13/2022]
Abstract
Introduction Smoking in military settings is of major concern. We aimed to assess the association between personal, family, and military factors and smoking behavior change during compulsory military service in Israel. Methods Participants were soldiers recruited between 1987 and 2008 who were interviewed at recruitment and reinterviewed at discharge (1987-2011) (total: 29 189; males:15 136; females:14 053). The primary outcome variables were smoking initiation during service among nonsmokers at recruitment, and cessation during service among smokers at recruitment. We examined potential predictors of change, and trends by calendar year. Results Smoking prevalence increased by 39.4% during military service (recruitment: 26.2%, discharge: 36.5%). 18.4% of nonsmoking recruits initiated smoking, and 12.4% of smoking recruits quit smoking between recruitment and discharge. There was no observed trend in initiation between 1987 and 2011. The strongest predictor of smoking initiation among nonsmokers at recruitment was smoking history (former vs. never-smoker, odds ratio (OR) [95% confidence interval [CI]]: males: 5.63 [4.63,6.85], females: 6.76 [5.27, 8.68]. Other variables had smaller effects on initiation. Females were less likely to initiate smoking than males (OR [CI]): 0.75 [0.69,0.81]. Both males and females with high military fitness levels were more likely to initiate smoking. Among women, those with lower education, with fathers with lower education, of lower socioeconomic status, and ever-users of contraceptives were more likely to initiate smoking. Cessation among males modestly increased over the years (OR [CI]): 1.03 [1.01,1.05]. Conclusions Smoking increased substantially during mandatory military service in Israel. Former smokers were at greatly increased risk of initiation and should be targeted for relapse prevention. Military service represents a golden opportunity for tobacco control. Implications Military tobacco control policy is an important contributor to longevity among service personnel, and population-wide mortality in countries with compulsory service. The increased smoking prevalence among military personnel, and increases in smoking during military service should act as a wake-up call to governments and health systems in countries lacking strong military tobacco control policies. The substantial progress in military tobacco control in the United States, which includes strong antitobacco policies for prevention of smoking initiation, aid to smokers to quit smoking, and protection of nonsmokers from tobacco smoke, should be emulated by others. Former smokers and others at high risk should be targeted for relapse prevention. The closed environment of military service provides a golden opportunity for tobacco control.
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Affiliation(s)
- Salman Zarka
- Preventive Medicine Branch, Medical Corps, Israel Defense Force, Israel.,Ziv Medical Center, Tzfat, Israel.,School of Public Health, University of Haifa, Haifa, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine Hebrew University-Hadassah, Jerusalem, Israel
| | | | - Tamar Sela
- Preventive Medicine Branch, Medical Corps, Israel Defense Force, Israel
| | - Yael Bar-Ze'ev
- Preventive Medicine Branch, Medical Corps, Israel Defense Force, Israel.,School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | | | - Laura J Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Akinboro O, Olorunfemi O, Basak P, Phillips E, Pomerantz D, Bernhardt B, Gucalp R, Jesmajian S, Ostroff JS. Secondhand Smoke Exposure Among Community-Dwelling Adult Cancer Survivors in the United States: 1999-2012. Cancer Epidemiol Biomarkers Prev 2017; 26:1296-1305. [PMID: 28642231 PMCID: PMC5671647 DOI: 10.1158/1055-9965.epi-16-0777] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/01/2016] [Accepted: 04/12/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Little is known about the prevalence of secondhand smoke exposure (SHSe) among cancer survivors. We sought to determine the prevalence, trends, and correlates of SHSe among nonsmoking adult cancer survivors in the United States.Methods: Interview and serum cotinine data for nonsmoking adults, age 20 years and older, with a history of cancer (N = 686) were obtained from consecutive two-year cross-sectional cycles of the National Health and Nutrition Examination Survey from 1999 to 2012. SHSe was defined as serum cotinine 0.05-10 ng/mL among nonsmokers. We calculated and trended the prevalence of SHSe among nonsmoking cancer survivors. Multivariable logistic regression was used to examine the associations of SHSe with sociodemographic, smoking, and clinical characteristics. Survey weights were applied in estimating prevalence rates, adjusted ORs, and confidence intervals (CI).Results: The weighted aggregate SHSe and self-reported indoor SHSe prevalence rates over the study period were 28.26% (95% CI: 24.97%-31.55%) and 4.53% (95% CI: 3.48%-5.57%), respectively. SHS exposure declined from 39.61% (95% CI: 27.88%-51.34%) in 1999/2000 to 15.68% (95% CI: 9.38%-21.98%) in 2011/2012 (Ptrend < 0.001). Age ≥ 60 years was protective against SHSe, while being black, having less than high school education, poverty, and a smoking-related cancer history were associated with higher odds of SHSe.Conclusions: Fortunately, SHSe among nonsmoking cancer survivors in the United States is on the decline, although certain subgroups remain disproportionately burdened.Impact: These findings highlight clinical and public health imperatives to target socioeconomically disadvantaged nonsmoking cancer survivors to reduce their SHSe. Cancer Epidemiol Biomarkers Prev; 26(8); 1296-305. ©2017 AACR.
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Affiliation(s)
| | | | - Prasanta Basak
- Montefiore New Rochelle Hospital, New Rochelle, New York
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Kram Y, Klesges RC, Ebbert JO, Talcott W, Neilands TB, Ling PM. Dual tobacco user subtypes in the U.S. Air Force: dependence, attitudes, and other correlates of use. Nicotine Tob Res 2014; 16:1216-23. [PMID: 24721813 DOI: 10.1093/ntr/ntu056] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION To describe the characteristics associated with patterns of daily and dual tobacco use among U.S. Air Force (USAF) personnel transitioning from basic military training to technical training. METHODS Cross-sectional survey of USAF personnel in Technical Training School at Lackland Air Force Base (N = 8,956, response rate: 73%). Logistic regression analyzed the association of predictor variables between daily smokers, daily smokeless tobacco (ST) users, daily smokers who used ST nondaily, daily ST users who smoked cigarettes nondaily, and daily users of both cigarettes and ST. RESULTS Compared to daily smokers, participants who were daily smokers/nondaily ST users were more likely to be male, would use ST and multiple forms of tobacco in the future, reported more friends using ST and cigarettes, and were more susceptible to tobacco advertising. Compared to daily ST users, daily ST users/nondaily cigarette users were more likely to live in the Midwest, would use multiple forms of tobacco in the future, reported more friends smoked cigarettes and used ST, and were more likely to try a product that claimed to be safer than cigarettes. Daily users of both cigarettes and ST were significantly more likely to be nicotine dependent than daily smokers/nondaily ST users and daily ST users/nondaily smokers. CONCLUSIONS Dual users are heterogeneous groups of tobacco users who are at high risk for continued tobacco use. Daily users of both cigarettes and ST have higher levels of nicotine dependence, even when compared to other dual users. Specific interventions targeted at dual users are needed in this increasingly prevalent and high-risk population.
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Affiliation(s)
- Yoseph Kram
- School of Medicine, University of California, San Francisco, San Francisco, CA
| | - Robert C Klesges
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Jon O Ebbert
- Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN;
| | - Wayne Talcott
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Torsten B Neilands
- School of Medicine, University of California, San Francisco, San Francisco, CA; Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Pamela M Ling
- School of Medicine, University of California, San Francisco, San Francisco, CA; Division of General Internal Medicine, Department of Medicine, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA
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Prospective Examination of Cigarette Smoking Among Iraq-Deployed and Nondeployed Soldiers: Prevalence and Predictive Characteristics. Ann Behav Med 2014; 48:38-49. [DOI: 10.1007/s12160-013-9584-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Substance use and misuse in the Croatian Army Special Forces: prevalence and influencing factors. Int J Occup Med Environ Health 2014; 27:123-31. [DOI: 10.2478/s13382-014-0241-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 01/15/2014] [Indexed: 11/20/2022] Open
Abstract
Abstract
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Trautmann S, Schönfeld S, Behrendt S, Höfler M, Zimmermann P, Wittchen HU. Substance use and substance use disorders in recently deployed and never deployed soldiers. Drug Alcohol Depend 2014; 134:128-135. [PMID: 24210162 DOI: 10.1016/j.drugalcdep.2013.09.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/19/2013] [Accepted: 09/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Military studies investigating the prevalence of substance use (SU) and substance use disorders (SUD) and the relation between SU and mental disorders often lack a comprehensive assessment of SU, SUD and mental disorders and comparable groups of deployed and non-deployed personnel. There is also limited data regarding SU and SUD in the German military to date. METHODS Cross-sectional examination of n=1483 soldiers recently deployed in Afghanistan and 889 never deployed soldiers using a fully-standardized diagnostic interview (MI-CIDI) including a comprehensive substance section. RESULTS Across both groups, 12-months prevalence of DSM-IV alcohol use disorders was 3.1%, 36.9% reported binge drinking, 13.9% heavy drinking, 1.3% illegal drug use. 55.1% were regular smokers, 10.9% nicotine dependent. Although recently deployed soldiers revealed slightly higher rates in some measures, there were no significant differences to the never deployed regarding SU und SUD except that recently deployed soldiers smoked more cigarettes per day. The association of SU with mental mental disorders was substantially different though, revealing significant associations between SU and mental disorders only among recently deployed soldiers. CONCLUSIONS We do not find remarkable differences in the prevalence of SU and SUD between recently deployed and never deployed soldiers. Especially binge drinking and regular smoking were prevalent across both samples indicating needs for improved interventions. The finding that SU and mental disorders are only associated in recently deployed soldiers might have implications for improved screening and prevention and suggests that deployment might promote different pathways and mechanisms involved in the evolution of SU and mental disorders.
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Affiliation(s)
- S Trautmann
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany.
| | - S Schönfeld
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - S Behrendt
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - M Höfler
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
| | - P Zimmermann
- "Center of Military Mental Health" (Zentrum für Psychiatrie und Psychotraumatologie am Bundeswehrkrankenhaus), 10115 Berlin, Germany
| | - H U Wittchen
- Institute of Clinical Psychology and Psychotherapy and Center of Epidemiology and Longitudinal Studies (CELOS), Technische Universitaet Dresden, 01187 Dresden, Germany
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Kullgren JT, Volpp KG, Polsky D. Are the healthy behaviors of US high-deductible health plan enrollees driven by people who chose these plans? Smoking as a case study. PLoS One 2013; 8:e56154. [PMID: 23418528 PMCID: PMC3572017 DOI: 10.1371/journal.pone.0056154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 01/07/2013] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To determine whether negative associations between enrollment in a high-deductible health plan (HDHP) and one exemplar unhealthy behavior--daily smoking--are found only among people who chose these plans. DESIGN Cross-sectional analysis of nationally-representative data. SETTING United States from 2007 to 2008. SUBJECTS 6,941 privately insured non-elderly adult participants in the 2007 Health Tracking Household Survey. MEASURES Self-reported smoking status. ANALYSIS We classified subjects as HDHP or traditional health plan enrollees with employer-sponsored insurance (ESI) and no choice of plans, ESI with a choice of plans, or coverage through the non-group market. We used multivariate logistic regression to measure associations between HDHP enrollment and daily smoking within each of the 3 coverage source groups while controlling for potential confounders. RESULTS HDHP enrollment was associated with lower odds of smoking among individuals with ESI and a choice of plans (AOR 0.55, 95% CI 0.33-0.90) and those with non-group coverage (AOR 0.64, 95% CI 0.34-1.22), though the latter association was not statistically significant. HDHP enrollment was not associated with lower odds of smoking among individuals with ESI and no choice of plans (AOR 1.04, 95% CI 0.69-1.56). CONCLUSIONS HDHP enrollment is associated with lower odds of smoking only among individuals who chose to enroll in an HDHP. Lower rates of unhealthy behaviors among HDHP enrollees may be a reflection of individuals who choose these plans.
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Affiliation(s)
- Jeffrey T Kullgren
- Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, United States of America.
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Sangthong R, Wichaidit W, McNeil E, Chongsuvivatwong V, Chariyalertsak S, Kessomboon P, Taneepanichskul S, Putwatana P, Aekplakorn W. Health behaviors among short- and long- term ex-smokers: results from the Thai National Health Examination Survey IV, 2009. Prev Med 2012; 55:56-60. [PMID: 22569485 DOI: 10.1016/j.ypmed.2012.04.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Revised: 04/25/2012] [Accepted: 04/27/2012] [Indexed: 01/26/2023]
Abstract
BACKGROUND Although numerous studies have shown the health behaviors of ex-smokers to be better than those in regular smokers, the differences in health behaviors among ex-smokers at varying durations of cessation have not been investigated. This study aims to examine the relationship between different durations of smoking cessation and health behaviors. METHODS Data on dietary intake, alcohol consumption, physical activity, and smoking behavior from the Thai National Health Examination Survey IV for subjects aged 15-98 years (n=19 371) were included in the analysis. Trends between health behaviors among regular smokers, ex-smokers with different durations of smoking (<1 year, 1-10 years, >10 years), and never smokers were tested. Logistic regression models adjusted for sex, age, and economic status were used. RESULTS The prevalences of regular smoking, ex-smoking, and never smoking were 22.3%, 12% , and 65.7%, respectively. A trend was found for consumption of fruit, beans and meats, dairy and soy milk, whole-grain products, nutritional supplements, and eating habits. Average daily alcohol consumption (g) was lowest among ex-smokers who had quit for>10 years ex-smokers (16.4) followed by 1-10 years ex-smokers (27.2), and <1 year ex-smokers (33.7). CONCLUSION A longer duration of smoking cessation correlated with better health behaviors.
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Affiliation(s)
- Rassamee Sangthong
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Thailand.
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Haddock CK, Jitnarin N, Poston WSC, Tuley B, Jahnke SA. Tobacco use among firefighters in the central United States. Am J Ind Med 2011; 54:697-706. [PMID: 21656838 DOI: 10.1002/ajim.20972] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2011] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study provides a comprehensive, population-based examination of tobacco use among both career and volunteer firefighters. METHODS Data are from a population-based cohort study of randomly selected career (N = 11) and volunteer (N = 13) departments comprised of 677 male firefighters. RESULTS Unadjusted rates of smoking were 13.6% and 17.4% for career and volunteer firefighters, respectively. Smoking rates were less than a comparable occupational group (military personnel) and adult males in the states represented. Smokers were more likely to have been diagnosed with an anxiety disorder (OR = 5.8; P = 0.010), have an elevated CAGE alcohol problem score (OR = 2.9; P = 0.040), and more likely to report driving after drinking too much (OR = 4.5; P = 0.020) compared to never-smokers. Large percentages of career (18.4%) and volunteer (16.8%) firefighters used smokeless tobacco. CONCLUSIONS Smoking among firefighters is associated with other significant health and safety risks. High rates of smokeless tobacco use suggest that the fire service is an important target for intervention. Thus, despite strong statements against smoking by the fire service, the need to maintain high levels of health and fitness and relatively low smoking rates, a significant proportion of firefighters continue to use tobacco products.
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Affiliation(s)
- C Keith Haddock
- Center for Fire, Rescue, & EMS Health Research, National Development and Research Institutes, Inc., Leawood, Kansas, USA. ,
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Olmsted KLR, Bray RM, Reyes-Guzman CM, Williams J, Kruger H. Overlap in use of different types of tobacco among active duty military personnel. Nicotine Tob Res 2011; 13:691-8. [PMID: 21498430 DOI: 10.1093/ntr/ntr060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the prevalence and overlapping combinations in past thirty-day cigarette use, smokeless tobacco use, and cigar use in the active duty U.S. military. METHODS Data were taken from the 2008 Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel. A total of 28,546 service members participated for a response rate of 70.6%. RESULTS Analyses showed that 41.2% of active duty service members used one or more forms of tobacco in the past month. Cigarette use only was most prevalent (21.3%); other combinations were much lower ranging from 0.7% to 13.5%. Multinomial regression modeling yielded no consistent patterns in sociodemographic groups with higher risk of using one or more types of tobacco concurrently. Frequency and quantity of cigarette use were related to tobacco use patterns. From 60% to 67% of smokers were daily users of cigarettes only or cigarettes in combination with other tobacco types. The majority of cigarette users (54%-69%) smoked 15 or fewer cigarettes/day regardless of tobacco use patterns, but those who smoked at heaviest levels were most likely to use all 3 tobacco types (19%). CONCLUSIONS Four of 10 service members place themselves at increased risk of tobacco-related illness and disease by using one or more types of tobacco. Daily cigarette smokers and very heavy smokers are at highest risk of using multiple tobacco types. Further research is needed to better understand the levels of use and the reasons for use of multiple types of tobacco.
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Affiliation(s)
- Kristine L Rae Olmsted
- Department of Social, Statistical and Environmental Sciences, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA.
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Zajc I, Brajdić D, Biočić J, Bošan-Kilibarda I, Kopić V, Siber S, Macan D. The effect of tobacco use on oral health and dental readiness in the Croatian Army. J Addict Dis 2011; 30:159-68. [PMID: 21491297 DOI: 10.1080/10550887.2011.554783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examined tobacco use as a risk factor in the development of periodontal disease as dental emergency and dental readiness among soldiers. A total of 884 soldiers were followed: 650 recruits and 234 professional active veterans. They were categorized into dental readiness classes, and questionnaires were completed about tobacco use. Overall, 62.7% of soldiers reported current smoking, with a higher prevalence of smokers among recruits. The results showed a significant difference in smokers vs. non-smokers in dental readiness, supragingival/subgingival calculus, gingivitis, and Class 3 dental fitness. More recruits (63.8%) smoked than veterans (59.4%), but greater prevalence of daily cigarette smoking and duration of smoking habits was found among veterans. In both groups, soldiers who smoked were characterized by a higher percentage of periodontal health problems and decreased combat readiness compared to soldiers who did not smoke. This indicates a need for oral health prevention program, and cigarette smoking and cessation programs.
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Affiliation(s)
- Ivan Zajc
- University Hospital Dubrava, School of Dental Medicine, University of Zagreb, Croatia
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Grier T, Knapik JJ, Canada S, Canham-Chervak M, Jones BH. Tobacco use prevalence and factors associated with tobacco use in new U.S. Army personnel. J Addict Dis 2010; 29:284-93. [PMID: 20635278 DOI: 10.1080/10550887.2010.489445] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the prevalence of tobacco use and factors associated with pre-military service cigarette and smokeless tobacco use. From January 2000 to December 2006, military students arriving for Advanced Individual Training at the U.S. Army Ordnance School completed a questionnaire that asked about their use of tobacco products. The prevalence of smokeless tobacco use from 2000 to 2006 for women generally decreased, as did the number of cigarettes smoked per day by men. For men and women, factors associated with cigarette use included younger age, Caucasian race, and use of smokeless tobacco. Factors associated with smokeless tobacco use among men included younger age, Caucasian race, and cigarette use. For women, cigarette use was the only factor associated with smokeless tobacco use. The identified factors in this study could be used to establish strategies in the future to reduce tobacco use in the military.
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Affiliation(s)
- Tyson Grier
- Directorate of Epidemiology and Disease Surveillance, United States Army Public Health Command, Aberdeen Proving Ground, MD 21010, USA.
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Cooper TV, Taylor T, Murray A, DeBon MW, Vander Weg MW, Klesges RC, Talcott GW. Differences between intermittent and light daily smokers in a population of U.S. military recruits. Nicotine Tob Res 2010; 12:465-73. [PMID: 20203108 PMCID: PMC2861885 DOI: 10.1093/ntr/ntq025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 02/04/2010] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Few studies have assessed differences between intermittent and light smokers, particularly among young adults. Exploring these differences promotes a systematic approach to research and treatment in low-level smokers. This study explored demographic, tobacco-related, and psychosocial predictors of intermittent nondaily smoking relative to light smoking among basic military training (BMT) recruits. The impact of smoking status on abstinence rates at follow-up was also assessed. METHODS Participants were 5,603 U.S. Air Force BMT intermittent nondaily (n = 3,134) or light daily (n = 2,469) smoking recruits participating in a population-based group randomized trial targeting tobacco use prevention and cessation (Klesges et al., 2006, Efficacy of a tailored tobacco control program on long-term use in a population of U.S. military troops. Journal of Consulting and Clinical Psychology, 74, 295-306.). Participants completed baseline measures assessing demographics; tobacco use and history; and common social, attitudinal, and behavioral risk factors for tobacco use. Flights of recruits were randomly assigned to a tobacco use intervention or health education control intervention. At the 1-year follow-up, participants reported 7-day point prevalence and continuous abstinence. RESULTS Intermittent nondaily smoking relative to light daily smoking was associated with lesser perceived addiction, intermittent and daily use of smokeless tobacco, nonsmoking male and female heads of household, lesser likelihood of smoking while stressed or while bored, and higher likelihood of intentions to quit smoking. Intermittent smokers were significantly more likely than light daily smokers to report abstinence at follow-up. DISCUSSION Intermittent and daily light smokers differ on several tobacco-related and psychosocial variables. Attending to these factors in prevention and cessation programs may enhance abstinence in both groups.
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Affiliation(s)
- Theodore V Cooper
- Department of Psychology, The University of Texas at El Paso, 500 West University Avenue, El Paso, TX 79968, USA.
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Woodruff SI, Conway TL, Shillington AM, Clapp JD, Lemus H, Reed MB. Cigarette smoking and subsequent hospitalization in a cohort of young U.S. Navy female recruits. Nicotine Tob Res 2010; 12:365-73. [PMID: 20156886 DOI: 10.1093/ntr/ntq007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Tobacco use is of particular concern to the U.S. Department of Defense because the military historically has had higher and heavier rates of tobacco use than civilians. Few prospective studies have examined the association of cigarette smoking with medical outcomes, particularly among initially healthy female military personnel. METHODS This prospective cohort study followed over 5,000 young U.S. Navy female recruits varying in their smoking status at entry into the Navy and collected their subsequent hospitalization data (i.e., International Classification of Diseases, Ninth Revision codes) for up to 7-8 years of service. RESULTS Results indicated that after adjusting for differences in time at risk and sociodemographic variables, daily smokers (compared with never-and other smokers) had higher rates of hospitalization for any reason and for musculoskeletal conditions. Daily smokers also had higher rates than never- and other smokers for non-pregnancy-related hospitalizations and for mental disorders, although only the daily/other differences reached statistical significance. Daily smokers' average number of days hospitalized was significantly longer than that of never- and other smokers. DISCUSSION Results suggest that young women do not have to wait decades to experience the harmful effects of smoking. A recent history of cigarette smoking is an important determinant of hospitalization risk for even young healthy women in the U.S. Navy.
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Affiliation(s)
- Susan I Woodruff
- Center for Alcohol and Drug Studies, School of Social Work, San Diego State University, 6386 Alvarado Ct, Ste 224, San Diego, CA 92120, USA.
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Jahnke SA, Haddock CK, Poston WSC, Hoffman KM, Hughey J, Lando HA. A qualitative analysis of the tobacco control climate in the U.S. military. Nicotine Tob Res 2010; 12:88-95. [PMID: 20097841 DOI: 10.1093/ntr/ntp181] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Rates of tobacco use in the U.S. military have traditionally been higher than in the general U.S. population. While the military has experienced decreases in tobacco use over the past two decades, recent surveys suggest a trend of increased use. Given the negative impact of tobacco on both the readiness and the long-term health of military members, it is important to understand what factors may be related to the increased use rates. It has been suggested that there is a culture that supports tobacco use in the military. METHODS We examined perceptions about the climate of tobacco control among military installation Tobacco Control Managers and Service Policy Leaders from all four branches of the military (n = 52) using semistructured interviews. RESULTS The primary strength of the military's tobacco control program, according to the participants, was mandating the provision of treatment services on every military installation. Any military member can receive both counseling and pharmacotherapy for tobacco. Opinions vary on the most promising new strategies for tobacco control. Many have pushed for a completely tobacco-free Department of Defense, including requiring troops to be tobacco-free and banning tobacco sales on military installations. However, a number of tobacco control experts within the military worry about unintended consequences of a complete ban. DISCUSSION While several benefits of the current tobacco control program were identified, opportunities for improvement were identified at both the installation and service level.
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Affiliation(s)
- Sara A Jahnke
- Institute for Biobehavioral Health Research, National Development and Research Institutes, Leawood, KS 66214, USA.
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Green KJ, Hunter CM, Bray RM, Pemberton M, Williams J. Peer and role model influences for cigarette smoking in a young adult military population. Nicotine Tob Res 2008; 10:1533-41. [PMID: 18946772 DOI: 10.1080/14622200802398763] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Previous research has shown that 8% to 10% of nonsmokers initiated smoking during their first year of military service despite a period of forced abstinence during boot camp. To our knowledge, no studies have looked at the influence of peers and role models on the initiation of smoking among U.S. Air Force personnel who recently completed boot camp. This cross-sectional study examined the role of perceived peer norms, roommate influence, role model influence, perceived norms of all active duty personnel, and depressive symptoms in the initiation and reinitiation of smoking among 2,962 Air Force technical training students. Previous nonsmokers were more likely to initiate smoking if they perceived that the majority of their classmates smoked (OR = 1.67, 95% CI[1.05-2.67]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.69, 95% CI[1.12-2.56]). Additionally, previous nonsmokers were more likely to initiate smoking if their roommate smoked (OR = 1.67, 95% CI[1.09-2.56]). Similar results were seen with previous smokers who perceived that the majority of their classmates smoked (OR = 1.63, 95% CI[1.03-2.58]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.95, 95% CI[1.29-2.94]). Our study suggests that military role models who use tobacco, peer smoking behavior, and perceived smoking norms increase the likelihood of smoking initiation among newly enlisted military personnel who have recently undergone a period of forced abstinence.
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Affiliation(s)
- Kathy J Green
- United States Air Force, Health Promotion, Air Force Medical Operations Agency, Office of the Surgeon General, Bolling AFB, DC 20032-7050, USA.
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Porter CK, Tribble DR, Aliaga PA, Halvorson HA, Riddle MS. Infectious gastroenteritis and risk of developing inflammatory bowel disease. Gastroenterology 2008; 135:781-6. [PMID: 18640117 DOI: 10.1053/j.gastro.2008.05.081] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 05/20/2008] [Accepted: 05/30/2008] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Infectious gastroenteritis (IGE) is known to exacerbate previously diagnosed inflammatory bowel disease (IBD). However, limited data are available describing a causal link between IGE and incident IBD. METHODS By using a medical encounter data repository of active duty military personnel, a study was conducted to assess IBD risk in subjects with an antecedent case of IGE. RESULTS Between 1999 and 2006, there were 3019 incident IBD cases and 11,646 matched controls who were evaluated in a conditional logistic regression model. To control for potential misclassification, IGE episodes within 6 months of IBD diagnosis were excluded as exposures. After adjusting for potential confounders, an episode of IGE increased the risk of IBD (odds ratio, 1.40; 95% confidence interval, 1.19-1.66). The risk was slightly higher for Crohn's disease compared with ulcerative colitis. In addition, there was an approximate 5-fold increase in IBD risk for persons with a previous irritable bowel syndrome diagnosis. CONCLUSIONS These data support theories that the initiation of IBD is a multifactorial process that might include the disruption of normal gut homeostatic mechanisms. Further studies are warranted to evaluate the pathogen-specific risks, identify susceptible populations, and better understand the pathophysiologic relationship between IGE and IBD.
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Affiliation(s)
- Chad K Porter
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, Maryland 20910-7500, USA.
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Cooper TV, DeBon M, Haddock CK, Esquivel DR, Klesges RC, Lando H, Talcott GW. Demographics and Risky Lifestyle Behaviors Associated with Willingness to Risk Sexually Transmitted Infection in Air Force Recruits. Am J Health Promot 2008; 22:164-7. [DOI: 10.4278/ajhp.22.3.164] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To investigate sexually transmitted infection (STL) risk-taking behaviors relative to other lifestyle and risk-taking behaviors. Design. The study design is cross sectional. Setting. Lackland Air Force Base in San Antonio, Texas. Subjects. Participants (N = 32,144) were 100% of Air Force recruits beginning basic military training from August 1995 to August 1996. Measures. Recruits completed a questionnaire that included rating the statement “Sex without condoms is sometimes worth the risk of possibly getting AIDS or sexually transmitted diseases.” Risky behaviors, such as risk taking rebelliousness, seat belt use, smoking alcohol use and binge drinking opinions of illicit drug use, and lifestyle behaviors, such as dietary intake and physical activity, were also assessed. Analysis. Univariate and multivariate logistic regression analyses examined the relationships between participant characteristics and willingness to risk STI. Results. Sixteen percent stated willingness to risk STI to have sex without a condom. Women and white/non-Hispanic participants were less likely to agree with the statement than men and minority participants. Those who reported willingness toward risky sexual behaviors were less likely to use seat belts, were more likely to binge drink, had more positive views of illicit drugs, and reported eating fewer fruits and vegetables. Conclusion. Results of this study suggest the importance of continued education on condom use and the possibility that multiple risk behavior interventions include sexual risk components.
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Affiliation(s)
- Theodore V. Cooper
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - Margaret DeBon
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - C. Keith Haddock
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - Denise Rodríguez Esquivel
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - Robert C. Klesges
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - Harry Lando
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
| | - G. Wayne Talcott
- Theodore V. Cooper, PhD, and Denise Rodríguez Esquivel, BA, are with the Department of Psychology, University of Texas at El Paso. Margaret DeBon, PhD, and Robert C. Klesges, PhD, are with the Department of Preventive Medicine, University of Tennessee Health Sciences Center in Memphis. C. Keith Haddock, PhD, is with the University of Missouri—Kansas City, Mid America Heart Institute, Saint Luke's Hospital. Harry Lando, PhD, is with the Transdisciplinary Tobacco Use Research Center, University of
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Larson GE, Booth-Kewley S, Ryan MAK. Tobacco Smoking as an Index of Military Personnel Quality. MILITARY PSYCHOLOGY 2007. [DOI: 10.1080/08995600701548205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Haddock CK, Poston WSC, Pyle SA, Klesges RC, Vander Weg MW, Peterson A, Debon M. The validity of self-rated health as a measure of health status among young military personnel: evidence from a cross-sectional survey. Health Qual Life Outcomes 2006; 4:57. [PMID: 16939653 PMCID: PMC1569825 DOI: 10.1186/1477-7525-4-57] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 08/29/2006] [Indexed: 11/25/2022] Open
Abstract
Background Single item questions about self ratings of overall health status are widely used in both military and civilian surveys. Limited information is available to date that examines what relationships exist between self-rated health, health status and health related behaviors among relatively young, healthy individuals. Methods The current study uses the population of active duty United States Air Force recruits (N = 31,108). Participants completed surveys that asked about health behaviors and health states and were rated their health on a continuum from poor to excellent. Results Ratings of health were consistently lower for those who used tobacco (F = 241.7, p < .001), reported binge drinking (F = 69.0, p < .001), reported drinking and driving (F = 19.4, p < .001), reported taking health risks (F = 109.4, p < .001), were depressed (F = 256.1, p < .001) and were overweight (F = 39.5, p < .001). Conclusion Given the consistent relationship between self-rated overall health and factors important to military health and fitness, self-rated health appears to be a valid measure of health status among young military troops.
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Affiliation(s)
- Christopher K Haddock
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Room MC-M03, Kansas City, MO 64110, USA
| | - Walker SC Poston
- School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Room MC-M03, Kansas City, MO 64110, USA
| | - Sara A Pyle
- Departments of Preventive Medicine and Family Medicine, Kansas City University of Medicine and Biosciences, 1750 Independence Avenue, Kansas City, MO 64106, USA
| | - Robert C Klesges
- Department of Preventive Medicine, St. Jude's Hospital, 66 N. Pauline, Suite 633, Memphis, TN 38163, USA
| | - Mark W Vander Weg
- Department of Internal Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52241, USA
| | - Alan Peterson
- Department of Psychiatry, University of Texas Health Sciences Center, 3939 Medical Drive, San Antonio, TX 78229, USA
| | - Margaret Debon
- Health Sciences Center, University of Tennessee, 5050 Poplar Avenue, Suite 1800, Memphis, TN 38157, USA
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Haddock CK, Lando H, Klesges RC, Peterson AL, Scarinci IC. Modified tobacco use and lifestyle change in risk-reducing beliefs about smoking. Am J Prev Med 2004; 27:35-41. [PMID: 15212773 DOI: 10.1016/j.amepre.2004.03.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study examined beliefs about potential risk-reduction strategies for tobacco users among a large group of young adults. Strategies examined included switching to low-yield cigarettes, replacing cigarettes with cigars, switching from cigarettes to smokeless tobacco, adopting a healthy diet, and engaging in regular exercise. METHODS One-year longitudinal survey of 36,012 young adults (mean 20.1 years) entering the U.S. Air Force from October 1999 to September 2000. RESULTS Smokers generally rated the strategies as providing more risk-reduction potential than never smokers or ex-smokers, although the group differences were small. Diet, exercise, and switching to low-yield cigarettes were rated as providing the most health benefits, regardless of smoking status. Smokers who had either changed their diet or exercise to lower their risks from smoking had significantly lower perceived personal risk of developing a tobacco-related disease than other smokers. Smokers who believed that switching to smokeless tobacco would lower the health risks associated with smoking were more likely, while smokers reporting switching to low-yield cigarettes were significant less likely, to quit during a 1-year follow-up period. CONCLUSIONS Beliefs about the risk-reduction benefits of both changes in tobacco use and health behaviors may impact tobacco use attitudes and practices.
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Affiliation(s)
- C Keith Haddock
- Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA.
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Abstract
PURPOSE To investigate whether parenting style is an independent risk factor of smoking initiation and experimentation among adolescents, and whether there is a relationship between parenting style and readiness to quit, or nicotine dependence among smokers. METHODS The 84-item Health and Smoking Questionnaire, which assesses demographics, smoking status and smoking history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style, was administered to 816 adolescents in grades 7 to 12 (mean age, 15.1 years) of whom 22.6% (n = 182) were smokers. Parenting style was measured by the brief, non-retrospective version of the Family of Origin Scale (FOS). Higher scores on the FOS indicated more positive perceived parenting style with high levels of intimacy and autonomy, characteristics of healthy parent-child relationships. Data were analyzed using a model-building approach to logistic regression with demographic and other psychosocial variables in the first two steps, and with parenting style as the last step. RESULTS Results from two logistic regression models indicate that although parenting style is not a significant risk factor for smoking experimentation [odds ratio (OR) =.998; confidence interval (CI) =.977-1.019; p =.820], it is a significant independent risk factor for smoking initiation (OR =.950; CI =.930-.970; p =.000). Smokers who were more ready to quit had higher parenting style scores than those who were not ready to quit, and smokers who had made a serious quit attempt (an indicator of nicotine addiction) had higher parenting style scores than those who had not made a quit attempt. Moreover, nonsmokers who reported they would smoke a cigarette if their best friend offered had significantly lower parenting style scores than those who reported they would not smoke a cigarette. CONCLUSIONS Additional research on parenting style and its impact on adolescent smoking with a more economically and ethnically diverse sample is warranted. If future research confirms the strength of the relationship between parenting style and adolescent smoking, teaching positive parenting, including facilitating intimate yet autonomous relationships, may be considered as part of smoking prevention and cessation programs.
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Stein RJ, Haddock CK, O'Byrne KK, Hymowitz N, Schwab J. The pediatrician's role in reducing tobacco exposure in children. Pediatrics 2000; 106:E66. [PMID: 11061803 DOI: 10.1542/peds.106.5.e66] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Pediatricians have a unique and important role to play in the prevention and treatment of childhood and adolescent tobacco use, the protection of patients from the harmful effects of environmental tobacco smoke, and the encouragement of smoking cessation among parents. However, because recent research indicates that physician training in tobacco dependence is woefully weak and lacks a model for training, this article constructs a useful approach to this problem. METHODOLOGY A comprehensive review of the literature served as the basis for the development of a new model for pediatrician training in tobacco dependence. RESULTS A comprehensive model is presented for training pediatricians in the areas of reducing infant and child exposure to environmental tobacco smoke, preventing youth smoking initiation, and providing smoking cessation assistance for adolescents and parents. CONCLUSIONS Pediatricians have been called on to play an active role in the antitobacco arena. Because of their unique opportunity to interact with children, adolescents, and parents, pediatricians can and should be antitobacco interventionists. For this to occur, however, additional guidance should be provided to pediatricians during their training to better prepare them to carry out effective assessment and intervention practices. smoking initiation, smoking prevention, smoking cessation, environmental tobacco smoke, pediatricians.
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Affiliation(s)
- R J Stein
- Department of Psychology, Rockhurst University, Kansas City, Missouri 64110, USA.
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