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Lopez A, Tinella L, Caffò A, Bosco A. Measuring the reliability of proxy respondents in behavioural assessments: an open question. Aging Clin Exp Res 2023; 35:2173-2190. [PMID: 37540380 PMCID: PMC10520105 DOI: 10.1007/s40520-023-02501-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND In behavioural assessment, information can be gathered from internally referenced self-reports or from proxy informants. AIMS This study aimed to fine-tune a brief but reliable method for evaluating the proxy accuracy in cases where responses obtained from adult and older adults' patient cannot be considered reliable. METHODS We generated a set of items reflecting both overt and covert behaviours related to the basic instrumental activities of daily living. The psychometric properties of the content, factorial, and criterium validity of these items were then checked. The Proxy Reliability Questionnaire-ProRe was created. We tested the frequency of "I don't know" responses as a measure of proxy reliability in a sample of healthy older adults and their proxies, and in a second sample of proxy respondents who answered questions about their parents. RESULTS As expected, response precision was lower for items characterizing covert behaviours; items about covert compared to overt behaviours generated more "I don't know" answers. Proxies provided less "I don't know" responses when evaluating the parent, they claimed they knew better. Moreover, we tried to validate our approach using response confidence. Encouragingly, these results also showed differences in the expected direction in confidence between overt and covert behaviours. CONCLUSIONS The present study encourages clinicians/researchers to how well the proxy the patient know each other, the tendency of proxies to exhibit, for example, response bias when responding to questions about patients' covert behaviours, and more importantly, the reliability of informants in providing a clinical assessment of neurocognitive diseases associated with aging.
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Affiliation(s)
- Antonella Lopez
- Faculty of Law, Giustino Fortunato University, Via Delcogliano, 12, Benevento, Italy
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Luigi Tinella
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Alessandro Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Bari, Via Crisanzio 42, 70122 Bari, Italy
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Kalousova L. Parental Smoking in Childhood as a Smoking Risk Factor Throughout Middle Age. Am J Prev Med 2023:S0749-3797(23)00112-5. [PMID: 36863667 PMCID: PMC10363230 DOI: 10.1016/j.amepre.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Children of people who smoke have a well-documented higher risk of smoking initiation. However, little is known about the persistence of the association between parental smoking and children's own smoking as they age. METHODS This study uses data collected by the Panel Study of Income Dynamics collected between 1968 and 2017 and investigates the association between parental smoking and children's own smoking through middle age and how it may be modified by adult children's SES using regression models. The analysis was conducted between 2019 and 2021. RESULTS The results show an increased risk of smoking among adult children of parents who smoked. Their odds were elevated in young adulthood (OR=1.55, 95% CI=1.11, 2.14), established adulthood (OR=1.53, 95% CI = 1.08, 2.15), and middle age (OR=1.63, 95% CI=1.04, 2.55). Interaction analysis shows that this statistically significant relationship is limited to high-school graduates only. Among people who smoked in the past or who currently smoke, children of people who smoked had longer average smoking duration. Interaction analysis shows that this risk is limited to high-school graduates only. The adult children of people who smoked and have less than a high-school education, some college, and college graduates did not have a statistically significantly increased risk of smoking or longer smoking duration. CONCLUSION The findings highlight the durability of early life influences, especially for people with low SES.
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Affiliation(s)
- Lucie Kalousova
- Department of Medicine, Health, Society and Sociology, Vanderbilt University, Nashville, Tennesse.
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Yang H, Chen B, Guo A, Song J, Cheng X, Jin C. Association of Householder Smoking With Poverty and the Mediating Effect of NCDs in Relatively Underdeveloped Regions in China. Front Public Health 2022; 10:858761. [PMID: 35664093 PMCID: PMC9160790 DOI: 10.3389/fpubh.2022.858761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background:Studies have not provided clear enough evidence on the direct association between cigarette smoking and poverty. This study aims to assess the association of householder smoking with near-poverty households, and the potential mediating effect of NCDs.MethodsA cross-sectional survey was conducted from November 2019 to October 2020 in relatively underdeveloped regions in China. In total, 2,409 households were investigated in areas under the jurisdiction of 24 primary health care (PHC) institutions of eight provinces. Pearson's χ2-test was performed, and multivariable logistic regression and extended probit regression models were fitted to examine the association between householder smoking and near-poverty households. Moreover, generalized structural equation modeling was used to explore the mediating effect of NCDs.ResultsAfter adjusting for all other potential confounding factors, compared with households headed by never-smokers, households headed by smokers exhibited significantly elevated risks of being near poverty, with an odds ratio of 2.01 (95% CI: 0.48–0.91). We also found that living in rural areas and having a low education level both had a negative effect on being near poverty. Additionally, NCDs had a significantly positive mediating effect, with a 31.57% effect of householder smoking on near-poverty status mediated by NCDs; the indirect effect was estimated to be 0.17 (95% CI: 0.04–0.31).ConclusionsHouseholder smoking significantly elevated the risk of the household being near poverty, and suffering NCDs had a positive mediating effect.
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Affiliation(s)
- Huimin Yang
- Department of Child Health Development, Capital Institute of Pediatrics, Beijing, China
| | - Bowen Chen
- Department of Child Health Development, Capital Institute of Pediatrics, Beijing, China
| | - Aili Guo
- Community Health Association of China, Beijing, China
| | - Jiarui Song
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Xi Cheng
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chenggang Jin
- Research Center for Health and Social Policy, Beijing Normal University, Zhuhai, China
- *Correspondence: Chenggang Jin
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Andriani H. Exposure to parental smoking and children being overweight: residence as an effect modifier. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01153-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Farzanegan B, Elkhatib THM, Elgazzar AE, Moghaddam KG, Torkaman M, Zarkesh M, Goharani R, Bashar FR, Hajiesmaeili M, Shojaei S, Madani SJ, Vahedian-Azimi A, Hatamian S, Mosavinasab SMM, Khoshfetrat M, Khatir AK, Miller AC. Impact of Religiosity on Delirium Severity Among Critically Ill Shi'a Muslims: A Prospective Multi-Center Observational Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:816-840. [PMID: 31435840 DOI: 10.1007/s10943-019-00895-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study assesses the impact of religiosity on delirium severity and patient outcomes among Shi'a Muslim intensive care unit (ICU) patients. We conducted a prospective observational cohort study in 21 ICUs from 6 Iranian academic medical centers. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU) tool. Eligible patients were intubated, receiving mechanical ventilation (MV) for ≥ 48 h. Illness severity was assessed using Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. A total of 4200 patients were enrolled. Patient religiosity was categorized as more (40.6%), moderate (42.3%), or less (17.1%) based on responses to patient and surrogate questionnaires. The findings suggest that lower pre-illness religiosity may be associated with greater delirium severity, MV duration, and ICU and hospital LOS. The lower mortality in the less religiosity group may be related in part to a greater proportion of female patients, but it remains unclear whether and to what extent greater religiosity impacted treatment decisions by patients and families. Further investigation is needed to validate and clarify the mechanism of the mortality findings.
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Affiliation(s)
- Behrooz Farzanegan
- Tracheal Diseases Research Center, Anesthesia and Critical Care Department, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Alaa E Elgazzar
- Department of Chest Diseases, Zagazig University, Sharkia, Egypt
| | - Keivan G Moghaddam
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Torkaman
- Department of Pediatrics, School of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Zarkesh
- Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Goharani
- Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshid R Bashar
- Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadreza Hajiesmaeili
- Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedpouzhia Shojaei
- Anesthesiology Research Center, Anesthesia and Critical Care Department, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed J Madani
- Trauma Research Center, Medicine Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sevak Hatamian
- Anesthesia and Critical Care Department, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyed M M Mosavinasab
- Anesthesiology Research Center, Anesthesia Care Department, Modares Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoum Khoshfetrat
- Anesthesiology Research Center, Anesthesia and Critical Care Department, Khatam-o-anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali K Khatir
- Anesthesiology Research Center, Anesthesia and Critical Care Department, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Andrew C Miller
- Department of Emergency Medicine, Vidant Medical Center, East Carolina University Brody School of Medicine, 600 Moye Blvd, Greenville, NC, 27834, USA.
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Patel O, Syamlal G, Henneberger PK, Alarcon WA, Mazurek JM. Pesticide use, allergic rhinitis, and asthma among US farm operators. J Agromedicine 2019; 23:327-335. [PMID: 30230435 DOI: 10.1080/1059924x.2018.1501451] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of the study is to examine associations between use of specific pesticides and lifetime allergic rhinitis and current asthma in US primary farm operators. METHODS The 2011 Farm and Ranch Safety Survey data from 11,210 primary farm operators were analyzed. Pesticide use on the farm was determined using an affirmative response to the question of whether the operator ever mixed, loaded, or applied pesticides on their farm in the 12 months prior to the interview. Operators who answered "yes" were further asked about the specific trade name and formulation identifiers of the product they used and personal protective equipment (PPE) used. Data were weighted to produce national estimates. Adjusted prevalence odds ratios (PORs) were calculated using logistic regression. The referent group included operators who did not use any pesticides in the 12 months prior to the interview. RESULTS Of an estimated 2.1 million farm operators, 40.0% used pesticides, 30.8% had lifetime allergic rhinitis, and 5.1% had current asthma. Insecticide and herbicide use were significantly associated with lifetime allergic rhinitis and current asthma. The use of 2,4-dichlorophenoxyacetic acid (POR = 1.5; 95% CI 1.2-1.9) and carbaryl (POR = 2.3; 1.4-3.7) was significantly associated with lifetime allergic rhinitis. Of operators using pesticides, 64.9% used PPE the last time they mixed, loaded, or applied pesticides. CONCLUSIONS Pesticide use was associated with lifetime allergic rhinitis and current asthma among farm operators. Further studies are needed to clarify the dose-response relationship between pesticide use and adverse respiratory health effects.
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Affiliation(s)
- Opal Patel
- a Association of Schools and Programs of Public Health (ASPPH)/Centers for Disease Control and Prevention (CDC) Public Health Fellowship Program, Washington, DC, USA.,b Respiratory Health Division , National Institute for Occupational Safety and Health (NIOSH), CDC , Morgantown , WV , USA
| | - Girija Syamlal
- b Respiratory Health Division , National Institute for Occupational Safety and Health (NIOSH), CDC , Morgantown , WV , USA
| | - Paul K Henneberger
- b Respiratory Health Division , National Institute for Occupational Safety and Health (NIOSH), CDC , Morgantown , WV , USA
| | - Walter A Alarcon
- c Division of Surveillance , Hazard Evaluations and Field Studies (DSHEFS), NIOSH, CDC , Cincinnati , OH , USA
| | - Jacek M Mazurek
- b Respiratory Health Division , National Institute for Occupational Safety and Health (NIOSH), CDC , Morgantown , WV , USA
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Hsia J, Puckcharern H, Town M. Effect of Proxy Responses on Tobacco Use Surveys in Thailand, 2011. Prev Chronic Dis 2018; 15:E129. [PMID: 30367719 PMCID: PMC6219849 DOI: 10.5888/pcd15.180158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Proxy responses are often allowed in household tobacco surveys when all household members are included in a sample. To assess the effect of proxy responses on prevalence estimates, we compared 2 surveys in 2011 that gauged tobacco use in Thailand: the Cigarette Smoking and Alcohol Drinking Survey (SADS) and the Global Adult Tobacco Survey (GATS). Both surveys had similar nonsampling errors and design, but SADS allowed proxy responses and GATS did not. When proxy responses were included in SADS, the prevalence estimate was 10% lower in GATS for men (41.69% in GATS vs 46.55% in SADS) and 18% lower in GATS for women (2.14% in GATS vs 2.61% in SADS). Eliminating proxy responses is recommended to increase accuracy of tobacco-use surveillance.
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Affiliation(s)
- Jason Hsia
- Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS-F78, Atlanta, GA 30341.
| | | | - Machell Town
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Pilot Study of an Internet-Based, Simulated Teachable Moment for Smoking Cessation. J Smok Cessat 2018. [DOI: 10.1017/jsc.2018.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractIntroductionThe internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.AimsTo investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.MethodsSmokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).Results/FindingsSeventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.ConclusionsThis pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.
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Vijayaraghavan M, Benmarnhia T, Pierce JP, White MM, Kempster J, Shi Y, Trinidad DR, Messer K. Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. PLoS One 2018; 13:e0201467. [PMID: 30052671 PMCID: PMC6063424 DOI: 10.1371/journal.pone.0201467] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 07/15/2018] [Indexed: 11/19/2022] Open
Abstract
Background Lower rates of successful quitting among low-income populations in the United States may be from slower dissemination of smoke-free homes, a predictor of cessation. Objectives To explore the role of smoke-free homes in cessation behavior across income levels. Participants Current smokers who were ≥18 years and who participated in the longitudinal 2002–2003 (n = 2801) or 2010–2011 (n = 2723) Tobacco Use Supplements to the Current Population Survey. Measurements We categorized income as multiples of the federal poverty level (FPL) (<300% FPL versus ≥300% FPL). We examined the association of smoke-free homes with 1+day quit attempts and 30+days abstinence at 1-year follow-up. We then conducted a mediation analysis to examine the extent that smoke-free homes contributed to income disparities in 30+days abstinence. Results Between the two surveys, heavy smoking (≥ 1 pack/day) declined by 17%, and smoking prevalence declined by 15% among those with higher-incomes (>300%FPL). Although similar in 2002, the prevalence of smoke-free homes was 33% lower among individuals living <300% FPL than those living ≥300% FPL. Although the quit attempt rate was similar, the 30+days abstinence rate was higher in the 2010–11 cohort than in 2002–3 cohort (20.6% versus 15.5%, p<0.008). Whereas smoking ≥ 1 pack/ day was associated with lower odds of 30+days abstinence (Adjusted odds ratio [AOR] 0.7; 95% CI 0.5–0.9), having a higher income (AOR 1.9, 95% CI 1.4–2.6) and a smoke-free home (AOR 1.6, 95% CI 1.2–2.1) were associated with greater odds of 30+day abstinence. Differential changes in smoke-free homes across income groups between the two surveys contributed to 36% (95% CI 35.7–36.3) of the observed income disparity in 30+days abstinence. Conclusions Increasing the diffusion of smoke-free homes among low-income populations may attenuate at least a third of the income disparities in smoking cessation, highlighting the need for interventions to increase adoption of smoke-free homes among low-income households.
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Affiliation(s)
- Maya Vijayaraghavan
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, United States of America
- * E-mail:
| | - Tarik Benmarnhia
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
- Climate, Atmospheric Science & Physical Oceanography, Scripps Institution of Oceanography, La Jolla, CA, United States of America
| | - John P. Pierce
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Martha M. White
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
| | - Jennie Kempster
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Yuyan Shi
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Dennis R. Trinidad
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
| | - Karen Messer
- Division of Population Sciences, Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States of America
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Mirzazadeh A, Shokoohi M, Navadeh S, Danesh A, Jain J, Sedaghat A, Farnia M, Haghdoost A. Underreporting in HIV-related high-risk behaviors: comparing the results of multiple data collection methods in a behavioral survey of prisoners in Iran. THE PRISON JOURNAL 2018; 98:213-228. [PMID: 30078913 PMCID: PMC6075723 DOI: 10.1177/0032885517753163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
We explored the potentials of using three indirect methods including crosswise, proxy respondent method, and network scale-up (NSU) in comparison to direct questioning in collecting sensitive and socially stigmatized HIV-related risk behaviors information from prisoners (N=265). Participants reported more sexual contact in prison for their friends than they did for themselves (10.6% vs. 3.8% in men, 13.7% vs. 0% in women). In men, NSU provided lower estimates than direct questioning, while in women NSU estimates were higher. Different data collection methods provide different estimates, and collectively offer a more comprehensive picture of HIV-related risk behaviors in prisons.
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Affiliation(s)
- Ali Mirzazadeh
- Global Health Sciences, University of California, San Francisco California; San Francisco, CA USA
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shokoohi
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Canada
| | - Soodabeh Navadeh
- Global Health Sciences, University of California, San Francisco California; San Francisco, CA USA
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Danesh
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Health and Community Medicine, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Jennifer Jain
- Global Health Sciences, University of California, San Francisco California; San Francisco, CA USA
| | - Abbas Sedaghat
- HIV National Program, Center for Disease Control, Ministry of Health, Tehran, Iran
| | - Marziyeh Farnia
- Health and Treatment Office of Iranian Prisons Organization, Tehran, Iran
| | - AliAkbar Haghdoost
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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A population study on the time trend of cigarette smoking, cessation, and exposure to secondhand smoking from 2001 to 2013 in Taiwan. Popul Health Metr 2016; 14:38. [PMID: 27822144 PMCID: PMC5097365 DOI: 10.1186/s12963-016-0109-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 10/10/2016] [Indexed: 11/10/2022] Open
Abstract
Background In 2001, the National Health Interview Survey (NHIS) commenced in Taiwan. This survey, conducted on a sample of the whole Taiwanese population, is nationally representative and has a high response rate (>80 %). As a result, the four already completed surveys from 2001 to 2013 can be used to investigate the time trend of smoking prevalence, the rate of cessation, and exposure to secondhand smoking. Methods There were 72918 adults combined from the 2001, 2005, 2009 and 2013 National Health Interview Surveys (NHIS). Smoking status, exposure to secondhand smoking, and smoking cessation were asked, as well as demographic characteristics and other variables. Statistical analyses with sampling weights were carried out using SAS and SUDAAN. Results In males, the prevalence of smoking significantly decreased (rates in 4 surveys were 44.4 %, 44.6 %, 38.9 %, and 34.2 %, respectively). Since 2005 the rate of smoking cessation increased significantly (p = 0.033). The odd ratio (OR) exposure of secondhand among non-smokes (OR) in 2009 and 2013 were 0.96 (CI = 0.85–1.08) and 0.78 (CI = 0.70–0.88) comparing to 2005. In females, the prevalence of smoking was stable over time. The rate of smoking cessation only appeared significantly high in the older age group. The OR for exposure to secondhand smoking were 0.81 (CI = 0.74–0.89) and 0.68 (CI = 0.62–0.74), for 2009 and 2013 comparing to 2005, respectively. Conclusion Early anti-smoking legislation in Taiwan might have raised the awareness of the harm of smoking. However, the implementation of the Tobacco Hazards Prevention Act (THPA) in 2009 had great contribution to the reduction of smoking rate, especially in males. Electronic supplementary material The online version of this article (doi:10.1186/s12963-016-0109-x) contains supplementary material, which is available to authorized users.
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Holford TR, Levy DT, Meza R. Comparison of Smoking History Patterns Among African American and White Cohorts in the United States Born 1890 to 1990. Nicotine Tob Res 2016; 18 Suppl 1:S16-29. [PMID: 26980861 DOI: 10.1093/ntr/ntv274] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Characterizing smoking history patterns summarizes life course exposure for birth cohorts, essential for evaluating the impact of tobacco control on health. Limited attention has been given to patterns among African Americans. METHODS Life course smoking histories of African Americans and whites were estimated beginning with the 1890 birth cohort. Estimates of smoking initiation and cessation probabilities, and intensity can be used as a baseline for studying smoking intervention strategies that target smoking exposure. US National Health Interview Surveys conducted from 1965 to 2012 yielded cross-sectional information on current smoking behavior among African Americans and whites. Additional detail for smokers including age at initiation, age at cessation and smoking intensity were available in some surveys and these were used to construct smoking histories for participants up to the date that they were interviewed. Age-period-cohort models with constrained natural splines provided estimates of current, former and never-smoker prevalence in cohorts beginning in 1890. RESULTS This approach yielded yearly estimates of initiation, cessation and smoking intensity by age for each birth cohort. Smoking initiation probabilities tend to be lower among African Americans compared to whites, and cessation probabilities also were generally lower. Higher initiation leads to higher smoking prevalence among whites in younger ages, but lower cessation leads to higher prevalence at older ages in blacks, when adverse health effects of smoking become most apparent. CONCLUSIONS These estimates provide a summary that can be used to better understand the effects of changes in smoking behavior following publication of the Surgeon General's Report in 1964. IMPLICATIONS A novel method of estimating smoking histories was applied to data from the National Health Interview Surveys, which provided an extensive summary of the smoking history in this population following publication of the Surgeon General's Report in 1964. The results suggest that some of the existing disparities in smoking-related disease may be due to the lower cessation rates in African Americans compared to whites. However, the number of cigarettes smoked is also lower among African Americans. Further work is needed to determine mechanisms by which smoking duration and intensity can account for racial disparities in smoking-related diseases.
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Affiliation(s)
- Theodore R Holford
- Department of Biostatistics, Yale School of Public Health, New Haven, CT;
| | - David T Levy
- Cancer Control, Department of Oncology, Georgetown University, Washington, DC
| | - Rafael Meza
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
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Richter KP, Faseru B, Shireman TI, Mussulman LM, Nazir N, Bush T, Scheuermann TS, Preacher KJ, Carlini BH, Magnusson B, Ellerbeck EF, Cramer C, Cook DJ, Martell MJ. Warm Handoff Versus Fax Referral for Linking Hospitalized Smokers to Quitlines. Am J Prev Med 2016; 51:587-96. [PMID: 27647059 PMCID: PMC5031370 DOI: 10.1016/j.amepre.2016.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/29/2016] [Accepted: 04/04/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Few hospitals treat patients' tobacco dependence. To be effective, hospital-initiated cessation interventions must provide at least 1 month of supportive contact post-discharge. STUDY DESIGN Individually randomized clinical trial. Recruitment commenced July 2011; analyses were conducted October 2014-June 2015. SETTING/PARTICIPANTS The study was conducted in two large Midwestern hospitals. Participants included smokers who were aged ≥18 years, planned to stay quit after discharge, and spoke English or Spanish. INTERVENTION Hospital-based cessation counselors delivered the intervention. For patients randomized to warm handoff, staff immediately called the quitline from the bedside and handed the phone to participants for enrollment and counseling. Participants randomized to fax were referred on the day of hospital discharge. MAIN OUTCOME MEASURES Outcomes at 6 months included quitline enrollment/adherence, medication use, biochemically verified cessation, and cost effectiveness. RESULTS Significantly more warm handoff than fax participants enrolled in quitline (99.6% vs 59.6%; relative risk, 1.67; 95% CI=1.65, 1.68). One in four (25.4% warm handoff, 25.3% fax) were verified to be abstinent at 6-month follow-up; this did not differ significantly between groups (relative risk, 1.02; 95% CI=0.82, 1.24). Cessation medication use in the hospital and receipt of a prescription for medication at discharge did not differ between groups; however, significantly more fax participants reported using cessation medication post-discharge (32% vs 25%, p=0.01). The average incremental cost-effectiveness ratio of enrolling participants into warm handoff was $0.14. Hospital-borne costs were significantly lower in warm handoff than in fax ($5.77 vs $9.41, p<0.001). CONCLUSIONS One in four inpatient smokers referred to quitline by either method were abstinent at 6 months post-discharge. Among motivated smokers, fax referral and warm handoff are efficient and comparatively effective ways to link smokers with evidence-based care. For hospitals, warm handoff is a less expensive and more effective method for enrolling smokers in quitline services.
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Affiliation(s)
- Kimber P Richter
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas.
| | - Babalola Faseru
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Theresa I Shireman
- Department of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island
| | - Laura M Mussulman
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Niaman Nazir
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Kristopher J Preacher
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Beatriz H Carlini
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, Washington
| | | | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Carol Cramer
- Tobacco Use Prevention, Kansas Department of Health and Environment, Topeka, Kansas
| | - David J Cook
- Department of Health Policy and Management, University of Kansas Medical Center, Kansas City, Kansas
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Moore E, Blatt K, Chen A, Van Hook J, DeFranco EA. Relationship of trimester-specific smoking patterns and risk of preterm birth. Am J Obstet Gynecol 2016; 215:109.e1-6. [PMID: 26827877 DOI: 10.1016/j.ajog.2016.01.167] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/16/2016] [Accepted: 01/20/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND In 2011, the US national rate of smoking early in pregnancy was 11.5%. Unfortunately, our home state of Ohio had a rate twice as high at 23%. Smoking in pregnancy remains one of the most important modifiable risk factors for pregnancy complications, specifically preterm birth. OBJECTIVE The objective of the study was to quantify the preterm birth risk to various trimester-specific smoking behaviors. STUDY DESIGN The study was a population-based, retrospective cohort study of singleton non-anomalous live births, using Ohio birth records 2006 to 2012. Preterm birth rates were compared between non-smokers and women who smoked in the preconception period only, those who quit smoking after the 1st and 2nd trimesters, and those who smoked throughout pregnancy. Multivariate logistic regression quantified the risk of smoking with cessation at various times in pregnancy and preterm birth risk, adjusted for maternal race, education, age, Medicaid use, marital status, and parity. A stratified analysis was performed on the basis of preterm birth subtype: spontaneous preterm birth versus indicated preterm birth. We also performed an additional analysis stratifying for maternal race using the 2 largest categories of race (non-Hispanic white and non-Hispanic black). RESULTS Of the 913,757 birth records analyzed, nearly 25% of the women reported some smoking behavior on the birth certificate data. Of smokers, less than half quit during pregnancy (38.8% vs 61.2% smoked throughout pregnancy). Early quitters had a similar preterm birth rate compared with non-smokers. Women who smoked through the 1st trimester only did not have a significant increase in their overall preterm birth odds ratio <37 weeks; however, it did increase the odds of extreme preterm birth <28 weeks by 20% (adjusted odds ratio, 1.20; 95% confidence interval [CI], 1.02, 1.40). Quitting late in pregnancy resulted in the highest odds ratio increase: 70% for preterm birth <37 weeks (adjusted odds ratio 1.70; CI, 1.60, 1.80), even after adjustment for the confounding influences. Quitting smoking early in pregnancy after the 1st trimester did not increase the overall risk of spontaneous or indicated preterm birth <37 weeks significantly. However, quitting after the 1st trimester was associated with a significant increase in risk of extreme spontaneous preterm birth <28 weeks, an effect not seen with indicated preterm birth <28 weeks. Delaying cessation until late in pregnancy-after the 2nd trimester-was associated with the highest risk increases, 65% increased odds of spontaneous and 78% increase in odds of indicated preterm births. The rate of preterm births to non-Hispanic black mothers was increased in all categories over those of non-Hispanic white mothers. The relative influence of smoking cessation in pregnancy was similar in black compared with white mothers. The effect modification in the regression model was analyzed and revealed no significant interaction between race and smoking patterns on preterm birth risk. CONCLUSION Smoking throughout pregnancy is associated with an increased risk of preterm birth. However, quitting early in pregnancy negates this risk. Widespread programs aimed at smoking cessation early in pregnancy could have a significant impact on reducing the rate of preterm birth nationally.
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Affiliation(s)
- Elizabeth Moore
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Kaitlin Blatt
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - James Van Hook
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Emily A DeFranco
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio; Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Mishra S, Joseph RA, Gupta PC, Pezzack B, Ram F, Sinha DN, Dikshit R, Patra J, Jha P. Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education. BMJ Glob Health 2016; 1:e000005. [PMID: 28588906 PMCID: PMC5321300 DOI: 10.1136/bmjgh-2015-000005] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/13/2016] [Accepted: 01/19/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives Smoking of cigarettes or bidis (small, locally manufactured smoked tobacco) in India has likely changed over the last decade. We sought to document trends in smoking prevalence among Indians aged 15–69 years between 1998 and 2015. Design Comparison of 3 nationally representative surveys representing 99% of India's population; the Special Fertility and Mortality Survey (1998), the Sample Registration System Baseline Survey (2004) and the Global Adult Tobacco Survey (2010). Setting India. Participants About 14 million residents from 2.5 million homes, representative of India. Main outcome measures Age-standardised smoking prevalence and projected absolute numbers of smokers in 2015. Trends were stratified by type of tobacco smoked, age, gender and education level. Findings The age-standardised prevalence of any smoking in men at ages 15–69 years fell from about 27% in 1998 to 24% in 2010, but rose at ages 15–29 years. During this period, cigarette smoking in men became about twofold more prevalent at ages 15–69 years and fourfold more prevalent at ages 15–29 years. By contrast, bidi smoking among men at ages 15–69 years fell modestly. The age-standardised prevalence of any smoking in women at these ages was 2.7% in 2010. The smoking prevalence in women born after 1960 was about half of the prevalence in women born before 1950. By contrast, the intergenerational changes in smoking prevalence in men were much smaller. The absolute numbers of men smoking any type of tobacco at ages 15–69 years rose by about 29 million or 36% in relative terms from 79 million in 1998 to 108 million in 2015. This represents an average increase of about 1.7 million male smokers every year. By 2015, there were roughly equal numbers of men smoking cigarettes or bidis. About 11 million women aged 15–69 smoked in 2015. Among illiterate men, the prevalence of smoking rose (most sharply for cigarettes) but fell modestly among men with grade 10 or more education. The ex-smoking prevalence in men at ages 45–59 years rose modestly but was low: only 5% nationally with about 4 current smokers for every former smoker. Conclusions Despite modest decreases in smoking prevalence, the absolute numbers of male smokers aged 15–69 years has increased substantially over the last 15 years. Cigarettes are displacing bidi smoking, most notably among young adult men and illiterate men. Tobacco control policies need to adapt to these changes, most notably with higher taxation on tobacco products, so as to raise the currently low levels of adult smoking cessation.
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Affiliation(s)
- Sujata Mishra
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Renu Ann Joseph
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prakash C Gupta
- Healis-Sekhsaria Institute of Public Health,Mumbai, Maharashtra, India
| | - Brendon Pezzack
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Faujdar Ram
- International Institute of Population Studies, Mumbai, Maharashtra
| | - Dhirendra N Sinha
- World Health Organization Regional Office of South East Asia, New Delhi, India
| | | | - Jayadeep Patra
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prabhat Jha
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Mishra S, Joseph RA, Gupta PC, Pezzack B, Ram F, Sinha DN, Dikshit R, Patra J, Jha P. Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education. BMJ Glob Health 2016. [PMID: 28588906 DOI: 10.1136/bmjgh-2015-000005.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Smoking of cigarettes or bidis (small, locally manufactured smoked tobacco) in India has likely changed over the last decade. We sought to document trends in smoking prevalence among Indians aged 15-69 years between 1998 and 2015. DESIGN Comparison of 3 nationally representative surveys representing 99% of India's population; the Special Fertility and Mortality Survey (1998), the Sample Registration System Baseline Survey (2004) and the Global Adult Tobacco Survey (2010). SETTING India. PARTICIPANTS About 14 million residents from 2.5 million homes, representative of India. MAIN OUTCOME MEASURES Age-standardised smoking prevalence and projected absolute numbers of smokers in 2015. Trends were stratified by type of tobacco smoked, age, gender and education level. FINDINGS The age-standardised prevalence of any smoking in men at ages 15-69 years fell from about 27% in 1998 to 24% in 2010, but rose at ages 15-29 years. During this period, cigarette smoking in men became about twofold more prevalent at ages 15-69 years and fourfold more prevalent at ages 15-29 years. By contrast, bidi smoking among men at ages 15-69 years fell modestly. The age-standardised prevalence of any smoking in women at these ages was 2.7% in 2010. The smoking prevalence in women born after 1960 was about half of the prevalence in women born before 1950. By contrast, the intergenerational changes in smoking prevalence in men were much smaller. The absolute numbers of men smoking any type of tobacco at ages 15-69 years rose by about 29 million or 36% in relative terms from 79 million in 1998 to 108 million in 2015. This represents an average increase of about 1.7 million male smokers every year. By 2015, there were roughly equal numbers of men smoking cigarettes or bidis. About 11 million women aged 15-69 smoked in 2015. Among illiterate men, the prevalence of smoking rose (most sharply for cigarettes) but fell modestly among men with grade 10 or more education. The ex-smoking prevalence in men at ages 45-59 years rose modestly but was low: only 5% nationally with about 4 current smokers for every former smoker. CONCLUSIONS Despite modest decreases in smoking prevalence, the absolute numbers of male smokers aged 15-69 years has increased substantially over the last 15 years. Cigarettes are displacing bidi smoking, most notably among young adult men and illiterate men. Tobacco control policies need to adapt to these changes, most notably with higher taxation on tobacco products, so as to raise the currently low levels of adult smoking cessation.
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Affiliation(s)
- Sujata Mishra
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Renu Ann Joseph
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prakash C Gupta
- Healis-Sekhsaria Institute of Public Health,Mumbai, Maharashtra, India
| | - Brendon Pezzack
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Faujdar Ram
- International Institute of Population Studies, Mumbai, Maharashtra
| | - Dhirendra N Sinha
- World Health Organization Regional Office of South East Asia, New Delhi, India
| | | | - Jayadeep Patra
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Prabhat Jha
- Centre for Global Health Research, St. Michael's Hospital and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Abstract
UNLABELLED This commentary draws on the articles contained in this special African American youth and adult tobacco use supplement to better understand the apparent paradox of low youth smoking rates and high adult smoking rates. Implications for tobacco use prevention and control are discussed. IMPLICATIONS This commentary introduces the reader to the topics and questions addressed in the supplement and urges an invigorated public health response to address tobacco-caused disease and death in African Americans.
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Affiliation(s)
- Ursula E Bauer
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Validation of Non-Smoking Status by Spouse Following a Cessation Intervention. J Smok Cessat 2015; 12:38-42. [PMID: 28239426 DOI: 10.1017/jsc.2015.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Following cessation interventions, self-reported smoking abstinence with biochemical verification is the "gold standard" for defining outcomes. Because obtaining biochemical verification is challenging in community studies, we compared self-reported cessation among smokers completing treatment to the smoking status reported by each participant's spouse or proxy. METHOD Participants were smokers who had reported quitting 12 months after a cessation intervention. Participants had either attended a smoking cessation clinic or they were patients seen by physicians who had recently participated in a cessation-training program. Proxies living with these participants were interviewed by telephone to ask about their partner's smoking status. We compared the participants' responses to those from their spouses. RESULTS At 12 months, 346 of 1423 baseline smokers had quit; 161/346 reported non-smokers were called and 140 proxies were interviewed. The participants averaged 51 years of age, 69% were women. At baseline, the mean number of cigarettes smoked per day was 20.1 (SD = 9.9) and the average number of quit attempts was 2.4 (SD = 1.2). Cessation methods used were medical advice (21%) and/or pharmacotherapy (79%). Of the 140 spouses interviewed, only 10 (7.1%) reported that their partners were currently smoking. CONCLUSIONS Proxy-reported data on smoking status could be used to validate self-report.
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Abstract
The Great Recession produced the highest rates of unemployment observed in decades, in part due to particularly high rates of people losing work involuntarily. The impact of these job losses on health is unknown, due to the length of time required for most disease development, concerns about reverse causation, and limited data that covers this time period. We examine associations between job loss, employment status and smoking, the leading preventable cause of death, among 13,571 individuals participating in the 2001-2011 waves of the U.S.-based Panel Study of Income Dynamics. Results indicate that recent involuntary job loss is associated with an average 1.1 percentage point increase in smoking probability. This risk is strongest when people have returned to work, and appears reversed when they leave the labor market altogether. Although some job loss is associated with changes in household income and psychological distress levels, we find no evidence that these changes explain smoking behavior modifications. Smoking prevention programs and policies targeted at displaced workers or the newly employed may alleviate some negative health effects produced by joblessness during the Great Recession.
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Regan S, Reid ZZ, Kelley JHK, Reyen M, Korotkin M, Japuntich SJ, Viana JC, Levy DE, Rigotti NA. Smoking Status Confirmation by Proxy: Validation in a Smoking Cessation Trial. Nicotine Tob Res 2015; 18:34-40. [PMID: 25847290 DOI: 10.1093/ntr/ntv073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 03/20/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Biochemical confirmation (BC) of self-report is the gold standard of evidence for abstinence in smoking cessation research, but difficulty in obtaining samples may bias estimates of quit rates. Proxy confirmation (PC) has not been validated in cessation trials. We assessed the feasibility and validity of PC in a cessation trial for hospitalized smokers. METHODS We enrolled 402 daily cigarette smokers during a hospital admission. At enrollment, participants provided demographics, smoking history, and named proxies to confirm their smoking status at follow-up. Participants provided self-reported (SR) 7-day tobacco abstinence by telephone at 6 months post-discharge. SR quitters were asked to mail a saliva sample for BC. Incentives were offered for survey completion ($20) and returned samples ($50). We called proxies for all those with SR to obtain PC. Quit rates were calculated with missing data indicating smoking. We assessed associations of nonresponse with baseline characteristics using chi-squared tests and logistic regression. We calculated the sensitivity and specificity of PC in detecting smokers as determined by BC. RESULTS All patients named at least one proxy. Response rates were 82% for SR, 84% for PC, and 69% for BC. Observed participant characteristics were unrelated to provision of sample for BC. Estimated quit rates were 35% for SR, 27% for SR + PC, 21% for SR + BC and 27% for SR + BC or PC. Sensitivity of PC was not higher than SR (73% vs. 77%); specificity was lower (84% vs. 100%). CONCLUSION PC was feasible but not superior to self-report in a cessation trial.
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Affiliation(s)
- Susan Regan
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA;
| | - Zachary Z Reid
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Jennifer H K Kelley
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
| | - Michele Reyen
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Molly Korotkin
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
| | - Sandra J Japuntich
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; National Center for PTSD, VA Boston Healthcare System, Boston, MA
| | - Joseph C Viana
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Department of Health Policy and Management, University of California, Los Angeles, CA
| | - Douglas E Levy
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
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Adverse effects of parental smoking during pregnancy in urban and rural areas. BMC Pregnancy Childbirth 2014; 14:414. [PMID: 25551278 PMCID: PMC4302514 DOI: 10.1186/s12884-014-0414-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/05/2014] [Indexed: 12/02/2022] Open
Abstract
Background Parental smoking during pregnancy is associated with lower birthweight and gestational age, as well as with the risks of low birthweight (LBW) and preterm birth. The present study aims to assess the association of parental smoking during pregnancy with birth outcomes in urban and rural areas. Methods This was a secondary analysis of data collected in the Indonesia Family Life Survey, between 1993 and 2007, the first national prospective longitudinal cohort study in Indonesia. Retrospective data of parental smoking habits, socioeconomic status, pregnancy history and birth outcomes were collected from parents with children aged 0 to 5 years (n = 3789). We assessed the relationships between the amount of parental smoking during pregnancy with birthweight (LBW) and with gestational age (preterm birth). Results We found a significant reduction in birthweight to be associated with maternal smoking. Smoking (except for paternal smoking) was associated with a decrease in the gestational age and an increased risk of preterm birth. Different associations were found in urban area, infants born to smoking fathers and both smoking parents (>20 cigarettes/day for both cases) had a significant reduction in birthweight and gestational age as well as an increased risk of LBW and preterm birth. Conclusions Residence was found to be an effect modifier of the relation between parental smoking during pregnancy, amount of parental smoking, and birth outcomes on their children. Smoking cessation/reduction and smoking intervention program should be advised and prioritized to the area that is more prone to the adverse birth outcomes.
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Holford TR, Levy DT, McKay LA, Clarke L, Racine B, Meza R, Land S, Jeon J, Feuer EJ. Patterns of birth cohort-specific smoking histories, 1965-2009. Am J Prev Med 2014; 46:e31-7. [PMID: 24439359 PMCID: PMC3951759 DOI: 10.1016/j.amepre.2013.10.022] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 10/01/2013] [Accepted: 10/25/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Characterizing the smoking patterns for different birth cohorts is essential for evaluating the impact of tobacco control interventions and predicting smoking-related mortality, but the process of estimating birth cohort smoking histories has received limited attention. PURPOSE Smoking history summaries were estimated beginning with the 1890 birth cohort in order to provide fundamental parameters that can be used in studies of cigarette smoking intervention strategies. METHODS U.S. National Health Interview Surveys conducted from 1965 to 2009 were used to obtain cross-sectional information on current smoking behavior. Surveys that provided additional detail on history for smokers including age at initiation and cessation and smoking intensity were used to construct smoking histories for participants up to the date of survey. After incorporating survival differences by smoking status, age-period-cohort models with constrained natural splines were used to estimate the prevalence of current, former, and never smokers in cohorts beginning in 1890. This approach was then used to obtain yearly estimates of initiation, cessation, and smoking intensity for the age-specific distribution for each birth cohort. These rates were projected forward through 2050 based on recent trends. RESULTS This summary of smoking history shows clear trends by gender, cohort, and age over time. If current patterns persist, a slow decline in smoking prevalence is projected from 2010 through 2040. CONCLUSIONS A novel method of generating smoking histories has been applied to develop smoking histories that can be used in micro-simulation models, and has been incorporated in the National Cancer Institute's Smoking History Generator. These aggregate estimates developed by age, gender, and cohort will provide a complete source of smoking data over time.
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Affiliation(s)
- Theodore R Holford
- Department of Biostatistics (Holford, McKay), Yale School of Public Health, New Haven, Connecticut.
| | - David T Levy
- Cancer Control Department of Oncology (Levy), Washington DC
| | - Lisa A McKay
- Department of Biostatistics (Holford, McKay), Yale School of Public Health, New Haven, Connecticut
| | - Lauren Clarke
- Cornerstone Systems Northwest Inc. (Clarke, Racine), Lynden
| | - Ben Racine
- Cornerstone Systems Northwest Inc. (Clarke, Racine), Lynden
| | - Rafael Meza
- Department of Epidemiology (Meza), University of Michigan, Ann Arbor, Michigan
| | - Stephanie Land
- Division of Cancer Control and Population Sciences (Land, Feuer), National Cancer Institute, Bethesda, Maryland
| | - Jihyoun Jeon
- Departments of Biostatistics and Biomathematics (Jeon), Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Eric J Feuer
- Division of Cancer Control and Population Sciences (Land, Feuer), National Cancer Institute, Bethesda, Maryland
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Tyc VL, Lensing S, Vukadinovich C, Hovell MF. Smoking restrictions in the homes of children with cancer. Am J Health Behav 2013; 37:440-8. [PMID: 23985225 DOI: 10.5993/ajhb.37.4.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine smoking restrictions in households of children with cancer and their effect on biological measures of children's secondhand smoke exposure (SHSe). METHODS A sample of 135 parents of nonsmoking children with cancer who lived with a smoker completed structured interviews. RESULTS Approximately 43% of families prohibited smoking in the home. Children living in homes that prohibited smoking had median cotinine levels that were 71% and 52% lower than did those from homes with no and partial restrictions. CONCLUSIONS Parents should be directed to completely ban all smoking from the home and car to best protect their children from SHSe.
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Affiliation(s)
- Vida L Tyc
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
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Tyc VL, Puleo E, Emmons K, de Moor JS, Ford JS. Smoking Restrictions Among Households of Childhood and Young Adult Cancer Survivors: Implications for Tobacco Control Efforts. J Adolesc Young Adult Oncol 2013; 2:17-24. [PMID: 23610739 DOI: 10.1089/jayao.2012.0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study assessed the prevalence of smoking restrictions among households of survivors of childhood and young adult cancer who smoke. It also examined the relationship between home smoking restrictions and motivation to quit smoking, as well as other smoking, psychosocial, and environmental factors. METHODS Participants included 374 smokers who were childhood or young adult cancer survivors (between the ages of 18 and 55 years) recruited from five cancer centers to participate in a randomized smoking cessation trial. Survivors completed baseline measures about the smoking restrictions in their households, their smoking behavior, and related psychological and environmental factors, which are the focus of the current manuscript. RESULTS Almost 54% of survivors reported that smoking was prohibited in their households. Living with a nonsmoking partner, having a strict smoking policy at work, and not being nicotine dependent all increased the likelihood of having a total home smoking ban. Participants who were older, smoked more cigarettes per day over the prior week, and received prior chemotherapy were less likely to reside in households that adopted total bans. CONCLUSION Findings suggest that socio-environmental factors and current smoking behaviors are associated with complete smoking restrictions in the homes of survivors. These factors should be considered when communicating with survivors about the importance of establishing strict smoking policies in their private residences.
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Affiliation(s)
- Vida L Tyc
- St. Jude Children's Research Hospital , Memphis, Tennessee
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St Claire AW, Boyle RG, Schillo BA, Rode P, Taylor KA. Smokefree home rules adoption by smokers and nonsmokers: Minnesota, 1999-2010. Am J Prev Med 2012; 43:S197-204. [PMID: 23079217 DOI: 10.1016/j.amepre.2012.07.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 07/26/2012] [Accepted: 07/30/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Smokefree workplace policies have successfully limited indoor exposure to secondhand smoke. However, exposure still exists in other indoor locations, most notably in the home. PURPOSE This paper examines change in the public's awareness of secondhand smoke harm, exposure to secondhand smoke, and prevalence of smokefree home rules between 1999 and 2010 in Minnesota. METHODS The Minnesota Adult Tobacco Survey is a statewide, cross-sectional, random-digit-dial telephone-based survey. The survey measures tobacco use, behaviors, attitudes, and beliefs among adults aged 18 and older in 1999, 2003, 2007, and 2010. Analysis was conducted in 2011. RESULTS There was a significant decrease in self-reported exposure to secondhand smoke among all nonsmokers in Minnesota from 2003 (60.9%) to 2010 (37.7%) (p<0.05). The prevalence of smokefree home rules adoption among all Minnesotans increased significantly between each time point: 1999 (64.5%); 2003 (74.8%); 2007 (83.2%); 2010 (87.2%) (p<0.05). Although smokers tended to adopt smokefree home rules at rates lower than nonsmokers, the percentage of smokefree home rules among smokers nearly doubled between 1999 (31.4%) and 2010 (58.1%) (p<0.05). CONCLUSIONS Over 10 years, Minnesotans reported a significant decline in exposure to secondhand smoke and a significant increase in voluntary smokefree home rules. Such a trend is notable as virtually all public tobacco control efforts were aimed at raising awareness and support for smokefree policies within workplaces. These findings demonstrate positive changes in social norms and suggest that behavior change in public settings might also be translated into practice in private settings.
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Grundtvig M, Hagen TP, Amrud ES, Reikvam Å. Reduced life expectancy after an incident hospital diagnosis of acute myocardial infarction--effects of smoking in women and men. Int J Cardiol 2012; 167:2792-7. [PMID: 22901693 DOI: 10.1016/j.ijcard.2012.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 05/03/2012] [Accepted: 07/20/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim was to investigate possible gender differences in the years of life lost after acute myocardial infarction (MI) and to explore how smoking affects life expectancy in the two genders. METHODS In the years 1998-2005, 2281 patients (36.8% women) who were discharged from or died in hospital following a diagnosis of MI were included. Survivors were followed for a mean of 8 years. The age of death for each patient was subtracted from the average projected age of death for individuals in the general population with a similar age to the patient at the time of their MI. The effects of gender, smoking, and other risk factors on the years of life lost were analysed. RESULTS During follow-up, 55% of the patients died. Non-smokers, ex-smokers and current smokers lost 5.4, 6.4 and 10.3 years of life, respectively. Structural equation modeling showed that currently smoking men lost 4.2 more years more than did non-smoking men (P<0.001), and this was mediated through more prematurely occurring MIs. Female current smokers lost 1.9 years more than male current smokers and female ex-smokers lost 1.8 years more than male ex-smokers (both P<0.001). CONCLUSIONS MI caused a substantial number of years of life lost, with a heavier loss in current smokers than in ex-smokers and non-smokers. The effect was predominantly related to the patient's age at the event. More years of life were lost among smoking women than among smoking men, indicating that smoking is most detrimental for the female gender.
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Affiliation(s)
- Morten Grundtvig
- Division Lillehammer, Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
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Gomez SL, Chang ET, Shema SJ, Fish K, Sison JD, Reynolds P, Clément-Duchêne C, Wrensch MR, Wiencke JL, Wakelee HA. Survival following non-small cell lung cancer among Asian/Pacific Islander, Latina, and Non-Hispanic white women who have never smoked. Cancer Epidemiol Biomarkers Prev 2011; 20:545-54. [PMID: 21239685 DOI: 10.1158/1055-9965.epi-10-0965] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer death among U.S. Asian/Pacific Islander (API) and Latina women despite low smoking prevalence. This study examined survival patterns following non-small cell lung cancer in a population-based sample of lung cancer cases from the San Francisco Bay Area Lung Cancer Study (SFBALCS). METHODS Women diagnosed with lung cancer from 1998 to 2003 and 2005 to 2008 and identified through the Greater Bay Area Cancer Registry were telephone-screened for eligibility for the SFBALCS. The screener data were linked to the cancer registry data to determine follow-up. This analysis included 187 non-Hispanic (NH) white, 23 U.S.-born Latina, 32 foreign-born Latina, 30 U.S.-born API, and 190 foreign-born API never-smokers diagnosed with lung cancer and followed through 2008. RESULTS All-cause survival was poorer among APIs [HR=1.7 (95% CI: 1.0-2.8) among U.S.-born APIs and HR=1.2 (95% CI: 0.9-1.5) among foreign-born APIs] and Latinas [HR=2.1 (95% CI: 1.2-3.6) among U.S.-born Latinas; HR=1.4 (95% CI: 0.9-2.3) among foreign-born Latinas] relative to NH whites. These survival differences were not explained by differences in selected sociodemographic or clinical factors. CONCLUSIONS Further research should focus on factors such as cultural behaviors, access to or attitudes toward health care, and genetic variations as possible explanations for these striking racial/ethnic differences. IMPACT Latina and API female never-smokers diagnosed with lung cancer were up to two times more likely to die than NH whites, highlighting the need for additional research to identify the underlying reasons for the disparities and heightened clinical awareness.
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Affiliation(s)
- Scarlett L Gomez
- Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA 94538, USA.
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Brune KA, Lau B, Palmisano E, Canto M, Goggins MG, Hruban RH, Klein AP. Importance of age of onset in pancreatic cancer kindreds. J Natl Cancer Inst 2010; 102:119-26. [PMID: 20068195 PMCID: PMC2808346 DOI: 10.1093/jnci/djp466] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Young-onset cancer is a hallmark of many familial cancer syndromes, yet the implications of young-onset disease in predicting risk of pancreatic cancer among familial pancreatic cancer (FPC) kindred members remain unclear. METHODS To understand the relationship between age at onset of pancreatic cancer and risk of pancreatic cancer in kindred members, we compared the observed incidence of pancreatic cancer in 9040 individuals from 1718 kindreds enrolled in the National Familial Pancreas Tumor Registry with that observed in the general US population (Surveillance, Epidemiology, and End Results). Standardized incidence ratios (SIRs) were calculated for data stratified by familial vs sporadic cancer kindred membership, number of affected relatives, youngest age of onset among relatives, and smoking status. Competing risk survival analyses were performed to examine the risk of pancreatic cancer and risk of death from other causes according to youngest age of onset of pancreatic cancer in the family and the number of affected relatives. RESULTS Risk of pancreatic cancer was elevated in both FPC kindred members (SIR = 6.79, 95% confidence interval [CI] = 4.54 to 9.75, P < .001) and sporadic pancreatic cancer (SPC) kindred members (SIR = 2.41, 95% CI = 1.04 to 4.74, P = .04) compared with the general population. The presence of a young-onset patient (<50 years) in the family did not alter the risk for SPC kindred members (SIR = 2.74, 95% CI = 0.05 to 15.30, P = .59) compared with those without a young-onset case in the kindred (SIR = 2.36, 95% CI = 0.95 to 4.88, P = .06). However, risk was higher among members of FPC kindreds with a young-onset case in the kindred (SIR = 9.31, 95% CI = 3.42 to 20.28, P < .001) than those without a young-onset case in the kindred (SIR = 6.34, 95% CI = 4.02 to 9.51, P < .001). Competing risk survival analyses indicated that the lifetime risk of pancreatic cancer in FPC kindreds increased with decreasing age of onset in the kindred (hazard ratio = 1.55, 95% CI = 1.19 to 2.03 per year). However, youngest age of onset for pancreatic cancer in the kindred did not affect the risk among SPC kindred members. CONCLUSIONS Individuals with a family history of pancreatic cancer are at a statistically significantly increased risk of developing pancreatic cancer. Having a member of the family with a young-onset pancreatic cancer confers an added risk in FPC kindreds.
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Affiliation(s)
- Kieran A Brune
- Department of Pathology, Sol Goldman Pancreatic Cancer Research Center at Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, MD 21231, USA
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Messer K, Pierce JP. Changes in age trajectories of smoking experimentation during the California Tobacco Control Program. Am J Public Health 2009; 100:1298-306. [PMID: 19965566 DOI: 10.2105/ajph.2009.160416] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to investigate population-level changes in smoking initiation during California's Tobacco Control (CTC) Program from 1990 to 2005, a period during which tobacco industry marketing practices also changed. METHODS We used a discrete time survival analysis of data from the California Tobacco Survey to model changes in age of first smoking experimentation across birth cohorts. RESULTS Smoking initiation patterns were stable across cohorts aged 9 years or older at the start of the CTC program. For children entering preadolescence since 1990, initiation declined with each more recent cohort. By 2005, the observed decline in experimentation was 80% for male participants and 92% for female participants at age 12 to 14 years; by age 15 to 17 years, 10% of Californian adolescents had experimented in 2005 compared with 45% in preprogram cohorts. However, rates of new experimentation after age 17 years did not change, except for a recent increase in late experimentation (after age 20 years) among young adult men. CONCLUSION Our models suggest that the CTC program greatly reduced adolescent smoking initiation among younger adolescents. Late experimentation may have recently increased among young adult men in California, coincident with an increase in tobacco industry marketing aimed at young adults.
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Affiliation(s)
- Karen Messer
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, La Jolla, CA 92093-0901, USA
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Mills AL, Messer K, Gilpin EA, Pierce JP. The effect of smoke-free homes on adult smoking behavior: a review. Nicotine Tob Res 2009; 11:1131-41. [PMID: 19633273 DOI: 10.1093/ntr/ntp122] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Smoke-free homes are known to reduce exposure to harmful secondhand smoke. Recent studies suggest that they may also positively affect smoking behavior among smokers themselves. METHODS We review the literature on the effect of smoke-free homes on adult smoking behavior. The literature search included database (PubMed) and manual searches of related articles and reference lists for English-language studies published from 1 January 1990 to 16 November 2008. RESULTS We identified 16 cross-sectional and 7 longitudinal studies of the population-level association of smoke-free homes with adult smoking behavior. Additional studies provided population estimates of trends in and correlates of smoke-free homes. Prevalence of smoke-free homes varies but has been increasing over time in the countries studied and was greater among smokers who were younger, of higher income or educational attainment, smoked fewer cigarettes per day, or lived with a nonsmoking adult or child. Both longitudinal and cross-sectional studies showed that smokers who had or who newly implemented a smoke-free home were significantly more likely to make a quit attempt and to be abstinent, after controlling for confounding factors. In longitudinal studies, those who continued to smoke had a modest, but significant, decrease in cigarette consumption at follow-up. DISCUSSION There is strong and consistent population-level evidence that a smoke-free home is associated with increased smoking cessation and decreased cigarette consumption in adult smokers. As they not only reduce exposure to secondhand smoke but also increase cessation rates, promotion of smoke-free homes should be a key element in tobacco control programs.
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Affiliation(s)
- Alice L Mills
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, CA 92093-0901, USA
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Pierce JP, White MM, Messer K. Changing age-specific patterns of cigarette consumption in the United States, 1992-2002: association with smoke-free homes and state-level tobacco control activity. Nicotine Tob Res 2009; 11:171-7. [PMID: 19246423 DOI: 10.1093/ntr/ntp014] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION During the 1990s, both prevalence and average cigarette consumption declined in the United States, but age-specific changes have not been reported. METHOD All four of the nationally and state representative U.S. Current Population Surveys-Tobacco Use Supplements from 1991-2002 (n = 542,470) were analyzed for trends in cigarette consumption among smokers in three age groups: 18-29, 30-44, and 45-64 years. A strength of tobacco control index ranking state of residence was added and weighted logistic regression analyses undertaken. RESULTS Over the decade, both prevalence and average consumption declined. Moderate-heavy smoking (> or =15 cigarettes/day [CPD]) prevalence fell strongly over the period in all three age groups. For those aged > or =30 years, this reduction was accompanied by a similar drop in total smoking prevalence. For those aged 18-29 years, this reduction was associated with an increase in very light smoking (<5 CPD; 12% daily and 88% intermittent smokers) to 22.5% of current smokers with a much smaller reduction in prevalence. Smoke-free homes more than doubled in each age group and mediated the increase in very light smoking levels. Smoke-free workplaces and the strength of tobacco control in the state were also important predictors. Very light smoking was particularly prevalent among college students and graduates. DISCUSSION The marked reduction in prevalence of moderate-heavy smoking across age groups should translate into a reduced population risk of smoking-related disease in the near term. That this reduction is offset by an increase in light and intermittent smoking in young adults suggests the effectiveness of tobacco industry marketing and needs further research.
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Affiliation(s)
- John P Pierce
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, 3855 Health Sciences Drive #0901, University of California-San Diego, La Jolla, CA 92093-0901, USA.
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Zhu SH, Wang JB, Hartman A, Zhuang Y, Gamst A, Gibson JT, Gilljam H, Galanti MR. Quitting cigarettes completely or switching to smokeless tobacco: do US data replicate the Swedish results? Tob Control 2009; 18:82-7. [PMID: 19168476 DOI: 10.1136/tc.2008.028209] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Swedish male smokers are more likely than female smokers to switch to smokeless tobacco (snus) and males' smoking cessation rate is higher than that of females. These results have fuelled international debate over promoting smokeless tobacco for harm reduction. This study examines whether similar results emerge in the United States, one of few other western countries where smokeless tobacco has long been widely available. METHODS US DATA SOURCE: national sample in Tobacco Use Supplement to Current Population Survey, 2002, with 1-year follow-up in 2003. Analyses included adult self-respondents in this longitudinal sample (n = 15,056). Population-weighted rates of quitting smoking and switching to smokeless tobacco were computed for the 1-year period. RESULTS Among US men, few current smokers switched to smokeless tobacco (0.3% in 12 months). Few former smokers turned to smokeless tobacco (1.7%). Switching between cigarettes and smokeless tobacco, infrequent among current tobacco users (<4%), was more often from smokeless to smoking. Men quit smokeless tobacco at three times the rate of quitting cigarettes (38.8% vs 11.6%, p<0.001). Overall, US men have no advantage over women in quitting smoking (11.7% vs 12.4%, p = 0.65), even though men are far likelier to use smokeless tobacco. CONCLUSION The Swedish results are not replicated in the United States. Both male and female US smokers appear to have higher quit rates for smoking than have their Swedish counterparts, despite greater use of smokeless tobacco in Sweden. Promoting smokeless tobacco for harm reduction in countries with ongoing tobacco control programmes may not result in any positive population effect on smoking cessation.
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Affiliation(s)
- S-H Zhu
- Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive 0905, La Jolla, CA 92093-0905, USA.
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Soulakova J, Davis WW, Hartman A, Gibson J. The Impact of Survey and Response Modes on Current Smoking Prevalence Estimates Using TUS-CPS: 1992-2003. SURVEY RESEARCH METHODS 2009; 3:123-137. [PMID: 21841957 PMCID: PMC3153871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study identified whether survey administration mode (telephone or in-person) and respondent type (self or proxy) result in discrepant prevalence of current smoking in the adult U.S. population, while controlling for key sociodemographic characteristics and longitudinal changes of smoking prevalence over the 11-year period from 1992-2003. We used a multiple logistic regression analysis with replicate weights to model the current smoking status logit as a function of a number of covariates. The final model included individual- and family-level sociodemographic characteristics, survey attributes, and multiple two-way interactions of survey mode and respondent type with other covariates. The respondent type is a significant predictor of current smoking prevalence and the magnitude of the difference depends on the age, sex, and education of the person whose smoking status is being reported. Furthermore, the survey mode has significant interactions with survey year, sex, and age. We conclude that using an overall unadjusted estimate of the current smoking prevalence may result in underestimating the current smoking rate when conducting proxy or telephone interviews especially for some sub-populations, such as young adults. We propose that estimates could be improved if more detailed information regarding the respondent type and survey administration mode characteristics were considered in addition to commonly used survey year and sociodemographic characteristics. This information is critical given that future surveillance is moving toward more complex designs. Thus, adjustment of estimates should be contemplated when comparing current smoking prevalence results within a given survey series with major changes in methodology over time and between different surveys using various modes and respondent types.
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Declining maternal smoking prevalence did not change low birthweight prevalence in Massachusetts from 1989 to 2004. Eur J Public Health 2008; 19:65-8. [DOI: 10.1093/eurpub/ckn106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Messer K, Mills AL, White MM, Pierce JP. The effect of smoke-free homes on smoking behavior in the U.S. Am J Prev Med 2008; 35:210-6. [PMID: 18620837 DOI: 10.1016/j.amepre.2008.05.023] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Revised: 05/16/2008] [Accepted: 05/19/2008] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence from longitudinal population surveys is needed to establish whether smoke-free homes might influence smoking behavior. METHODS The Tobacco Use Supplement of the nationally representative U.S. Current Population Survey (TUS-CPS) interviewed 3292 adult recent smokers in 2002 and again 12 months later. Both surveys measured smoking status, rules on smoking in the home, and the number of cigarettes smoked per day (cpd). For the main study outcome, an early marker of successful cessation (>or=90 days quit) was used. Analysis was completed in 2008. RESULTS In the 12 months ending February 2003, the prevalence of smoke-free homes among recent smokers increased from 33% to 39%. A smoke-free home at baseline was associated with >or=90 days cessation at follow-up (10.9% vs 6.2%, AOR=1.44; 95% CI=0.97, 2.21), and those who maintained a smoke-free home were more likely to be >or=90 days quit than those who did not (12.9% vs 5.7%, AOR=1.99; 95% CI=0.93, 4.25). However, adopting a smoke-free home during the year was associated with a nearly fivefold increase in the percentage of >or=90 days quit (AOR=4.81; 95% CI=3.06, 7.59). This increase was seen among all smokers, including moderate-to-heavy smokers (>or=90 days quit: a smoke-free home=13.0% vs no smoke-free home=2.9%, p<0.001). Among continuing smokers with a smoke-free home at baseline, maintenance of te smoke-free home was associated with a decline in consumption (micro=or-2.18; 95 CI=or-1.24; -3.10 cpd). Among continuing smokers with no smoke-free home at baseline, adoption of that status was also associated with a decline in consumption (micro=or-1.72; 95% CI=or-0.58; -2.85 cpd). CONCLUSIONS This study provides strong evidence that the adoption of a smoke-free home is associated with successful quitting among smokers in the U.S.
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Affiliation(s)
- Karen Messer
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California San Diego, La Jolla, California 92093-0901, USA
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Smoking trends among Filipino adults in California, 1990-2002. Prev Med 2008; 46:336-9. [PMID: 18207227 DOI: 10.1016/j.ypmed.2007.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 12/01/2007] [Accepted: 12/04/2007] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Filipinos comprise about 18% of the Asian/Pacific Islander American (APIA) population and are increasing. Few studies have examined Filipino current smoking prevalence rates (CSPR) and none have described trends over time. METHODS Trends in CSPR were estimated for Filipinos and non-Hispanic whites (NHW) from 1990-2002 from the California Tobacco Surveys (N>42,000/year). RESULTS CSPR for Filipino males declined: 23.7% (95% CI: 18.7, 28.7) in 1990 to 18.7% (15.3, 22.1) in 2002 (p<0.05). The decline in CSPR for Filipino women was non-significant (p=0.24), 9.8% (5.5, 14.1) in 1990 and 7.7% (5.3, 10.1) in 2002. During the same period, CSPR among NHW males declined: 24.4% (23.8, 25.0) in 1990 to 18.8% (18.1, 19.4) in 2002 (p<0.01). For female NHW, CSPR were 21.3% (20.5, 22.0) in 1990 and 15.0% (14.4, 15.6) in 2002 (p<0.01). Adjusted logistic regression for Filipinos suggest that English language use is associated with current smoking among females (p<0.01) and that, overall, 18-29 year-olds were more likely to be current smokers than those 45+ years old (p<0.01). CONCLUSION Trends for male Filipino current smokers declined similarly to male NHW from 1990-2002; female rates were lower but did not decline. Future smoking prevention and cessation programs would benefit by taking into account important differences in smoking rates between genders and age groups.
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Napper LE, Branson CM, Fisher DG, Reynolds GL, Wood MM. Assessing the validity of a single-item HIV risk stage-of-change measure. JOURNAL OF DRUG EDUCATION 2008; 38:27-37. [PMID: 18592805 DOI: 10.2190/de.38.1.c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study examined the validity of a single-item measure of HIV risk stage of change that HIV prevention contractors were required to collect by the California State Office of AIDS. The single-item measure was compared to the more conventional University of Rhode Island Change Assessment (URICA). Participants were members of Los Angeles County-defined behavioral risk groups recruited from a mobile HIV testing program (N = 123). The study found low correspondence between participants' stage of change on the single-item and the URICA, suggesting that they do not assess the same construct, and that the single item may not provide a valid measure. The current data suggests that the single-item measure should be revised or abandoned in favor of more conventional stage-of-change measures.
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Affiliation(s)
- Lucy E Napper
- California State University, Long Beach, CA 90813, USA
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Messer K, Pierce JP, Zhu SH, Hartman AM, Al-Delaimy WK, Trinidad DR, Gilpin EA. The California Tobacco Control Program's effect on adult smokers: (1) Smoking cessation. Tob Control 2007; 16:85-90. [PMID: 17400944 PMCID: PMC2598468 DOI: 10.1136/tc.2006.016873] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Accepted: 08/16/2006] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate national population trends in long-term smoking cessation by age group and to compare cessation rates in California (CA) with those of two comparison groups of states. SETTING Retrospective smoking history of a population sample from the US: from CA, with a comprehensive tobacco-control programme since 1989 with the goal of denormalising tobacco use; from New York and New Jersey (NY & NJ), with similar high cigarette prices but no comprehensive programme; and from the tobacco-growing states (TGS), with low cigarette prices, no tobacco-control programme and social norms relatively supportive of tobacco use. PARTICIPANTS Respondents to the Current Population Survey-Tobacco Use Supplements (1992-2002; n = 57 918 non-Hispanic white ever-smokers). MAIN OUTCOME MEASURES The proportion of recent ever-smokers attaining long-term abstinence (quit > or = 1 year) and the successful-quit ratio (the proportion of all ever-smokers abstinent > or = 1 year). RESULTS Nationally, long-term cessation rates increased by 25% from the 1980s to the 1990s, averaging 3.4% per year in the 1990s. Cessation increased for all age groups, and by > 40% (p<0.001) among smokers aged 20-34 years. For smokers aged < 50 years, higher cigarette prices were associated with higher quitting rates. For smokers aged < 35 years, quitting rates in CA were higher than in either comparison group (p<0.05). Half of the ever-smokers had quit smoking by age 44 years in CA, 47 years in NY & NJ, and by age 54 years in TGS. CONCLUSION Successful smoking cessation increased by 25% during the 1990s in the US. Comprehensive tobacco-control programmes were associated with greater cessation success than were with high cigarette prices alone, although both effects were limited to younger adults.
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Affiliation(s)
- Karen Messer
- Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, California 92093-0901, USA
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Harakeh Z, Engels RCME, Vries HD, Scholte RHJ. Correspondence between proxy and self-reports on smoking in a full family study. Drug Alcohol Depend 2006; 84:40-7. [PMID: 16386380 DOI: 10.1016/j.drugalcdep.2005.11.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2005] [Revised: 10/18/2005] [Accepted: 11/27/2005] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The present study investigated the reliability of proxy reports obtained from family members with self-reports on adolescent and parental lifetime and current smoking status. METHODS Data were assessed from 416 families, consisting of both biological parents and two adolescent siblings aged 13-17 years. These families were assessed at baseline and 1 year later. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to test whether proxy reports corresponded with self-reports. RESULTS Mothers scored higher than fathers on most measures on lifetime and current smoking status of both children. The sensitivity was low for parental reports, but moderate to high for children's reports. Specificity and positive predictive value were high in all proxy reports. The negative predictive value was moderate (parents as proxy reporters) to low (children as proxy reporters) on lifetime smoking, but high on current smoking. CONCLUSIONS Adolescents, aged 13-17 years, can be used as a reliable source to assess the smoking status of their mothers and fathers. Parents, however, appeared to accurately identify the smoking status of their adolescent children less reliably.
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Affiliation(s)
- Zeena Harakeh
- Institute of Family and Child Care Studies, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
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Benedetti A, Parent ME, Siemiatycki J. Consumption of Alcoholic Beverages and Risk of Lung Cancer: Results from Two Case–control Studies in Montreal, Canada. Cancer Causes Control 2006; 17:469-80. [PMID: 16596299 DOI: 10.1007/s10552-005-0496-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Accepted: 11/30/2005] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the association between consumption of alcoholic beverages and lung cancer risk. METHODS Data were collected in two population-based case-control studies, conducted in Montreal (Study I--mid-1980s and Study II--mid-1990s). Study I included 699 cases and 507 controls, all males; Study II included 1094 cases and 1468 controls, males and females. In each study group (Study I men, Study II men and Study II women) odds ratios (OR) were estimated for the associations between beer, wine or spirits consumption and lung cancer, while carefully adjusting for smoking and other covariates. The reference category included abstainers and occasional drinkers. RESULTS For Study I men, lung cancer risk increased with the average number of beers/week consumed (for 1-6 beers/week: OR=1.2, 95% confidence interval (CI): 0.9-1.7; for >or=7 beers/week: OR=1.5, 95% CI: 1.1-2.1). For Study II men, beer consumption appeared harmful only among subjects with low fruit and vegetable consumption. In Study II, wine consumers had low lung cancer risk, particularly those reporting 1-6 glasses/week (women: OR=0.3, 95% CI: 0.2-0.4; men: OR=0.6, 95% CI: 0.4-0.8). CONCLUSIONS Beer consumption increased lung cancer risk, particularly so among men who had relatively low fruit and vegetable consumption. Moderate wine drinkers had decreased lung cancer risk.
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Affiliation(s)
- Andrea Benedetti
- Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Université du Québec, Montreal, Canada.
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Raherison C, Marjary A, Valpromy B, Prevot S, Fossoux H, Taytard A. Evaluation of smoking cessation success in adults. Respir Med 2005; 99:1303-10. [PMID: 16137875 DOI: 10.1016/j.rmed.2004.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2004] [Indexed: 10/25/2022]
Abstract
BACKGROUND Smoking is a preventable cause of increased morbidity and mortality. Therefore, interventions have been used to assist smokers in overcoming their addiction. The aim of the study was to describe factors associated with smoking cessation, in patients applied to our smoking cessation (SC) unit in 1999, in a prospective study. METHODS Patients were followed-up during two years. Detailed medical history, Fagerstrom test, Hospital Anxiety and Depression (HAD) scale questionnaire, Motivation scale and replacement therapy were systematically recorded. RESULTS Three hundred patients (58% men, 42% women) applied to the SC unit from January to December 1999. The mean age was 42 yrs old. They smoked in average 24 cig/d. Mean duration of smoking was 20 years. Fagerstrom score was 5.86 (min 0; max: 10). Patients seemed to be more anxious (score 9.6) than depressed (5.09), according to the HAD score. 79% of them received both psychosocial intervention, pharmacotherapy and nicotine replacement therapy. 66% of patients were followed-up (n=198). Two years later, the smoking cessation rate was 12% (n=36). Motivation, Fagerstrom and HAD scores were not associated with the quitting rate. Quitting rate was higher (25.9%) in patients who attempted to quit smoking for the first time than in others (19%). By contrast, the quitting rate was significantly associated with age (P=0.03). CONCLUSION Success to quit smoking was positively associated with age, and negatively with alcohol dependence.
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Affiliation(s)
- C Raherison
- Smoking Cessation Unit, Service Des Maladies Respiratoires, Hospital du Haut-Leveque, Avenue Magellan, 33604 Pessac, France.
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Loke AY, Lam TH. A randomized controlled trial of the simple advice given by obstetricians in Guangzhou, China, to non-smoking pregnant women to help their husbands quit smoking. PATIENT EDUCATION AND COUNSELING 2005; 59:31-7. [PMID: 16198216 DOI: 10.1016/j.pec.2004.08.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Revised: 07/28/2004] [Accepted: 08/10/2004] [Indexed: 05/04/2023]
Abstract
This is a randomized controlled trial to examine the effects of obstetrician's simple advice given to non-smoking pregnant women with the aim to help their husbands to give up smoking. Non-smoking pregnant women who were attending the Guangzhou Women and Children Health Care Centre and whose husbands were smokers were each randomised to an intervention (N = 380) or a control (N = 378) group. The members of the intervention group each received simple advice on encouraging their husbands to give up smoking and an educational booklet at their first antenatal visit, and reminders during subsequent visits, whereas the control group received none, as is the usual practice. Husbands' not smoking for 7 and for 30 days were the main outcomes of the study; other outcomes included husbands' attempts to stop and any decrease in the number of cigarettes smoked. These outcomes were assessed by means of a questionnaire responded to in the last month of pregnancy, which was subjected to 'intention-to-treat' analysis. Results show that more husbands in the intervention group had attempted to stop smoking (30.0% versus 22.2%; p = 0.02), reduced the number of cigarettes smoked (39.7% versus 17.7%; p < 0.0001), and had not smoked any cigarettes for the last 7 days before their wives completed the questionnaire (8.4% versus 4.8%; p = 0.04). The difference between groups in the number of husbands who had abstained from cigarettes for at least 30 days was not significant (6.1% versus 4.2%; p = 0.26). Obstetricians should consider incorporating advice on passive smoking into the antenatal programme for non-smoking pregnant women with smoking husbands.
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Affiliation(s)
- Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, PR China.
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Pierce JP, White MM, Gilpin EA. Adolescent smoking decline during California's tobacco control programme. Tob Control 2005; 14:207-12. [PMID: 15923472 PMCID: PMC1748037 DOI: 10.1136/tc.2004.010116] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE California's comprehensive tobacco control programme was 13 years old in 2002; by then, children entering adolescence at the start of the programme were young adults. This study examines whether adolescent smoking declined over this period, whether any decline carried through to young adulthood, and whether it was specific to California. SETTING AND PARTICIPANTS Most data were from the 1990-2002 California Tobacco Surveys (CTS) (adolescents 12-17 years, > 5000/survey, young adults 18-24 years, > 1000/survey). Additional data were from the national 1992/93-2001/02 Current Population Survey (CPS) (young adults 18-24 years, > 15,000/survey). RESULTS Over the 13 year period in California, ever puffing declined by 70% in 12-13 year olds, by 53% in 14-15 year olds from 1992-2002, and by 34% in 16-17 year olds from 1996-2002 (CTS). As noted, the decline commenced progressively later in each older group. Smoking experimentation (1+ cigarettes) and established smoking (> 100 cigarettes in lifetime) showed similar patterns. Compared to 1990, the percentage of California young adults (CTS data) who ever experimented declined by 14%, with half of the decline from 1999-2002. CPS young adult smoking prevalence (established and now smoke everyday or some days) was constant in the rest of the USA over the entire period, but California showed a recent 18% decline from 1998/99 to 2001/02. CONCLUSIONS California's comprehensive programme may have kept new adolescent cohorts from experimenting with cigarettes. Low young adolescent experimentation rates at programme start appeared to carry through to young adulthood, resulting in a recent drop in young adult smoking prevalence in California not observed in the rest of the USA.
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Affiliation(s)
- J P Pierce
- Rebecca and John Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0645, USA.
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Mak YW, Loke AY, Lam TH, Abdullah ASM. Validity of self-reports and reliability of spousal proxy reports on the smoking behavior of Chinese parents with young children. Addict Behav 2005; 30:841-5. [PMID: 15833586 DOI: 10.1016/j.addbeh.2004.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to examine the validity of self-reports and reliability of spousal proxy reports of smoking behavior among Chinese parents with young children. Agreement of self-reported smoking status with expired CO concentration among parents in the intake interview was significant with kappa at 0.70. Agreement of the mothers' and fathers' proxy reports on their spouses' smoking status and cigarette consumption by ICC were 1.0 and 0.58, and 0.82 and 0.33, respectively. Self-report and proxy reports of smoking status are considered valid and reliable to assess smoking behavior of parents with young children in Hong Kong.
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Affiliation(s)
- Yim Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Abstract
BACKGROUND Response rates have been declining in statewide tobacco surveys. This study investigated whether there was associated evidence of increasing bias in smoking prevalence estimates. METHODS Demographic characteristics of respondents to tobacco surveys in Massachusetts and California were compared to population data in the early 1990s, when response rates were high, and in more recent years, when response rates were lower. State estimates of smoking prevalence at three times were compared with estimates from the Current Population Survey Tobacco Use Supplement (CPS-TUS), conducted by the U.S. Census Bureau. RESULTS Under- and over-representation of population subgroups has not changed as response rates have declined. Smoking prevalence estimates from state surveys remain relatively close to the state-specific CPS-TUS estimates. CONCLUSIONS There is no evidence that declining response rates have resulted in less accurate or biased estimates of smoking behavior.
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Abstract
Drug use is a complex behavior influenced by multiple biological, family, and sociocultural factors. The concurrent use/misuse of multiple drugs is often seen and drug use also co-occurs with other psychiatric conditions. Behavior and molecular genetic studies support an important posited role of genes in drug use. This posited genetic risk does not appear to be conferred by one or two major genes manifesting large effects, but rather by a number of genes manifesting smaller effects. Genetic factors explain, on average, only about half of the total variability in drug use, with the remaining variability influenced by environmental factors. Also, genetic risk may be differentially expressed in the presence vs. absence of particular environmental conditions. Thus, investigation of environmental factors and their interaction with genetic risk is a necessary component of genetic research. While the full potential of genetic investigations for the prevention of drug misuse has yet to be realized, an example of the impact of risk factor modification under various conditions of gene-environment interaction is provided, and the implications for use of genetic information in drug-misuse prevention are discussed. The multifactorial nature of drug use necessitates coordinated investigation from multiple disciplines and timely dissemination of scientific findings. In addition, this work demands adherence to the highest standards of confidentiality and ethical use of genetic information to best inform future prevention efforts.
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Affiliation(s)
- Christina N Lessov
- Center for Health Sciences, SRI International, Menlo Park, California 94025, USA.
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McKee MD, DiPasquale DJ, Wild LM, Stephen DJG, Kreder HJ, Schemitsch EH. The effect of smoking on clinical outcome and complication rates following Ilizarov reconstruction. J Orthop Trauma 2003; 17:663-7. [PMID: 14600564 DOI: 10.1097/00005131-200311000-00001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of smoking on outcome and complication rates following Ilizarov reconstruction. DESIGN We performed a retrospective review of 84 adult patients (86 limbs) who underwent Ilizarov reconstruction. There were 39 "limbs" in nonsmokers and 47 "limbs" in active smokers. Complications and an outcome score based on ASAMI (Association for the Study and Application of the Methods of Ilizarov) criteria were recorded for each patient. DATA ANALYSIS AND RESULTS: There were 35 major complications including 15 malunions/nonunions, 7 refractures, 8 persisting infections, and 5 amputations. Results were measured using the ASAMI outcome scale. There were significantly more poor results in the smoking group than in the nonsmoking group (18/47, 38% versus 4/39, 10%; P = 0.003). Seven of eight patients with persisting infection were smokers (P = 0.049). There was a higher incidence of nonunion in the smoking group (P = 0.031). All five amputations were in smokers (P = 0.035). CONCLUSION Smokers had a higher percentage of poor results (P = 0.01), due primarily to higher complication rates. Smoking is a significant, potentially remediable risk factor for failure following Ilizarov reconstruction, and cessation strategies are of paramount importance prior to initiating treatment.
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Affiliation(s)
- Michael D McKee
- Department of Surgery, St Michael's Hospital and the University of Toronto, Toronto, Canada. mckee@the-wire-com
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Woo JG, Pinney SM. Retrospective smoking history data collection for deceased workers: completeness and accuracy of surrogate reports. J Occup Environ Med 2002; 44:915-23. [PMID: 12391770 DOI: 10.1097/00043764-200210000-00010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Few studies have considered the completeness and accuracy of smoking histories from surrogates for deceased workers. We surveyed 68 surrogates for uranium plant workers who completed smoking histories before their deaths. Completeness: 96% of surrogates answered definitively (yes or no) about overall smoking status (e.g., used any tobacco type), and 79 to 100% of those answered definitively about specific tobacco types. Of those reporting positive history, 50% to 67% answered detailed questions. Accuracy: Surrogates were accurate about overall smoking status (Kappa (kappa) = 0.75) compared with index self-report, but tended to underreport (P = 0.10). Spouses and nonspouses performed similarly. Accuracy by tobacco type was moderate (kappa = 0.21 to 0.56), with cigar smoking underreported. Surrogates for cigarette smokers underreported duration and amount smoked. Surrogates for deceased workers can report accurately on overall smoking status, but underreport other smoking habits.
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Affiliation(s)
- Jessica Graus Woo
- University of Cincinnati, Department of Environmental Health, Division of Epidemiology and Biostatistics, P.O. Box 670056, Cincinnati, OH 45267-0056, USA.
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Patten CA, Martin JE, Filter KJ, Wolter TD. Utility and accuracy of collateral reports of smoking status among 256 abstinent alcoholic smokers treated for smoking cessation. Addict Behav 2002; 27:687-96. [PMID: 12201377 DOI: 10.1016/s0306-4603(01)00202-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examined the utility and accuracy of collateral reports of smoking status among 256 abstinent alcoholic smokers (140 males, 116 females) treated for smoking cessation. Data were gathered prospectively from two randomized clinical trials of behavioral smoking cessation treatment conducted in San Diego, CA. The mean age of the participants was 42.0 years (S.D.= 10.0) and 93% were Caucasian. Self-reported smoking status was obtained at posttreatment (1 week after the target quit date) and at 1 year. Collateral reports obtained by telephone and expired air carbon monoxide (CO) levels of < 10 ppm were used to confirm self-reported smoking status. Collateral reports were available for 89.1% of subjects at posttreatment and 90.6% of subjects at 1 year. The smoking abstinence rates were similar when using collateral reports or CO confirmation of smoking status at both time points. Collateral reports refuted self-reported abstinence as often or more than CO levels, and showed relatively high concordance with CO levels. In conclusion, collateral reports have utility and are reasonably accurate for confirming self-reported smoking status in clinical trials of smoking cessation for abstinent alcoholic smokers.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and the Nicotine Research Center, Mayo Clinic, Rochester, MN 55905, USA.
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Björk J, Albin M, Mauritzson N, Strömberg U, Johansson B, Hagmar L. Smoking and acute myeloid leukemia: associations with morphology and karyotypic patterns and evaluation of dose-response relations. Leuk Res 2001; 25:865-72. [PMID: 11532519 DOI: 10.1016/s0145-2126(01)00048-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This case-control study of tobacco smoking and acute myeloid leukemia (AML), emphasizing specific associations with morphologic and cytogenetic subtypes, comprised smoking histories for 333 cases and 351 controls. Smoking status (ever smokers versus life-long non-smokers) showed no evident effect on AML risk. However, an effect of smoking was indicated at high cumulative smoking doses (pack-years), e.g. 40 pack-years was associated with an odds ratio (OR) of 1.5 [95% confidence interval (CI) 1.0-2.3]. Among morphologic subtypes, the smoking associated OR for acute erythroleukemia was 8.9 (95% CI 1.0-76). No clear associations between smoking and cytogenetic subtypes of AML were observed.
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Affiliation(s)
- J Björk
- Department of Occupational and Environmental Medicine, Lund University Hospital, SE-221 85, Lund, Sweden.
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