Adverse Health Consequences Of Smoking Research Articles

Emotional salience of the image component facilitates recall of the text of cigarette warning labels.

Graphic warning labels (GWLs) on cigarette packages, that combine textual warnings with emotionally salient images depicting the adverse health consequences of smoking, have been adopted in most European countries. In the US, the courts deemed the evidence justifying the inclusion of emotionally salient images in GWLs insufficient and put the implementation on hold. We conducted a controlled experimental study examining the effect of emotional salience of GWL's images on the recall of their text component. Seventy-three non-treatment-seeking daily smokers received cigarette packs carrying GWLs for a period of 4 weeks. Participants were randomly assigned to receive packs with GWLs previously rated as eliciting high or low level of emotional reaction (ER). The two conditions differed in respect to images but used the same textual warning statements. Participants' recognition of GWL images and statements were tested separately at baseline and again after the 4-week repetitive exposure. Textual warning statements were recognized more accurately when paired with high ER images than when paired with low ER images, both at baseline and after daily exposure to GWLs over a 4-week period. The results suggest that emotional salience of GWLs facilitates cognitive processing of the textual warnings, resulting in better remembering of the information about the health hazards of smoking. Thus, high emotional salience of the pictorial component of GWLs is essential for their overall effectiveness.

Social Determinants of Health and Tobacco Use in Five Low - and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012

Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

Electronic cigarette marketers manipulate antitobacco advertisements to promote vaping

A device commonly used by public health advocates is the alteration of cigarette advertisements to convey an antismoking message.1 ,2 Well-known examples include ‘Joe Chemo’ for Joe Camel and ‘Fool’...

Nicotine content and abstinence state have different effects on subjective ratings of positive versus negative reinforcement from smoking

Despite the well-known adverse health consequences of smoking, approximately 20% of US adults smoke tobacco cigarettes. Much of the research on smoking reinforcement and the maintenance of tobacco smoking behavior has focused on nicotine; however, a number of other non-nicotine factors are likely to influence the reinforcing effects of smoked tobacco. A growing number of studies suggest that non-nicotine factors, through many pairings with nicotine, are partially responsible for the reinforcing effect of smoking. Additionally, both clinical studies and preclinical advances in our understanding of nicotinic receptor regulation suggest that abstinence from smoking may influence smoking reinforcement. These experiments were conducted for 2 reasons: to validate a MRI-compatible cigarette smoking device; and to simultaneously investigate the impact of nicotine, smoking-associated conditioned reinforcers, and smoking abstinence state on subjective ratings of smoking reinforcement. Participants smoked nicotine and placebo cigarettes through an fMRI compatible device in an overnight-abstinent state or in a nonabstinent state, after having smoked a cigarette 25minutes prior. Outcome measures were within-subject changes in physiology and subjective ratings of craving and drug effect during the smoking of nicotine or placebo cigarettes on different days in both abstinence states. Cigarette type (nicotine vs. placebo) had a significant effect on positive subjective ratings of smoking reinforcement (“High”, “Like Drug”, “Feel Drug”; nicotine>placebo). In contrast, abstinence state was found to have significant effects on both positive and negative ratings of smoking reinforcement (“Crave”, “Anxiety”, “Irritability”; abstinence>nonabstinence). Interaction effects between abstinence and nicotine provide clues about the importance of neuroadaptive mechanisms operating in dependence, as well as the impact of conditioned reinforcement on subjective ratings of smoking-induced high.

Individual- and area-level unemployment influence smoking cessation among African Americans participating in a randomized clinical trial

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative impact on smoking cessation among African Americans. Addressing unemployment through public policy and within smoking cessation interventions, and providing smoking cessation treatment for the unemployed may have a beneficial impact on tobacco-related health disparities.

Determinants of heavy smoking: Results from the global adult tobacco survey in Poland (2009–2010)

The aim of current analysis was to identify socio-demographic correlates of heavy smoking. Global Adult Tobacco Survey (GATS), a nationally representative household study was implemented in Poland between 2009 and 2010. We used data on representative sample of 1915 adults, age 25 years and older. The Odds Ratios (OR) and 95% Confidence Intervals (CI) for heavy smoking to the broad number of variables including age, age at smoking onset, education, occupational classification, living conditions, place of residence, place of residence at age about 14 years, awareness of smoking health consequences were tested in logistic regression model. Among daily smokers the rate of heavy smokers was 63% in males and 45% in females (p < 0.001). The present study indicated that three characteristics: age, early age at smoking onset and lack of awareness of smoking health consequences were significantly associated with heavy smoking among both genders. Significantly higher risk of heavy smoking was observed among the 50-59 years of age population compared to the youngest group. The heavy smoking rate was highest among males who started smoking under age 14 years (OR = 3.1; 95% CI: 1.4-6.7; p < 0.001) and females that started smoking at age 14-17 years (OR = 2.3; 95% CI: 1.5-3.5; p < 0.0001) compared to those who started smoking at age 21 years or older. Heavy smoking was significantly correlated to lack of awareness of adverse health consequences of smoking (OR = 1.5; 95% CI: 1.1-2.03; p < 0.01 and OR = 1.5; 95% CI: 1.0-2.2; p < 0.01 for men and women, respectively) compared to aware respondents. These outcomes should be taken into account while developing tobacco control measures. Among other things, educational interventions to increase knowledge of adverse tobacco health effects should be widely implemented.

Prisoners' attitudes towards cigarette smoking and smoking cessation: a questionnaire study in Poland

BackgroundIn the last decade Poland has successfully carried out effective anti-tobacco campaigns and introduced tobacco control legislation. This comprehensive strategy has focused on the general population and has led to a considerable decrease in tobacco consumption. Prisoners constitute a relatively small part of the entire Polish population and smoking habits in this group have been given little attention. The aim of the study was to assess the prevalence of cigarette smoking in Polish male prisoners, factors determining smoking in this group, prisoners' attitudes towards smoking cessation, and to evaluate prisoners' perception of different anti-tobacco measures.MethodsAn anonymous questionnaire including personal, demographic and smoking data was distributed among 944 male inmates. Of these, 907 men aged between 17 and 62 years (mean 32.3 years) met the inclusion criteria of the study. For the comparison of proportions, a chi-square test was used with continuity correction whenever appropriate.ResultsIn the entire group, 81% of the subjects were smokers, 12% – ex-smokers, and 7% – never smokers. Current smokers had significantly lower education level than non-smokers (p < 0.0001) and ever-smokers more frequently abused other psychoactive substances than never smokers (p < 0.0001). Stress was reported as an important factor in prompting smoking (77%). Forty-nine percent of daily smokers were aware of the adverse health consequences of smoking. The majority of smokers (75%) had attempted to quit smoking in the past. Forty percent of smoking prisoners considered an award for abstaining from cigarettes as the best means to limit the prevalence of smoking in prisons.ConclusionThe prevalence of cigarette smoking among Polish prisoners is high. However, a majority of smokers attempt to quit, and they should be encouraged and supported. Efforts to reduce cigarette smoking in prisons need to take into consideration the specific factors influencing smoking habits in prisons.

An E-Mail Assessment of Undergraduates' Attitudes Toward Smoking

Responses from 513 of 1,000 randomly selected undergraduate students who were sent an e-mail questionnaire, about cigarette smoking were analyzed. Thirteen percent of the respondents identified themselves as smokers. No statistically significant differences were observed between smokers and non-smokers and year in college, sex, age, race, or having attended public or private high schools. Ninety-eight percent of the respondents considered themselves knowledgeable about adverse health consequences of smoking, yet 39.1% of current smokers seriously considered stopping smoking, and 11.5% of current nonsmokers intended to start smoking. The preferred quitting method of smokers and ex-smokers was stopping all at once (“cold turkey”). Fifty-two percent of the smokers did not want professional assistance to stop smoking; 40% of the nonsmokers wanted information on second-hand smoke.

Influence of smoking fewer cigarettes on exposure to tar, nicotine, and carbon monoxide.

In the hope of reducing the adverse health consequences of smoking, physicians frequently advise their patients who cannot quit to smoke fewer cigarettes. Habitual smokers may compensate for the reduced number of cigarettes, however, by taking in more smoke per cigarette. We measured the intake of tar (estimated as mutagenic activity of the urine), nicotine, and carbon monoxide during short-term cigarette restriction. With a reduction from an average of 37 cigarettes to an average of 5 cigarettes per day, the intake of tobacco toxins per cigarette increased roughly threefold and daily exposure to tar and carbon monoxide declined only 50 percent. We conclude that smoking fewer cigarettes may reduce exposure to toxins and related adverse health consequences. However, consistent with a tendency to maintain intake of nicotine, the magnitude of the benefit is much less than expected. Whether "oversmoking" persists during long-term restriction of cigarettes requires further investigation.

Smoking among medical students.

A survey of smoking habits of medical students was done using basic medical science graduate students at the same institution as a comparison group. Smoking status was not significantly related to sex, race, or academic classification. Knowledge of adverse health consequences of smoking was related to time spent in medical school and to whether or not the respondent smoked (ie. probable denial of knowledge of the adverse consequences among smokers). The respondent's smoking status was significantly related to familial and peer group smoking status and to peer group attitude. The most common reason given by quitters was "the media influence." The nonsmoker most frequently never began the habit because of fear of health consequences. Because of the finding that a small percentage of medical students still are not convinced of the dangers of smoking, it was suggested that increased educational emphasis on these dangers be included in the medical curriculum.