Health Effects Of Tobacco Use Research Articles

Perceived Effectiveness of Pictorial Health Warning Labels of Tobacco Products and Associated Factors among Smokers and Quitters in Kaski District, Nepal

Introduction: Globally, tobacco kills more than seven million people per year. In Nepal, more than fifty different types of tobacco products, both in smoke and smokeless forms, are available. Pictorial health warning labels (PHWLs) on tobacco products provide an effective way to aware both literates and illiterates about the health effects of tobacco use. This study aimed to assess the perceived effectiveness of pictorial health warning labels of tobacco products and associated factors among smokers and quitters.
 Methods: The study design was community-based cross-sectional analytical with the quantitative method. We interviewed 389 adults (111 Quitters and 278 Smokers) of Kaski district. The sample was taken from both rural and urban areas based on existing household proportion. Ethical approval was taken from NHRC. We entered data in EpiData and analyzed in SPSS softwares. The perceived effectiveness scores of PHWLs were calculated (alpha ranges from 0.91 to 0.96) and compared among different groups using the Wilcoxon rank-sum test and Kruskal-Wallis test with the Dunn’s multiple comparisons. The perceived effectiveness score of PHWLs were correlated with discrete covariates using Spearman rank correlation.
 Results: Nearly one-third of the participants (32.7%) had bought a single piece of tobacco product, which is not allowed in Nepal. Nearly sixteen percentage of the participants were moderate to high level of nicotine dependent. Only twelve percent of participants wanted to quit or already quitted as s/he saw the PHWLs. Scores of Premature birth was statistically significant (p=0.031) on smoking status. Martial status, ethnicity, any family member use tobacco, age at first exposure psychological response, behavioral response and message credibility were statistically significant for the perceived effectiveness of PHWLs among smokers. Whereas place of resident, education status, age, psychological response, behavioral response, self efficacy and message credibility were statistically significant at p<0.05 for the perceived effectiveness of PHWLs among quitters.
 Conclusions: This study concluded that premature type of PHWL was more effective than other type of PHWLs. The interventional program along with social and behavior change communication should be focused on the psychological, behavioral related and geographical setting. Further research is suggested to carryout the interventional study addressing behavioral and psychological factors.

P109. Tobacco use is associated with worse patient-reported outcomes following elective cervical spine surgery

BACKGROUND CONTEXT Tobacco use has been shown to be a major modifiable risk factor for the development of postoperative complications in elective orthopedic surgeries. Numerous studies have described the adverse health effects of tobacco use and the associations between tobacco use and poor surgical outcomes, as well as increased post-operative health care utilization. PURPOSE The purpose of this study was to investigate the effect of preoperative tobacco use on (1) pre- and postoperative patient-reported outcomes, (2) complications, and (3) pre- and postoperative opioid consumption in patients undergoing elective cervical spine surgery. STUDY DESIGN/SETTING Retrospective chart review. PATIENT SAMPLE A total of 179 consecutive patients who underwent elective cervical spine surgery at a single academic institution from 2014-2016 with 2-year follow up data. OUTCOME MEASURES Perioperative variables, pre- and postoperative, opiod consumption, Neck Disabiity Index (NDI) score, VAS (visual analog scale) pain scores and Distressed Communities Index (DCI) METHODS Patient tobacco use, baseline characteristics, medical comorbidities, operative variables, and surgical complications (superficial and deep infection, wound complication, emergency department [ED] visits, readmissions, and repeat operations) were recorded. Additionally, preoperative ED visits, pre- and postoperative opioid use, total postoperative opioid prescription quantities, and most recent date of opioid prescription were collected. Quantitative measurements of pain (VAS) and disease specific disability score (NDI) were recorded preoperatively and 3 months after surgery. In addition, the Economic Innovation Group's 2017 Distressed Communities Index (DCI) was recorded for each patient's home zip code. DCI Scores are based on percentages of adults without a high school education, percentage living under the poverty line, unemployment rates, and the overall housing and business climate in a given area. DCI Scores range from 0 to 100, with higher scores indicative of greater economic distress, and DCI Scores ≥80 are considered to be highly distressed regions. Continuous variables were compared between patients that did vs did not use tobacco using two-tailed independent t-test, and categorical variables were compared using chi-square or Fisher Exact tests. RESULTS Of the 179 patients involved in this study, 98 (54.7%) were current tobacco users. Compared to non-users, current tobacco users were more likely to have COPD (p=0.001), illicit drug abuse (p=0.002), and worse distressed community index scores (p=0.02). Tobacco users had less pain relief than non-smokers at 3 months postoperatively (4.9±2.7 vs. 2.7±2.3, respectively), as they experienced significantly less improvement in VAS pain score (p 0.05). There were no other between-group differences. CONCLUSIONS Tobacco users undergoing elective cervical spine surgery may experience significantly worse pain during the early postoperative period compared to non-smokers. Tobacco use may represent a modifiable risk factor for persistent pain in this population. Surgeons should counsel patients about reducing tobacco use before cervical spine surgery, and socioeconomic status should be considered when developing patient education materials and smoking cessation programs for this at risk subset. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Head and Neck Squamous Cell Carcinoma in Young Adults: A Hospital‑Based Study

Abstract Background: Head and neck cancers (HNCs) account for 30% of all cancers in India. In north eastern India, tobacco-related cancers are very common because of the widespread use of tobacco. The paucity of any study from this region in young head and neck patients has prompted us to take up this study. Methodology: A retrospective study was conducted at Dr. B Borooah Cancer Institute, Guwahati during January 2015–December 2015. Data regarding tumor site, age, sex, education, habit of tobacco (smokeless and smoke), and betel nut consumption were analyzed using IBM SPSS version 19. P < 0.05 was considered as statistically significant. Results: About 75.1% patients were males. Among patients ≤39 years, 83.7% were tobacco chewers, 50.5% were smokers, and 83.7% betel nut chewers, and among >39 years, these proportions were 83.7%, 56.2%, and 78.7%, respectively. The most common site among ≤39 years and >39 were mouth (40.8%) and hypopharynx (36.8%). Among tobacco and betel nut chewers and smokers, the most common sites were mouth (40.3%, 42.5%) and hypopharynx (41.5%). The site of head and neck squamous cell carcinoma was highly associated with chewing and smoking habit (P < 0.05). Among illiterate patients, proportions of tobacco and betel nut chewers and smokers were 65.3%, 61.6%, and 67.9%, respectively. Conclusion: A positive association between tobacco use, male gender, and low education levels were found. The younger generation should be made aware about the adverse health consequences of tobacco use to reduce the preventable risk factors of HNC.

Dental Care Utilization among Veterans by Smoking Status.

Background Given the critical importance of dental care utilization among veterans and the overall health consequences of tobacco use in all populations, the purpose of this research is to examine smoking as a risk factor for poor dental care utilization among United States Veterans. Methods A secondary data analysis of cross-sectional data from the National Survey of Veterans was conducted. The primary outcome was dental care utilization (Yes, No). Frequency, chi-square analyses, and multivariate logistic regression statistical tests were performed while adjusting for confounding factors. Results There were 6,308 veterans in the study. Veterans who were current smokers were less likely to have dental care utilization within the previous six months than former smokers or never smokers. In unadjusted logistic regression analysis, current smokers had an odds ratio of 2.83 [95% CI: 2.36, 3.40] as compared with never smokers. The adjusted odds ratio for current smoking on dental care utilization was 1.71 [95% CI: 1.40, 2.09] as compared with never smoking. Conclusions Since veterans who smoked are less likely to have dental care utilization within the previous six months, they are at higher risk for later diagnosis of dental problems. Veterans who smoke should be specifically targeted with interventions to ensure frequent dental visits, so future problems may be averted or managed early in their development.

Prevalence and determinants of hookah use among college-going women of Delhi.

As governments across the world implement tobacco-control measures, the tobacco industry responds by coming up with new products such as hookah, which are more appealing and affordable for young people-especially women-their primary target group. We assessed the prevalence and determinants of tobacco use among undergraduate women students of the University of Delhi with special emphasis on hookah use. Using an anonymous self-administered questionnaire, we conducted a survey among the undergraduate women students of four colleges of the University of Delhi during March 2016. The tool was adapted from standard global surveys and had specific sections on tobacco use and patterns-use of shisha (hookah), smokeless tobacco as well as cessation and exposure to media and awareness about the harmful health effects of tobacco use. Point estimates along with 95% confidence intervals were estimated. Multivariate logistic regression was done to identify the determinants of current tobacco use and hookah use. Of the 780 respondents (mean [SD] age 19.3 [1.08] years), 22.9% (20.1-26.0) used tobacco in any form, with hookah being the most prevalent form (20.3%). One-third of the respondents believed that hookah smoking was less harmful than cigarette smoking. The major determinants of hookah use were-attending a private school (1.84; 1.11-3.01) or all-women college (2.79; 1.80-4.33); tobacco use by friends (2.47; 1.61-3.77); belief that smoking is a sign of women empowerment (2.09; 1.05-4.1 7) and the belief that hookah smoking is less harmful than cigarette smoking (2.81; 1.92-4.13). High prevalence of hookah use among young girls and women calls for a comprehensive approach including legislative options as well as increasing awareness about tobacco-cessation programmes among them.

Nursing Education to Reduce Use of Tobacco and Alternative Tobacco Products: Change Is Imperative

Tobacco use continues to be the leading cause of preventable death worldwide. To assess perceived tobacco educational preparation of undergraduate and graduate nurses in a large urban university. A cross-sectional web-based survey of all nursing students in an urban college of nursing was conducted to assess perceived tobacco educational content, skills, and self-efficacy for cessation counseling with patients who smoke cigarettes and use alternative tobacco products (e.g., hookah and e-cigarettes). Participants reported the most education about health effects of tobacco use (67%), and less than 6% reported education about alternative tobacco products. While the majority of nurses agreed that advising patients to quit is a priority, less than 40% reported receiving sufficient training in cessation counseling. There continues to be a compelling need articulated by leaders in tobacco policy and research over the past decade for a more vigorous response by nurses to the tobacco epidemic.

Media exposure and tobacco product addiction beliefs: Findings from the 2015 Health Information National Trends Survey (HINTS–FDA 2015)

BackgroundAddiction beliefs about tobacco use are associated with intentions to use and use of tobacco products. Exposure to information about tobacco products in media sources may affect addiction beliefs. PurposeTo examine the relationship between media exposure and tobacco product addiction beliefs. MethodsA nationally representative sample of US adults (n=3738) from the 2015 National Cancer Institute's Health Information National Trends Survey was used to examine addiction beliefs about cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah/waterpipe tobacco, and roll-your-own cigarettes. We used logistic regression to examine the relationship between media exposure and addiction beliefs. We defined media exposure by hours exposed, as well as exposure to tobacco use health effects information through media sources including social media. We categorized media sources by whether respondents actively or passively engaged with the source. FindingsA majority (60.6% to 87.3%) of respondents believed that cigarettes, cigars, roll-your-own cigarettes and smokeless tobacco are addictive. Less than half of respondents believed that electronic cigarettes or hookah/waterpipes are addictive (45.2% and 49.8%, respectively). Respondents exposed to messages about tobacco use health effects on active media channels (e.g., social media) had greater odds of believing that smokeless tobacco (adjusted odds ratio [AOR]=1.48), hookah/waterpipe (AOR=1.69), and roll-your-own cigarettes (AOR=1.61) are addictive. Respondents exposed to tobacco use health effects messages on passive media channels (e.g., television), had greater odds of believing that cigarettes (AOR=2.76) and electronic cigarettes (AOR=2.12) are addictive. ConclusionsUS adult exposure to information about the health effects of tobacco use was associated with addiction beliefs about tobacco products.

Potential Effectiveness of Pictorial Warning Labels That Feature the Images and Personal Details of Real People.

Pictorial warning labels (PWL) that use photographs and the personal details of real people whose health has been affected by smoking (testimonial PWL) provide factual information about the consequences of tobacco use. Nine hundred and twenty-four adult current smokers participated in an online experiment that tested responses to four types of warning labels: (1) non-testimonial text warning labels (currently on packs in the United States); (2) non-testimonial PWL (previously proposed by the United States Food and Drug Administration); (3) image only testimonial PWL (created for study); (4) image + personal details testimonial PWL (created for study). Participants were randomly assigned to condition and then exposed to up to five warning labels addressing different health effects. Differences between conditions were assessed using emotional responses and a set of intention measures immediately following exposure, and self-reported behavior change at 5-week follow-up. Compared to the non-testimonial text warning labels, all PWL elicited stronger emotional responses and intentions to forgo cigarettes and avoid the warning labels. Non-testimonial PWL and image + personal details testimonial PWL elicited stronger intentions to quit, whereas image only testimonial PWL generated a greater amount of quitting activity in the weeks following exposure. There were no significant differences in responses when comparing the non-testimonial PWL with both types of testimonial PWL. PWL that use images of real people convey factual information about the health effects of tobacco use. These testimonial PWL may be a promising alternative to the images previously proposed for use on PWL in the United States. In the United States, the PWL developed by the Food and Drug Administration (FDA) in 2011 were found by the courts to be unconstitutional, in part because they were deemed to present an opinion rather than fact. Findings from this experimental study indicate that PWL that use the images and personal details of real people to convey factual information about the health effects of tobacco use may satisfy the FDA's requirement for a set of PWL that (1) have the potential to positively impact the determinants of smoking cessation behavior, (2) meet legislative requirements under the Family Smoking Prevention and Tobacco Control Act and (3) may be more acceptable to the courts than the previously proposed and now dismissed PWL that carried non-factual images.

Tobacco use is associated with increased rates of infection and revision surgery after primary superior labrum anterior and posterior repair

Although the general health consequences of tobacco use have been well defined, the effects of perioperative tobacco use on arthroscopic shoulder procedures remain largely unknown. The purpose of this study is to use a national database to investigate the relationship between tobacco use and rates of superior labrum anterior and posterior (SLAP) repair failure and postoperative infection after primary SLAP repair compared with matched controls. A national private-payer insurance database was queried for patients who underwent arthroscopic primary SLAP from 2005-2012. These patients were divided into tobacco use and non-tobacco use cohorts using International Classification of Diseases, Ninth Revision coding. The non-tobacco use patients were then matched to the patients with coded tobacco use. Both cohorts were assessed for postoperative infection within 90 days and subsequent ipsilateral revision SLAP repair or biceps tenodesis within up to 7 years postoperatively. The incidences of revision SLAP repair or revision to a biceps tenodesis (P = .023) and postoperative infection (P = .034) were significantly higher in patients who used tobacco versus matched controls. SLAP repair in patients who use tobacco is associated with significantly increased rates of postoperative infection and revision SLAP repair or conversion to a biceps tenodesis.

Application of the PEN-3 Model to Tobacco Initiation, Use, and Cessation Among American Indian and Alaska Native Adults.

American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and its sequelae. As part of a formative research project investigating stakeholder understandings, preferences, and needs surrounding the use of pharmacogenetics toward tobacco cessation treatment, we sought to characterize sociocultural issues related to tobacco use and cessation. We used the PEN-3 cultural model to frame the research question and analysis of stakeholder interviews with 20 AI/AN patients, 12 health care providers, and 9 tribal leaders. Our study found high knowledge levels of the negative health effects of tobacco use; however, most patient participants ascribed negative health effects only to regular, heavy tobacco use and not to light use, which is more common in the population. The majority of patient participants did not endorse use of tobacco cessation treatment despite evidence of efficacy among AI/AN adults. Health promotion messaging to target low-tobacco consuming AI/AN people is needed. Additionally, messaging to promote tobacco cessation treatment using successful AI/AN former tobacco users to improve community perception of tobacco cessation treatment is recommended.

Factors Associated with Tobacco Use in Students Attending Local Government Schools in Mumbai, India

Purpose:Factors associated with ever-use and differences between ever-users and non-users of tobacco among adolescent school students from low income families in Mumbai were assessed.Materials and Methods:A self-administered questionnaire, completed by 1918 students from grades 7, 8 and 9 in 12 schools managed by the city municipal corporation in July 2015, gathered data on socio-demographic characteristics, tobacco use and tobacco-related knowledge, attitudes and beliefs.Results:Although only 1% of respondents thought tobacco was cool, nearly 35% were unaware of associations between tobacco use and health problems. Male students were almost twice as likely (OR=2.5, P <= 0.05) to have ever used tobacco compared to females and Supari (areca nut) users were eight times more likely (OR=8.99, P < 0.001) than Supari non -users. Tobacco-users were more likely to agree with statements: ‘People who use tobacco have more friends’ (OR=2.8, P = 0.004), ‘Smoking relieves stress’ (OR=5.6, P = 0.002) and ‘It is possible to purchase any tobacco product within 100 yards of school’ (OR=10.8, P < 0.001).Conclusion:This study highlights the gains made by tobacco prevention campaigns in that almost all students did not consider tobacco as cool or a stress reliever. However, they still need education about health consequences of tobacco-use. In addition, Supari use has to be addressed in school-based tobacco prevention and cessation initiatives. Furthermore, programs must also address perceptions and norms related to peers and tobacco use and ensure active implementation of existing laws. Such integrated measures will help ensure tobacco-free spaces around schools.

Tobacco smoking: From 'glamour' to 'stigma'. A comprehensive review.

In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries.

Abstract 19070: Hispanic/Latino Knowledge, Attitudes and Behaviors About Tobacco Use: Results of Focus Groups in 4 US Cities

Despite the reduction in the overall prevalence of cigarette smoking in the US, use has remained high among Hispanics/Latinos (H/Ls), particularly Puerto Ricans (33.7%) and Cuban/Cuban Americans (27.2%) (HCHS/SOL Databook, 2013). There is limited understanding about H/Ls knowledge, attitudes and behaviors (KAB) toward the use of other tobacco products such as e-cigs and hookah and how they may differ across diverse ethnic backgrounds, SES and acculturation. Objective: To assess KAB and perception of risk about the use of tobacco products among H/Ls that can inform the development of a culturally appropriate campaign to reduce prevalence. Methods: During the summer of 2014, 26 English and Spanish-speaking focus groups (6-10 persons per group, N = 182) were conducted among smokers and non-smokers, young (18-35) and old (36-65), men and women, of different SES and acculturation levels in: Chicago (Central and South Americans), New York City (Puerto Ricans and Dominicans), San Diego (Mexican/Mexican Americans) and Miami (Cubans). During 1 ½ hrs. discussion, participants were asked about: tobacco use problem in the community, type of tobacco use, health consequences of tobacco use, tobacco industry policy, second hand smoke, efforts to quit cigarette use, and channels of communication, including information technology. Data were analyzed using Atlas.ti for prevalent themes, perceptions and KAB. Results: Regardless of ethnic background, Latino smokers were most likely to use regular cigarettes, e-cigs and hookah. Older H/Ls (36+) and Spanish-speaking immigrants were most likely to use regular cigarettes while younger adults (women and men), US-born or more acculturated, were most likely to report using e-cigarette and/or hookah. Users stated that easy access, appeal of the different flavored tobacco taste &amp; smell, no restrictions in their use, and socializing with others, made these products attractive. Differences did emerge in KAB and perceptions of tobacco risk by specific H/L group, smoking status, city, SES and acculturation. Conclusion: Tobacco use continues to be a serious problem in the H/L communities with growing use and acceptance of e-cigarettes and hookah among younger and more acculturated H/Ls.

The environmental and health impacts of tobacco agriculture, cigarette manufacture and consumption.

The health consequences of tobacco use are well known, but less recognized are the significant environmental impacts of tobacco production and use. The environmental impacts of tobacco include tobacco growing and curing; product manufacturing and distribution; product consumption; and post-consumption waste. The World Health Organization’s Framework Convention on Tobacco Control addresses environmental concerns in Articles 17 and 18, which primarily apply to tobacco agriculture. Article 5.3 calls for protection from policy interference by the tobacco industry regarding the environmental harms of tobacco production and use. We detail the environmental impacts of the tobacco life-cycle and suggest policy responses.

Information seeking regarding tobacco and lung cancer: effects of seasonality.

This paper conducted one of the first comprehensive international Internet analyses of seasonal patterns in information seeking concerning tobacco and lung cancer. Search query data for the terms “tobacco” and “lung cancer” from January 2004 to January 2014 was collected from Google Trends. The relevant countries included the USA, Canada, the UK, Australia, and China. Two statistical approaches including periodogram and cross-correlation were applied to analyze seasonal patterns in the collected search trends and their associations. For these countries except China, four out of six cross-correlations of seasonal components of the search trends regarding tobacco were above 0.600. For these English-speaking countries, similar patterns existed in the data concerning lung cancer, and all cross-correlations between seasonal components of the search trends regarding tobacco and that regarding lung cancer were also above 0.700. Seasonal patterns widely exist in information seeking concerning tobacco and lung cancer on an international scale. The findings provide a piece of novel Internet-based evidence for the seasonality and health effects of tobacco use.

Prevalence, determinants and impact of unawareness about the health consequences of tobacco use among 17 929 school personnel in 29 African countries

ObjectivesTo assess prevalence, determinants and impact of unawareness about the health consequences of tobacco use among school personnel in Africa.DesignCross-sectional surveys.SettingTwenty-nine African countries.ParticipantsRepresentative samples of school personnel from 29 African...

Strategies to reduce youth tobacco use: opportunities for local government.

Published by This issue of the American Journal of Preventive Medicine examines factors associated with youth tobacco use–a timely topic given that this year is the 50th anniversary of the first Surgeon General’s Report on Tobacco. In 1960, the outlook was grim. The probability that a boy born in 1960 would be smoking by the time he was 20 years old was about 35%. After more than a dozen Surgeon General’s Reports describing the health consequences of tobacco use, the youth smoking rate in 1991 was still 27.5%. To reduce youth and adult tobacco use, states and localities have employed a number of interventions–smoke-free air laws now cover almost half of the U.S. population, and 30 states have cigarette taxes of $1.00 per pack or higher. As a result of these efforts, the youth smoking rate over the last two decades has declined by one third to 18.1% in 2011– much higher than it should be, but a figure that represents considerable progress. Although youth cigarette use has decreased over time, the growing use of other tobacco products threatens to undermine these gains. The research in this issue examines youth use of various products, including hookah, cigars, smokeless tobacco, and e-cigarettes, specifically looking at factors influencing use such as advertising, coupons, warning labels, and perception and curiosity of tobacco products. With the emergence and growing popularity of other tobacco products, localities have seized a number of regulatory opportunities to curb youth tobacco, including limiting access to cigars, limiting exposure to coupons, and increasing the minimum sales age. Cigar use among youth has increased nationally, even surpassing cigarette smoking in some states, because many regulations that apply to cigarettes do not apply to cigars. This loophole has led to the increasing popularity of cigars and little cigars, which are nearly identical to cigarettes except that they are wrapped in brown tobacco

Self-reported exposure to tobacco warning labels among U.S. middle and high school students.

Warning labels on tobacco products are a means to communicate information about the negative health effects of tobacco use to current and potential users. Most tobacco use begins in early adolescence, making it particularly important to understand the degree to which warning labels reach adolescents. To examine the extent to which youth report (1) seeing the current warnings on cigarettes and smokeless tobacco (SLT) products in the U.S. and (2) that seeing warnings makes them think about the health risks associated with tobacco use. Exposure to warning labels on cigarettes and SLT, as well as the degree to which adolescents report thinking about health risks in response to warnings, was examined among U.S. middle and high school students using data from the 2012 National Youth Tobacco Survey (NYTS) and analyzed in 2013. Current data suggest that less than half of adolescents who saw a cigarette pack (46.9%) or SLT product (40.3%) reported seeing the warning label "most of the time" or "always." Among adolescents who reported seeing a warning, less than one third reported that cigarette (30.4%) or SLT (25.2%) warning labels made them think about health risks "a lot." These rates were even lower among current tobacco users (<14%). Current warning labels for cigarettes and SLT could be improved by implementing warnings that incorporate features that make them salient and more likely to evoke thoughts about health risks.

Receiving Versus Being Denied an Abortion and Subsequent Tobacco Use

The negative health consequences of tobacco use are well documented. Some research finds women receiving abortions are at increased risk of subsequent tobacco use. This literature has methodological problems, most importantly, inappropriate comparison groups. This study uses data from the Turnaway Study, a longitudinal study of women who all sought, but did not all receive, abortions at 30 facilities across the United States. Participants included women presenting just before an abortion facility's gestational age limit who received abortions (Near Limit Abortion Group, n = 452), just after the gestational limit who were denied abortions (Turnaways, n = 231), and who received first trimester abortions (First Trimester Abortion Group, n = 273). This study examined the association between receiving versus being denied an abortion and subsequent tobacco use over 2-years. Trajectories of tobacco use over 2 years were compared using multivariate mixed effects regression. Women receiving abortion maintained their level of tobacco use over 2 years. Women denied abortion initially had lower levels of tobacco use than women receiving abortion, but increased their tobacco use from 1 week through 12-18 months post-abortion seeking and then decreased their use by 2 years post-abortion seeking. Baseline parity modified these associations. Receiving an abortion was not associated with an increase in tobacco use over time. Overall, women who carry unwanted pregnancies to term appear to demonstrate similar cessation and resumption patterns to other pregnant women.

Tobacco control in a changing media landscape: how tobacco control programs use the internet.

More than 80% of U.S. adults use the Internet, 65% of online adults use social media, and more than 60% use the Internet to find and share health information. State tobacco control campaigns could effectively harness the powerful, inexpensive online messaging opportunities. Characterizing current Internet presence of state-sponsored tobacco control programs is an important first step toward informing such campaigns. A research specialist searched the Internet for state-sponsored tobacco control resources and social media presence for each state in 2010 and 2011, to develop a resource inventory and observe change over 6 months. Data were analyzed and websites coded for interactivity and content between July and October 2011. Although all states have tobacco control websites, content and interactivity of those sites remain limited. State tobacco control program use of social media appears to be increasing over time. Information presented on the Internet by state-sponsored tobacco control programs remains modest and limited in interactivity, customization, and search engine optimization. These programs could take advantage of an important opportunity to communicate with the public about the health effects of tobacco use and available community cessation and prevention resources.