Individual Smoking Behavior Research Articles

Maximizing the Effectiveness of Anti-Smoking Campaigns With Targeted Framing Strategies: Evidence From Behavioral and Neurological Studies

Background The global prevalence of smoking remains a significant public health concern, necessitating the development of effective anti-smoking campaigns to promote smoking cessation and discourage smoking initiation. Understanding the factors that influence individual responses to anti-smoking messages is critical for tailoring campaigns to different populations. Focus of the Article This study substantially exhibits the concepts of audience segmentation and targeting, informed by theory and formative research, and monitoring and evaluation research in the context of anti-smoking campaigns. Research Question The article aims to answer how smoking behavior and message framing influence individuals’ counterarguing responses to anti-smoking advertisements and the implications for ad effectiveness. Approach The research investigates the role of smoking behavior (smokers vs. non-smokers) and message framing (positive vs. negative) in shaping individuals’ counterarguing responses to anti-smoking advertisements, using two studies involving behavioral and neuroscientific methods. Methods Study 1 employed an online video task with 1920 participants, examining the effects of smoking behavior and message framing on ad effectiveness. Study 2 used electroencephalography (EEG) to record brain activity from 31 participants while they viewed anti-smoking video advertisements, focusing on the neural correlates of counterarguing and their effect on anti-smoking ad effectiveness. Results Study 1 found that smokers report lower ad effectiveness compared to non-smokers, and observed an interaction between smoking behavior and message framing. Study 2 found that smoking behavior significantly influenced brain activity in the dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (VLPFC), and anterior cingulate cortex (ACC) regions in response to anti-smoking ads. Additionally, a significant interaction was observed between smoking behavior and ad framing on brain activity in all three regions. Recommendations for Research or Practice The findings suggest that anti-smoking campaigns should be tailored to the specific needs and attitudes of smokers and non-smokers, with separate campaigns for each group. Future research could explore the role of other individual differences in shaping counterarguing responses, the long-term effects of exposure to different types of anti-smoking messages on smoking behavior, and using more advanced neuroimaging techniques to investigate the neural processes that underlie counterarguing responses to anti-smoking messages for better flow.

Differences in biobehavioral measures of cigarette smoking by depression symptomology

IntroductionResearch that explores the clinical relevance of subclinical depressive symptoms and smoking is primarily focused on smoking cessation. We examine whether depression symptoms vary across an array of biological (carbon monoxide boost), behavioral (FagerströmTest of Nicotine Dependence, cigarettes per day, smoking topography), and psychological smoking-related outcomes (Questionnaire on Smoking Urges, Withdrawal Symptoms Checklist) in non-treatment-seeking smokers. MethodsBaseline data were pooled from three research trials with identical procedures designed to assess individual smoking behavior using smokers preferred cigarette brands. Depression symptom level (asymptomatic, subsyndromal, syndromal) was defined using established Center for Epidemiological Depression Scale (CES-D) cutpoint criteria. Smokers were instructed to smoke as usual for one-week. At the beginning and end of the baseline period, nicotine dependence, smoking topography, CO boost, desire to smoke, anticipation of positive reinforcement, negative affect, and withdrawal were measured. ResultsOrdinary least squares linear regression models were used to test the association between depression symptom level and outcome measures adjusting for sex and education (N = 355). The results revealed no differences in topography measures, cigarettes per day and FTND. Smoking withdrawal and smoking urges were higher among both individuals with subsyndromal symptoms and syndromal depression symptoms compared to those who were asymptomatic. Individuals with subsyndromal depressive symptoms experienced higher smoke exposure and higher relief from negative affect. ConclusionIncreased smoke exposure, greater withdrawal symptoms and urges to smoke, and anticipation of negative affect relief among smokers with subsyndromal depression symptoms suggest that depression symptoms need not reach syndromal levels to alter smoking-related outcomes.

The Relationship Between Individual Factors And Smoking Behavior In Adolescents In The Working Area Of Rawasari Community Health Center

<p align="center"><strong><em>Abstract</em></strong></p><p><em><em>Smoking is a bad habit that if left unchecked will cause health problems that lead to death. In addition, smoking is closely related to various neurological, cardiovascular, and pulmonary diseases. Cigarettes can also cause other people around the smoker to get diseases due to being a passive smoker. Factors that influence smoking behavior include knowledge and attitudes toward smoking. This study aimed to analyze the relationship between individual factors and adolescent smoking behavior in the Rawasari Health Center, Jambi City working area. This research is a quantitative study with a cross-sectional design. The population in this study were all male adolescents in the working area of the Rawasari Health Center with an age range of 15-24 years, namely 6.490 youths and the sample in this study was 100 adolescents. Data analysis using chi-square. The results of the study most of the respondents smoked, namely as many as 70 respondents (70%). Most of the respondents knowledge was low about smoking, its ingredients, the effects or health impacts caused, and the disadvantages of smoking, namely as many as 69 respondents (69%). More than half of the respondents (59%) have a supportive attitude towards smoking as many do not agree (38 respondents) not to smoke rather than creating a bad image in their environment. Based on the analysis there is a relationship between knowledge (p=0.000) and attitude (p=0.000) with smoking behavior in adolescents (p <0.05). There needs to be direction and guidance from parents, the role of puskesmas officers to conduct counseling about the dangers of smoking, and appeals not to smoke.</em></em></p><p><strong><em>Keywords: Male Youth, Rawasari Health Center, Smoking Behavior</em></strong></p>

Serological and oncoinformatic analysis of HbA1c as a prognostic biomarker in screening the risks of different cancers among the male T2D patients of Bangladesh

Hemoglobin A1C (HBA1c) represents the average serological sugar status of T2D patients of the past three months, considered a clinically standard method of studying sugar metabolism. Overexpressing HbA1 can metabolically forecast the risk of different cancers among T2D patients. Based on this, the study aimed to analyze the impact of sugar metabolism in cancer development considering the overexpression of HbA1 as the prognostic biomarker of screening the risks of eight different cancers among the chronic male T2D patients of Bangladesh. Serological analysis of the concentrations of FBS, THABF, creatinine, SC, STGs, HDLC, and LDLC of the T2D patients was conducted in response to their individual HbA1c concentration. Afterward, HbA1 overexpression and promotor-methylation responsible for BLCA, BRCA, CHOL, COAD, LUAD, LUSC, PAAD, and PRAD cancers in the male T2D patients were profiled as the oncoinformatic screening, where the sample types used, individual cancer stages, racial-footprints, gender, age, nodal metastasis, p53-methylations, pancreatitis, diabetes status, smoking behaviors, and survivability status were studied. Finally, the genetic involvement of a group of genes responsible for genetic co-expression of HbA1, endophytic vesicle regulation, antioxidant regulation, and reactive oxygen species based-metabolic regulation in T2D males was identified and comprehensively discussed. The research revealed a significant correlation between BMI and FBS in both the patient and the control groups (p<0.0001). Besides, FBS, THABF, and creatinine were found significantly regulated with their respective HbA1c concentrations (p<0.0001) for each group. The SC, STGs, HDLC, and LDLC regulated ardently and equally for both groups (p<0.0001), while HbA1c ranged from 3.8-5.8% and 5.11-15.8%, for the controls and patients respectively. HbA1 was found interactive with diversified cancer-causing genes, while HbA1 was mostly downregulating with the progressing metastasis. To receive maximum benefits from using HbA1c in clinical profiling of cancer risks among chronic-male T2D patients in minimal time and expense further studies can be needed with a larger sample size.

Associations between COVID-19 risk perceptions and smoking and quitting behavior among U.S. adults

ObjectivesThe COVID-19 pandemic may impact cigarette smokers’ behaviors. Among smokers, perceptions about the risks of contracting COVID-19 and the severity of COVID-19 illness likely vary, and perceptions may be associated with individual smoking behavior. Our study measured smokers’ perceptions of COVID-19 risks and their association with smoking and quitting outcomes. MethodsA sample of 1,223 U.S. adult cigarette smokers participated in an online survey in October-November 2020 to assess their COVID-19-related risk perceptions and changes in smoking, readiness to quit, and quit attempts during the COVID-19 pandemic. ResultsMore smokers believed smoking could increase the severity of COVID-19 (43.6%, 95% CI: 40.1, 47.3) than believed smoking makes them more susceptible to COVID-19 (20.0%, 95% CI: 17.2, 23.0.). While there were no associations between perceptions of COVID-19 susceptibility and smoking behaviors or intentions, perceptions of greater smoking-related COVID-19 severity were associated with both higher likelihood of smoking increases (aOR: 2.16, 95% CI: 1.19, 3.93) and greater readiness to quit smoking (aOR: 1.65, 95% CI: 1.18, 2.30). Greater perceptions of general COVID-19 severity were associated with higher likelihood of smoking reductions (aOR: 1.12, 95% CI: 1.02, 1.22), greater readiness to quit smoking (aOR: 1.14, 95% CI: 1.07, 1.22), and higher likelihood of making a quit attempt (aOR: 1.12, 95% CI: 1.04, 1.22). ConclusionsSmokers’ perceptions about COVID-19 severity are related to their smoking behavior and likelihood of making a quit attempt. Providing smokers with accurate information on the relationship between smoking and the severity of COVID-19 may alter smoking behaviors.

The influence of endogenous behaviors among social pairs: Social interaction effects of smoking

We model the observed smoking outcomes of an individual and her social contact - a spouse, friend, sibling, parent or adult child - as a simultaneous move game with complete information. We allow an individual’s smoking behavior to depend on her previous behavior and carefully account for observed and unobserved heterogeneity. Our econometric model addresses simultaneity, homophily, health endogeneity, non-random attrition, and multiplicity of equilibria together. Using network data from the Framingham Heart Study, we find smaller social interaction effects among spouses and friends than Christakis and Fowler (2008) who pioneered such exploration with these data. We also find that social interaction impacts of the endogenous behaviors of siblings or a parent and an adult child are not statistically significant after disentangling them from homophily. In addition, we find that the effects of social contacts’ cardiovascular disease shocks on individual smoking behavior are not statistically significant.

Understanding long-term trends in smoking in England, 1972-2019: an age-period-cohort approach.

Smoking prevalence has been falling in England for more than 50 years, but remains a prevalent and major public health problem. This study used an age-period-cohort (APC) approach to measure lifecycle, historical and generational patterns of individual smoking behaviour. APC analysis of repeated cross-sectional smoking prevalence data obtained from three nationally representative surveys. England (1972-2019). Individuals aged 18-90 years. We studied relative odds of current smoking in relation to age in single years from 18 to 90, 24 groups of 2-year survey periods (1972-73 to 2018-19) and 20 groups of 5-year birth cohorts (1907-11 to 1997-2001). Age and period rates were studied for two groups of birth cohorts: those aged 18-25 years and those aged over 25 years. Relative to age 18, the odds of current smoking increased with age until approximately age 25 [odds ratio (OR) = 1.48, 95% confidence interval (CI) = 1.41-1.56] and then decreased progressively to age 90 (OR = 0.06, 95% CI = 0.04-0.08). They also decreased almost linearly with period relative to 1972-73 (for 2018-19: OR = 0.30, 95% CI = 0.26-0.34) and with birth cohort relative to 1902-06, with the largest decreased observed for birth cohort 1992-96 (OR = 0.44, 95% CI = 0.35-0.46) and 1997-2001 (OR = 0.35, 95% CI = 0.74-0.88). Smoking declined in the 18-25 age group by an average of 7% over successive 2-year periods and by an average of 5% in those aged over 25. Smoking in England appears to have declined over recent decades mainly as a result of reduced smoking uptake before age 25, and to a lesser extent to smoking cessation after age 25.

The Effectiveness of Health Education Using Audiovisual on the Santri Smokers' Motivation to Stop Smoking.

Background and objective:Low motivation to quit smoking affects individual smoking behavior. Health education using audiovisual media can increase smokers’ motivation to quit smoking. The objective of this study was to determine the effectiveness of health education using audiovisuals on the Santri smokers’ motivation to stop smoking. Methods:This quasi-experimental study was carried out using a pretest-posttest design. The sample in this study included Santri smokers studying at the Traditional Islamic Boarding School in Aceh Besar . This study consisted of 4 groups. Three groups were given intervention (audiovisual health education with different themes) and one group received just health education. Groups were compered in terms of difference in the mean smokers’ motivation to quit smoking. The data analysis was done by running paired t-test and one-way ANOVA. Results:The results of statistical tests showed that there was a difference in the mean motivation to quit smoking before and after the intervention in each group (mean ± SD for group 1 to 4 was 11.52 ± 4.76, 15.39 ± 6.06, 22.57 ± 6.23, and 9.84 ± 6.42, respectively). The highest increase in the mean motivation to quit smoking was allocated to group 3 who received audiovisual health education with the theme of risk of developing cancer due to smoking. Conclusion:Health education using audiovisuals could increase the motivation of students to quit smoking, especially interventions on the risk of developing cancer due to smoking. Therefore, health workers are suggested to use audiovisuals to implement various intervention in order to change smoking behavior in students.

Purposeful play: exploring a bar-based, anti-tobacco intervention for young adults

Social smoking is increasingly prevalent among young Americans and often takes place in nightlife social settings. Yet, few smoking interventions are embedded in these settings. This paper focuses on space, embodiment, and practice to explore young adults’ experiences of COMMUNE, a bar-based anti-tobacco intervention for ‘Hipster’ young adults; a group with shared aesthetics and interests, and high smoking rates. We conducted in-depth interviews (n = 21) with young adults involved with COMMUNE (event organizers, artists/brand ambassadors, event attendees) and observed two COMMUNE events. We analyzed the data thematically and identified three prominent affective registers: (1) ‘Fun and flow’—Messaging did not disrupt essential elements of nightlife assemblages; (2) ‘Openness and receptivity’—Playful bar settings encouraged openness and receptivity, allowing event attendees to learn about COMMUNE without feeling taught or patronized; and (3) ‘Belonging and purpose’—Events focused on an external adversary (Big Tobacco) rather than individual smoking behavior and offered a role in supporting community. This anti-tobacco intervention leveraged the capacity-enhancing elements of nightlife settings where social smoking often takes place and emphasized access to a desired experience rather than the loss of smoking. More playful, capacity-enhancing approaches can engage with smoking and other health-related behaviors. Highlights Young adult social smoking is often practiced in nightlife settings Few smoking interventions are embedded in nightlife settings We explored young adults’ experiences of a bar-based, anti-tobacco intervention Fun, flow, openness, receptivity, belonging, and purpose were prominent Smoking interventions can offer playful, capacity-enhancing experiences

The Moderating Effect of Community-Level Deprivation on the Association between Individual Characteristics and Smoking Behavior among Chinese Adults: A Cross-Level Study.

China joined the World Health Organization (WHO) Framework Convention on Tobacco Control in 2006; however, the overall Chinese smoking rate is still high. The aim of this study is to provide new evidence for the direct effects of community-level deprivation, and the effects of interactions between community-level deprivation and individual characteristics, on smoking intensity, by using cross-sectional data from the 2015 China Health and Nutrition Survey (CHNS). The results show that there is a strong association between community-level deprivation and individual smoking intensity, and that community deprivation moderates the relationship between individual perceived stress and smoking intensity. The findings imply that adequate interventions should be conducted in the context of deprived neighborhoods, and should consider differences between levels of individual perceived stress and between sexes, especially focusing on highly stressed women who live in deprived communities.

A Single-Arm, Open-Label, Pilot, and Feasibility Study of a High Nicotine Strength E-Cigarette Intervention for Smoking Cessation or Reduction for People With Schizophrenia Spectrum Disorders Who Smoke Cigarettes.

IntroductionAn estimated 60%–90% of people with schizophrenia smoke, compared with 15%–24% of the general population, exacerbating the already high morbidity and mortality rates observed in this population.Aims and MethodsThis study aimed to assess the feasibility of using a new-generation high strength nicotine e-cigarette to modify smoking behavior in individuals with schizophrenia spectrum disorders who smoke cigarettes. A single-arm pilot study was conducted with 40 adults with schizophrenia spectrum disorders who smoked and did not intend to reduce or quit smoking. Participants were given a 12-week supply of a JUUL e-cigarette loaded with a 5% nicotine pod. The primary outcome was smoking cessation at week 12. Additional outcomes included: smoking reduction, continuous abstinence at week 24, adoption rate, adherence to the e-cigarette, feasibility, acceptability, and subjective effects.ResultsSixteen (40%) participants quit by the end of 12 weeks. For the whole sample, we observed an overall, sustained 50% reduction in smoking or smoking abstinence in 37/40 (92.5%) of participants and an overall 75% reduction in median cigarettes per day from 25 to six was observed by the end of the 12 weeks (p < .001).ConclusionsA high strength nicotine e-cigarette has the potential to help people with schizophrenia spectrum disorders to quit or reduce smoking. Further research with a larger sample and a comparator group is needed. The results provide useful information and direction to augment the existing body of knowledge on smoking cessation for people with schizophrenia spectrum disorders.ImplicationsConsidering that most people with schizophrenia spectrum disorders continue smoking, alternative and efficient interventions to reduce or prevent morbidity and mortality are urgently needed. This study showed that adults who smoke and were not motivated to quit, when provided a new-generation e-cigarette with high nicotine content, demonstrated substantially decreased cigarette consumption without causing significant side effects. Although not specifically measured in this study, nicotine absorption in new-generation devices has been shown to be consistently superior compared with the first generation of e-cigarette devices, and this may help explain the lower quit rates in studies using earlier generation devices.

Effects of a Cigarette Price Increase on the Smoking Behavior of Smokers and Non-smokers

Objectives: The government of the Republic of Korea (ie, South Korea) drastically increased cigarette prices by 80% in 2015. The exogenous regulatory change provided us with an opportunity to examine the effects of the cigarette price increase on smoking behavior. Methods: Utilizing 2011-2016 balanced panel data from the Korea Health Panel (3693 participants each year), we divided the sample into smokers and non-smokers and traced each individual's smoking behavior. Results: Overall smoking prevalence (OR = 0.476, p < .01) and daily cigarette consumption (IRR = 0.737, p < .01) were reduced after the cigarette price increase. However, although the cigarette price increase was inversely related to smokers' cigarette consumption (OR = 0.799, p < .01), we found no statistically significant impact on smoking cessation among smokers. On the other hand, the cigarette price increase was associated with decreased smoking onset among non-smokers (OR = 0.172, p < .01) and reduced cigarette consumption after they started smoking (IRR = 0.279, p < .01). Conclusions: The reduction in smoking prevalence after the increase of the cigarette price resulted from the fact that non-smokers did not start smoking rather than from a decrease in the number of existing smokers.

The social gradient in smoking: individual behaviour, norms and nicotine dependence in the later stages of the cigarette epidemic

The cigarette epidemic tends to develop in a similar pattern across diverse populations in different parts of the world. First, the prevalence of smoking increases, then it plateaus and finally it declines. The decline in smoking prevalence tends to be more pronounced in higher social strata. The later stages of the cigarette epidemic are characterized by emerging and persisting socioeconomic gradients in smoking. Due to its detrimental health consequences, smoking has been the subject of extensive research in a broad range of academic disciplines. I draw on literature from both the social and medical sciences in order to develop a model in which physiological nicotine dependence, individual smoking behaviour and norms surrounding smoking in the immediate social environment are related through reflexive processes. I argue that the emergence and persistence of social gradients in smoking at the later stages of the cigarette epidemic can be attributed to a combination of the pharmacological properties of nicotine, network homophily and the unequal distribution of material and non-material resources across social strata.

The Effects of Smoke-Free Workplace Policies on Individual Smoking Behaviors in China.

Studies have shown that smoke-free (SF) workplace policies can create an SF environment, but most of them have focused only on reducing secondhand smoke (SHS) exposure or changing smoking behavior. Our study aims to explore the effects of SF workplace policies and the pathway between workplace SF policies and SHS exposure. 14 195 employees from 79 companies in China participated in this survey. Binary logistic regression is used to examine the direct effects of SF workplace policies. Structured Equation Modeling approach is used to test other indirect effects. The Sobel test is used to estimate the mediation effect. Working in a company with SF policies was associated with lower SHS exposure (odds ratio = 0.56; 95% confidence interval = 0.51 to 0.60). Such policy were associated with lower smoking prevalence (Coef. = -0.05, p < .05) and positively associated with smoking harm awareness (Coef. = 0.07, p < .05) and SHS harm awareness (Coef. = 0.05, p < .05). Sobel test suggests that approximately 16.3% of the effects on SHS exposure reduction are mediated through the channel of lower smoking prevalence for males. For smokers, we did not identify a direct effect of such policies on quitting intentions, but a significant indirect effect via increased smoking harm awareness (Coef. = 0.07, p < .05) and lower smoking consumption (Coef. = -0.10, p < .05) were found. This study finds that SF workplace policies are not only associated with lower SHS exposure but also related to some indirect effects. Further mediation analyses for males confirmed that the effect on SHS exposure reduction is mediated through the channel of lower smoking prevalence. This study joins the debate in recent years on the effects of workplace SF policies and provides evidence with more comprehensive data from Asia Best Workplace Mainland China program. It shows that SF workplace policies not only can reduce SHS exposure but also are associated with lower smoking prevalence, fewer cigarettes smoked, and higher smoking harm-related awareness. These findings provide valuable evidence to promote such policies in all workplaces and underline the need for more stringent SF policies to be enacted in all countries.

The effect of SLC6A3 variable number of tandem repeats and methylation levels on individual susceptibility to start tobacco smoking and on the ability of smokers to quit smoking.

Nicotine acts through the dopamine pathway in the brain affecting reward processing through cigarette consumption. Thus, both genetic and epigenetic factors related to dopamine metabolism may influence individual's smoking behavior. We studied variations of two variable numbers of tandem repeats (VNTRs), 40 and 30 bp in length, in SLC6A3 gene together with six DNA methylation sites located in a first intron of the gene in relation to several smoking-related phenotypes in a study population consisting of 1230 Whites of Russian origin. Both the 5R allele of 30 bp VNTR and the 9R allele of 40 bp VNTR in SLC6A3 were associated with a reduced risk to tobacco smoking [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.37-0.75; OR 0.62, 95% CI 0.43-0.88]. Although the carriers of 9R allele also had high Fagerström test for nicotine dependence scores (OR 1.65, 95% CI 1.04-2.60), they were still more likely to succeed in smoking cessation (OR 0.59, 95% CI 0.40-0.88). Also, current smokers had more than 2.5-fold likelihood to have increased SLC6A3 methylation levels than former smokers (OR 2.72, 95% CI 1.63-4.53). The SLC6A3 5R of 30 bp and 9R of 40 bp VNTR variants may lead to a reduced risk to start smoking through decreased dopamine availability, and can also affect the success in subsequent smoking cessation attempts. Moreover, the elevated mean methylation values in the first intron of SLC6A3 may be related to nicotine dependence via a more active dopamine transporter.

The effect of outdoor smoking ban: Evidence from Korea.

To address exposure to secondhand smoke, which is highly prevalent in Korea, local governments have implemented smoking bans at open public places (parks, bus stops, and school zones) since 2011. Exploiting temporal and spatial variation in the implementation dates of these bans, this study estimates their causal effects on individual smoking behavior. The individual-level longitudinal data from the 2009-2017 Korean Labor and Income Panel Study are linked to the smoking ban legislation information from the National Law Information Center. I find robust evidence that outdoor smoking bans increased the probability of making a quit attempt by 16%. This effect appears immediately after a ban goes into effect and lasts for three or more years. People who spend more time outdoors are more likely to change smoking behavior. I also find heterogeneity in effects across the amount of monetary penalty. Whereas the policy change did not affect the prevalence of smoking overall, higher penalties had stronger impacts on reducing the intensity of smoking and increasing the propensity to try to quit.

Socioeconomic disparities in prevalence and behaviors of smoking in rural Southwest China

BackgroundThis study examines how prevalence and behaviors of smoking differ by socioeconomic status among rural southwest Chinese adults.MethodsA cross-sectional survey was conducted including 7743 adults aged ≥35 years in rural regions of Yunnan Province, China from 2016 to 2018. Information on individual socioeconomic status (SES), ethnicity, and self-reported smoking behaviors was collected utilizing a standardized questionnaire. The individual socioeconomic position (SEP) index was constructed using principal component analysis. Multivariate logistic regression models were used to analyze the association between individual SES variables and the prevalence and behaviors of smoking.ResultsIn the study population, the overall prevalence rate of current smokers was 33.5%. Males had a markedly higher prevalence of current smokers than females (62.6% vs. 4.8%, P < 0.01). Of these smokers, 74.5% began smoking during adolescence, 88.8% had never attempted to quit smoking, and 81.1% reported smoking in public places. Ethnic minority participants and those with low levels of education and/or low SEP were more likely to use tobacco as well as more likely to start smoking, and regularly smoke, during adolescence (P < 0.01). Participants with poor access to medical services had a higher prevalence of current smoking than their counterparts (P < 0.01). Among current smokers, Han ethnicity, good access to medical services, and high SEP were positively associated with the probability of having attempted to quit smoking at least once, while a high level of education and high SEP were negatively associated with the probability of smoking in public places.ConclusionsDisparities in prevalence and behaviors of smoking exist across a diversity of indicators of individual SES in rural southwest China. Future tobacco cessation interventions should focus on men, ethnic minorities, and those with low education levels, poor access to medical services, and low SEP.

Retailer Compliance as a Predictor of Youth Smoking Participant and Consumption.

Ninety percent of smokers report having their first whole cigarette before the age of 19. Policies, such as youth access laws, are essential to prevent youth from becoming future smokers. In Canada, the Tobacco Act prohibits retailers from furnishing tobacco products to individuals under the age of 18. These laws can only be effective when retailers comply with them. This paper investigates the effect of retailer compliance on youth smoking behavior. Data on individual smoking behavior in conjunction with provincial retailer compliance rates and cigarette prices for the years 1999-2005 were employed to examine the effects of retailer compliance on youth smoking participation and consumption. Both price and retailer compliance were significant predictors of smoking participation. A large portion of participants endorsed obtaining their cigarettes through social means. Price elasticity of demand for the overall sample was estimated to be -0.54. Consistent with previous literature, our results found that retailer compliance is an essential component to the successful implementation of youth access laws. Given that youth access laws and retailer compliance did not quell social access to cigarettes, there is an apparent need within schools and communities to reduce the social sale of tobacco products.

Changes in Smoking Behaviors following Exposure to Health Shocks in China.

Background: Evidence suggests that following major individual health shocks, smokers change their smoking behaviors. However, little is known about the association between spousal health shocks and smoking. This study examined the contemporaneous and long-term effects of individual and spousal health shocks on males’ smoking behaviors in China. Methods: This study employed a nation-wide data base from the 1991–2011 China Health and Nutrition Study. Random effects models were estimated to ascertain the impacts of health shocks on males’ smoking behavior. Smoking behaviors were measured by smoking status, smoking consumption and smoking cessation. Results: In the short term, respondents who incurred health shocks decreased their likelihood of smoking by 10%. In addition, health shocks decreased the likelihood of heavy smoking versus the combined moderate and light categories by 41.6%, and increased their likelihood of quitting by 85.3% for ever smokers. Spousal health shocks had no significant effects on individual smoking behaviors. The long-term effects were similar to the short term impacts. Conclusions: People changed their smoking behaviors in response to their own health experiences but not those of their spouses. Antismoking messages about the health effects on others are unlikely to influence individual smoking behaviors, unless individuals believed that they are personally vulnerable to smoking-related diseases.

Impact of prediagnostic smoking and smoking cessation on colorectal cancer prognosis: a meta-analysis of individual patient data from cohorts within the CHANCES consortium

Smoking has been associated with colorectal cancer (CRC) incidence and mortality in previous studies and might also be associated with prognosis after CRC diagnosis. However, current evidence on smoking in association with CRC prognosis is limited. For this individual patient data meta-analysis, sociodemographic and smoking behavior information of 12 414 incident CRC patients (median age at diagnosis: 64.3 years), recruited within 14 prospective cohort studies among previously cancer-free adults, was collected at baseline and harmonized across studies. Vital status and causes of death were collected for a mean follow-up time of 5.1 years following cancer diagnosis. Associations of smoking behavior with overall and CRC-specific survival were evaluated using Cox regression and standard meta-analysis methodology. A total of 5229 participants died, 3194 from CRC. Cox regression revealed significant associations between former [hazard ratio (HR) = 1.12; 95 % confidence interval (CI) = 1.04-1.20] and current smoking (HR = 1.29; 95% CI = 1.04-1.60) and poorer overall survival compared with never smoking. Compared with current smoking, smoking cessation was associated with improved overall (HR<10 years = 0.78; 95% CI = 0.69-0.88; HR≥10 years = 0.78; 95% CI = 0.63-0.97) and CRC-specific survival (HR≥10 years = 0.76; 95% CI = 0.67-0.85). In this large meta-analysis including primary data of incident CRC patients from 14 prospective cohort studies on the association between smoking and CRC prognosis, former and current smoking were associated with poorer CRC prognosis compared with never smoking. Smoking cessation was associated with improved survival when compared with current smokers. Future studies should further quantify the benefits of nonsmoking, both for cancer prevention and for improving survival among CRC patients, in particular also in terms of treatment response.