Occasional Smokers Research Articles

Interest and Use of Mental Health and Specialty Behavioral Medicine Counseling in US Primary Care Patients

Counseling interventions have the potential to improve health and quality of life for primary care patients, but there are few studies describing the interest in and utilization of counseling among this patient population in the USA. The purpose of the study was to evaluate interest in mental health and specialty behavioral medicine counseling and predictors of utilization over 1 year among US primary care patients. Participants in this two-survey longitudinal study included 658 primary care patients in an urban US academic medical center (461 females, age M = 51.05, SD = 15.46 years). Retention rate was 61.2% at survey 2. Patient demographics, depression, anxiety, and interest in counseling services were assessed through a survey mailed 1 week following an outpatient appointment. Respondents to survey 1 were re-contacted 1 year later to assess. Interest and use of the following counseling services were evaluated in the relevant subgroups: mental health (the entire sample and patients with elevated anxiety and/or depression), health/lifestyle (overweight and obese participants), smoking cessation (current and occasional smokers), and pain management (participants with elevated daily pain ratings). At survey 1, 45.7% of the sample reported interest in mental health counseling, and 58.9% of the sample reported interest in behavioral medicine counseling. Among overweight or obese participants, 59.9% were interested in health/lifestyle counseling. Among smokers, 55.3% were interested in smoking cessation, and among participants with chronic pain, 33.8% were interest in pain management. Rates of utilization of services at survey 2 were 21.3% for mental health, 7.7% for health/lifestyle, 6.7% for smoking cessation, and 6.6% for pain management. Interest in receiving services at survey 1 was the strongest predictor of utilization. Results demonstrate high interest but low utilization over 1 year among US primary care patients. Identifying patients interested in counseling services and reducing barriers may help facilitate receipt of services for those with interest and need for behavioral treatments.

Assessing smoking status in disadvantaged populations: is computer administered self report an accurate and acceptable measure?

BackgroundSelf report of smoking status is potentially unreliable in certain situations and in high-risk populations. This study aimed to determine the accuracy and acceptability of computer administered self-report of smoking status among a low socioeconomic (SES) population.MethodsClients attending a community service organisation for welfare support were invited to complete a cross-sectional touch screen computer health survey. Following survey completion, participants were invited to provide a breath sample to measure exposure to tobacco smoke in expired air. Sensitivity, specificity, positive predictive value and negative predictive value were calculated.ResultsThree hundred and eighty three participants completed the health survey, and 330 (86%) provided a breath sample. Of participants included in the validation analysis, 59% reported being a daily or occasional smoker. Sensitivity was 94.4% and specificity 92.8%. The positive and negative predictive values were 94.9% and 92.0% respectively. The majority of participants reported that the touch screen survey was both enjoyable (79%) and easy (88%) to complete.ConclusionsComputer administered self report is both acceptable and accurate as a method of assessing smoking status among low SES smokers in a community setting. Routine collection of health information using touch-screen computer has the potential to identify smokers and increase provision of support and referral in the community setting.

Autoeficacia y consumo de tabaco en estudiantes universitarios

The tobacco consumption continues being today one of the major problems for the health and, nevertheless, it is one of the drugs most consumed in Spain. Bearing in mind that the majority of smokers begin the tobacco consumption in the adolescence and that the university is a context where the students begin or are consolidated in this habit, the specific interventions in this area turn out to be necessary. In this study we examine the existing relation between the self-efficacy and the temptations and the consumption of tobacco in university students, in a sample of 145 students with an average age of 22,80 years. The sample was distributed of the following way: 15,39 % was ex-smokers, 26,57 % occasional smokers and 58,04% smoking daily. The results confirm that the consumption of tobacco continues being today one of the major ones the variable cognitive temptations and self-efficacy they change depending on the ownership group. CITE AS:Morales Domínguez, Z., Díaz Batanero, C., Garrido Muñoz De Arenillas, M.R. & Pascual Orts, L.M. (2011). Autoeficacia y consumo de tabaco en estudiantes universitarios. Apuntes de Psicología, 29, 459-470.

Waterpipe smoking among health sciences university students in Iran: perceptions, practices and patterns of use.

BackgroundIn recent years waterpipe smoking has become a popular practice amongst young adults in eastern Mediterranean countries, including Iran. The aim of this study was to assess waterpipe smoking perceptions and practices among first-year health sciences university students in Iran and to identify factors associated with the initiation and maintenance of waterpipe use in this population.ResultsOut of 371 first-year health sciences students surveyed, 358 eight students completed a self-administered questionnaire in the classrooms describing their use and perceptions towards waterpipe smoking. Two hundred and ninety six responders met study inclusion criteria. Waterpipe smoking was common among first-year health sciences university students, with 51% of students indicating they were current waterpipe smokers. Women were smoking waterpipes almost as frequently as men (48% versus 52%, respectively). The majority of waterpipe smokers (75.5%) indicated that the fun and social aspect of waterpipe use was the main motivating factor for them to continue smoking. Of waterpipe smokers, 55.3% were occasional smokers, using waterpipes once a month or less, while 44.7% were frequent smokers, using waterpipes more than once a month. A large number of frequent waterpipe smokers perceived that waterpipe smoking was a healthier way to use tobacco (40.6%) while only 20.6% thought it was addictive. Compared to occasional smokers, significantly more frequent smokers reported waterpipe smoking was relaxing (62.5% vs. 26.2%, p = 0.002), energizing (48.5% vs. 11.4%, p = 0.001), a part of their culture (58.8% vs. 34.1%, p = 0.04), and the healthiest way to use tobacco (40.6% vs. 11.1%, p = 0.005).ConclusionsSocial and recreational use of waterpipes is widespread among first-year health sciences university students in Iran. Women and men were almost equally likely to be current waterpipe users. Public health initiatives to combat the increasing use of waterpipes among university students in Iran must consider the equal gender distribution and its perception by many waterpipe smokers as being a healthier and non-addictive way to use tobacco.

A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: a unique opportunity for reaching the disadvantaged

BackgroundSocial and community service organisations (SCSOs) are non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals. SCSOs hold considerable potential for providing smoking cessation support to disadvantaged smokers. This study aimed to establish the prevalence of smoking, interest in quitting and interest in receiving cessation support amongst clients accessing SCSOs.MethodsClients seeking financial or material assistance from three SCSOs in NSW, Australia, between February and October 2010 were invited to complete a 60-item general health touch screen computer survey. This included questions about smoking status, past quit attempts and interest in receiving support to quit smoking from SCSO staff.ResultsA total of 552 clients were approached to participate during the study period, of which 383 provided consent and completed the survey (69% consent rate). Daily smoking was reported by 53.5% of participants. Occasional smoking (non-daily smoking) was reported by a further 7.9% of participants. Most participants had tried to quit smoking in the past (77%) and had made an average of two quit attempts (SD = 3.2) lasting longer than 24 hours in the previous 12 months. More than half of all participants (52.8%) reported that they would like help from SCSO staff to quit smoking. For those interested in receiving help, the preferred types of help were access to free NRT (77%), cash rewards (52%) and non-cash rewards (47%) for quitting, and to receive support and encouragement from SCSO staff to quit (45%).ConclusionsSmoking rates among clients accessing SCSO are substantially higher than the general population rate of 15.1%. A substantial proportion of clients are interested in quitting and want support from the SCSO to do so.

A comparison of daily and occasional smokers' implicit affective responses to smoking cues

Previous research has not compared implicit affective responses to smoking-related stimuli in occasional (i.e., those who smoke less than one cigarette per day) and daily smokers (i.e., those who smoke at least once per day). In addition to assessing their motivations for smoking, implicit affective responses were measured using the Affect Misattribution Procedure (AMP) in occasional ( n = 19) and daily smokers ( n = 34) to smoking-related and neutral cues. Half of the cues depicted a human interacting with an object (i.e., active), whereas the remaining cues depicted objects alone (i.e., inactive). Results indicated that for the active cues, daily smokers responded more positively to smoking-related than to neutral cues, whereas occasional smokers showed no difference in their implicit responses. In addition to smoking frequency, relative differences in implicit responses to active cues were related to cognitive enhancement motivation. For inactive cues, implicit responses were related to cognitive enhancement as well as reinforcement. Because daily smokers have more positive implicit responses to active smoking-related cues than occasional smokers, these cues may play an important role in maintaining smoking behavior in daily smokers.

Peering through the smoke: The effect of parental smoking behavior and addiction on daily smokers’ attentional bias to smoking cues

Although previous research has demonstrated that individuals with parents who smoke are more likely to become smokers and are less successful in smoking cessation efforts compared with those without a smoking parent, the reasons for this link have not been established. In the current study, implicit attentional bias to smoking-related cues was investigated in college-age smokers, based on models of addiction that suggest that attention to drug-related cues plays an important role in drug addiction. Sixty-one participants completed a dot-probe task to measure attentional bias to smoking-related and matched non-smoking-related control pictures. Results indicated that while those who reported smoking occasionally did not demonstrate an attentional bias, daily smokers who had a smoking parent showed more of an attentional bias to the smoking cues than those without a smoking parent, but only to cues that did not contain human content. In addition to parental influence, nicotine dependence explained a significant portion of the variance in the attentional bias for daily smokers. Implications for models of nicotine addiction and the development of smoking cessation programs are discussed.

Predictors of Spontaneous Smoking Cessation Among Chinese Men Whose Wives are Pregnant

This is an exploratory study to identify the predictors that Chinese men will spontaneously quit smoking during their wives' pregnancy. Smoking husbands who accompanied their non-smoking pregnant wives to an antenatal clinic were invited to complete a questionnaire soliciting information regarding their smoking behaviours, perceptions of support received from their wives, and motivating factors for quitting smoking. A total of 74 men were recruited. Two-thirds (67.6%) were daily smokers, had started smoking under the age of 18 (66.2%), and smoked 6-15 cigarettes (48.6%) a day. Nearly one-third of the smoking husbands (n = 50, 67.6%) reported that their wife was the person who provided them with the necessary main support in quitting. Nearly a quarter (18 out of 74, 24.3%) of the husbands indicated that they quit smoking during their wives' pregnancy. Those more likely to quit were the 'occasional smokers' (61.1% vs. 38.9%), those who craved cigarettes a few hours after getting up (0% vs. 100%), those who were confident in their ability to quit (77.8% vs. 22.2%), and those who had previously attempted to quit (88.9% vs. 11.1%). The level of negative support from wives to quit smoking was significantly related to men's quitting (55.6% vs. 44.4%). The results of this study identified the husbands most likely to spontaneously quit smoking during their wives' pregnancy as those who were occasional smokers, were confident about smoking cessation, and reported their wives as being bothered by smoke.

Tabagismo passivo no Brasil: resultados da Pesquisa Especial Do Tabagismo, 2008

The scope of this article was to describe indoor passive smoking, at home and at work, among Brazilians (15+ years) participants of the "Special Research on Smoking", a sub-sample of the PNAD 2008. Non-smokers who reported exposure to indoor household smoking were classified as daily or occasional passive smokers, based on the frequency of exposure. Associations with socio-demographic factors were verified by logistic regression analysis. Among 25,005 participants, prevalence of daily and occasional household exposure were 12.5% and 21%, respectively. Compared to those not exposed, daily exposure decreased with increasing age, schooling and income. Occasional exposure is not influenced by age, but decreases with increasing schooling and income. Compared to the Southeast Region, daily exposure was lower in the North and Central West and higher in the Northeast. Among those 10,933 with indoor occupations, 55% of men and 45% of women reported worksite exposure and 67% of them also reported household exposure. Prevalence of exposure at work is higher in men, older adults (55+ years) and among those with lower schooling and income and lower among South Region residents. Social inequality in Brazil is seen in greater exposure to passive smoking among those with lower incomes and less education.

Hardcore Smokers in Norway 1996-2009

Introduction:The aim of this study was to investigate changes in the relative proportion of hardcore smokers (HCS) in Norway for the years 1996–2009.Methods:Data were derived from Statistics Norway’s annually cross-sectional representative samples of the adult population. The total sample size of smokers each year was between 250 and 500. The outcome measure was HCS, defined by their intention not to quit smoking and absence of attempts to quit during the last 12 months. Logistic regression analysis was conducted to estimate the association between time (survey year) and the number of HCS.Results:We identified three groups of smokers: occasional smokers, daily non-HCS, and HCS. The relative proportion of HCS declined in the period 1996–2009, from 30% to 23%. A model adjusted for gender, age, educational level, and the use of snus (smokeless tobacco) showed the same downward trend.Conclusions:Within this sample of Norwegian smokers, the relative share of HCS is not increasing. This knowledge is important for tobacco prevention policy. The result does not support a hardening hypothesis regarding changes in the size of the group of HCS. Further analysis is needed to investigate individual resistance to smoking cessation.

Impulsivity and Symptoms of Nicotine Dependence in a Young Adult Population

Introduction:Impulsivity is widely regarded as a risk factor for drug dependence. However, its relationship with the symptomatology of nicotine dependence is poorly understood.Methods: To examine the nature of these relationships, we recruited 404 daily and occasional smokers from a predominantly student population and assessed the association between impulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11) and several self-reported measures of smoking rate and nicotine dependence, including the Diagnostic and Statistical Manual’s (DSM-IV) criteria.Results:Overall, impulsivity was high throughout the entire sample but only modestly associated with nicotine dependence. Within the diagnostic criteria of nicotine dependence, two symptoms, which reflect automatized or habitual smoking, were most strongly associated with impulsivity.Conclusion:These data support recent human and animal work, which suggests that impulsivity is linked to the formation of habitual drug use, and are discussed within the framework of a dual-system account of drug seeking.

Cigar, Cigarillo, and Little Cigar Use among Canadian Youth: Are We Underestimating the Magnitude of This Problem?

Data from 29,296 students in grades 9-12 as part of the 2008-2009 Youth Smoking Survey were used to examine the prevalence of cigar, cigarillo, and little cigar use and factors associated with their use. Among Canadian youth in grades 9-12, 12.9% reported current use of cigarillos or little cigars, and 8.1% reported current use of cigars. The characteristics of youth most likely to use either cigars or cigarillos and little cigars were being male, being in grade 11 or 12, being a daily or occasional cigarette smoker, having more than $20 of weekly spending money, and having ever tried flavored tobacco. Our findings suggest that cigars, cigarillos, and little cigars are used by a substantial number of Canadian youth, many of whom do not smoke cigarettes. As such, current national prevalence estimates of youth smoking may be underestimated, and existing tobacco control prevention programs and policies may be overlooking a large population of at-risk youth.

SP4-14 Passive smoking in Brazil: results from the special research on smoking 2008

IntroductionPassive smoking has been linked to an increased morbid-mortality risk, mainly by cardiovascular and respiratory diseases. This is first Brazilian nationwide study that describes indoor passive smoking, at home and...

Occasional smoking in college: Who, what, when and why?

Introduction The majority of college students who smoke do so on an occasional basis and generally do not define themselves as smokers. This represents a considerable challenge for public health efforts to prevent escalation of use and to promote cessation. Strengthening such efforts will require further examination of the motivations behind occasional smoking within this vulnerable group. Methods Based within a priori identified content areas, we conducted eight focus groups of occasional smokers (N = 53) at two demographically diverse colleges in the southeastern U.S. Results Few participants self-identified as a smoker and few had immediate desire to quit. Most identified extrinsic motivations for future quitting, including college graduation and parenthood. Although participants acknowledged smoking-related health risks, they minimized them as being personally irrelevant. Participants highlighted social (i.e., alcohol and other smokers) and stress-related smoking triggers. They also described how they carefully managed the situations in which they would, and would not smoke in order to preserve their identity. Conclusions College students who smoke occasionally appear to engage in impression management, taking effort to shape their personal image to not appear as a smoker. They use smoking mainly as a social engagement tool, but also to alleviate negative emotions. They express minimal desire to quit and believe they are immune to the health risks of smoking. Public health messages should address this common pattern of smoking among young adults differently than regular smoking patterns by highlighting the social, emotional, and health consequences of occasional smoking before nicotine dependence has fully developed.

Knowledge, attitude, prevalence and factors leading to smoking among students of the Center for Physical Education and Sports Science, University of Sindh, Jamsoro, Pakistan

The objective of this study was to determine the knowledge, attitude, prevalence and factors leading to smoking among students at the Center for Physical Education and Sports Science, University of Sindh, Jamsoro Pakistan. A total of 148 (128 males and 20 females) students of Center for Physical Education and Sports Science were randomly selected. A self-administered questionnaire was used to elicit information on demographics, smoking habits, attitude towards public action against smoking and knowledge of health hazards. Smoking was more common among bachelors (n=18) than master’s degree students (n=04). There were 22 smokers, but most of them were occasional smokers (n=13). All female students indicated that they never smoked. The students’ ages ranged from 18-35 years (mean age 22. 3 + 9.37 years). Sixteen students started smoking between ages 10-20 years. Out of 22 smokers, only five were heavy smokers (>20 cigarettes/d). The most favoured smoking tool was filter tipped cigarettes (n=12). The most common reason for smoking was peer pressure (n=12). Majority of students (n=53) who do not smoke believed that it is a useless habit. Twelve smokers and 112 non-smokers favoured banning smoking advertisements in print and electronic media. Fourteen smokers and all non-smokers favored banning smoking at public places. Both smokers (91%) and non smokers (98%) had good knowledge of health hazards associated with smoking and passive smoking. Smoking still constitutes a major problem among university students inspite of their knowledge of its hazards. This may be due to the addictive effect of smoking, peer pressure, negative parental attitudes and other reasons. There is a need to implement an anti-smoking programme for college students in order to educate them on the health implications of smoking, thereby possibly preventing or controlling smoking among the students.

건강믿음모형을 이용한 금연성공자의 재흡연에 영향을 미치는 요인 분석: 금연클리닉 등록자를 중심으로

이 연구는 보건소 금연클리닉에 등록하여 6개월 금연에 성공한 사람들의 장기적인 금연 지속 여부와 재흡연에 영향을 미치는 요인을 파악하기 위하여 실시되었다. 2008년 1월부터 2009년 2월까지 C시 보건소 금연클리닉에 등록하여 6개월 금연에 성공한 920명 중 조사에 응한 남성 159명을 최종 분석 대상으로 하였다. 연구 자료는 금연클리닉 등록카드와 2010년 9월 20일부터 10월 20일까지 실시된 우편설문을 통해 수집되었다. 연구에 포함된 변수는 응답자들의 흡연상태, 인구사회학적 특성, 금연클리닉 등록 당시의 흡연관련 특성, 금연클리닉을 통하여 제공받은 서비스, 건강행태, 건강믿음모형의 구성 변수 등이었다. 연구의 결과는 다음과 같다. 6개월 금연성공자 중 지속적 금연성공자는 57.2%, 중간 흡연자는 17.0%, 재흡연자는 25.8%였다. 재흡연자들의 재흡연 이유는 스트레스가 쌓여서 76.2%, 본인의 의지가 약해서 16.7%, 주위의 유혹에 의해서 7.1%로 나타났다. 응답자의 인구사회학적 특성, 과거의 흡연관련 특성, 제공받은 금연상담서비스, 건강행태 요인 등은 6개월 금연 성공자의 1년 후 재흡연 여부에 유의한 영향을 미치지 못하였으며, 건강믿음모형의 구성요소 중 (1) 흡연으로 인한 질병의 발생 가능성, (2) 흡연으로 야기되는 질환의 심각성, (3) 금연의 건강증진에 대한 도움, (4) 금연으로 인한 스트레스와 사회생활에 대한 장애정도, (5) 자기효능감이 단변량분석에서 재흡연 여부에 유의한 영향을 미치는 것으로 나타났다. 서열 로짓 분석을 시행한 결과 이 중 (4) 금연으로 인한 스트레스와 사회생활에 대한 장애정도, (5) 자기효능감만이 재흡연 여부에 유의한 영향을 미쳤으며, 특히 자기효능감이 매우 중요한 영향을 미치는 것으로 밝혀졌다. 이 연구를 통해 보건소 금연클리닉을 통하여 6개월 금연에 성공한 남성들 중 상당수가 재흡연을 하게 된다는 것을 알 수 있었다. 재흡연자들은 다시 담배를 피우게 된 이유를 스트레스의 증가나 자신의 의지부족 때문이라고 하였으며, 재흡연에 영향을 미치는 요인이 금연자의 인구사회학적 변수나, 과거의 금연습관보다는 심리학적 요인, 특히 자기효능감과 금연과 관련된 인지된 장애임도 밝혀졌다. 이러한 연구결과는 금연클리닉 등록자 중 재흡연 위험이 높은 사람을 선별하여 맞춤식 관리를 하는데 도움을 줄 것으로 기대되며, 금연 클리닉 등록자를 위한 스트레스 해소나 자기효능감 강화 프로그램 개발이 시급함을 시사한다. 이 연구는 일개 중소도시의 금연클리닉 등록자 중 남성만을 대상으로 하였고, 우편조사로 인한 낮은 응답률, 조사 시기에 따른 회상 오차, 금단 증상, 행동계기(cue to action), 금연에 대한 사회적 지지와 같은 변수가 누락되는 등 연구방법론 상에 제한이 있어 연구결과의 일반화에 주의를 요하며, 향후 연구에서는 이러한 문제점을 보완할 필요가 있다. Objectives: This study aimed to identify factors associated with smoking relapse. Methods: The study sample was recruited among subjects who were enrolled in the smoking cessation clinic of a public health center and had succeeded in quitting smoking for at least six months. A total of 159 male subjects were followed via mail survey one year later. The independent variables in the analyses were socio-demographic characteristics, smoking history and behavior, receipt of smoking cessation aids, health behaviors and components of the health belief model (HBM). The dependent variable was smoking relapse assessed one year after quitting. Ordered logit regressions were used to identify factors associated with smoking relapse. Results: The relapse rate of the ex-smokers in our sample was 25.8%, and the occasional smoking rate was 17.0%. Univariate analyses revealed that only factors related to the HBM, such as perceived susceptibility to diseases (p<0.01), perceived severity of diseases (p<0.01), perceived health benefits of not smoking (p<0.01), perceived barriers to quitting smoking due to increasing stress and difficulty in social life (p<0.01), and self-efficacy (p<0.01) were associated with the likelihood of relapse for ex-smokers. Ordered logit analyses yielded two significant factors affecting the likelihood of relapse, the perceived barriers to quitting smoking and self-efficacy. Conclusions: Our results indicate that higher levels of barriers to quitting smoking and lower levels of self-efficacy were significantly related to risk of smoking relapse. These findings may be useful for identifying those at highest risk for relapse and choosing the optimal strategies for prevention of relapse for ex-smokers.

Maxillary necrosis - a case report

Osteonecrosis of the jaws have been reported due to fungal infection, radiotherapy, medicinal side effects, coupled with systemic debilitating conditions. A case of avascular necrosis or osteonecrosis of the right maxillary segment, caused by alcohol abuse coupled with uncontrolled diabetes is being reported. The patient was an alcoholic, taking tobacco in gutkha form and an occasional bidi smoker with a history of diabetes mellitus and cirrhosis of liver. Ail of these could have led to the necrosis of the right maxillary segment.

Factors Associated with Quit Attempts and Quitting among Eastern Hungarian Women who Smoked at the Time of Pregnancy

The purpose of this research was to assess factors associated with quit attempts and successful smoking cessation among a sample of socioeconomically disadvantaged pregnant women living in Eastern Hungary. In-person interviews were conducted among 201 women residing in Eastern Hungary who self-identified as occasional or regular smokers at the time they learned they were pregnant. 54% of the women were smokers at the time they learned they were pregnant. Just over half tried to quit, but only 20% were successful. Factors associated with reduced likelihood of quit attempts included being a regular (vs. occasional) smoker (OR = 0.36, 95% CI 0.13-1.00) and being Roma (vs. non-Roma) (OR = 0.32, 95% CI 0.14-0.72). Women who completed high school were 7% times more likely to quit (OR = 7.5, 95% CI 1.68-33.2) and those who were employed were 7% times more likely to quit (OR = 7.6, 95% CI 1.88-30.35). Regular smokers were 88% less likely to quit than occasional smokers. Smoking cessation interventions targeting pregnant women are needed in Eastern Hungary. Efforts to integrate smoking cessation into the current excellent pre-natal care and health visitor program will reach most women who are pregnant or who have given birth within the preceding 3 years.

Perceptions of young Jordanian adults to proposed anti-tobacco pictorial warning labels

BackgroundIn commitment to the Framework Convention on Tobacco Control (FCTC), four new pictorial warnings are now being proposed for display on cigarette packages sold in Jordan. The aim of this study was to gauge the immediate perceptions of young Jordanian adults towards these new pictorials and compare these perceptions to those of the pictorial currently being used in the country.MethodsA cross-sectional survey was conducted on a convenience sample of youth aged 17-26. The interviewer-administered survey gauged participants' perceptions of salience, fear elicitation, and gained information as well as participants' motivation to remain non-smokers or quit smoking after viewing each of the four proposed new pictorials as well as the current pictorial used in Jordan. Perceptions regarding each new pictorial were compared to the current pictorial.ResultsA total of 450 surveys were included in the analysis. The sample (mean age 20.9) was 51.6% female and 31.3% cigarette (regular or occasional) smokers. In smokers, only one proposed pictorial had significantly more smokers perceiving it as salient or adding to information when compared to the current pictorial. More smokers reported fear when observing the proposed pictorials compared with current pictorial, but overall proportions reporting fear were generally less than 50%. Furthermore, all new pictorials motivated significantly more smokers to consider quitting compared with the current pictorial; however, the overall proportion of smokers reporting motivation was < 25%. Among nonsmokers, significantly more respondents perceived the new pictorials as salient and fear-eliciting compared to the old pictorial, but there were no major differences in information added. Motivation to remain non-smokers was comparable between the old and new pictorials.ConclusionGiven the variability of response across both smokers and nonsmokers, and across the three elements of perception (salience, added information, fear) for each pictorial, further testing of the pictorials in a more diverse sample of Jordanian young adults prior to launch is recommended.

Alcohol and tobacco co‐use in nondaily smokers: An inevitable phenomenon?

Alcohol use has consistently been associated with smoking among nondaily smokers. However, this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long-term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non-smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol-tobacco co-administration patterns. 183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face-to-face interviews during which they provided details about their lifetime and past-week tobacco and alcohol administration patterns. EOS were more likely to report having used alcohol at the time of their first-ever cigarette relative to the other subgroups (P ≤ 0.001), but there were no differences in past-week co-administration patterns between the subgroups. Overall, less than one-third of all smoking sessions occurred when drinking, but these accounted for more than half of all cigarettes consumed during the previous week. Moreover, while only 42% of drinking sessions involved tobacco co-administration, when drinking and smoking did co-occur, significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01). Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co-administration is associated with mutual dose escalation.