Past Smoking Behavior Research Articles

Cigarette smoking and alcohol behaviour among adolescents in Italy

The onset of cigarette smoking and alcohol con-sumption during early adolescence is of criticalsignificance since it may contribute to the devel-opment of a variety of diseases. Indeed, there is astrong link between smoking and alcohol consump-tion and the increasing mortality and morbidityrates of respiratory and cardiovascular diseases,cancer, and psychiatric disorders. In Italy, greatattention has been paid to prevention strategiesaimed at communicating health risks and reducingconsumption, and recently the parliament enactedmore comprehensive and aggressive tobacco con-trol legislation, which included restrictions onsmoking in all public settings and an increase inthe price of a packet of cigarettes.The purpose of this study was to evaluate theprevalence of cigarette smoking and alcohol con-sumption, and the knowledge concerning theirhealth effects among adolescents in Italy.This study was conducted from October toDecember 2002, involving 700 adolescents aged14–18 years randomly selected from randomlyselected public secondary classes in the city ofCatanzaro, Italy. Students completed an anon-ymous self-administered questionnaire in the class-room; participation was voluntary after providinginformed consent. The questionnaire includeditems on: socio-demographics; past and currentcigarette smoking and alcohol consumption beha-viour; knowledge and main sources of informationon the health effects of active and passivecigarette smoking and of alcohol consumption;number of adult family members and close friends

Association of parental smoking behaviors and absences in school‐age children: Implications for the nurse practitioner

To examine the association between reported absences and parental smoking in school-age children, aged 6-17, and to specifically explore the impact of maternal smoking on the health and attendance of school-age children. The sample of 7488 parent-child dyads was randomly selected from the 2002 National Health Interview Survey, a multipurpose cross-sectional household interview survey conducted by the Centers for Disease Control and Prevention. The parent sample included 2673 men and 4375 women. Children's ages ranged from 6 to 17 with a mean of 11.7 years. Maternal, but not paternal, present and past smoking behavior significantly impacts the child's wellness and school attendance. The reasons for this disparity are unclear but may relate to synergistic effects of pre- and postnatal nicotine exposure, the traditional role of mother as caregiver, or specific smoking habits that increase environmental tobacco exposure. Assessment and educational strategies for families regarding the hazards of childhood exposure to environmental tobacco smoke are indicated. Specific implications for the role of the nurse practitioner across diverse specialties are addressed with emphasis on the need for development of gender, age, and culturally sensitive smoking cessation programs and support networks.

Impact of reproductive experience on women's smoking behaviour in Japanese nurses

The objectives of this study were to describe current and past smoking behaviour of female Japanese nurses, to examine factors associated with developing and stopping a smoking habit, and to examine how their reproductive experiences affect their smoking behaviour. A cross-sectional study. This study was a baseline survey of a prospective occupational cohort study. A self-administered survey of 1748 female Japanese nurses aged over 20 years was conducted in Gunma prefecture, Japan, in 1999. Overall, 27.2% developed a smoking habit (current smokers, 19.8%; ex-smokers, 7.4%) and 72.2% were never smokers. Logistic regression analysis showed that the type of nursing certificate was statistically associated with developing a smoking habit. It also showed that the type of nursing certificate, work place, marital status and current pregnancy were statistically associated with smoking cessation. Currently pregnant women were more likely to stop smoking than non-pregnant women (adjusted odds ratio, 3.18; 95% confidence intervals, 1.25-8.06). For women aged 20-29 years, the proportions of current smokers, ex-smokers and never smokers among pregnant women were 11.5, 23.1 and 65.4%, respectively; among non-pregnant women of this age, the values were 22.3, 4.3 and 73.4%, respectively. There was a statistically significant difference in such proportions between the two groups (chi2=19.27; P<0.0001). More than half of the ex-smokers who were currently pregnant had stopped smoking in the last 12 months. Smoking behaviour showed no statistically significant difference between women who had had at least one delivery and women who had not. The results suggest that pregnancy provides a good opportunity for smoking cessation, but a large proportion of women who successfully quit smoking during pregnancy relapse after delivery.

The association of cigarette smoking and anxiety, depression and fears of recurrence in patients following treatment of oral and oropharyngeal malignancy.

Psychological factors, including distress and fears of recurrence, may be implicated in explaining why head and neck oncology patients continue or refrain from smoking. The aim was to determine the role of psychological factors in understanding smoking behaviour in a consecutive group of cancer patients attending a Regional Maxillofacial Unit over an assessment period of 12 months. A consecutive sample (n = 87) was assessed at 3, 7, 11 and 15 months following initial treatment. Measures of psychological distress included the Worry of Cancer Scale and the Hospital Anxiety and Depression Scale. Patient self-report assessed tobacco consumption. At follow-up, 73 patients successfully completed the four timed assessments (84% response rate). Twenty patients were consistent smokers (27%), 37 (51%) abstained, 7 (10%) returned to smoking, whereas 9 (12%) ceased to smoke by the final 15-month follow-up. Between the consistent smokers and abstainers there was a significant raised level of distress in the smoking group at each assessment after the initial baseline. Fear of recurrence was weakly related to smoking behaviour. The level of cigarette consumption at baseline was a significant predictor (adjust r (2) = 0.37) of psychological distress at 15 months in committed smokers. Previous duration of tobacco consumption prior to illness predicted psychological distress in abstainers (standardized coefficient = 0.29, n = 30, P < 0.036). In conclusion, past and current smoking behaviour is associated with psychological distress in patients with oral and oropharyngeal malignancy in their first 15 months of recovery following initial treatment. This behaviour successfully identified a psychologically at-risk group.

Strength of the relationship between tobacco smoking, nicotine dependence and the severity of alcohol dependence syndrome criteria in a population-based sample.

Little is known about the relationship between current and past smoking behaviour and the severity of alcohol dependence. The purpose was to explore the strength of this relationship. A random population sample of 18 to 64 year-olds from northern Germany was used (n = 4075; participation rate: 70%). It included 761 cigarette smokers fulfilling at least one alcohol-dependence criterion. The severity of alcohol dependence according to the alcohol-dependence syndrome criteria frequency (ASF) was estimated by a standardized questionnaire based on diagnostic instruments of the alcohol dependence syndrome and which included five response categories, from 'never' to 'daily'. Nicotine dependence was diagnosed according to the Diagnostic and Statistical Manual of mental disorders (DSM-IV) with the Composite International Diagnostic Interview (CIDI). As a second measure, the Fagerström Test of Nicotine Dependence (FTND) was used. The number of cigarettes and years of daily smoking, nicotine dependence, and the number of nicotine dependence symptoms each showed a relationship with the ASF. Effect size (w) were 0.17-0.21 for chi-squared (chi(2)) tests. In a general linear regression model with the ASF as the dependent variable (R(2) = 0.17), number of years of daily smoking, age at onset of smoking, number of attempts to reduce or quit, the number of nicotine-dependence symptoms according to DSM-IV and the FTND sum score were retained as independent variables. Long-term smoking, a large number of nicotine-dependence symptoms according to DSM and a strong urge to smoke according to the FTND are related with a high ASF.

Understanding adolescent smoking: The role of the Theory of Planned Behaviour and implementation intentions

This research examined the power of the Theory of Planned Behaviour (TPB) to predict smoking intentions and smoking behaviour in a sample of adolescents (N = 162). In addition, the role of past smoking behaviour and an implementation intention intervention was assessed. TPB variables and smoking behaviour was assessed by self-report questionnaires given to children (11 and 12 years old) at the beginning of the study (time 1) and again 8 weeks later (time 2). All children received information against smoking and either formed an implementation intention about how, where and when they could resist smoking, or in the control condition how, where and when they could finish all their work at school. The TPB provided good predictions of intentions cross-sectionally (R2 = 0.27) and prospectively (R2 = 0.23) and behaviour prospectively (91% correctly classified). Past behaviour was only significant in the prospective analyses. Implementation intentions produced modest reductions in smoking and smoking initiation compared to the control group. These differences were not significant. Implementation intentions increased the power of attitudes and decreased the power of perceived behavioural control to predict intentions prospectively. Implications for furthering our understanding of smoking initiation in this group are discussed.

Changes of neoplasm concentration with geographical co-ordinates

We investigated the regional differences in diversity—from another respect concentration—of causes of cancer mortality in England and Wales. Statistical analyses of published mortality data were done, using the jackknifed estimate of the Shannon index, for each region, sex and age group and year of death. In males diversity of cancer death causes is secularly increasing whilst it is decreasing in females. Latitude was negatively associated with diversity in male 45+ year age groups and longitude negatively associated with diversity in male 65+ age groups. Although, there were some significant associations in the female groups, there was no general trend across age groups as found in males. These trends remained after accounting for regional variation in past smoking behaviour. We suggest that the observed patterns may be related to prior occupational exposures and non-identified environmental and socioeconomical factors. It is concluded that techniques drawn from population ecology have a potential value in epidemiological studies of human disease. Ecological methods by themselves are likely to be of value in hypothesis generation rather than hypothesis testing.

The impact of aging and smoking on the future burden of chronic obstructive pulmonary disease: a model analysis in the Netherlands.

Chronic obstructive pulmonary disease (COPD) causes extensive disability, primarily among the elderly. On the World Health Organization ranking list of disability-adjusted life years (DALYs), COPD rises from the twelfth to the fifth place from 1990 to 2020. The purpose of this study is to single out the impact of changes in demography and in smoking behavior on COPD morbidity, mortality, and health care costs. A dynamic multistate life table model was used to compute projections for the Netherlands. Changes in the size and composition of the population cause COPD prevalence to increase from 21/1,000 in 1994 to 33/1,000 in 2015 for men, and from 10/ 1,000 to 23/1,000 for women. Changes in smoking behavior reduce the projected prevalence to 29/1,000 for men, but increase it to 25/ 1,000 for women. Total life years lost increase more than 60%, and DALYs lost increase 75%. Costs rise 90%; smokers cause approximately 90% of these costs. The model demonstrates the unavoidable increase in the burden of COPD, an increase that is larger for women than for men. The major causes of this increase are past smoking behavior and the aging of the population; changes in smoking behavior will have only a small effect in the nearby future.

Public and private self-consciousness and smoking behavior in head and neck cancer patients.

Patients who continue to use tobacco following treatment for head and neck cancers are at a greater risk for cancer recurrence and earlier mortality. This study examined the unique effects of public and private self-consciousness and negative affect on smoking behavior in a sample of 40 patients with cancers of the head and neck. Measures of public and private self-consciousness and negative affect were administered and assessments of past and current smoking behavior were obtained. Only public self-consciousness was a significant predictor of continued smoking following oncologic treatment. Specifically, individuals with low levels of public self-consciousness were nearly 13 times more likely to continue smoking compared to those with relatively higher levels of public self-consciousness. This pattern is interpreted in the context of previous theorizing that suggests individuals high in public self-consciousness are more likely to discontinue habitual behavior that is perceived as socially undesirable or incorrect.

Psychosocial versus nicotine-only self-report measures for predicting follow-up smoking status.

The most popular measure of tobacco dependence, the Fagerstrom Tolerance Questionnaire (FTQ), measures only tobacco-specific behaviors. In contrast, the most popular assessment of addiction among polydrug users is the Addiction Severity Index (ASI). Most of the subscales comprising the ASI are psychosocial measures, not drug-specific measures. A study was undertaken to compare the predictive utility of these two contrasting measures. The NAS (adapted from the FTQ) and the Addiction Severity Index (ASI) were used to predict future smoking status in a cohort of polydrug users followed annually for 3 years. The baseline NAS score explained more of the variance in Time 2 and Time 3 smoking status than did the ASI subscales. When previous smoking status was included as a covariate, however, the NAS no longer predicted future smoking status, whereas the ASI Subscales continued to explain significant variance in future smoking status. Results suggest that when past smoking behavior is known, a respondent's legal status and alcohol use may be more useful than a measure of tobacco dependence for predicting future smoking status.

Lung cancer and cigarette use: Cognitive factors, protection motivation and past behaviour

Objective. To assess relationships between health cognitions and protection motivation regarding cigarette use and lung cancer. Design. Cross‐sectional questionnaire survey. Variables were intentions (i.e., motivation) perceptions of susceptibility to and severity of lung cancer, the benefits or effectiveness of not smoking in reducing the risk of lung cancer, barriers to not smoking, past smoking behaviour, and demographic factors (age, gender). Method. Two‐hundred and seventy‐five men and women (aged 18‐66 years) were administered and returned the questionnaire. Multiple regression analysis was used to analyse the data. Results. Past cigarette use predicted stronger intention to smoke, accounting for 70% of the variance. Perceptions of susceptibility and barriers increased the variance explained, but only marginally. Greater perceived likelihood of contracting lung cancer and stronger perceived barriers to not smoking predicted higher motivation to smoke. Conclusions. Results provide limited support for the role of health cognitions in intended cigarette use, and justify the incorporation of past risk behaviour in social cognition models applied to cigarette use.

Lack of improvement of life expectancy at advanced ages in The Netherlands.

Several countries have reported an increase in life expectancy at advanced ages. This paper analyses recent changes in life expectancy at age 60 and 85 in The Netherlands, a low mortality country with reliable mortality data. We used data on the population and the number of deaths by age, sex and underlying cause of death for 1970-1994. Life expectancy at age 60 and 85 was estimated using standard life-table techniques. The contribution of different ages and causes of death to the change in life expectancy during the 1970s (1970/74-1980/84) and the 1980s (1980/84-1990/94) were estimated with a decomposition technique developed by Arriaga. Life expectancy at age 60 increased in the 1970s and 1980s, whereas life expectancy at age 85 decreased (men) and stagnated (women) in the 1980s, and has decreased in both sexes since 1985/89. The decomposition by age showed that constant mortality rates in women aged 85-89, and increasing mortality rates at ages 85+ (men) and 90+ (women) have caused this lack of increase in life expectancy. The decomposition by cause of death showed that smaller mortality reductions from other cardiovascular and cerebrovascular diseases, which contributed most to the increase in life expectancy at age 85 in the 1970s, and mortality increases from, amongst others, chronic obstructive pulmonary disease (COPD), mental disorders and diabetes mellitus produced the decrease (men) and plateau (women) in life expectancy at age 85. Life expectancy at advanced ages stopped increasing during the 1980s in The Netherlands due to mortality increases at ages 85+ (men) and 90+ (women). Cause-specific trends suggest that, in addition to (past) smoking behaviour in men, changes in the distribution of morbidity and frailty in the population might have contributed to this stagnation.

Stage transitions and the transtheoretical “stages of change” model of smoking cessation 1Joseph P. Carbonari, Ed.D., Kenneth B. Sewell, M.S., M.A. are in the Psychology Department at the University of Houston. Carlo C. DiClemente, Ph.D., is Chair of the Psychology Department at the University of Maryland, Baltimore County. This research was partially supported by Grant CA 27821 from the National

This study examined the application of a Markov chain analysis for modeling transitions in the process of smoking cessation from the perspective of the Transtheoretical “Stages of Change” model. A convenience sample of 308 individuals, who were followed at 6-month intervals for a 30-month period, answered questionnaires regarding their past and current smoking behavior, and their quitting attempts and intentions. A first order, single transition, Markov model was found to fit the data well, indicating that stage information from a single previous 6 month time point was sufficient to predict current stage membership. A composite transition probability matrix indicated that significant stability occurred in Precontemplation, Contemplation, and Maintenance stages with greater transitions among stages for smokers in Preparation and Action stages. In addition, more people tended to progress in stage status toward successfully maintained cessation than to either regress or make no change in stage membership over the 2 1/2 years of the study. These results support the utility of stage based models of change in understanding the process of smoking cessation. Smoking cessation is marked by significant periods of stasis as well as recycling through the stages. For a significant number of this cohort of participants there was progress and movement toward successful change that seemed to support the spiral movement through the stages of change proposed by the Transtheoretical “stages of change” model.

The synergy of low lung function and low body mass index predicting all-cause mortality among older Japanese-American men.

To assess the joint characteristics of low standardized weight and compromised pulmonary function in predicting all-cause mortality. A population-based, prospective cohort study. Oahu Island, Hawaii. Surviving Japanese-American men of the Honolulu Heart Program cohort, 71 to 93 years of age (N = 3059). Body mass index (BMI-weight in kilograms/square of height in meters) and 1-second forced expiratory volume (FEV1) as a percentage of age- and height-predicted FEV1 from the 1991 to 1993 examination of the cohort. Mortality data derived from the ongoing tracking of deaths of the cohort. Relations of selected risk factors among joint levels of BMI (< or = 21, > 21 to < 25, > or = 25 kg/m2) and percent predicted FEV1 (< or = 70%, > 70%) were determined. The impact of these covariates on relations between joint BMI/percent predicted FEV1 levels and subsequent all-cause mortality was assessed. The highest age-adjusted mortality rate (91.9 deaths per 1000 person-years) was noted among men characterized by the joint conditions of percent predicted FEV1 < or = 70% and BMI < or = 21 kg/m2. This rate was 4.0 times the mortality rate of a "healthy" reference group characterized by percent predicted FEV1 > 70% and 21 < BMI < 25 kg/m2. This rate ratio is attenuated to 3.2 upon statistical control for measures of current and past smoking behavior. Among the three strata of BMI, statistical interaction is reflected in a heterogeneity of mortality rate differences (49.7, 21.8, -9.6 deaths/person-year, respectively) and rate ratios (2.18, 1.98, .66, respectively) comparing men with percent predicted FEV1 < or = 70% to > 70%. Joint loss of pulmonary function and relative weight is predictive of subsequent all-cause mortality in excess of additive or multiplicative effects of each condition separately. Smoking behavior may contribute to this observation.

Predictors of smoking cessation in a cohort of adult smokers followed for five years.

OBJECTIVE: To identify variables predictive of smoking cessation in a cohort of cigarette smokers followed for five years. DESIGN: Data analysed in this paper come from a cohort tracking telephone...

Past and present smoking behaviour and its association with health-related habits in selected Israeli working populations. The Cordis Study.

Comprehensive surveys on the characteristics of smokers provide important data for the targeting and monitoring of smoking cessation programmes, and making international comparisons. Current information on this subject in Israel is very limited. During 1985-1987, the prevalence and correlates of cigarette smoking were examined in 5281 employees in Israeli industry, screened in the framework of the CORDIS study. The prevalence of smoking in men ranged from 44.7% in the age group 20-24 years to 28.0% in those aged 55-64. For women the prevalence ranged from 23.2% to 15.0% over the same age range. Ethnic differences were most marked in younger males with the highest prevalence in those of North African origin. Among females, the highest prevalence was among those of Western European origin. In most age groups, the highest proportion of exsmokers was found among those of Eastern European origin, except for older females where differences were not significant. Among males, educational differences were strong, with those of lower education smoking the most, whereas among females no significant differences were observed. For both sexes, past smokers were more prevalent in the highest education category. There was a cohort effect in declining age at starting smoking in both sexes and females tended to start smoking about 2 years older than males. Exsmokers tended to have been heavier smokers than current smokers, suggesting that heavy smokers may be more likely to quit than light smokers.(ABSTRACT TRUNCATED AT 250 WORDS)