Past Smoking Behavior Research Articles

The effects of substance use on non-communicable diseases among older adults aged 60 and above in the North-eastern States of India.

The North-eastern region of India has a relatively higher prevalence of substance use, which together with poor dietary practices and a lack of physical activity is one of the key risk factors for NCDs among older adults in the region. Understanding the prevalence of NCDs and their relationship to substance use can help develop preventive strategies and sensitization in North-eastern India. To assess the prevalence of NCDs and the strength of the association of substance abuse among the geriatric population of North-eastern states in India, for the development of preventive strategies. Data from the Longitudinal Ageing Study in India (LASI Wave-I, 2017-18) were drawn to develop this paper. The bi-variate and binary logistic regression analyses were carried out to predict the association between non-communicable diseases and substance use adjusting select socio-demographic characteristics. The paper revealed the prevalence of NCDs among urban people (61.45%) is higher than among rural people (42.45%). Hypertension (37.29%) can be seen as the most prevalent disease among the following given NCDs followed by Diabetes (8.94%). The chances of having Cancer are nineteen times higher (OR = 19.8; C.I. = 18.82-20.83) if an individual has past smoking behaviour after controlling for socio-demographic and physical activity variables. Since, the high prevalence of hypertension correlated with the high level of substance abuse, require immediate attention to develop appropriate intervention strategies for its control (substance abuse) and prevention of hypertension. In a lower middle-income country like India, preventive measures, rather than curative measures will be cost-effective and helpful.

The Prevalence and Determinants of Vitamin D Status among Older Adults: Data from a Longitudinal Aging Study.

Aging is identified as a risk factor for vitamin D deficiency (VDD) therefore this investigation was designed to determine the prevalence of VDD and its determinants in a sample of older adults. The data of this study were obtained from the baseline wave of the Longitudinal Aging Study (LAS). Demographic, past medical history, medication history, and smoking behavior were collected using an interview approach. The physical activity and nutritional status of the participants were assessed using a standard questionnaire. Anthropometric indices were measured according to a standard protocol then body mass index (BMI) was calculated. Serum vitamin D and calcium levels were measured by autoanalyzers. Univariate and multiple logistic regression models were applied to detect the associated factors with VDD. Mean age of the participants was 71.82 (SD = 7.63) years. A total of 1319 people participated in our study, and 51.16% (n = 688) were female. A total of 8.42% (n = 111) of the participants had VDD and 17.06% of them (n = 225) had insufficient vitamin D levels. In the multivariable logistic regression model, the age group of 70-79 years in comparison with the age group of 60-69 years had a 43% less chance of VDD. Furthermore, being overweight (OR = 0.36, P = 0.01) and obese (OR = 0.35, P = 0.02), and taking vitamin D supplements (OR = 0.31, P = 0.04) were significantly associated with VDD. Our results showed that 25% of older adults had vitamin D deficiency or insufficiency. In addition, some modifiable lifestyle factors were associated with VDD. Given that, old age is considered a risk factor for VDD. Therefore, detection and improvement of VDD may be a preventive measure in at-risk subjects.

Quantifying the contribution of smoking to regional mortality disparities in Germany: a cross-sectional study.

ObjectivesSubstantial regional variation in smoking behaviour in Germany has been well documented. However, little is known about how these regional differences in smoking affect regional mortality disparities. We aim to assess the contribution of smoking to regional mortality differentials in Germany over the last four decades.DesignA cross-sectional study using official cause-specific mortality data by German Federal State aggregated into five macro-regions: East, North, South, West-I and West-II.ParticipantsThe entire population of Germany stratified by sex, age and region during 1980–2019.Main outcome measuresSmoking-attributable fraction estimated using the Preston-Glei-Wilmoth method; life expectancy at birth before and after the elimination of smoking-attributable deaths.ResultsIn all macro-regions, the burden of past smoking has been declining among men but growing rapidly among women. The hypothetical removal of smoking-attributable deaths would eliminate roughly half of the contemporary advantage in life expectancy of the vanguard region South over the other macro-regions, apart from the East. In the latter, smoking only explains around a quarter (0.5 years) of the 2-year difference in male life expectancy compared with the South observed in 2019. Among women, eliminating smoking-attributable deaths would put the East in a more disadvantageous position compared with the South as well as the other macro-regions.ConclusionWhile regional differences in smoking histories explain large parts of the regional disparities in male mortality, they are playing an increasingly important role for female mortality trends and differentials. Health policies aiming at reducing regional inequalities should account for regional differences in past smoking behaviour.

Lung cancer pathogenesis and poor response to therapy were dependent on driver oncogenic mutations

AimsLung cancer was the most fatal malignancy, dominated the cancer related mortality list for years, and we tried to distinguish the lung adenocarcinoma patients at higher risk from those bearing lower therapy resistance and recurrence risk. MaterialsPatients information from clinical Sequencing Cohorts and from the Regional Medical Center of the Middle-West China were included. The whole-exome sequencing was analyzed for risk evaluation. Key findingsWe found that Smoking stimulated the oncogenic genes mutations, and the most frequently mutated genes of EGFR, KRAS, and TP53 (E/K/P) were identified. Different N stage affected the survival prognosis of patients bearing E/K/P mutations, but the T stage and AJCC stage did not. Radiation failed to prolong survival of phase II/III patients who didn't receive surgery. In those received surgery, radiation also failed to prolong survival of phase II/III patients. Radiation did not improve the prognosis in patients bearing E/K/P mutation burdens, whose differences were identified in gender or smoking-history classified groups. SignificanceSmoking status and history contributed to oncogenic mutation burdens associated therapy resistance, and the aggressive treatment, especially to radiation, may lead to worse therapy response to current and past smoking behavior.

Those who believe they can, do: The relationship between smoking avoidance beliefs, perceived risks of smoking, and behavior in a sexual and gender minority young adult sample

An individual’s beliefs in their perceived risk and ability to resist smoking have been found to be associated with smoking behavior. The current study explores the effects of confidence in one’s ability to avoid smoking, measured by avoidance beliefs, on the relationship between perceived risks of smoking and behavior. This analysis was done using 2016 baseline data collected among 4057 participants aged 18–24 for the evaluation of a large-scale public education campaign in the U.S. aimed at reducing tobacco use among sexual and gender minority young adults. The analytic sample included roughly 3493 participants per analysis. Analyses used the following measures: (1) perceived risks of smoking (e.g., smoking cigarettes will shorten my life); (2) confidence to avoid smoking in various situations (i.e., avoidance beliefs), and (3) past 30-day cigarette smoking. Binary logistic regression models with interaction analyses assessed the relationship between perceived risks of smoking and past 30-day smoking behavior using the interaction term of avoidance beliefs. An interaction between perceived risks of smoking and avoidance behaviors interaction emerged, such that the negative relationship between perceived risks of smoking and smoking behavior was stronger for those who believed that they could avoid smoking in various situations. This suggests that the relationship between perceived risk and smoking behavior can be bolstered if one’s beliefs about their ability to avoid smoking are strong. Campaigns that build smoking avoidance confidence may enhance the effects of tobacco outcome expectations-related messaging on smoking.

A Combination of Factors Related to Smoking Behavior, Attractive Product Characteristics, and Socio-Cognitive Factors are Important to Distinguish a Dual User from an Exclusive E-Cigarette User.

Although total cessation of nicotine and tobacco products would be most beneficial to improve public health, exclusive e-cigarette use has potential health benefits for smokers compared to cigarette smoking. This study investigated differences between dual users and exclusive e-cigarette users provide information to optimize health communication about smoking and vaping. A cross-sectional survey (n = 116) among 80 current, adult dual users and 36 current, adult-exclusive e-cigarette users was conducted in the Netherlands. The questionnaire assessed four clusters of factors: (1) Past and current smoking and vaping behavior, (2) product characteristics used, (3) attractiveness and reasons related to cigarettes and e-cigarettes, and (4) socio-cognitive factors regarding smoking, vaping, and not smoking or vaping. We used random forest—a machine learning algorithm—to identify distinguishing features between dual users and e-cigarette users. We are able to discern a dual user from an exclusive e-cigarette user with 86.2% accuracy based on seven factors: Social ties with other smokers, quantity of tobacco cigarettes smoked in the past (e-cigarette users) or currently (dual users), self-efficacy to not vape and smoke, unattractiveness of cigarettes, attitude towards e-cigarettes, barriers: accessibility of e-cigarettes, and intention to quit vaping (A). This combination of features provides information on how to improve health communication about smoking and vaping.

Effect of tobacco control policies on intention to quit smoking cigarettes: A study from Beirut, Lebanon.

INTRODUCTIONIn Lebanon, the tobacco control policy, Law 174, became effective in 2011. Using the International Tobacco Control Policy Evaluation Project (ITC) conceptual model, this study aims to assess the association between exposure to control measures related to the policy and the intention to quit, which is a mediator in the pathway leading to behavioral change (quitting).METHODSThis is a secondary data analysis of 154 cigarette smokers from a cross-sectional survey that assessed compliance with Law 174 among Beirut residents aged 15–65 years. Data were collected face-to-face, three months after the implementation of indoor public places and tobacco advertisement/promotion bans. Intention to quit smoking was the main outcome. Exposure to policy control measures such as seeing smokers in restaurants, and noticing warning labels on cigarette packs were the explanatory variables. Sociodemographics, past smoking behavior, and psychosocial variables were also considered for their moderating and mediating effects, respectively. Crude and adjusted odds ratios (ORs) were generated. Sobel test was used to check for possible mediation.RESULTSIntention to quit was reported by 24% of cigarette smokers. The association between noticing warning labels and having intentions to quit was statistically significant (adjusted OR=6.27). Concerns about influencing children’s smoking behavior had a statistically significant mediation effect on the relationship. After adding the interaction term between noticing the warnings and previous quit attempts, the OR was inflated to 12.92, suggesting a possible interaction.CONCLUSIONSThis study offers preliminary insight into how Lebanese smokers are influenced by policy related control measures like health warning labels on cigarette packs. Tobacco control policy advocates should push for stronger enforcement of public smoking bans in general. Behavioral intervention should work on the mediator variables to influence smoking behavior and encourage quitting. Further prospective studies modelling quitting as outcome are needed.

Does time preference affect smoking behavior? A dynamic panel analysis

The association between time preference and smoking behavior forms supportive evidence for the rational addiction model. Individuals with a high discount rate place more weight on the immediate satisfaction of smoking than on its future consequences. However, the endogenous time preference model proposes an alternative explanation, that is, smoking behavior affects time preference. Since previous studies have overlooked it, using a dynamic panel analysis, I analyze the effect of time preferences on smoking behavior, while controlling for the effect of past smoking behavior. I use nationwide micro panel data from Japan and present three main findings. First, as in the previous literature, using a probit model, I find positive associations between time preferences and smoking behavior. Second, using a dynamic panel analysis, I find that time preferences affect smoking behavior significantly for women, but not for men. Third, male smokers who have a low discount rate are more likely to want to quit or reduce smoking behavior. This result implies that, while male smokers are concerned about the future consequences of smoking, they cannot manage to quit.

Unaided Smoking Cessation in Healthy Employees

Background: According to guidelines, behavioral and pharmacological assistance should be offered to all smokers willing to quit. However, a large proportion of ex-cigarette smokers are self-quitters. Objectives: To identify characteristics of long-term, unaided self-quitters, as compared to recurrent smokers among health care employees. Methods: University hospital employees (n = 5,218) were addressed through a 17-question questionnaire inquiring about past and current smoking behavior. Questions included daily cigarette consumption, pack-years, previous quit attempts, smoking-free period, and utilization of pharmacological therapies and counseling. Results: 2,574 (49.3%) questionnaires were returned. 791 subjects declared to have successfully quit smoking. A complete data set was available for 763 cases. Patients remained smoking free for a mean period of 11.8 ± 9.7 years. The most common smoking cessation method in these subjects was unaided (77.2%), followed by alternative approaches (15.4%), nicotine replacement therapy (4.5%), counseling (1.7%), and bupropion (1.2%). Smoking cessation was achieved with 1 attempt in 53% of the cases, 2 in 19%, 3 in 13%, and more than 3 attempts in 15%, respectively. On average, 2.4 ± 3.02 attempts led to successful smoking cessation. After 2 or more unsuccessful attempts, the odds ratio for a further unsuccessful smoking cessation was 2.58 (95% CI 1.94–3.45). Conclusion: The majority of the ex-smokers quitted smoking without any behavioral or pharmacological support. The chance to successfully quit smoking without any help in a first or second attempt is considerably high. The risk for smoking recurrence after 2 ineffective quit attempts is markedly increased (OR 2.58).

The dynamics of smoking-related disturbed methylation: a two time-point study of methylation change in smokers, non-smokers and former smokers

BackgroundThe evidence for epigenome-wide associations between smoking and DNA methylation continues to grow through cross-sectional studies. However, few large-scale investigations have explored the associations using observations for individuals at multiple time-points. Here, through the use of the Illumina 450K BeadChip and data collected at two time-points separated by approximately 7 years, we investigate changes in methylation over time associated with quitting smoking or remaining a former smoker, and those associated with continued smoking.ResultsOur results indicate that after quitting smoking the most rapid reversion of altered methylation occurs within the first two decades, with reversion rates related to the initial differences in methylation. For 52 CpG sites, the change in methylation from baseline to follow-up is significantly different for former smokers relative to the change for never smokers (lowest p-value 3.61 x 10-39 for cg26703534, gene AHRR). Most of these sites’ respective regions have been previously implicated in smoking-associated diseases. Despite the early rapid change, dynamism of methylation appears greater in former smokers vs never smokers even four decades after cessation. Furthermore, our study reveals the heterogeneous effect of continued smoking: the methylation levels of some loci further diverge between smokers and non-smokers, while others re-approach. Though intensity of smoking habit appears more significant than duration, results remain inconclusive.ConclusionsThis study improves the understanding of the dynamic link between cigarette smoking and methylation, revealing the continued fluctuation of methylation levels decades after smoking cessation and demonstrating that continuing smoking can have an array of effects. The results can facilitate insights into the molecular mechanisms behind smoking-induced disturbed methylation, improving the possibility for development of biomarkers of past smoking behavior and increasing the understanding of the molecular path from exposure to disease.

Posttraumatic Symptom Reporting and Reported Cigarette Smoking During Pregnancy.

Increased prevalence of nicotine dependence among individuals suffering from posttraumatic stress disorder (PTSD) is well established. However, there are limited studies on the prevalence of smoking during pregnancy in relation to prepregnancy history of trauma exposures and active PTSD symptoms during pregnancy. Prenatal smoking has been implicated in a host of negative outcomes for mother and baby. Given maternal and fetal risk, it is critical to define predictors of continued cigarette smoking during pregnancy. Pregnant women from an urban perinatal clinic completed an anonymous survey of trauma history using a modified Traumatic Life Events Questionnaire (TLEQ), PTSD symptoms using the PTSD Symptom Checklist-Civilian Version (PCL-C) and current and past smoking behavior. Those who smoked any number of cigarettes per day after pregnancy confirmation were considered to be "pregnant smokers." Of 218 women who completed the survey, 34 (15.6%) reported smoking cigarettes after confirmation of pregnancy. In unadjusted models, trauma exposure that resulted in fear, helplessness, or horror (FHH), as well as current PTSD symptom severity and probable PTSD diagnosis showed statistical significance as predictors of smoking during pregnancy. After adjusting for age only, PTSD symptoms retained their significant association with smoking during pregnancy. When history of smoking at least five cigarettes per day was added to our models, none of the associations remained significant. These findings emphasize the importance of the behavioral response to past traumatic exposures in influencing cigarette smoking behavior before pregnancy. Given such behaviors enhance risk for continued tobacco use during pregnancy, a trauma-informed approach to smoking cessation in preconception care may ultimately reduce the likelihood of smoking during pregnancy and requires further study.

Determinants of Hypertension among Elderly People in the Bongo District of Ghana

Hypertension is one of the commonest non-communicable diseases seen among elderly persons in Ghana in recent times, with many preventable factors contributing to its prevalence. This study sought to establish the determinants of hypertension among elderly people living in the Bongo district of Ghana. This was a cross-sectional study conducted among 240 participants, aged 60 years and above, in 5 randomly selected centres in the Bongo district. Data on participants smoking habits, salt intake behaviour, alcohol consumption and physical activity level were collected. Blood pressure and anthropometric measurements were taken. The prevalence of hypertension among the participants was 38.3%. Past smoking behaviour (OR=2.541, p=0.043), high alcohol intake (OR=1.657, p=0.040), high salt intake (OR=3.839, p=0.037) and physical activity (OR= 0.804, p=0.032), obesity (OR=2.311, p=0.019) and low socioeconomic status (OR=2.211, p=0.029) were the determinants of hypertension among the study participants. Hypertension among elderly people in the Bongo district is on the ascendancy and assuming proportion of public health importance. Findings from this study could serve as an impetus for public health policy formulation for prevention and early diagnosis of hypertension among elderly people in the Bongo district and other resource poor rural communities in Ghana.

The Enduring Effects of Smoking in Latin America

We estimated smoking-attributable mortality, assessed the impact of past smoking on recent mortality, and computed expected future losses in life expectancy caused by past and current smoking behavior in Latin America and the Caribbean. We used a regression-based procedure to estimate smoking-attributable mortality and information for 6 countries (Argentina, Brazil, Chile, Cuba, Mexico, and Uruguay) for the years 1980 through 2009 contained in the Latin American Mortality Database (LAMBdA). These countries jointly comprise more than two thirds of the adult population in Latin America and the Caribbean and have the region's highest rates of smoking prevalence. During the last 10 years, the impact of smoking was equivalent to losses in male (aged ≥ 50 years) life expectancy of about 2 to 6 years. These effects are likely to increase, particularly for females, both in the study countries and in those that joined the epidemic at later dates. Unless innovations in the detection and treatment of chronic diseases are introduced soon, continued gains in adult survival in Latin America and the Caribbean region may slow down considerably.

Role of smoking in regional variation in mortality in Poland.

We assess the effect of smoking on regional disparities in mortality in Poland and its contribution to the change in regional disparities during the last two decades. We used population-level mortality data from the population registry for 379 Nomenclature of Territorial Units for Statistics (NUTS)-4 Polish regions for 1991-93 and 2008-10. The importance of smoking was assessed by smoking-attributable mortality (SAM) derived using a simplified indirect Peto-Lopez method. Regional differences in age-standardized all-cause, smoking- and non-smoking-attributable mortality (NSAM) rates at ages 35 years and over were mapped, and spatial clustering (Moran's I) and coefficients of variation (CV) were estimated. The contribution of SAM to variation in all-cause mortality was assessed by variance decomposition and compared over time. In 2008-10, all-cause and SAM rates were characterized by a similar pattern of spatial clustering (Moran's I > 0.44, P < 0.0001). For NSAM, a more random pattern with less regional clustering showed (Moran's I = 0.34, P < 0.0001). The contribution of smoking to regional variation was substantial [54%, 95% confidence interval (CI) = 44.9, 62.5 among men; 24.9%, 95% CI = 20.9, 29.1 among women], and compared with 1991-93, 27.5 percentage points lower for men and 6.3 percentage points higher for women. Smoking contributed to the divergence between the regions in all-cause mortality between 1991-93 and 2008-10 for men [increase in CV of SAM by 2% (0, 4%)], but not for women [decrease in CV of SAM by 15% (22, 10%)]. Differences in past smoking behaviour may largely explain the regional differences in all-cause mortality existing in 2008-10 in Poland, and its trends since 1991-1993.

Alcohol problems as a signal for sensitivity to nicotine dependence and future smoking

BackgroundAlcohol use is a well-documented risk factor for the emergence of chronic smoking behavior. Very little is known, however, about the mediating pathways through which alcohol and/or alcohol-related problems influence future smoking. MethodsData were drawn from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study (SECASPS). Adolescents who had smoked under 100 cigarettes in their lifetime (n=898; experimenters) and adolescents who had smoked over 100 cigarettes, but fewer than 5 cigarettes per day (n=152: current smokers) were examined separately (grouping variable). Path analysis was performed to investigate the association between alcohol related problems at baseline (primary predictor) and smoking regularity at the 48month follow-up (primary outcome), both directly and through mediating variables of smoking quantity and frequency, and nicotine dependence (averaged across these measures at 6-, 15-, and 24-month assessment waves). ResultsAmong experimenters, after controlling for smoking and alcohol use, the association between alcohol-related problems at baseline and smoking frequency 48months later was fully mediated by nicotine dependence symptoms. Among current smokers, only past smoking behavior was associated with 48-month smoking frequency. ConclusionsAlcohol-related problems are a risk factor for future smoking among novice adolescent smokers above and beyond drinking or smoking per se. By signaling sensitivity to nicotine dependence symptoms, alcohol related problems represent an easily measureable risk factor that can be used to identify and intervene with adolescents before more chronic smoking behaviors emerge.

Inflammatory Myofibroblastic Tumor of the Pancreas: A Case Report

Context Inflammatory myofibroblastic tumors (IMTs), although originally described in the pulmonary system, are being reported in different anatomical locations. Case report A 55-year-old, asymptomatic man with clinical history of arterial hypertension and past smoking behavior, was admitted to our Surgical Unit in March 2012. A previous CT scan, performed for benign prostatic hyperplasia, revealed a 30 mm diameter mass in the pancreatic tail. Laboratory tests were within normal range. A further contrast-enhanced CT scan confirmed the presence of a nodular hypodense lesion with calcifications in the pancreatic tail, with no involvement of the spleen. A CWRM showed no communication with the main pancreatic duct. Finally, a 18 F-FDG PET-CT scan showed no areas of pathological hyperfixation. The patient underwent a laparoscopic distal pancreatectomy. During the surgical procedure, due to the infiltration of transverse mesocolon and retroperitoneal fat, an en-block resection of pancreatic body-tail, spleen and splenic flexure of the colon was performed. The postoperative course was uneventful and the patient was discharged in postoperative day 9 th . Macroscopically, the pathological examination showed a whitish, solitary, calcific, irregular shaped nodule. Microscopically, the lesion was characterized by myofibroblastic spindle cells mixed with diffuse inflammation made up of lymphocytes, plasmacells and eosinophils. Moreover, a myxoid struma together with a rich vascular growth was detected. These findings were consistent with a fasciitis-like variant of IMT. The patient is well and alive at 3 months from surgery. Conclusion To our knowledge, only 26 case of pancreatic IMT are reported in literature. They were mostly discovered incidentally and surgically treated, as in our case. This management seems to be correct because IMT is described as a neoplasm of intermediate biological behavior, with tendency for local recurrence instead of distant metastasizing.

Prevalence of smoking among the lesbian, gay, bisexual, transsexual, transgender and queer (LGBTTQ) subpopulations in Toronto--the Toronto Rainbow Tobacco Survey (TRTS).

Research in the United States has found a higher likelihood of smoking among lesbian, gay and bisexual people compared to the general population. However, the smoking prevalence of these subpopulations in Canada is not well documented. The objective of this study was to determine the prevalence of smoking among the LGBTTQ subpopulations in Toronto, Ontario. A self-report questionnaire was administered from April to July 2006 to a convenience sample of lesbian, gay, bisexual, transsexual, transgender and queer (LGBTTQ) community members in Toronto, Ontario. Items measured included: past and current smoking behaviour, sexual orientation, gender identity, age and residential area. In total, 3,140 LGBTTQ community members completed the Toronto Rainbow Tobacco Survey (TRTS). Overall, 36% of LGBTTQ participants reported current smoking, 25% were former smokers and 39% had never smoked. The smoking prevalence rates ranged from 24% to 45% across the different sexual orientation and gender identity groups of the sample, with bisexual women and bisexual men reporting the highest smoking rate at 45%. The study also reports the first known smoking prevalence rate for gender queer people at 44%. Younger LGBTTQ participants reported even higher smoking rates. This study corroborates prior research done in other jurisdictions by finding similar and higher smoking rates among Toronto's LGBTTQ subpopulations compared to the "mainstream" population. The relatively higher rates among LGBTTQ youth, bisexual and gender queer people have implications for targeted awareness and cessation initiatives. Need for future research is discussed.

Does smoking really harm your earnings so much? Biases in current estimates of the smoking wage penalty

Empirical studies on the earnings effects of tobacco use have found significant wage penalties attached to smoking. This article produces evidence that suggests that these estimates are significantly upward biased. The bias arises from a general failure in the literature to control for past smoking behaviour of individuals. Two-Stage Least Squares (2SLS) regressions show that the smoking wage penalty is reduced by as much as a third, if past smoking of individuals is controlled for.

Smoking attitudes, intentions, and behavior among college student smokers: Positivity outweighs negativity

Smokers’ attitudes toward smoking tend to be characterized by ambivalent feelings of positivity and negativity, thereby raising the question of whether the effect of smoking attitudes on smoking behavior is mediated by the absence of negativity and/or by the presence of positivity. In two studies, undergraduate smokers rated how positive and negative they felt about smoking and reported how much they had smoked the previous month. Study 2's participants also reported how much they intended to smoke over the next month and, at 1-month follow-up, how much they actually had smoked during the previous month. Positivity, but not negativity, toward smoking predicted past smoking behavior, concurrent intentions to smoke, and future smoking behavior. Results suggest that weakening positive reactions toward smoking may deter smoking more than strengthening negative reactions does. Potential mechanisms are discussed, as well as the prospect of increasing negativity's deterrent effect.

Biases in Estimates of the Smoking Wage Penalty

Empirical studies on the earnings effects of tobacco use have found significant wage penalties attached to smoking. We produce evidence that suggests that these estimates are significantly upward biased. The bias arises from a general failure in the literature to control for the past smoking behavior of individuals. 2SLS earnings estimates show that the smoking wage penalty is reduced by as much as a third, if past smoking of individuals is controlled for. Our results also point to significant wage gains for individuals that quit smoking, a finding that is of substantial interest, given the lack of evidence on the earnings effects of smoking cessation.