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Laskar RS, Qu C, Huyghe JR, Harrison T, Hayes RB, Cao Y, Campbell PT, Steinfelder R, Talukdar FR, Brenner H, Ogino S, Brendt S, Bishop DT, Buchanan DD, Chan AT, Cotterchio M, Gruber SB, Gsur A, van Guelpen B, Jenkins MA, Keku TO, Lynch BM, Le Marchand L, Martin RM, McCarthy K, Moreno V, Pearlman R, Song M, Tsilidis KK, Vodička P, Woods MO, Wu K, Hsu L, Gunter MJ, Peters U, Murphy N. Genome-wide association studies and Mendelian randomization analyses provide insights into the causes of early-onset colorectal cancer. Ann Oncol 2024:S0923-7534(24)00058-9. [PMID: 38408508 DOI: 10.1016/j.annonc.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The incidence of early-onset colorectal cancer (EOCRC; diagnosed <50 years of age) is rising globally; however, the causes underlying this trend are largely unknown. CRC has strong genetic and environmental determinants, yet common genetic variants and causal modifiable risk factors underlying EOCRC are unknown. We conducted the first EOCRC-specific genome-wide association study (GWAS) and Mendelian randomization (MR) analyses to explore germline genetic and causal modifiable risk factors associated with EOCRC. PATIENTS AND METHODS We conducted a GWAS meta-analysis of 6176 EOCRC cases and 65 829 controls from the Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO), the Colorectal Transdisciplinary Study (CORECT), the Colon Cancer Family Registry (CCFR), and the UK Biobank. We then used the EOCRC GWAS to investigate 28 modifiable risk factors using two-sample MR. RESULTS We found two novel risk loci for EOCRC at 1p34.1 and 4p15.33, which were not previously associated with CRC risk. We identified a deleterious coding variant (rs36053993, G396D) at polyposis-associated DNA repair gene MUTYH (odds ratio 1.80, 95% confidence interval 1.47-2.22) but show that most of the common genetic susceptibility was from noncoding signals enriched in epigenetic markers present in gastrointestinal tract cells. We identified new EOCRC-susceptibility genes, and in addition to pathways such as transforming growth factor (TGF) β, suppressor of Mothers Against Decapentaplegic (SMAD), bone morphogenetic protein (BMP) and phosphatidylinositol kinase (PI3K) signaling, our study highlights a role for insulin signaling and immune/infection-related pathways in EOCRC. In our MR analyses, we found novel evidence of probable causal associations for higher levels of body size and metabolic factors-such as body fat percentage, waist circumference, waist-to-hip ratio, basal metabolic rate, and fasting insulin-higher alcohol drinking, and lower education attainment with increased EOCRC risk. CONCLUSIONS Our novel findings indicate inherited susceptibility to EOCRC and suggest modifiable lifestyle and metabolic targets that could also be used to risk-stratify individuals for personalized screening strategies or other interventions.
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Affiliation(s)
- R S Laskar
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France; Early Cancer Institute, Department of Oncology, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - C Qu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle
| | - J R Huyghe
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle
| | - T Harrison
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle
| | - R B Hayes
- Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York
| | - Y Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis; Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St Louis; Alvin J. Siteman Cancer Center, St Louis
| | - P T Campbell
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - R Steinfelder
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle
| | - F R Talukdar
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France; Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Ogino
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston; Program in Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston
| | - S Brendt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - D T Bishop
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - D D Buchanan
- Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville; University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne; Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, Australia
| | - A T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - M Cotterchio
- Ontario Health (Cancer Care Ontario), Toronto; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - S B Gruber
- Department of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, USA
| | - A Gsur
- Center for Cancer Research, Medical University of Vienna, Vienna, Austria
| | - B van Guelpen
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå; Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - M A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - T O Keku
- Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, USA
| | - B M Lynch
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne; Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - R M Martin
- Medical Research Council (MRC) Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol; National Institute for Health Research (NIHR) Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol
| | - K McCarthy
- Department of Colorectal Surgery, North Bristol NHS Trust, Bristol, UK
| | - V Moreno
- Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - R Pearlman
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus
| | - M Song
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - K K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - P Vodička
- Department of Molecular Biology of Cancer, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague; Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague; Faculty of Medicine and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic
| | - M O Woods
- Memorial University of Newfoundland, Discipline of Genetics, St. John's, Canada
| | - K Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA
| | - L Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle
| | - M J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - U Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle; Department of Epidemiology, University of Washington, Seattle, USA
| | - N Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France.
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Fuemmeler BF, Wheeler DC, Miller CA, Hayes RB, Do EK, Jeremy Barsell D, Fugate-Laus K, Pope MA. Advertising Exposure From Online and Offline Sources and Youth Tobacco Use: Findings From the Adolescents, Place, and Behavior Study. Nicotine Tob Res 2024; 26:353-360. [PMID: 37715625 DOI: 10.1093/ntr/ntad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/06/2023] [Accepted: 07/27/2023] [Indexed: 09/17/2023]
Abstract
INTRODUCTION Tobacco use among adolescents is an ongoing public health concern. Youth tobacco use has been associated with advertising, from both online sources and retail environments. AIMS AND METHODS This study examined associations between exposure to tobacco advertisements from tobacco retail outlets (TROs), internet, and social media sources and ever tobacco use among adolescents. Data were obtained from youth, aged 11-17 years (N = 401) from Richmond, VA. Bayesian index and group index models were fitted to estimate indices of exposure to (1) social media use, (2) tobacco ads on social media, and (3) TRO store visits and their association with ever tobacco use. The most important components of the exposure indices were also determined based on the index component weights from the Bayesian index models. RESULTS In Bayesian index models of single exposures, each exposure index was significantly associated with tobacco use. In the best-fitting model, social media tobacco ads (odds ratio [OR] = 2.2; 95% credible interval [CI]: 1.2, 4.5) and TRO store visits (OR = 1.6; 95% CI: 1.1, 2.3) were significantly associated with ever tobacco use, as was older age (OR = 1.4; 95% CI: 1.2, 1.8). Index component weights revealed Snapchat ad frequency as the most important platform in the social media index and convenience stores as the most important type of store in the TRO index. CONCLUSIONS Exposure to pro-tobacco advertisements on social media and visits to TROs are associated with adolescent ever tobacco use. Results provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Tobacco regulations and interventions targeting convenience stores and Snapchat may be warranted to reduce youth tobacco use. IMPLICATIONS Current evidence provide support for policies that would restrict the promotion of tobacco products at TROs and on social media. Findings suggest that regulations and interventions that specifically target advertisements in convenience stores and on Snapchat may be currently warranted to reduce youth tobacco use.
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Affiliation(s)
- Bernard F Fuemmeler
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Carrie A Miller
- College of Journalism and Communication, University of Florida, Gainesville, FL, USA
- STEM Translational Communication Center, University of Florida, Gainesville, FL, USA
- University of Florida Health Cancer Center, Gainesville, FL, USA
| | - Rashelle B Hayes
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - D Jeremy Barsell
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Kendall Fugate-Laus
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Moore DJ, Bradner MK, Strayer SM, Santen SA, Edwards C, Hayes RB, Cronholm PF. Motivational Interviewing Education in North American Family Medicine Clerkships: A CERA Study. Fam Med 2023; 55:598-606. [PMID: 37540536 PMCID: PMC10622121 DOI: 10.22454/fammed.2023.476432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Many health conditions are preventable or modifiable through behavioral changes. Motivational interviewing (MI) is an evidence-based communication technique that explores a patient's reasons for behavioral changes. This study assesses the current landscape of MI training in North American Family Medicine (FM) clerkships. METHODS We analyzed data gathered as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of FM clerkship directors (CDs). The survey was distributed via email invitation to 159 US and Canadian FM CDs in June 2022. RESULTS Of the 94 responses received, 61% indicated that MI training is provided in their FM clerkship. Medical school type, class size, and location were associated with MI training priority, offerings, and duration in the clerkship, respectively. CD experience correlated with MI training duration; student MI skill training level was associated with MI training duration and priority; the rigor of student MI skills evaluation was correlated with MI teaching methods and training duration; self-reported student MI competency was associated with the length of time students spent with FM community preceptors as well as MI training priority and teaching methods; and several items emerged as predictors of student, CD, and FM faculty MI training expansion. CONCLUSIONS Opportunities exist to enhance the volume, content, and rigor of MI training in North American FM clerkships as well as to improve self-reported student MI competency within those clerkships.
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Affiliation(s)
- Denee J. Moore
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Melissa K. Bradner
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Scott M. Strayer
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Sally A. Santen
- Office of Assessment, Evaluation, and Scholarship, Virginia Commonwealth University School of MedicineRichmond, VA
- Department of Emergency Medicine, Virginia Commonwealth University School of MedicineRichmond, VA
- Department of Emergency Medicine, University of CincinnatiCincinnati, OH
| | - Cherie Edwards
- Office of Assessment, Evaluation, and Scholarship, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Rashelle B. Hayes
- Department of Psychiatry, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Peter F. Cronholm
- Department of Family Medicine and Community Health, Center for Public Health Initiatives, Leonard Davis Institute of Health Economics, University of Pennsylvania School of MedicinePhiladelphia, PA
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He Y, Anderson B, Hu Q, Hayes RB, Huff K, Isaacson J, Warner KS, Hauser H, Greenberg M, Chandra V, Kauser K, Berceli SA. Photochemically Aided Arteriovenous Fistula Creation to Accelerate Fistula Maturation. Int J Mol Sci 2023; 24:ijms24087571. [PMID: 37108733 PMCID: PMC10142855 DOI: 10.3390/ijms24087571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Rates of arteriovenous fistula maturation failure are still high, especially when suboptimal size veins are used. During successful maturation, the vein undergoes lumen dilatation and medial thickening, adapting to the increased hemodynamic forces. The vascular extracellular matrix plays an important role in regulating these adaptive changes and may be a target for promoting fistula maturation. In this study, we tested whether a device-enabled photochemical treatment of the vein prior to fistula creation facilitates maturation. Sheep cephalic veins were treated using a balloon catheter coated by a photoactivatable molecule (10-8-10 Dimer) and carrying an internal light fiber. As a result of the photochemical reaction, new covalent bonds were created during light activation among oxidizable amino acids of the vein wall matrix proteins. The treated vein lumen diameter and media area became significantly larger than the contralateral control fistula vein at 1 week (p = 0.035 and p = 0.034, respectively). There was also a higher percentage of proliferating smooth muscle cells in the treated veins than in the control veins (p = 0.029), without noticeable intimal hyperplasia. To prepare for the clinical testing of this treatment, we performed balloon over-dilatation of isolated human veins and found that veins can tolerate up to 66% overstretch without notable histological damage.
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Affiliation(s)
- Yong He
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USA
| | | | - Qiongyao Hu
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USA
| | - R B Hayes
- Alucent Biomedical Inc., Salt Lake City, UT 84108, USA
| | - Kenji Huff
- Alucent Biomedical Inc., Salt Lake City, UT 84108, USA
| | - Jim Isaacson
- Alucent Biomedical Inc., Salt Lake City, UT 84108, USA
| | | | - Hank Hauser
- Alucent Biomedical Inc., Salt Lake City, UT 84108, USA
| | | | - Venita Chandra
- Division of Vascular Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USA
| | | | - Scott A Berceli
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Florida, Gainesville, FL 32611, USA
- North Florida/South Georgia Veterans Health System, Gainesville, FL 32608, USA
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5
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Hohl SD, Shoenbill KA, Taylor KL, Minion M, Bates-Pappas GE, Hayes RB, Nolan MB, Simmons VN, Steinberg MB, Park ER, Ashing K, Beneventi D, Sanderson Cox L, Goldstein AO, King A, Kotsen C, Presant CA, Sherman SE, Sheffer CE, Warren GW, Adsit RT, Bird JE, D’Angelo H, Fiore MC, Van Thanh Nguyen C, Pauk D, Rolland B, Rigotti NA. The Impact of the COVID-19 Pandemic on Tobacco Treatment Program Implementation at National Cancer Institute-Designated Cancer Centers. Nicotine Tob Res 2023; 25:345-349. [PMID: 35778237 PMCID: PMC9384385 DOI: 10.1093/ntr/ntac160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The COVID-19 pandemic disrupted cancer screening and treatment delivery, but COVID-19's impact on tobacco cessation treatment for cancer patients who smoke has not been widely explored. AIMS AND METHODS We conducted a sequential cross-sectional analysis of data collected from 34 National Cancer Institute (NCI)-designated cancer centers participating in NCI's Cancer Center Cessation Initiative (C3I), across three reporting periods: one prior to COVID-19 (January-June 2019) and two during the pandemic (January-June 2020, January-June 2021). Using McNemar's Test of Homogeneity, we assessed changes in services offered and implementation activities over time. RESULTS The proportion of centers offering remote treatment services increased each year for Quitline referrals (56%, 68%, and 91%; p = .000), telephone counseling (59%, 79%, and 94%; p = .002), and referrals to Smokefree TXT (27%, 47%, and 56%; p = .006). Centers offering video-based counseling increased from 2020 to 2021 (18% to 59%; p = .006), Fewer than 10% of centers reported laying off tobacco treatment staff. Compared to early 2020, in 2021 C3I centers reported improvements in their ability to maintain staff and clinician morale, refer to external treatment services, train providers to deliver tobacco treatment, and modify clinical workflows. CONCLUSIONS The COVID-19 pandemic necessitated a rapid transition to new telehealth program delivery of tobacco treatment for patients with cancer. C3I cancer centers adjusted rapidly to challenges presented by the pandemic, with improvements reported in staff morale and ability to train providers, refer patients to tobacco treatment, and modify clinical workflows. These factors enabled C3I centers to sustain evidence-based tobacco treatment implementation during and beyond the COVID-19 pandemic. IMPLICATIONS This work describes how NCI-designated cancer centers participating in the Cancer Center Cessation Initiative (C3I) adapted to challenges to sustain evidence-based tobacco use treatment programs during the COVID-19 pandemic. This work offers a model for resilience and rapid transition to remote tobacco treatment services delivery and proposes a policy and research agenda for telehealth services as an approach to sustaining evidence-based tobacco treatment programs.
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Affiliation(s)
- Sarah D Hohl
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Kimberly A Shoenbill
- Department of Family Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn L Taylor
- Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Washington, DC, USA
| | - Mara Minion
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Gleneara E Bates-Pappas
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rashelle B Hayes
- Department of Psychiatry, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Margaret B Nolan
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Michael B Steinberg
- Center for Tobacco Studies, Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital (MGH), Boston, MA, USA
| | - Kimlin Ashing
- Department of Population Sciences, Center of Community Alliance for Research & Education, City of Hope National Medical Center, Duarte, CA, USA
| | - Diane Beneventi
- Tobacco Research and Treatment Program, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Lisa Sanderson Cox
- Cancer Prevention and Control, University of Kansas School of Medicine, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Adam O Goldstein
- Department of Family Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Andrea King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Chris Kotsen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cary A Presant
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Graham W Warren
- Department of Radiation Oncology, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Robert T Adsit
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jennifer E Bird
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Heather D’Angelo
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael C Fiore
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Danielle Pauk
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Betsy Rolland
- Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
- Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI, USA
| | - Nancy A Rigotti
- Department of Medicine, Division of General Internal Medicine and Mongan Institute, Tobacco Research and Treatment Center, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
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Kauser K, Warner KS, Anderson B, Keyes ED, Hayes RB, Kawamoto E, Perkins DH, Scott R, Isaacson J, Haberer B, Spaans A, Utecht R, Hauser H, Roberts AG, Greenberg M. Creating a Natural Vascular Scaffold by Photochemical Treatment of the Extracellular Matrix for Vascular Applications. Int J Mol Sci 2022; 23:ijms23020683. [PMID: 35054866 PMCID: PMC8775700 DOI: 10.3390/ijms23020683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 02/01/2023] Open
Abstract
The development of bioscaffolds for cardiovascular medical applications, such as peripheral artery disease (PAD), remains to be a challenge for tissue engineering. PAD is an increasingly common and serious cardiovascular illness characterized by progressive atherosclerotic stenosis, resulting in decreased blood perfusion to the lower extremities. Percutaneous transluminal angioplasty and stent placement are routinely performed on these patients with suboptimal outcomes. Natural Vascular Scaffolding (NVS) is a novel treatment in the development for PAD, which offers an alternative to stenting by building on the natural structural constituents in the extracellular matrix (ECM) of the blood vessel wall. During NVS treatment, blood vessels are exposed to a photoactivatable small molecule (10-8-10 Dimer) delivered locally to the vessel wall via an angioplasty balloon. When activated with 450 nm wavelength light, this therapy induces the formation of covalent protein–protein crosslinks of the ECM proteins by a photochemical mechanism, creating a natural scaffold. This therapy has the potential to reduce the need for stent placement by maintaining a larger diameter post-angioplasty and minimizing elastic recoil. Experiments were conducted to elucidate the mechanism of action of NVS, including the molecular mechanism of light activation and the impact of NVS on the ECM.
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Affiliation(s)
- Katalin Kauser
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
- Correspondence: ; Tel.: +1-415-527-9892
| | - Kevin S. Warner
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Blake Anderson
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Edgar Dalles Keyes
- Department of Chemistry, University of Utah, 315 South 1400 East, Salt Lake City, UT 84112, USA; (E.D.K.); (A.G.R.)
| | - RB Hayes
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Eric Kawamoto
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - DH Perkins
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Robert Scott
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Jim Isaacson
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Barb Haberer
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Ann Spaans
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Ronald Utecht
- Alumend, LLC, 4800 N. Career Avenue, Suite #108, Sioux Falls, SD 57107, USA; (B.H.); (A.S.); (R.U.)
| | - Hank Hauser
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
| | - Andrew George Roberts
- Department of Chemistry, University of Utah, 315 South 1400 East, Salt Lake City, UT 84112, USA; (E.D.K.); (A.G.R.)
| | - Myles Greenberg
- Alucent Biomedical Inc., 675 Arapeen Dr, Suite #102, Salt Lake City, UT 84108, USA; (K.S.W.); (B.A.); (R.H.); (E.K.); (D.P.); (R.S.); (J.I.); (H.H.); (M.G.)
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7
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Wheeler DC, Do EK, Hayes RB, Hughes C, Fuemmeler BF. Evaluation of neighborhood deprivation and store characteristics in relation to tobacco retail outlet sales violations. PLoS One 2021; 16:e0254443. [PMID: 34270555 PMCID: PMC8284798 DOI: 10.1371/journal.pone.0254443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/27/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Regulations of the sale of tobacco products to minors have been effective at reducing adolescent tobacco use overall. However, these efforts may not be uniformly enforced in all areas, creating uneven protection against adolescent smoking. Knowledge regarding factors associated with tobacco retail outlet (TRO) violations could help inform better enforcement strategies. METHODS In this study, we used Bayesian index regression models to determine if tobacco sales to minors violations across Virginia (2012-2021) were related to store characteristics and neighborhood deprivation and identify geographic areas at significantly elevated risk for violations after adjusting for these factors. RESULTS Results show that there were multiple factors associated with a higher likelihood of tobacco sales violations. Store type was an important factor, as grocery stores and pharmacies had significantly lowered likelihood of violations compared with convenience stores. Being located near another TRO was significantly associated with increased risk of sales to a minor. Neighborhood deprivation was also positively associated with TRO sales violations. Further, there were statistically higher likelihood of sales violations occurring in specific areas (e.g., southwest and southeast) of the state that were not explained by neighborhood deprivation and store attributes. CONCLUSIONS Together, results highlight the need to better understand where and why TRO sales violations are occurring in order to improve efforts aimed at monitoring and remediating TRO sales violations.
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Affiliation(s)
- David C. Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Elizabeth K. Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Rashelle B. Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Colleen Hughes
- Virginia Department of Behavioral Health and Developmental Services, Richmond, VA, United States of America
| | - Bernard F. Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Richmond, VA, United States of America
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States of America
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8
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Berg CJ, Barker DC, Sussman S, Getachew B, Pulvers K, Wagener TL, Hayes RB, Henriksen L. Vape Shop Owners/Managers' Opinions About FDA Regulation of E-Cigarettes. Nicotine Tob Res 2021; 23:535-542. [PMID: 32722808 DOI: 10.1093/ntr/ntaa138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/25/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In the United States, prominent sources of vaping products are specialty vape shops, which are subject to Food and Drug Administration (FDA) regulation. This study interviewed vape shop owners/managers to assess: (1) reasons for entering into or engaging in vape shop retail; (2) personnel training, particularly with regard to FDA and state regulations; and (3) how existing regulations are perceived and the anticipated impact of future regulation. AIMS AND METHODS The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018 as FDA regulations regarding minimum age verification, bans on product sampling, and health warnings (among others) were first being implemented. RESULTS Vape shop owners/managers reported: (1) entering the industry with positive intentions for their customers, (2) training their personnel to adhere to regulations and provide good customer service, and (3) significant concerns about the impact of FDA regulations. With regard to the latter, participants reported mistrust of the intentions of the FDA regulations, financial implications of the regulations (particularly for small businesses), difficulty understanding and interpreting the regulations, insufficient evidence to support the regulations, negative impact on customer service, negative impact on product offerings and product innovation/advancement, and negative implications of flavor bans and/or restrictions on sale of flavors. CONCLUSIONS These findings indicate the complexities in implementing tobacco regulations, particularly from the perspective of the vape shop industry. Current findings should inform future regulatory actions and efforts to assess compliance with regulations. IMPLICATIONS Current and impending FDA regulation of vaping products present a critical period for examining regulatory impact on the vape shop industry. Current results indicated that many vape shop owners/managers reporting positive intentions for engaging in the vaping product industry and in training vape shop personnel to adhere to regulations. However, the majority reported concerns about FDA regulation and other state/local regulations that could have negative implications for their industry. Particular concerns include difficulty understanding the regulations due to complexity, vagueness, and changes in language and/or interpretation over time. These issues have implications for compliance that must be addressed.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC
| | | | - Steve Sussman
- Departments of Preventive Medicine and Psychology, and School of Social Work, University of Southern California, Alhambra, CA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Theodore L Wagener
- Ohio State University Comprehensive Cancer Center and Division of Medical Oncology, The Ohio State University, Columbus, OH
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA
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9
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Berg CJ, Barker DC, Meyers C, Weber A, Park AJ, Patterson A, Dorvil S, Fairman RT, Huang J, Sussman S, Livingston MD, Wagener TL, Hayes RB, Pulvers K, Getachew B, Schleicher N, Henriksen L. Exploring the Point-of-Sale Among Vape Shops Across the United States: Audits Integrating a Mystery Shopper Approach. Nicotine Tob Res 2021; 23:495-504. [PMID: 32149340 DOI: 10.1093/ntr/ntaa041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States. AIMS AND METHODS This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents). RESULTS 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions. CONCLUSIONS Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts.
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Affiliation(s)
- Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC
| | | | - Christina Meyers
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Amber Weber
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Amy J Park
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Akilah Patterson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Sarah Dorvil
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Robert T Fairman
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA
| | - Jidong Huang
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA
| | - Steve Sussman
- Departments of Preventive Medicine and Psychology, and School of Social Work, University of Southern California, Alhambra, CA
| | - Melvin D Livingston
- Department of Prevention and Community Health, Milken Institute School of Public Health; George Washington Cancer Center, George Washington University, Washington, DC
| | - Theodore L Wagener
- Ohio State University Comprehensive Cancer Center and Division of Medical Oncology, The Ohio State University, Columbus, OH
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Nina Schleicher
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
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10
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Do EK, Bradley KC, Fugate-Laus K, Kaur K, Halquist MS, Ray L, Pope MA, Hayes RB, Wheeler DC, Fuemmeler BF. An examination of social and environmental determinants of secondhand smoke exposure among non-smoking adolescents. Tob Prev Cessat 2021; 7:20. [PMID: 33728387 PMCID: PMC7954078 DOI: 10.18332/tpc/131875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Adolescents are at increased risk of secondhand smoke exposure (SHS) due to the limited control that they have over social and physical environments. Yet, knowledge regarding determinants of SHS among non-smoking adolescents is limited. This study identifies social and environmental factors associated with SHS among non-smoking adolescents. METHODS To be included, parents and adolescents (aged 11–17 years) of the Adolescents, Place, and Behavior Study had to have completed surveys between March 2019 and May 2020. Adolescents had to have not reported smoking within the past 30 days and provided a saliva sample assayed for cotinine (≤3 ng/mL). A series of stepwise linear regression models were fit to the data to identify social and environmental determinants of SHS, using log-transformed salivary cotinine. RESULTS Of the 105 adolescent and parent dyads included, 90.3% were African American, 26.9% of parents reported smoking, 33.3% resided in multi-unit housing, and 67.7% lived in homes where smoking was not permitted. Significant associations were found between parent tobacco use (β=2.56, SE=0.98, p=0.0082) and residing in multi-unit housing (β=1.72, SE=0.86, p=0.0460) with increased log-transformed cotinine levels among non-smoking adolescents. Adolescent age, gender, and race/ ethnicity, parental education, peer tobacco use, the number of adults and children in the home, average number of days of self-reported SHS within public spaces outside of the home, and home smoking policies were not significantly associated with cotinine. CONCLUSIONS Results emphasize the importance of reducing secondhand smoke exposure by reducing parental smoking and altering exposures within social and home environments. Parental tobacco use and residential setting should be considered when developing interventions to reduce secondhand smoke exposure among non-smoking adolescents.
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Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Massey Cancer Center, Virginia Commonwealth University, Richmond, United States
| | - Kennedy C Bradley
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, United States
| | - Kendall Fugate-Laus
- Department of Psychology, Virginia Commonwealth University, Richmond, United States
| | - Kiranpreet Kaur
- School of Medicine, Virginia Commonwealth University, Richmond, United States
| | - Matthew S Halquist
- School of Pharmacy, Virginia Commonwealth University, Richmond, United States
| | - Laure Ray
- School of Pharmacy, Virginia Commonwealth University, Richmond, United States
| | | | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, United States
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Richmond, United States
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, United States.,Massey Cancer Center, Virginia Commonwealth University, Richmond, United States
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11
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Soule EK, Plunk AD, Harrell PT, Hayes RB, Edwards KC. Longitudinal Analysis of Associations Between Reasons for Electronic Cigarette Use and Change in Smoking Status Among Adults in the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 22:663-671. [PMID: 30698815 PMCID: PMC7171285 DOI: 10.1093/ntr/ntz005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Electronic cigarette (ECIG) use and changes in cigarette smoking status may be influenced by self-reported reasons for using ECIGs. METHODS We analyzed adult current and former cigarette smokers who were also current or former ECIG users at wave 1 (n = 3044) using wave 1 and wave 2 Population Assessment of Tobacco and Health Study data (2013-2015). Prevalence of reporting 13 reasons for ECIG use at wave 1 was examined and weighted logistic regressions were conducted predicting smoking status changes from wave 1 to wave 2. RESULTS Reasons for ECIG use ranged from 18.1% (people in the media or public figures use them) to 82.5% (they might be less harmful to people around me than cigarettes). From wave 1 to wave 2, 27.2% of former smokers (n = 249) became current smokers and 11.6% of current smokers (n = 246) became former smokers. Among wave 1 former smokers, using ECIGs because of the availability of flavors (AOR = 0.57, 95% CI = 0.39-0.85) or because they don't smell (AOR = 0.64, 95% CI = 0.42-0.97) was associated with lower odds of relapse to smoking, but using ECIGs because using them helps people quit smoking (AOR = 1.55, 95% CI = 1.01-2.38) was associated with greater odds of relapse. Among wave 1 current smokers, using ECIGs because they can be used where smoking is not allowed (AOR = 0.56, 95% CI = 0.38-0.85) was associated with reduced odds of quitting cigarettes. CONCLUSIONS Some reasons for ECIG use are associated with changes in self-reported smoking status. Researchers should examine ECIG user characteristics when assessing associations between ECIG use and smoking status transitions. IMPLICATIONS Given that certain reasons for ECIG use, such as using ECIGs in locations are where smoking is not allowed, may inhibit smoking reduction, policies may be developed to prevent ECIG use in locations where smoking is banned. In addition, because certain reasons for ECIG use may aid in relapse prevention, such as availability of desired flavors, efforts should be made to identify ECIG device characteristics that are appealing to smokers but not youth or nontobacco users. These results provide support for future research on reasons for ECIG use to inform regulatory policies.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC
| | - Andrew D Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
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12
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Do EK, Fugate-Laus K, Fallavollita W, Conklin S, Hayes RB, Wheeler DC, Fuemmeler BF. Determinants of Youth-Reported Past 30-Day Tobacco Use. J Community Health 2020; 45:954-964. [PMID: 32246411 DOI: 10.1007/s10900-020-00813-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The objective of this study was to utilize cross-sectional surveys to identify factors associated with past 30-day tobacco use among a sample youth and to determine whether regional differences exist. Data were obtained from the Virginia Youth Survey (2015 and 2017). Multinomial logistic regression models were used to examine associations between measures of past 30-day tobacco use and region, sex, grade, race/ethnicity, tobacco advertisement exposure, and presence of tobacco-free policies in the home and personal vehicles. These correlates were selected based upon existing literature on youth tobacco use. Past 30-day cigarette use, combustible tobacco use, non-combustible tobacco use, and dual product use were associated with region, sex, grade, and race/ethnicity. Specifically, youth residing in the Southwestern region of the state, males, and non-Hispanic White students and youth of other race/ethnicity were more likely to report past 30-day tobacco use. Additionally, higher levels of exposure to tobacco advertisements was also associated with past 30-day tobacco use. Future research needs to investigate the mechanisms by which youth tobacco use may differ by region, to help guide and target future policy and programming related to tobacco prevention and control at the local level.
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Affiliation(s)
- Elizabeth K Do
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA.
| | - Kendall Fugate-Laus
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
| | - Westley Fallavollita
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
| | - Sarah Conklin
- Virginia Department of Health, 109 Governor Street, Richmond, VA, 23219, USA
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Box 980710, Richmond, VA, 23298, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University, Box 980032, Richmond, VA, 23298, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior & Policy, Virginia Commonwealth University, Box 980430, Richmond, VA, 23298, USA
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13
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Tran N, Hayes RB, Ho IK, Crawford SL, Chen J, Ockene JK, Bond M, Rayman P, Dean B, Smith S, Thorndyke L, Frankin P, Plummer D, Pbert L. Perceived Subtle Gender Bias Index: Development and Validation for Use in Academia. Psychology of Women Quarterly 2019. [DOI: 10.1177/0361684319877199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this article, we present the development and validation of the Perceived Subtle Gender Bias Index. Given the inherent difficulty in identifying and measuring the perceptions of subtle gender biases, this index provides researchers and interventionists with a tool that does not require participants to identify/label an event as a gender bias incident. We used a mixed method and constructivist approach that prioritized and privileged the voices and experiences of women in science, technology, engineering, and mathematics (STEM). The current article describes two studies: (1) index development and (2) index refinement and validation, using a national survey of women academics ( N = 882). Findings support a four-subscale structure, including perceived gender inequity, collegiality, mentorship, and institutional support. Methods and analyses support face, convergent, discriminant, and predictive validity for the use of the index among academic faculty women. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684319877199
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Affiliation(s)
- Nellie Tran
- Department of Counseling & School Psychology, San Diego State University, CA, USA
| | - Rashelle B. Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Ivy K. Ho
- Department of Psychology, University of Massachusetts Lowell, MA, USA
| | - Sybil L. Crawford
- Department of Medicine, University of Massachusetts Worcester Medical School, MA, USA
| | - Julie Chen
- Department of Mechanical Engineering, University of Massachusetts Lowell, MA, USA
| | - Judith K. Ockene
- Department of Population & Quantitative Health Sciences, University of Massachusetts Worcester Medical School, MA, USA
| | - Meg Bond
- Department of Psychology, University of Massachusetts Lowell, MA, USA
| | - Paula Rayman
- Department of Sociology, University of Massachusetts Lowell, MA, USA
| | - Brita Dean
- Department of Engineering Technology, University of Massachusetts Lowell, MA, USA
| | - Sable Smith
- Department of Psychology, University of Massachusetts Lowell, MA, USA
| | - Luanne Thorndyke
- Department of Medicine, University of Massachusetts Worcester Medical School, MA, USA
| | - Patricia Frankin
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
| | - Deborah Plummer
- Department of Psychiatry, University of Massachusetts Worcester Medical School, MA, USA
| | - Lori Pbert
- Department of Population & Quantitative Health Sciences, University of Massachusetts Worcester Medical School, MA, USA
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14
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Abstract
The concept of latency period has developed in chronic disease epidemiology by analogy with the incubation period associated with infectious diseases. We discuss the use of the concept of mean latency period to describe the temporal development of cancer and the underlying conceptual and methodologic problems. The respective roles of age at diagnosis, age at start of exposure, duration of exposure, and years since exposure in modifying cancer risks are considered. Multistep models for the development of cancer are illustrated, and their use and limitations for interpreting temporal associations in cancer development are discussed. Rather than trying to define exposure-disease relationships as being characterized by a long or a short latency period, It seems more promising to study the temporal sequence of disease development as a multistep process.
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Affiliation(s)
- R B Hayes
- Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland 20892
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15
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Jake-Schoffman DE, Silfee VJ, Waring ME, Boudreaux ED, Sadasivam RS, Mullen SP, Carey JL, Hayes RB, Ding EY, Bennett GG, Pagoto SL. Methods for Evaluating the Content, Usability, and Efficacy of Commercial Mobile Health Apps. JMIR Mhealth Uhealth 2017; 5:e190. [PMID: 29254914 PMCID: PMC5748471 DOI: 10.2196/mhealth.8758] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/11/2017] [Accepted: 10/29/2017] [Indexed: 02/06/2023] Open
Abstract
Commercial mobile apps for health behavior change are flourishing in the marketplace, but little evidence exists to support their use. This paper summarizes methods for evaluating the content, usability, and efficacy of commercially available health apps. Content analyses can be used to compare app features with clinical guidelines, evidence-based protocols, and behavior change techniques. Usability testing can establish how well an app functions and serves its intended purpose for a target population. Observational studies can explore the association between use and clinical and behavioral outcomes. Finally, efficacy testing can establish whether a commercial app impacts an outcome of interest via a variety of study designs, including randomized trials, multiphase optimization studies, and N-of-1 studies. Evidence in all these forms would increase adoption of commercial apps in clinical practice, inform the development of the next generation of apps, and ultimately increase the impact of commercial apps.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Valerie J Silfee
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Obstetrics and Gynecology, University of Massachusetts Medical School, Worcester, MA, United States
| | - Edwin D Boudreaux
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States.,Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rajani S Sadasivam
- Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sean P Mullen
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Jennifer L Carey
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Rashelle B Hayes
- Division of Consultation/Liaison Psychiatry and Psychology, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
| | - Eric Y Ding
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gary G Bennett
- Department of Psychology & Neuroscience, Duke University, Durham, NC, United States.,Duke Digital Health Science Center, Duke University, Durham, NC, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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16
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Ockene JK, Ashe KM, Hayes RB, Churchill LC, Crawford SL, Geller AC, Jolicoeur D, Olendzki BC, Basco MT, Pendharkar JA, Ferguson KJ, Guck TP, Margo KL, Okuliar CA, Shaw MA, Soleymani T, Stadler DD, Warrier SS, Pbert L. Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized controlled trial. Contemp Clin Trials 2017; 64:58-66. [PMID: 29128651 DOI: 10.1016/j.cct.2017.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 11/01/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Abstract
Physicians have an important role addressing the obesity epidemic. Lack of adequate teaching to provide weight management counseling (WMC) is cited as a reason for limited treatment. National guidelines have not been translated into an evidence-supported, competency-based curriculum in medical schools. Weight Management Counseling in Medical Schools: A Randomized Controlled Trial (MSWeight) is designed to determine if a multi-modal theoretically-guided WMC educational intervention improves observed counseling skills and secondarily improve perceived skills and self-efficacy among medical students compared to traditional education (TE). Eight U.S. medical schools were pair-matched and randomized in a group randomized controlled trial to evaluate whether a multi-modal education (MME) intervention compared to traditional education (TE) improves observed WMC skills. The MME intervention includes innovative components in years 1-3: a structured web-course; a role play exercise, WebPatientEncounter, and an enhanced outpatient internal medicine or family medicine clerkship. This evidence-supported curriculum uses the 5As framework to guide treatment and incorporates patient-centered counseling to engage the patient. The primary outcome is a comparison of scores on an Objective Structured Clinical Examination (OSCE) WMC case among third year medical students. The secondary outcome compares changes in scores of medical students from their first to third year on an assessment of perceived WMC skills and self-efficacy. MSWeight is the first RCT in medical schools to evaluate whether interventions integrated into the curriculum improve medical students' WMC skills. If this educational approach for teaching WMC is effective, feasible and acceptable it can affect how medical schools integrate WMC teaching into their curriculum.
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Affiliation(s)
- Judith K Ockene
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Karen M Ashe
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University Medical Center, 1200 East Broad Street, Richmond, VA 23298, United States.
| | - Linda C Churchill
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Sybil L Crawford
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States.
| | - Denise Jolicoeur
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Barbara C Olendzki
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Maria Theresa Basco
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Jyothi A Pendharkar
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
| | - Kristi J Ferguson
- University of Iowa Carver College of Medicine, OCRME, 1204 MEB, Iowa City, IA 52242, United States.
| | - Thomas P Guck
- Creighton University School of Medicine, Department of Family Medicine, 2412 Cuming Street, Omaha, NE 68131, United States.
| | - Katherine L Margo
- Perelman School of Medicine at University of Pennsylvania, 3451 Walnut St, Philadelphia, PA 19104, United States.
| | - Catherine A Okuliar
- Medstar Georgetown University Hospital, Department of Internal Medicine, 3800 Reservoir Road N.W., PHC 5, Washington, DC 20007, United States.
| | - Monica A Shaw
- University of Louisville School of Medicine, 500 S Preston St, Louisville, KY 40202, United States.
| | - Taraneh Soleymani
- University of Alabama at Birmingham, 1720 2nd Ave South, Webb 646, Birmingham, AL 35294-3360, United States.
| | - Diane D Stadler
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CR110, Portland, OR 97239, United States.
| | - Sarita S Warrier
- Warren Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, United States.
| | - Lori Pbert
- Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, United States.
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Procter-Gray E, Olendzki B, Kane K, Churchill L, Hayes RB, Aguirre A, Kang HJ, Li W. Comparison of Dietary Quality Assessment Using Food Frequency Questionnaire and 24-hour-recalls in Older Men and Women. AIMS Public Health 2017; 4:326-346. [PMID: 29546221 PMCID: PMC5690458 DOI: 10.3934/publichealth.2017.4.326] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/30/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To examine the agreement in nutrient intake and alternative healthy eating indices (AHEI) between a self-administered Food Frequency Questionnaire (FFQ) and 24-hour recall (24HR) measurements of diet by gender, among older adults. MATERIAL AND METHODS This is a cross-sectional observational study of 105 men and 99 women aged 65 and older living in urban and rural neighborhoods in Worcester County, Massachusetts, USA. Participants were queried on diet using both FFQ and 24HR. The healthy eating classification was compared between the two instruments by gender. RESULTS For men, the mean ± SD of AHEI total score was 48.2 ± 12.3 based on FFQ versus 34.7 ± 10.2 based on 24HR. For women, the mean ± SD was 47.9 ± 10.1 based on FFQ versus 36.1 ± 10.0 based on 24HR. Using 32 as the cutoff (40% of maximum AHEI score), 9% of men and 7% of women were classified as eating unhealthy based on the FFQ, versus 47% of men and 38% of women based on 24HR. Compared to women, men had larger 24HR to FFQ discrepancies in the nuts and vegetable protein subscore and white/red meat ratio, and smaller discrepancy in alcohol beverages subscore. CONCLUSION Agreements between FFQ and 24HR-based measures of diet quality were roughly comparable between men and women, though slightly better for women than men. Compared to 24HR, the FFQ tended to underestimate the proportions of older men and women classified as eating unhealthy and misclassified more men than women. Such limitations should be considered when the FFQ is used to study healthy eating in older age.
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Affiliation(s)
| | | | | | | | | | | | | | - Wenjun Li
- Health Statistics and Geography Lab, Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
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18
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Ockene JK, Hayes RB, Churchill LC, Crawford SL, Jolicoeur DG, Murray DM, Shoben AB, David SP, Ferguson KJ, Huggett KN, Adams M, Okuliar CA, Gross RL, Bass PF, Greenberg RB, Leone FT, Okuyemi KS, Rudy DW, Waugh JB, Geller AC. Teaching Medical Students to Help Patients Quit Smoking: Outcomes of a 10-School Randomized Controlled Trial. J Gen Intern Med 2016; 31:172-181. [PMID: 26391030 PMCID: PMC4720645 DOI: 10.1007/s11606-015-3508-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Early in medical education, physicians must develop competencies needed for tobacco dependence treatment. OBJECTIVE To assess the effect of a multi-modal tobacco dependence treatment curriculum on medical students' counseling skills. DESIGN A group-randomized controlled trial (2010-2014) included ten U.S. medical schools that were randomized to receive either multi-modal tobacco treatment education (MME) or traditional tobacco treatment education (TE). SETTING/PARTICIPANTS Students from the classes of 2012 and 2014 at ten medical schools participated. Students from the class of 2012 (N = 1345) completed objective structured clinical examinations (OSCEs), and 50 % (N = 660) were randomly selected for pre-intervention evaluation. A total of 72.9 % of eligible students (N = 1096) from the class of 2014 completed an OSCE and 69.7 % (N = 1047) completed pre and post surveys. INTERVENTIONS The MME included a Web-based course, a role-play classroom demonstration, and a clerkship booster session. Clerkship preceptors in MME schools participated in an academic detailing module and were encouraged to be role models for third-year students. MEASUREMENTS The primary outcome was student tobacco treatment skills using the 5As measured by an objective structured clinical examination (OSCE) scored on a 33-item behavior checklist. Secondary outcomes were student self-reported skills for performing 5As and pharmacotherapy counseling. RESULTS Although the difference was not statistically significant, MME students completed more tobacco counseling behaviors on the OSCE checklist (mean 8.7 [SE 0.6] vs. mean 8.0 [SE 0.6], p = 0.52) than TE students. Several of the individual Assist and Arrange items were significantly more likely to have been completed by MME students, including suggesting behavioral strategies (11.8 % vs. 4.5 %, p < 0.001) and providing information regarding quitline (21.0 % vs. 3.8 %, p < 0.001). MME students reported higher self-efficacy for Assist, Arrange, and Pharmacotherapy counseling items (ps ≤0.05). LIMITATIONS Inclusion of only ten schools limits generalizability. CONCLUSIONS Subsequent interventions should incorporate lessons learned from this first randomized controlled trial of a multi-modal longitudinal tobacco treatment curriculum in multiple U.S. medical schools. NIH Trial Registry Number: NCT01905618.
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Affiliation(s)
- Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Linda C Churchill
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Sybil L Crawford
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Denise G Jolicoeur
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - David M Murray
- Biostatistics and Bioinformatics Branch; Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Abigail B Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Sean P David
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Kathryn N Huggett
- Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA
| | - Michael Adams
- Department of Medicine, Georgetown University Hospital, Washington, DC, USA
| | | | - Robin L Gross
- Department of Medicine, Georgetown University Hospital, Washington, DC, USA
| | - Pat F Bass
- Louisiana State University Health Shreveport, Shreveport, LA, USA
| | - Ruth B Greenberg
- University of Louisville School of Medicine, Louisville, KY, USA
| | - Frank T Leone
- Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kola S Okuyemi
- Department of Family and Community Health, University of Minnesota School of Medicine, Minneapolis, MN, USA
| | - David W Rudy
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Jonathan B Waugh
- Clinical and Diagnostics Sciences Department, School of Health Professions, UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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Pagoto SL, Waring ME, Schneider KL, Oleski JL, Olendzki E, Hayes RB, Appelhans BM, Whited MC, Busch AM, Lemon SC. Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series. JMIR Res Protoc 2015; 4:e123. [PMID: 26500186 PMCID: PMC4704936 DOI: 10.2196/resprot.4864] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 08/13/2015] [Accepted: 09/22/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. OBJECTIVE Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. METHODS We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. RESULTS In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. CONCLUSIONS Future research should evaluate the efficacy and cost-effectiveness of online social network-delivered lifestyle interventions relative to traditional modalities.
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Affiliation(s)
- Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
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20
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Xiao RS, Hayes RB, Waring ME, Geller AC, Churchill LC, Okuyemi KS, Adams M, Huggett KN, Ockene JK. Tobacco counseling experience prior to starting medical school, tobacco treatment self-efficacy and knowledge among first-year medical students in the United States. Prev Med 2015; 73:119-24. [PMID: 25666737 PMCID: PMC4378235 DOI: 10.1016/j.ypmed.2015.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/30/2014] [Accepted: 02/01/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore students' tobacco dependence counseling experiences prior to medical school and their associations with tobacco counseling self-efficacy, and familiarity with and perceived effectiveness of tobacco dependence treatment among first-year medical students in the United States. METHOD In 2010, 1266 first-year medical students from 10 US medical schools completed a survey reporting their clinical experiences with specific tobacco counseling skills (e.g., 5As) prior to medical school. The survey also included questions on tobacco counseling self-efficacy, perceived physician impact on smokers, and familiarity and effectiveness of tobacco-related treatments. RESULTS Half (50.4%) reported some tobacco counseling experiences prior to medical school (i.e. at least one 5A). Students with prior counseling experiences were more likely to have higher tobacco counseling self-efficacy, and greater familiarity with medication treatment, nicotine replacement treatment, and behavioral counseling for smoking cessation, compared to those with no prior experiences. Perceived physician impact on patient smoking outcomes did not differ by prior tobacco counseling experiences. CONCLUSIONS Many first-year medical students may already be primed to learn tobacco dependence counseling skills. Enhancing early exposure to learning these skills in medical school is likely to be beneficial to the skillset of our future physicians.
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Affiliation(s)
- Rui S Xiao
- Clinical and Population Health Research Program, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
| | - Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
| | - Molly E Waring
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
| | - Linda C Churchill
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
| | - Kolawole S Okuyemi
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael Adams
- Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, USA
| | | | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue, Worcester, MA 01655, USA
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21
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Hayes RB, Geller AC, Crawford SL, Jolicoeur DG, Churchill LC, Okuyemi KS, David SP, Adams M, Waugh J, Allen SS, Leone FT, Fauver R, Leung K, Liu Q, Ockene JK. Medical school curriculum characteristics associated with intentions and frequency of tobacco dependence treatment among 3rd year U.S. medical students. Prev Med 2015; 72:56-63. [PMID: 25572623 PMCID: PMC4562320 DOI: 10.1016/j.ypmed.2014.12.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 12/20/2014] [Accepted: 12/26/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Physicians play a critical role in addressing tobacco dependence, yet report limited training. Tobacco dependence treatment curricula for medical students could improve performance in this area. This study identified student and medical school tobacco treatment curricula characteristics associated with intentions and use of the 5As for tobacco treatment among 3rd year U.S. medical students. METHODS Third year medical students (N=1065, 49.3% male) from 10 U.S. medical schools completed a survey in 2009-2010 assessing student characteristics, including demographics, tobacco treatment knowledge, and self-efficacy. Tobacco curricula characteristics assessed included amount and type of classroom instruction, frequency of tobacco treatment observation, instruction, and perception of preceptors as role models. RESULTS Greater tobacco treatment knowledge, self-efficacy, and curriculum-specific variables were associated with 5A intentions, while younger age, tobacco treatment self-efficacy, intentions, and each curriculum-specific variable were associated with greater 5A behaviors. When controlling for important student variables, greater frequency of receiving 5A instruction (OR=1.07; 95%CI 1.01-1.12) and perception of preceptors as excellent role models in tobacco treatment (OR=1.35; 95%CI 1.04-1.75) were significant curriculum predictors of 5A intentions. Greater 5A instruction (B=.06 (.03); p<.05) and observation of tobacco treatment (B=.35 (.02); p<.001) were significant curriculum predictors of greater 5A behaviors. CONCLUSIONS Greater exposure to tobacco treatment teaching during medical school is associated with both greater intentions to use and practice tobacco 5As. Clerkship preceptors, or those physicians who provide training to medical students, may be particularly influential when they personally model and instruct students in tobacco dependence treatment.
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Affiliation(s)
- Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Sybil L Crawford
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Denise G Jolicoeur
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Linda C Churchill
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Kolawole S Okuyemi
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Sean P David
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Michael Adams
- Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, United States
| | - Jonathan Waugh
- Department of Clinical and Diagnostics Sciences/UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Sharon S Allen
- Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Frank T Leone
- Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Randy Fauver
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Katherine Leung
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Qin Liu
- Wistar Institute, Philadelphia, PA, United States
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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22
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Mazor KM, Jolicoeur D, Hayes RB, Geller AC, Churchill L, Ockene JK. Assessing Medical Students' Tobacco Dependence Treatment Skills Using a Detailed Behavioral Checklist. Teach Learn Med 2015; 27:292-298. [PMID: 26158331 PMCID: PMC4685671 DOI: 10.1080/10401334.2015.1044660] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
UNLABELLED CONSTRUCT: This article describes the development and implementation of an assessment intended to provide objective scores that would be valid indications of medical students' abilities to counsel patients about tobacco dependence. BACKGROUND Assessing medical students' advanced communication skills, particularly in the context of providing tobacco-dependence treatment, consistently and accurately is challenging; doing so across multiple medical schools is even more difficult. APPROACH Ten medical schools implemented a tobacco-dependence treatment case as part of an Objective Structured Clinical Examination for 3rd-year medical students. A 33-item checklist with detailed criteria and examples was developed for scoring students' performances. Trained coders viewed and coded 660 videotaped encounters; approximately 10% also were coded by the coding supervisor to check accuracy. RESULTS Average time required to code an encounter was approximately 31 minutes; accuracy (i.e., agreement with the gold standard coder) was excellent. Overall, students performed an average of 1 in 4 of the 33 behaviors included on the checklist, and only 1 in 10 discussed setting a quit date. Most students (almost 9 in 10) asked how much the patient smoked in a day, and just over 7 in 10 informed the patient that the cough was due to smoking. CONCLUSIONS The authors developed and implemented a rigorous assessment that will be used to evaluate medical students' tobacco-dependence treatment skills. Operationalizing the specific counseling behaviors, training coders to accurately capture students' performances using a structured checklist, and conducting the coding all required substantial time commitments but will provide confidence in the objectivity of the assessment results. In addition, this assessment can be used to provide formative information on medical students' tobacco-dependence treatment skills and to tailor ongoing training for medical students in this area.
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Affiliation(s)
- Kathleen M Mazor
- a Meyers Primary Care Institute , Worcester , Massachusetts , USA , and Department of Medicine , University of Massachusetts Medical School , Worcester , Massachusetts , USA
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Choo EK, Beauchamp G, Beaudoin FL, Bernstein E, Bernstein J, Bernstein SL, Broderick KB, Cannon RD, D'Onofrio G, Greenberg MR, Hawk K, Hayes RB, Jacquet GA, Lippmann MJ, Rhodes KV, Watts SH, Boudreaux ED. A research agenda for gender and substance use disorders in the emergency department. Acad Emerg Med 2014; 21:1438-46. [PMID: 25444022 DOI: 10.1111/acem.12534] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 12/30/2022]
Abstract
For many years, gender differences have been recognized as important factors in the etiology, pathophysiology, comorbidities, and treatment needs and outcomes associated with the use of alcohol, drugs, and tobacco. However, little is known about how these gender-specific differences affect ED utilization; responses to ED-based interventions; needs for substance use treatment and barriers to accessing care among patients in the ED; or outcomes after an alcohol-, drug-, or tobacco-related visit. As part of the 2014 Academic Emergency Medicine consensus conference on "Gender-Specific Research in Emergency Care: Investigate, Understand and Translate How Gender Affects Patient Outcomes," a breakout group convened to generate a research agenda on priority questions related to substance use disorders.
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Affiliation(s)
- Esther K. Choo
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence RI
| | - Gillian Beauchamp
- Department of Emergency Medicine; Oregon Health & Sciences University; Portland OR
| | - Francesca L. Beaudoin
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence RI
| | - Edward Bernstein
- Department of Emergency Medicine; Boston University School of Medicine; Boston MA
- Department of Community Health Sciences; Boston University School of Public Health; Boston MA
| | - Judith Bernstein
- Department of Emergency Medicine; Boston University School of Medicine; Boston MA
- Department of Community Health Sciences; Boston University School of Public Health; Boston MA
| | | | - Kerryann B. Broderick
- Department of Emergency Medicine; Denver Health; University of Colorado School of Medicine; Denver CO
| | - Robert D. Cannon
- Department of Emergency Medicine; Lehigh Valley Hospital; University of South Florida Morsani College of Medicine; Allentown PA
| | - Gail D'Onofrio
- Department of Emergency Medicine; Yale School of Medicine; New Haven CT
| | - Marna R. Greenberg
- Department of Emergency Medicine; Lehigh Valley Hospital; University of South Florida Morsani College of Medicine; Allentown PA
| | - Kathryn Hawk
- Department of Emergency Medicine; Yale School of Medicine; New Haven CT
| | - Rashelle B. Hayes
- Department of Medicine; University of Massachusetts Medical School; Worcester MA
| | - Gabrielle A. Jacquet
- Department of Emergency Medicine; Boston University School of Medicine; Boston MA
| | - Melanie J. Lippmann
- Department of Emergency Medicine; Warren Alpert Medical School of Brown University; Providence RI
| | - Karin V. Rhodes
- Department of Emergency Medicine; University of Pennsylvania School of Medicine; Philadelphia PA
| | - Susan H. Watts
- Department of Emergency Medicine; Texas Tech University Health Sciences Center; El Paso TX
| | - Edwin D. Boudreaux
- Department of Emergency Medicine; University of Massachusetts Medical School; Worcester MA
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24
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Pulvers K, Hayes RB, Scheuermann TS, Romero DR, Emami AS, Resnicow K, Olendzki E, Person SD, Ahluwalia JS. Tobacco Use, Quitting Behavior, and Health Characteristics Among Current Electronic Cigarette Users in a National Tri-Ethnic Adult Stable Smoker Sample. Nicotine Tob Res 2014; 17:1085-95. [PMID: 25385875 DOI: 10.1093/ntr/ntu241] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/03/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The present study characterizes the tobacco use, quitting behaviors, and health characteristics of cigarette smokers who did not change their smoking pattern over the past 6 months and have used electronic cigarettes (ECs) in the past 30 days. This is an important subpopulation to characterize if EC dual use with cigarettes continues to grow. METHODS Participants (N = 2,376) from a research survey panel completed an online cross-sectional survey between June and August 2012. Sampling was stratified to recruit equal numbers of cigarette smoking participants by race/ethnicity (Black, Hispanic, and Caucasian) and smoking frequency (nondaily and daily). All displayed a stable rate of smoking for the past 6 months and were not currently in treatment. Bivariate and multivariate analyses were used to examine correlates of current EC use (any use within the past 30 days). RESULTS Current EC use was reported by 9.2% (n = 219) of the total sample. Of current EC users, 44% reported having used ECs as a quit method. Bivariate and multivariate analyses showed that current EC use was significantly associated with greater nicotine dependence, concurrent poly-tobacco use, more past-year quit attempts, past use of multiple cessation methods, and more depressive symptoms. No demographic variables were significantly associated with current EC use. CONCLUSIONS This study suggests that stable smokers who currently use ECs possess characteristics that are associated with difficulty in achieving smoking cessation. These characteristics should be considered when examining the effectiveness of ECs on cessation and in designing future cessation trials using ECs.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA;
| | - Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, San Marcos, CA
| | - Ashley S Emami
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Effie Olendzki
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Sharina D Person
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Jasjit S Ahluwalia
- Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
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Land T, Keithly L, Kane K, Chen L, Paskowsky M, Cullen D, Hayes RB, Li W. Recent increases in efficiency in cigarette nicotine delivery: implications for tobacco control. Nicotine Tob Res 2014; 16:753-8. [PMID: 24420328 DOI: 10.1093/ntr/ntt219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Recent increases in nicotine yield of cigarettes sold in the United States have been attributed by tobacco manufacturers to natural variation in agricultural products. We tested this assertion using data reported by the manufacturers. METHODS Data were collected from the annual reports filed with the Massachusetts Department of Public Health by 4 major manufacturers of cigarettes from 1997 to 2012. Reportable measures included nicotine yield (mg/cig) in smoke generated by a smoking machine based on the Massachusetts smoking regimen and nicotine content in the unburned tobacco per cigarette (mg/cig). We used multilevel linear mixed-effect models to examine temporal trends in and predictors of these measures, overall and by brand style and by brand family. RESULTS While nicotine content remained relatively stable in the range of 12-14 mg/cig between 1998 and 2012, average nicotine yield increased significantly (p < .01) over time and ranged from the lowest level of 1.65 mg/cigarette in 1999 to the highest level of 1.89 mg/cigarette in 2011. Nicotine yield and yield-to-content ratio varied significantly among manufacturers and brand families. When controlling for market category and all available design features, the yield-to-content ratio of all manufacturers except Lorillard increased significantly over time. CONCLUSIONS The data provided by tobacco manufacturers suggest that the increasing trend in yield is not related to variations in nicotine content but to the yield-to-content ratio, which contradicts their assertions of agricultural variations. Nicotine yield and yield-to-content ratio are controllable features of cigarettes, and they should be monitored and regulated by government agencies.
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Affiliation(s)
- Thomas Land
- Bureau of Community Health and Prevention, Massachusetts Department of Public Health, Boston, MA
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Hayes RB, Geller A, Churchill L, Jolicoeur D, Murray DM, Shoben A, David SP, Adams M, Okuyemi K, Fauver R, Gross R, Leone F, Xiao R, Waugh J, Crawford S, Ockene JK. Teaching tobacco dependence treatment and counseling skills during medical school: rationale and design of the Medical Students helping patients Quit tobacco (MSQuit) group randomized controlled trial. Contemp Clin Trials 2014; 37:284-93. [PMID: 24486635 PMCID: PMC4048818 DOI: 10.1016/j.cct.2014.01.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 01/20/2014] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Physician-delivered tobacco treatment using the 5As is clinically recommended, yet its use has been limited. Lack of adequate training and confidence to provide tobacco treatment is cited as leading reasons for limited 5A use. Tobacco dependence treatment training while in medical school is recommended, but is minimally provided. The MSQuit trial (Medical Students helping patients Quit tobacco) aims to determine if a multi-modal and theoretically-guided tobacco educational intervention will improve tobacco dependence treatment skills (i.e. 5As) among medical students. METHODS/DESIGN 10 U.S. medical schools were pair-matched and randomized in a group-randomized controlled trial to evaluate whether a multi-modal educational (MME) intervention compared to traditional education (TE) will improve observed tobacco treatment skills. MME is primarily composed of TE approaches (i.e. didactics) plus a 1st year web-based course and preceptor-facilitated training during a 3rd year clerkship rotation. The primary outcome measure is an objective score on an Objective Structured Clinical Examination (OSCE) tobacco-counseling smoking case among 3rd year medical students from schools who implemented the MME or TE. DISCUSSION MSQuit is the first randomized to evaluate whether a tobacco treatment educational intervention implemented during medical school will improve medical students' tobacco treatment skills. We hypothesize that the MME intervention will better prepare students in tobacco dependence treatment as measured by the OSCE. If a comprehensive tobacco treatment educational learning approach is effective, while also feasible and acceptable to implement, then medical schools may substantially influence skill development and use of the 5As among future physicians.
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Affiliation(s)
- Rashelle B Hayes
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Alan Geller
- Department of Society of Human Development and Health, Harvard School of Public Health, Boston, MA, United States.
| | - Linda Churchill
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Denise Jolicoeur
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - David M Murray
- Biostatistics and Bioinformatics Branch, Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Bethesda, MD, United States.
| | - Abigail Shoben
- Division of Biostatics, College of Public Health, The Ohio State University, Columbus, OH, United States.
| | - Sean P David
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
| | - Michael Adams
- Division of General Internal Medicine, Department of Medicine, Georgetown University Hospital, United States.
| | - Kola Okuyemi
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States.
| | - Randy Fauver
- Center for Education & Research in Family and Community Medicine, Division of General Medical Disciplines, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
| | - Robin Gross
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Georgetown University Hospital, Washington, DC, United States.
| | - Frank Leone
- Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Rui Xiao
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Jonathan Waugh
- Department of Clinical and Diagnostics Sciences, UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Sybil Crawford
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
| | - Judith K Ockene
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
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Khariwala SS, Scheuermann TS, Berg CJ, Hayes RB, Nollen NL, Thomas JL, Guo H, Ahluwalia JS, Benowitz NL. Cotinine and tobacco-specific carcinogen exposure among nondaily smokers in a multiethnic sample. Nicotine Tob Res 2013; 16:600-5. [PMID: 24297808 DOI: 10.1093/ntr/ntt194] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Nondaily smoking has increased among current U.S. smokers during the past decade and is practiced by a significant percentage of smokers. Although research in nondaily smoking has grown, little is known about levels of exposure to tobacco toxicants among nondaily smokers and their variation across ethnic groups. METHODS We examined urinary levels of cotinine and a tobacco-specific nitrosamine (NNAL) in community participants. Associations between the biomarker data and smoking characteristics were evaluated with Spearman's correlation analysis. RESULTS Participants included 28 Blacks, 4 Latinos, and 25 Whites who smoked at least 1 cigarette on 4-24 days in the past 30 days. Participants averaged 3.3 (SD = 2.1) cigarettes per day (cpd) on days smoked, they smoked an average of 13.0 (SD = 5.4) days in the past month, and they smoked nondaily for 10.5 (SD = 10.5) years. Median levels of creatinine-normalized cotinine and NNAL were 490.9 ng/mg and 140.7 pg/mg, respectively. NNAL and cotinine were highly correlated (r = .84); NNAL and cotinine were modestly correlated with cpd (r = .39 and r = .34; all p values <.05). The number of days smoked per month was not associated with any biomarker levels. CONCLUSIONS Our findings demonstrate that nondaily smokers are, on average, exposed to significant levels of nicotine and carcinogenic nitrosamines, with exposures of 40%-50% of those seen in daily smokers. This level of exposure suggests a significant health risk. Nicotine and carcinogen exposure is most closely related to number of cigarettes smoked per day but not to number of days per month of smoking.
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Affiliation(s)
- Samir S Khariwala
- Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN
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Geller AC, Hayes RB, Leone F, Churchill LC, Leung K, Reed G, Jolicoeur D, Okuliar C, Adams M, Murray DM, Liu Q, Waugh J, David S, Ockene JK. Tobacco dependence treatment teaching by medical school clerkship preceptors: survey responses from more than 1,000 US medical students. Prev Med 2013; 57:81-6. [PMID: 23623894 PMCID: PMC3767283 DOI: 10.1016/j.ypmed.2013.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/10/2013] [Accepted: 04/15/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To determine factors associated with tobacco cessation counseling in medical school clerkships. METHODS Third-year medical students at 10 medical schools across the United States completed a 100-item survey, measuring the frequency with which they experienced their preceptors providing clinical teaching components: clear instruction, feedback, modeling behavior, setting clear objectives, and responding to questions about tobacco dependence counseling as well as frequency of use of tobacco prompts and office systems. Our primary dependent measure was student self-reported skill level for items of tobacco dependence treatment (e.g. "5As"). RESULTS Surveys were completed by 1213 students. For both family medicine and internal medicine clerkships, modeling and providing clear instruction on ways to provide tobacco counseling were reported most commonly. In contrast, providing feedback and clear objectives for tobacco dependence treatment lagged behind. Overall, students who reported preceptors' provision of optimal clinical teaching components and office system prompts in both family medicine and internal medicine clerkships had higher self-reported skill (P<0.001) than students with no exposure or exposure during only one of the clerkships. CONCLUSIONS Future educational interventions intended to help students adopt effective tobacco dependence treatment techniques should be engineered to facilitate these critical precepting components.
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Affiliation(s)
- Alan C Geller
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, USA.
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Holahan CK, Holahan CJ, North RJ, Hayes RB, Powers DA, Ockene JK. Smoking status, physical health-related quality of life, and mortality in middle-aged and older women. Nicotine Tob Res 2012; 15:662-9. [PMID: 22965789 DOI: 10.1093/ntr/nts182] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Women who smoke, particularly older women, have been relatively neglected in smoking research. There is a lack of knowledge concerning the relation of level of smoking to quality of life and mortality among middle-aged and older women smokers. METHODS This study examined the relation of smoking status to physical health-related quality of life (PHRQL) and total mortality in women in the Women's Health Initiative (WHI) Observational Study. Participants were 90,849 postmenopausal women, who were an average age of 63.6 years at baseline. Analyses used multiple linear and Cox proportional hazards regression and controlled for age, educational level, and ethnicity. Never-smokers were the reference group. RESULTS We found that smoking status was significantly related to PHRQL cross-sectionally at baseline and prospectively at a 3-year follow-up, with those who smoked having lower PHRQL. Heavier smokers showed large, clinically meaningful associations with PHRQL and light smokers showed small associations. In addition, we found that the smoking status at baseline was significantly related to 10-year total mortality. Both light and heavier smoking at baseline significantly correlated with higher mortality risk; however, the relationship of smoking to mortality was dose dependent. Among former smokers, those who had smoked longer showed significantly lower PHRQL and significantly increased mortality risk. CONCLUSIONS Findings suggest that the risks of smoking may not be evident to light smokers and that educational interventions targeted to middle-aged and older women stressing the consequences of light smoking may be particularly beneficial.
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Affiliation(s)
- Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX 78712, USA.
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Abstract
The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA.
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Zhang L, Lan Q, Ji Z, Li G, Shen M, Vermeulen R, Guo W, Hubbard AE, McHale CM, Rappaport SM, Hayes RB, Linet MS, Yin S, Smith MT, Rothman N. Leukemia-related chromosomal loss detected in hematopoietic progenitor cells of benzene-exposed workers. Leukemia 2012; 26:2494-8. [PMID: 22643707 PMCID: PMC3472034 DOI: 10.1038/leu.2012.143] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Benzene exposure causes acute myeloid leukemia and hematotoxicity, shown as suppression of mature blood and myeloid progenitor cell numbers. As the leukemia-related aneuploidies monosomy 7 and trisomy 8 previously had been detected in the mature peripheral blood cells of exposed workers, we hypothesized that benzene could cause leukemia through the induction of these aneuploidies in hematopoietic stem and progenitor cells. We measured loss and gain of chromosomes 7 and 8 by fluorescence in situ hybridization in interphase colony-forming unit-granulocyte-macrophage (CFU-GM) cells cultured from otherwise healthy benzene-exposed (n=28) and unexposed (n=14) workers. CFU-GM monosomy 7 and 8 levels (but not trisomy) were significantly increased in subjects exposed to benzene overall, compared with levels in the control subjects (P=0.0055 and P=0.0034, respectively). Levels of monosomy 7 and 8 were significantly increased in subjects exposed to <10 p.p.m. (20%, P=0.0419 and 28%, P=0.0056, respectively) and ≥ 10 p.p.m. (48%, P=0.0045 and 32%, 0.0354) benzene, compared with controls, and significant exposure-response trends were detected (P(trend)=0.0033 and 0.0057). These data show that monosomies 7 and 8 are produced in a dose-dependent manner in the blood progenitor cells of workers exposed to benzene, and may be mechanistically relevant biomarkers of early effect for benzene and other leukemogens.
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Affiliation(s)
- L Zhang
- School of Public Health, Division of Environmental Health Sciences, University of California, Berkeley, CA, USA
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Hayes RB, Borrelli B. Differences between Latino daily light and heavier smokers in smoking attitudes, risk perceptions, and smoking cessation outcome. Nicotine Tob Res 2012; 15:103-11. [PMID: 22589424 DOI: 10.1093/ntr/nts095] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Daily light smoking is increasing and disproportionately represented among Latinos. The current study examines differences in smoking attitudes, psychosocial characteristics, risk perceptions, and cessation rates between Latino daily light (3-9 cigarettes/day) and heavier smokers (≥ 10 cigarettes/day). METHODS Participants (N = 131; M(age) = 36.8, 73.3% female, 53.1% light smokers) were enrolled in a study focused on motivating smokers to quit. Cessation was biochemically verified at 2 and 3 months after end of treatment. RESULTS Heavier smoking was more prevalent among males (65.7%) and those from Puerto Rico (69.0%). Compared with heavier smokers, light smokers were less nicotine dependent (p < .001), reported fewer pros of smoking (p ≤ .001), less perceived stress (p ≤ .001), had fewer friends who smoked (p ≤ .005), were more likely to live in a household with an indoor smoking ban (p ≤ .001), and self-reported better health (p < .05). Regarding risk perceptions, Latino light smokers reported less perceived vulnerability for the health effects from smoking on their child's health (p < .05). There were no significant differences in smoking cessation rates between daily light and heavier smokers at either 2- or 3-month follow-up. Belief that quitting would improve "their own health," however, significantly predicted smoking cessation at both 2- and 3-month follow-up, but only among heavier smokers. CONCLUSIONS Latino light smokers do not seem to be more likely to quit smoking than Latinos who smoke at heavier rates. Differences between Latino light and heavier smokers in demographics, smoking attitudes, and psychosocial factors may need to be considered when developing cessation programs and mass media campaigns. Future research should continue to explore whether Latino light smokers need different or more targeted treatments.
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Affiliation(s)
- Rashelle B Hayes
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Berg CJ, Ling PM, Hayes RB, Berg E, Nollen N, Nehl E, Choi WS, Ahluwalia JS. Smoking frequency among current college student smokers: distinguishing characteristics and factors related to readiness to quit smoking. Health Educ Res 2012; 27:141-50. [PMID: 22156071 PMCID: PMC3605919 DOI: 10.1093/her/cyr106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 11/07/2011] [Indexed: 05/22/2023]
Abstract
Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1-5 days, 10.5% (n = 281) smoked 6-29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (β = 0.63, 95% CI 0.57-0.69) and more frequent other tobacco use (β = 0.04, 95% CI 0.02-0.05), drinking (β = 0.04, 95% CI 0.02-0.07) and binge drinking (β = 0.09, 95% CI 0.06-0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Fifth Floor, Atlanta, GA 30322, USA.
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Ferrucci LM, Sinha R, Huang WY, Berndt SI, Katki HA, Schoen RE, Hayes RB, Cross AJ. Meat consumption and the risk of incident distal colon and rectal adenoma. Br J Cancer 2011; 106:608-16. [PMID: 22166801 PMCID: PMC3281548 DOI: 10.1038/bjc.2011.549] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Most studies of meat and colorectal adenoma have investigated prevalent events from a single screening, thus limiting our understanding of the role of meat and meat-related exposures in early colorectal carcinogenesis. Methods: Among participants in the screening arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial who underwent baseline and follow-up sigmoidoscopy (n=17 072), we identified 1008 individuals with incident distal colorectal adenoma. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) for associations between meat and meat-related components and incident distal colorectal adenoma using multivariate logistic regression. Results: We observed suggestive positive associations for red meat, processed meat, haeme iron, and nitrate/nitrite with distal colorectal adenoma. Grilled meat (OR=1.56, 95% CI=1.04–2.36), well or very well-done meat (OR=1.59, 95% CI=1.05–2.43), 2-amino-1-methyl-6-phenyl-imidazo[4,5-b]pyridine (PhIP) (OR=1.75, 95% CI=1.17–2.64), benzo[a]pyrene (OR=1.53, 95% CI=1.06–2.20), and total mutagenic activity (OR=1.57, 95% CI=1.03–2.40) were positively associated with rectal adenoma. Total iron (diet and supplements) (OR=0.69, 95% CI=0.56–0.86) and iron from supplements (OR=0.65, 95% CI=0.44–0.97) were inversely associated with any distal colorectal adenoma. Conclusion: Our findings indicate that several meat-related components may be most relevant to early neoplasia in the rectum. In contrast, total iron and iron from supplements were inversely associated with any distal colorectal adenoma.
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Affiliation(s)
- L M Ferrucci
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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Borrelli B, Hayes RB, Gregor K, Lee CS, McQuaid EL. Differences in smoking behavior and attitudes among Puerto Rican, Dominican, and non-Latino white caregivers of children with asthma. Am J Health Promot 2011; 25:S91-5. [PMID: 21510794 DOI: 10.4278/ajhp.100624-arb-214] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE No studies have examined the differences in smoking attitudes and behavior between Dominicans (DRs) and Puerto Ricans (PRs). Identification of pretreatment differences is important for cultural adaptation of evidenced-based smoking cessation treatments. DESIGN Secondary analysis. SETTING/INTERVENTION: Three home visits for asthma education and smoking cessation. SUBJECTS Caregivers who smoke and have a child with asthma: DRs (n = 30), PRs (n = 67), and non-Latino whites (n = 128; NLWs). MEASURES Baseline assessment of psychosocial variables. ANALYSES Controlled for age, education, and acculturation. RESULTS Compared with DRs, PRs were more acculturated, more nicotine dependent, less motivated and confident to quit, and identified more pros of smoking (all p < .05). Compared with NLWs, PRs were less likely to be employed, smoked fewer cigarettes per day, and had lower education, greater depressed mood, greater pros and cons of smoking, less social support, and higher child asthma morbidity (all p < .05). Compared with NLWs, DRs were less nicotine dependent, more confident to quit, and less likely to live with a smoker; reported greater cons of smoking and greater stress; and were more likely to have a household smoking ban (DRs 60% vs. NLWs 33.6%). Only 3.3% of DRs were precontemplators vs. 16.4% (PRs) and 10.9% (NLWs). CONCLUSIONS PRs appear to have more factors associated with risk of smoking treatment failure; DRs appear to have more protective factors. Examination of the role of these smoking attitudes as potential moderators and mediators of smoking behavior are needed to guide the cultural adaptation of evidenced-based treatments.
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Affiliation(s)
- Belinda Borrelli
- Centers for Behavioral and Preventive Medicine, Miriam Hospital, Brown Medical School, Providence, Rhode Island 02903, USA.
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Holahan CK, Holahan CJ, Powers DA, Hayes RB, Marti CN, Ockene JK. Depressive symptoms and smoking in middle-aged and older women. Nicotine Tob Res 2011; 13:722-31. [PMID: 21504881 DOI: 10.1093/ntr/ntr066] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smoking research and intervention efforts have neglected older women. Depressive symptoms, which are common in middle-aged and older women, are related to the maintenance of adult smoking. METHODS This study investigated the relation of a composite measure of current depressive symptoms, derived from a short form of the Center for Epidemiological Studies Depression Scale, and history of depressive symptoms, derived from two items from the Diagnostic Interview Schedule, to smoking outcomes in the Women's Health Initiative Observational Study (N = 90,627). Participants were postmenopausal with an average age of 63.6 years at baseline. Participants were recruited from urban, suburban, and rural areas surrounding 40 clinical centers in the United States. Analyses controlled for age, educational level, and ethnicity. RESULTS In multinomial logistic regression analyses, depressive symptoms were related cross-sectionally to current light (odds ratio [OR] = 1.19, 95% CI = 1.14-1.23) and heavier (OR = 1.28, 95% CI = 1.23-1.32) smoking at baseline compared with nonsmokers. In prospective multiple logistic regression analyses, baseline depressive symptoms were negatively predictive of smoking cessation at a 1-year follow-up (OR = .85, 95% CI = 0.77-0.93) and at participants' final assessments in the study (OR = .92, 95% CI = 0.85-0.98). Light smokers had more than 2 times higher odds of smoking cessation than did heavier smokers. CONCLUSIONS The present findings demonstrate a consistent link between depressive symptoms and negative smoking-related behaviors among middle-aged and older women at both light and heavier smoking levels.
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Affiliation(s)
- Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, 1 University Station, Austin, TX 78712, USA.
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Beckmann L, Hüsing A, Setiawan VW, Amiano P, Clavel-Chapelon F, Chanock SJ, Cox DG, Diver R, Dossus L, Feigelson HS, Haiman C, Hallmans G, Hayes RB, Henderson BE, Hoover RN, Hunter DJ, Khaw K, Kolonel LN, Kraft P, Lund E, Le Marchand L, Peeters PHM, Riboli E, Stram D, Thomas G, Thun MJ, Tumino R, Trichopoulos D, Vogel U, Willett WC, Yeager M, Ziegler R, Hankinson SE, Kaaks R. Comprehensive analysis of hormone and genetic variation in 36 genes related to steroid hormone metabolism in pre- and postmenopausal women from the breast and prostate cancer cohort consortium (BPC3). J Clin Endocrinol Metab 2011; 96:E360-7. [PMID: 21177793 PMCID: PMC3048330 DOI: 10.1210/jc.2010-0912] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Sex steroids play a central role in breast cancer development. OBJECTIVE This study aimed to relate polymorphic variants in 36 candidate genes in the sex steroid pathway to serum concentrations of sex steroid hormones and SHBG. DESIGN Data on 700 genetic polymorphisms were combined with existing hormone assays and data on breast cancer incidence, within the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Nurses' Health Study (NHS) cohorts; significant findings were reanalyzed in the Multiethnic Cohort (MEC). SETTING AND PARTICIPANTS We analyzed data from a pooled sample of 3852 pre- and postmenopausal Caucasian women from EPIC and NHS and 454 postmenopausal women from MEC. MAIN OUTCOME MEASURES Outcome measures were SHBG, testosterone, dehydroepiandrosterone (DHEAS), androstenedione, estrone (E1), and estradiol (E2) as well as breast cancer risk. RESULTS Globally significant associations were found among pre- and postmenopausal women combined between levels of SHBG and the SHBG gene and between DHEAS and the FSHR and AKR1C3 genes. Among postmenopausal women, serum E1 and E2 were significantly associated with the genes CYP19 and FSHR, and E1 was associated with ESR1. None of the variants related to serum hormone levels showed any significant association with breast cancer risk. CONCLUSIONS We confirmed associations between serum levels of SHBG and the SHBG gene and of E1 and E2 and the CYP19 and ESR1 genes. Novel associations were observed between FSHR and DHEAS, E1, and E2 and between AKR1C3 and DHEAS.
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Affiliation(s)
- L Beckmann
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany
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Lee CS, Hayes RB, McQuaid EL, Borrelli B. Predictors of retention in smoking cessation treatment among Latino smokers in the Northeast United States. Health Educ Res 2010; 25:687-697. [PMID: 20237106 DOI: 10.1093/her/cyq010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Only one previous study on minority retention in smoking cessation treatment has been conducted (Nevid JS, Javier RA, Moulton JL III. Factors predicting participant attrition in a community-based, culturally specific smoking cessation program for Hispanic smokers. Health Psychol 1996; 15: 226-29). We investigated predictors of intervention completion and assessment completion among Latino smokers (n = 131) with asthmatic children participating in a home-based asthma education study that included smoking cessation counseling. METHODS We examined a variety of pretreatment demographic and psychosocial predictors of intervention completion (completing all three home visits versus <3), assessment completion (attendance/not) and total study participation (completing all six contacts versus <6). RESULTS Lower levels of depressed mood (OR = 0.912, 95% CI: 0.857-0.971, P < 0.01) and fewer 'pros' of smoking (OR = 0.882, 95% CI: 0.809-0.961, P < 0.01) predicted intervention completion. Predictors of assessment completion included having more friends who smoke (OR = 2.09, 95% CI: 1.23-3.56, P < 0.01), fewer pros of smoking (OR = 0.87, 95% CI: 0.81-0.95, P < 0.01) and a strong belief that quitting smoking would benefit the child's asthma (OR = 1.69, 95% CI: 1.04-2.74, P < 0.05). Unemployed participants were more likely to complete all six study contacts than those who were working (OR = 0.37, 95% CI: 0.14-0.99, P < 0.05). DISCUSSION Findings suggest the need to tailor retention strategies during active treatment and follow-up assessments to target those who at risk of dropping out.
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Affiliation(s)
- Christina S Lee
- Center for Alcohol.ddiction Studies, Brown Medical School, 121 South Main Street, Providence, RI 02912, USA.
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Abstract
AIMS To examine the influence of risk perception on intentions to quit smoking and post-treatment abstinence. DESIGN Prospective and longitudinal. SETTING United States. PARTICIPANTS A total of 237 adult smokers (mean age 56 years) receiving medical care from home health-care nurses. Participants did not have to want to quit smoking to participate, but received cessation counseling within the context of their medical care. MEASUREMENTS Three measures of risk perception were given pre- and post-treatment: perceived vulnerability, optimistic bias and precaution effectiveness. Smoking status was verified biochemically at end of treatment and at 2, 6 and 12 months later. FINDINGS Principal components analysis supported the theoretical discriminability of the risk perception measures, and intercorrelations provided evidence for concurrent and predictive validity. Elevated risk perception was associated with a variety of socio-demographic and psychosocial characteristics. Optimistic bias was associated significantly with older age and ethnic minority status. Smokers in pre-contemplation had lower perceived vulnerability and precaution effectiveness and greater optimistic bias than those in contemplation and preparation. Smokers in preparation had higher perceived vulnerability and lower optimistic bias than those in earlier stages. Change in perceived vulnerability predicted smoking cessation at follow-up. Optimistic bias predicted a lower likelihood of cessation and precaution effectiveness predicted a greater likelihood of smoking cessation, but only among those with a smoking-related illness. CONCLUSIONS In patients receiving medical care from home health-care nurses, change in perceived vulnerability to smoking-related disease is predictive of smoking cessation. In those with smoking-related illnesses, optimistic bias predicts continued smoking while precaution effectiveness predicts cessation.
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Affiliation(s)
- Belinda Borrelli
- Centers for Behavioral and Preventive Medicine, Warren Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI 02903, USA.
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Jenkins FJ, Hayes RB, Jackson A, Pizza G, Mbisa G, Whitby D, Goedert JJ. Human Herpesvirus 8 Seroprevalence among Prostate Cancer Case Patients and Control Subjects. J Infect Dis 2007; 196:208-11. [PMID: 17570107 DOI: 10.1086/518790] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Accepted: 01/29/2007] [Indexed: 11/03/2022] Open
Abstract
To investigate a possible association between human herpesvirus 8 (HHV-8) and prostate cancer, we evaluated HHV-8 seroprevalence in 2 case-control studies. HHV-8 antibodies were detected by immunofluorescence with cells expressing lytic viral proteins and by enzyme immunoassays with recombinant viral structural protein (K8.1) and latent protein (latency-associated nuclear antigen-1; open reading frame 73), respectively. HHV-8 seroprevalence tended to be lower in patients with prostate cancer than in control subjects, but there was no significant difference in either study. These data imply that HHV-8 is not a major prevalent cause of prostate cancer.
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Affiliation(s)
- F J Jenkins
- Department of Pathology, University of Pittsburgh Cancer Institute, Pittsburgh, PA 15213, USA.
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Pinsky PF, Miller A, Kramer BS, Church T, Reding D, Prorok P, Gelmann E, Schoen RE, Buys S, Hayes RB, Berg CD. Evidence of a healthy volunteer effect in the prostate, lung, colorectal, and ovarian cancer screening trial. Am J Epidemiol 2007; 165:874-81. [PMID: 17244633 DOI: 10.1093/aje/kwk075] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Volunteers for prevention or screening trials are generally healthier and have lower mortality than the general population. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) is an ongoing, multicenter, randomized trial that randomized 155,000 men and women aged 55-74 years to a screening or control arm between 1993 and 2001. The authors compared demographics, mortality rates, and cancer incidence and survival rates of PLCO subjects during the early phase of the trial with those of the US population. Incidence and mortality from PLCO cancers (prostate, lung, colorectal, and ovarian) were excluded because they are the subject of the ongoing trial. Standardized mortality ratios for all-cause mortality were 46 for men, 38 for women, and 43 overall (100 = standard). Cause-specific standardized mortality ratios were 56 for cancer, 37 for cardiovascular disease, and 34 for both respiratory and digestive diseases. Standardized mortality ratios for all-cause mortality increased with time on study from 31 at year 1 to 48 at year 7. Adjusting the PLCO population to a standardized demographic distribution would increase the standardized mortality ratio only modestly to 54 for women and 55 for men. Standardized incidence ratios for all cancer were 84 in women and 73 in men, with a large range of standardized incidence ratios observed for specific cancers.
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Affiliation(s)
- P F Pinsky
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Purdue MP, Mink PJ, Hartge P, Huang WY, Weissfeld J, Buys S, Hayes RB. 038: Hormone Replacement Therapy and Colorectal Adenoma: Data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s10a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M P Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - P J Mink
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - P Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - W-Y Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - J Weissfeld
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - S Buys
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
| | - R B Hayes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892
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Daugherty SE, Platz EA, Fallin MD, Welch R, Reding D, Huang WY, Chatterjee N, Hayes RB. L3: Alpha-Methylacyl-Coa Racemase (AMACR) Variants and Prostate Cancer in PLCO. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s150c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - E A Platz
- Division of Cancer Epidemiology and Genetics, NCI
| | - M D Fallin
- Division of Cancer Epidemiology and Genetics, NCI
| | - R Welch
- Division of Cancer Epidemiology and Genetics, NCI
| | - D Reding
- Division of Cancer Epidemiology and Genetics, NCI
| | - W-Y Huang
- Division of Cancer Epidemiology and Genetics, NCI
| | - N Chatterjee
- Division of Cancer Epidemiology and Genetics, NCI
| | - R B Hayes
- Division of Cancer Epidemiology and Genetics, NCI
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Kenner GH, Brik AB, Liu G, Haskell EH, Hayes RB, Knight JA, Vajda EG, Miller SC, Jee WSS, Barrus JK. Variation of long-lived free radicals responsible for the EPR native signal in bone of aged or diseased human females and ovariectomized adult rats. RADIAT MEAS 2005; 39:255-62. [PMID: 15884170 DOI: 10.1016/j.radmeas.2004.01.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to gain insights into the variations seen in the electron paramagnetic resonance (EPR) spectroscopy of the native signals of teeth and bones used for retrospective dosimetry measurements. We determined that changes occur in the long-lived free radicals responsible for the native signal of cortical bone in aging or diseased human females and aged ovariectomized rats. This was done by measuring the magnitude of the broad (BC) and narrow (NC) components of the native EPR signal of bone following chemical extraction, aging, crushing and thermal annealing. Bone from the upper midshaft of femora of young (17-34 years old, n=5) and elderly (70-92 years old, n=18) females was examined. The results showed that the elderly women had significantly higher BC than the younger women (P<0.01). A similar interpretation was made of the data from an aging female rat osteoporosis model. The results for the NC signals were similar. Finally, dramatic decreases in both NC and BC signals were seen in HIV positive and uncontrolled diabetic (one each) patients indicating the need for studying this signal for a broad spectrum of metabolic disorders. Experiments were performed which strongly indicate that iron liganded with organic molecules is the source of the BC signal. Finally, the accuracy achieved in this study indicates that resolving the dosimetric signal (g=2.0018) should be improved by subtraction of the deconvoluted NC and BC signals from the original spectrum.
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Affiliation(s)
- G H Kenner
- Division of Radiobiology, School of Medicine, University of Utah, Salt Lake City, UT 84112, USA.
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Ronckers CM, Verduijn PG, Land CE, Hayes RB, Stovall M, van Leeuwen FE. [No convincing evidence for a causal relationship between childhood nasopharyngeal radium irradiation and head-neck tumors or hormone-related disorders later in life; a retrospective cohort study]. Ned Tijdschr Geneeskd 2004; 148:1775-80. [PMID: 15931724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To study the risk of malignant and benign tumours and hormone-related disorders among patients treated with nasopharyngeal radium irradiation for hypertrophic adenoid or hearing loss caused by otitis media serosa. DESIGN Retrospective cohort study. METHOD The medical record registries of 9 hospitals were used to identify a radium-exposed group (n = 5358) and a control group of unexposed patients (n = 5265), who were treated by an otolaryngologist in the period 1945-1981. The vital status of the subjects was determined using municipal resident registries, and the cause of death of decedents was retrieved from Statistics Netherlands (1950-1997). The data was also coupled with the Netherlands Cancer Registry (1989-1996). For the subjects still alive in 1997, the prevalence of relevant disorders was determined using a self-administered questionnaire and disorders reported by the participants were medically verified. The risk of disease in the radium group was then compared with that of the control group. RESULTS The average radiation doses were 2.75, 0.109 and 0.015 Gy for nasopharynx, pituitary, and thyroid, respectively. There was no statistically significantly elevated risk for malignancies of the head and neck area (radium-exposed group; n = 14; control group: n = 11 (relative risk (RR): 1.2; 95% CI: 0.6-2.8)). Four of the five thyroid carcinomas were found in the radium-exposed group (RR: 3.8; 0.5-76). Elevated risks were observed for breast cancer (RR: 1.6; 0.9-2.7) and non-Hodgkin's lymphoma (RR: 2.7; 1.0-8.7). There was an increased risk for skin basal cell carcinoma (BCC) of the head and neck (odds ratio (OR): 2.6; 1.0-6.7), but the risk of BCC of other body parts was lower (OR: 0.3; 0.1-1.3). There were no major differences between radium and control subjects with respect to benign head and neck tumours (OR: 1.0; 0.5-1.7) or hormonal disorders. Exposed men reported slightly more fertility disorders than men in the control group (OR: 1.4; 1.0-2.1), but there was no clear dose-response relationship. CONCLUSION After a mean follow-up of 31 years, there was no strong evidence for an elevated risk of head and neck tumours or hormone-related disorders in adulthood among subjects who had been treated with nasopharyngeal radium irradiation during childhood.
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Abstract
OBJECTIVE To identify risk factors for benign prostatic hyperplasia (BPH). SUBJECTS AND METHODS Medical history data, including reported urological conditions and treatments, and risk factor data were collected from 34 694 participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a randomized controlled trial designed to evaluate methods for the early detection of cancer. RESULTS Asian men had the lowest risks (odds ratio, 95% confidence interval) for nocturia (0.7, 0.5-0.9), physician-diagnosed BPH (0.3, 0.2-0.5) and transurethral prostatectomy (TURP, 0.2, 0.1-0.6), while risks for Whites and Blacks were similar for most measures of BPH. Greater alcohol intake was associated with decreased nocturia (P trend = 0.002), BPH (P trend < 0.001) and TURP (P trend < 0.001). Current tobacco use was associated with decreased nocturia (0.8, 0.7-0.9), BPH (0.7, 0.6-0.8) and TURP (0.6, 0.4-0.8) but dose-response patterns were weak. CONCLUSION Asian-Americans have the lowest risk of clinical BPH. Alcohol and possibly cigarettes are related to a lower risk for BPH.
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Affiliation(s)
- D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
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Vogt TM, Mayne ST, Graubard BI, Swanson CA, Sowell AL, Schoenberg JB, Swanson GM, Greenberg RS, Hoover RN, Hayes RB, Ziegler RG. Serum lycopene, other serum carotenoids, and risk of prostate cancer in US Blacks and Whites. Am J Epidemiol 2002; 155:1023-32. [PMID: 12034581 DOI: 10.1093/aje/155.11.1023] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Epidemiologic studies investigating the relation between individual carotenoids and risk of prostate cancer have produced inconsistent results. To further explore these associations and to search for reasons prostate cancer incidence is over 50% higher in US Blacks than Whites, the authors analyzed the serum levels of individual carotenoids in 209 cases and 228 controls in a US multicenter, population-based case-control study (1986-1989) that included comparable numbers of Black men and White men aged 40-79 years. Lycopene was inversely associated with prostate cancer risk (comparing highest with lowest quartiles, odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.36, 1.15; test for trend, p = 0.09), particularly for aggressive disease (comparing extreme quartiles, OR = 0.37, 95% CI: 0.15, 0.94; test for trend, p = 0.04). Other carotenoids were positively associated with risk. For all carotenoids, patterns were similar for Blacks and Whites. However, in both the controls and the Third National Health and Nutrition Examination Survey, serum lycopene concentrations were significantly lower in Blacks than in Whites, raising the possibility that differences in lycopene exposure may contribute to the racial disparity in incidence. In conclusion, the results, though not statistically significant, suggest that serum lycopene is inversely related to prostate cancer risk in US Blacks and Whites.
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Affiliation(s)
- T M Vogt
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT, USA.
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Affiliation(s)
- L K Dennis
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
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Affiliation(s)
- R B Hayes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
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Abstract
BACKGROUND Use of alcohol and tobacco are the major risk factors for cancers of the oral cavity and pharynx in most of the world. A heritable component to oral carcinoma risk also has been suggested, although only limited data are available on familial aggregation of this disease. METHODS A population-based case-control study of 342 subjects with carcinomas of the oral cavity and pharynx (oral carcinoma) and 521 controls was conducted in Puerto Rico. The relation between family history of carcinomas of the oral cavity, the upper aerodigestive tract (UADT), and other selected sites with risk of oral carcinoma was explored using logistic regression modeling techniques. RESULTS Risk of oral carcinoma was elevated for subjects reporting a first-degree relative with carcinoma of the oral cavity (odds ratio [OR], 2.5; 95% confidence interval [CI], 0.8-8.0) or any UADT carcinoma (OR, 2.6; 95% CI, 1.4-4.8). The increased risk associated with family history of UADT carcinoma tended to be greatest for subjects with known risk factors (i.e., heavy consumption of alcohol and/or tobacco and infrequent intake of raw fruits and vegetables) and with oral carcinoma diagnoses at ages younger than 65 years. CONCLUSIONS These findings are consistent with a heritable component to oral carcinoma, although shared lifestyle risk factors may be partially involved.
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Affiliation(s)
- L M Brown
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-7244, USA.
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