Health Risks Of Smoking Research Articles

CIGARETTE QUITLINES, TAXES, AND OTHER TOBACCO CONTROL POLICIES: A STATE‐LEVEL ANALYSIS

This paper estimates monthly quitline calls using panel data at the state level from January 2005 to June 2010. Calls to state quitline numbers (or 1-800-QUITNOW) were measured per million adult smokers in each state. The policies considered include excise taxes, workplace and public smoking bans, and a Peter Jennings television-based program warning of the health risks of smoking. We found that people anticipating increases in prices begin attempting to quit by calling quitlines. Finally, the Peter Jennings media campaign was highly correlated with quitline calls.

Addressing smoking and other health risk behaviours using a novel telephone‐delivered intervention for homeless people: A proof‐of‐concept study

Despite substantial health disadvantage, few intervention studies have examined ways to deliver smoking cessation support to homeless people. This proof-of-concept study explored the feasibility and acceptability of a novel, low-cost, telephone-delivered program. Clients aged over 18 years, English-speaking and currently receiving accommodation support from a homelessness outreach centre were invited to participate in a 'Phone for Health' program. Six sessions conducted once per week provided participants with personalised counselling about smoking cessation or reduction, as well as fruit and vegetable consumption, alcohol use, physical activity and sun protection. Both clients and staff completed follow-up quantitative surveys, and clients completed qualitative interviews. Of 14 eligible participants, 12 consented to taking part and completed baseline measures, 10 commenced the telephone intervention and six completed the intervention program. Average length of telephone sessions was 17.8 min and participants completed an average of 3.8 sessions. Findings suggested high acceptability with most participants reporting that the Phone for Health program helped them meet their smoking reduction goals, and was convenient, useful and practical. Most participants reported making changes to their health risk behaviours as a result of taking part in the program. Telephone delivery of the smoking cessation and other health behaviours intervention was acceptable and feasible. The results provide pragmatic lessons for the development of future health research and practice with an underserved population markedly difficult to reach and engage.

Indoor air quality in Virginia waterpipe cafés

IntroductionA revised indoor air quality law has been implemented in Virginia to protect the public from the harmful effects of secondhand smoke exposure. This legislation contains exemptions that include allowances...

What Limits the Effectiveness of School-based Anti-smoking Programmes?

It is generally accepted that living in families where there are smokers, children are stressed not only by the harmful physical exposure to second-hand and third-hand tobacco smoke, but also by the negative models of the adult relatives' behaviour, as relatives who smoke can inspire children to imitate this behaviour, influencing attitudes towards, and early experiments with smoking. In this paper, some of the most important results about influence of family smoking on the effects of the anti-smoking educational programme "Non-smoking Is Normal" are described. The school-based programme was created by medical and educational specialists and targets children at the first level of primary schools (aged from 6 to 11 years). The data about interesting outcomes of the programme (knowledge, attitudes, behaviour) were collected by anonymous questionnaire, administered twice in each school year: one month before the complex of 5 lectures (pre-tests) and 4-5 months after the last lecture (post-tests). The sample of participants (860-910) was divided into four groups, according to the intervention and family backrounds: (1) programme children from smoking families "P-S"; (2) control children from smoking families "C-S"; (3) programme children from non-smoking families "P-NS"; (4) control children from non-smoking families "C-NS". The differences in the frequency of children's answers were analysed using the tests in statistic Epi Info software, version 6.04a (chi-square, Mantel Haenszel, Yates, Fisher). In the programme group, the number of children with smoking relatives was significantly higher than in the control group (80.1% vs. 73.0%, p < 0.01) as well as of those who reported frequent/daily exposure to secondhand smoke at homes and/or in cars (49.5% vs. 40.0%, p < 0.01). Smoking families significantly influenced the children's seeking of smoking friends (40% vs. 17%, p < 0.01). The programme has significantly increased the amount of knowledge about health risks of smoking. Both in the programme and control groups of children from non-smoking families, the frequency of critics of adults smoking was significantly higher all the time of the study (p < 0.05 and 0.01 resp.); however, the programme influenced children's opinions about smoking (criticism) only partially. Children's actual intentions about their smoking in the future was fully influenced by their smoking household environment: the number of "future no-smokers" has decreased in time and was significantly less frequent among children from smoking families (p < 0.01). The frequency of those willing to smoke significantly increased within the period between 3rd and 5th grades, both in the programme and the control groups (p < 0.01). An almost linear increase of active experimentations with cigarette smoking in follow-up monitoring was seen, trends of smoking children were steeper in groups from smoking families. The number of experiments with smoking was significantly lower in programme children of non-smoking parents only at the end of the study (p < 0.05). Despite of the effort to initiate parental participation on the primary prevention of smoking, we have confirmed that smoking in families decreased the efficacy of anti-smoking intervention targeted on young children at school age.

Cigarette Smoking and Drinking Behavior of Migrant Adolescents and Young Adults in Hanoi, Vietnam

There has been a large migration from rural to urban areas in much of the developing world. In the past, this was less true in Vietnam, which remains largely agricultural; however, since the 1990s, economic reforms and loosening of government policies that had previously limited movement have led to a large increase in this rural to urban population movement. Risky health behaviors have been found among migrants in many other settings. The purpose of this research was to determine whether migrant adolescents and young adults in the city of Hanoi are more or less likely than local ones to engage in cigarette smoking and alcohol drinking health risk behaviors, to identify factors associated with these behaviors, and to suggest interventions to reduce these health risk behaviors among the study population. A cross-sectional survey of 4,550 adolescents and young adults aged 15-24 years was conducted in urban Hanoi in 2006. This study examines current use of cigarettes and alcohol by migration status using multivariate logistic regressions. Cigarette smoking and drinking alcohol are male phenomena. The prevalence of cigarette smoking and alcohol drinking is high among adolescents and young adults in Hanoi and is more common among migrants who came from rural areas of other provinces than nonmigrants in the city. However, multivariate analysis revealed that migrants were neither more likely to smoke cigarettes nor drink alcohol than nonmigrants after controlling for other factors, such as age, full-time worker status, depression, and having close friends who smoke and/or drink. The results suggest that interventions aiming at smoking and/or drinking reduction should pay more attention to adolescents, especially males, changing health risk behaviors at school and at work, and peer influence than their migration status.

Smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness for smoke-free air in the workplace: a study from the Balkans

Identify the psychosocial variables that predict smokers’ compliance with smoke-free policies at work, and non-smokers’ assertiveness for smoke-free rights in Greek and Bulgarian workplaces. Data were collected from employees in Greece and Bulgaria. The main outcome measures were smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness intentions. Demographic variables, tobacco use and dependence, as well as beliefs about second-hand smoke (SHS) exposure and smoking at work were also assessed. Regression analyses showed that smokers’ compliance with smoke-free policies was predicted by age, perceived health risks of smoking, and beliefs related to the benefits of smoking at work. Non-smokers’ assertiveness was predicted by annoyance from exposure to SHS at work, and assertiveness-related social cognitions (e.g., attitudes, social norms, and self-efficacy). Interventions to promote support for tobacco control policies at work in Greece and Bulgaria may benefit from targeting smokers’ beliefs about the actual effects of tobacco use on health and job performance. Accordingly, efforts to promote non-smokers assertiveness should build stronger assertiveness-related attitudes, convey anti-smoking normative messages, and strengthen self-efficacy skills.

Knowledge of Health Effects and Intentions to Quit Among Smokers in India: Findings From the Tobacco Control Policy (TCP) India Pilot Survey

Awareness of the health risks of smoking is an important factor in predicting smoking-related behaviour; however, little is known about the knowledge of health risks in low-income countries such as India. The present study examined beliefs about the harms of smoking and the impact of health knowledge on intentions to quit among a sample of 249 current smokers in both urban and rural areas in two states (Maharashtra and Bihar) from the 2006 TCP India Pilot Survey, conducted by the ITC Project. The overall awareness among smokers in India of the specific health risks of smoking was very low compared to other ITC countries, and only 10% of respondents reported that they had plans to quit in the next six months. In addition, smokers with higher knowledge were significantly more likely to have plans to quit smoking. For example, 26.2% of respondents who believed that smoking cause CHD and only 5.5% who did not believe that smoking causes CHD had intentions to quit (χ2 = 16.348, p < 0.001). Important differences were also found according to socioeconomic factors and state: higher levels of knowledge were found in Maharashtra than in Bihar, in urban compared to rural areas, among males, and among smokers with higher education. These findings highlight the need to increase awareness about the health risks of smoking in India, particularly in rural areas, where levels of education and health knowledge are lower.

The MAURO study: baseline characteristics and compliance with guidelines targets

The Multiple Intervention and Audit in Renal Diseases to Optimize Care (MAURO) study was a cluster randomized controlled trial in 22 renal clinics which aimed to assess the efficacy of a multimodal quality improvement intervention to increase compliance with guideline recommendations for prevention of chronic kidney disease (CKD) progression and cardiovascular (CV) complications. The trial aimed to test whether this multimodal intervention improved adherence to recommended targets for a series of surrogate indicators relevant to blood pressure (BP) control, sodium intake, proteinuria, dyslipidemia, anemia and calcium-phosphate alterations. The trial also tested whether the same intervention slowed CKD progression and prevented CV complications in CKD patients. Twenty-two renal clinics were randomized to 2 arms: an intervention arm applying a multimethod quality improvement intervention and a control arm providing standard care. Surrogate indicators were measured to evaluate blood pressure (BP) control, sodium intake, proteinuria, dyslipidemia, anemia and calcium-phosphate alterations. Notwithstanding the fact that the vast majority of patients enrolled in this study (95%) were being treated with antihypertensive drugs, BP goals at baseline (specific for proteinuria level and diabetes) were met only in 45% of nonproteinuric patients and in just 14% and 18% of proteinuric and diabetic patients, respectively. The use of diuretics in hypertensive patients was less than what was needed, and about 80% of patients showed a salt excretion >100 mmol/24 hours. Total and low-density lipoprotein cholesterol levels were out of target in over 40% of patients, but only about 60% of these were on statins. A large majority of CKD patients were obese or overweight. The proportion of smokers was relatively small (13%), and 37% of patients had quit smoking, indicating patients' awareness of the health risks of smoking. In our cohort, management of modifiable risk factors for CKD progression and CV disease could be substantially improved.

Size-change and deposition of conventional and composite cigarette smoke particles during inhalation in a subject-specific airway model

In light of the established health risks of cigarette smoking, less harmful cigarettes (or potential reduced exposure products (PREPs)) have been marketed. Thus, it is of interest to analyze and compare the inhaled droplet dynamics of conventional and new composite cigarette smoke particles (CSPs). Inhalation pattern, hygroscopic growth and deposition of different composite cigarette smoke particles (CSPs) have been simulated numerically in a subject-specific human respiratory airway model from the mouth to generation G9. The validated computer model has been developed to consider the interaction of different deposition mechanisms, including impaction, sedimentation, diffusion, hygroscopic growth, coagulation, as well as possible cloud motion under different exposure and steady breathing conditions (e.g., puffing, post-puffing and two-step inhalation). The computer simulation results are consistent with numerous in-vivo and in-vitro studies as well as whole-lung modeling for deposition of conventional CSPs including hygroscopic growth and cloud motion. It is demonstrated that changes in cigarette composition significantly influence the hygroscopic growth of CSPs. In general, the growth rate of new composite CSPs is larger than the conventional one if the initial water mole-fraction is lower in the droplet. Hygroscopic growth of the new composite CSPs is not a significant mechanism leading to elevated deposition in the oral and tracheobronchial (TB) airways, provided that the relative humidity in the lungs does not exceed 99.5% and the droplet size does not exceed 3μm; however, enhanced deposition may occur if the particles can grow over 3μm. In this case, the deposition patterns of CSPs may be controlled by changing the primary composition, especially the initial ratio of water and glycerol. The simulation data with cloud diameters of 0.15–0.2cm in the oral cavity and 0.5–0.6cm in the trachea closely match the in-vivo lung deposition measurements of highly dense (conventional) CSPs. Specifically, preferred deposition occurs in the upper airway region, i.e., from the oral cavity to the second bifurcation, with deposition fractions of about 13–22% from the oral cavity to the larynx and 40–57% in the TB airways. This study is helpful for quantitatively evaluating the dose-exposure and subsequent health effects of both conventional and potentially less-harmful cigarettes.

Effects of a Brief Cognitive Intervention Aimed at Communicating the Negative Reinforcement Explanation for Smoking on Relevant Cognitions and Urges to Smoke

AbstractIntroduction:The aim of the current study was to assess the impact of an intervention aimed at communicating the negative reinforcement explanation for smoking, a set of ideas derived from popular self-help books, upon participants' cognitions and urges to smoke. Methods: Smokers (n = 205) undergoing standard stop-smoking treatment were randomised to receive either the experimental intervention, a brief intervention aimed at communicating the explanation or a control intervention, a video on the health risks of smoking. Outcomes were participants' acceptance of the negative reinforcement explanation for smoking, positive outcome expectations for smoking, self-efficacy and urges to smoke reported at one week post-cessation. Results: Post-cessation urges to smoke were similar in the two groups (Adjusted expt. group mean = 2.50, Control group mean = 2.75, F(1,60) = 0.98, p = .33). Other cognitive measures were also unchanged. Conclusions: The brief cognitive intervention offered as an adjunct to standard care failed to reduce urges to smoke or alter smokers' cognitions. Changing smokers' cognitions may be as challenging as changing their behaviours. Suggestions are provided for further research.

Simulation-based smoking cessation intervention education for undergraduate nursing students

Smoking is one of the most important preventable risk factors that contributes to premature death from many tobacco-related diseases. Clinicians should offer and provide effective smoking cessation interventions to their smoking patients. Yet, few clinicians receive training in smoking cessation intervention. This one-group, quasi-experimental study was conducted to describe a simulation-based training of smoking cessation intervention and to evaluate its effectiveness on nursing students' self-efficacy in performing smoking cessation intervention, based on 5-As recommended by the United States Department of Health and Human Services. In addition, nursing students' experience, attitude and perceived barriers of smoking cessation intervention were also described. Among the 21 students (mean age: 21.6 ± 2.0 years), 86% were female, 62% were in their third year and 1% were current smokers. Most of students believed the health benefits of smoking cessation (100.0-66.7%) and were well educated about health risks of smoking (81.0-61.9%). However, few were taught (33.3-14.4%) and practiced (28.6-0.0%) smoking cessation intervention. Students reported that they should be actively involved in smoking cessation for patients (100.0-95.2%), but lack of knowledge and skills were the main barriers (90.5-85.7%). The simulation-based training of smoking cessation intervention improved nursing students' self-efficacy in seven out of nine skills of smoking cessation intervention (mean scores of pre- vs. post-intervention: 30.86 ± 3.80 vs. 34.05 ± 5.10; paired t=2.298, p=.027). These findings indicate that simulation could be effectively used in teaching smoking cessation intervention education delivered to nursing students.

Smoking behaviour, risk perception and attitudes toward anti-smoking legislation among a sample of South African students

This study sought to establish smoking behaviour, perceptions of health risks of smoking and attitudes toward anti-smoking legislation among a sample of South African university students. Undergraduates (225 women and 105 men) completed measures of behaviours, attitudes and perceptions related to smoking. The results showed that only 16% of the students reported to be smokers, of whom most were &bdquo;coloured‟ females. Both smokers and non-smokers indicated knowledge of increased risks of smoking and supported the strict anti-smoking legislation that has been implemented in South Africa. However, smokers minimised their personal risk of smoking related ill effects. These results suggest that anti-smoking strategies should consider the optimistic bias among smokers that leads them to minimise their susceptibility to smoking related illnesses.Key words: Smoking, tobacco, risk perception, anti-smoking legislation, students.

The Development and Validation of a Scale Assessing Individual Schemas Used in Classifying a Smoker: Implications for Research and Practice

Half of college students who have smoked in the past month do not consider themselves smokers. Understanding one's schema of smokers is important, as it might relate to smoking behavior. Thus, we aimed to develop a scale assessing how young adults classify smokers and establish reliability and validity of the scale. Of 24,055 students at six Southeast colleges recruited to complete an online survey, 4,840 (20.1%) responded, with complete smoking and scale development data from 3,863. The Classifying a Smoker Scale consisted of 10 items derived from prior research. Factor analysis extracted a single factor accounting for 40.00% of score variance (eigenvalue = 5.52). Higher scores (range 10-70) indicate stricter criteria in classifying a smoker. The scale yielded a Cronbach's alpha of .91. Current smoking (past 30-day) prevalence was 22.8%. Higher Classifying a Smoker Scale scores (p = .001) were significant predictors of current smoking, controlling for sociodemographics. Higher scores were related to being nondaily versus daily smokers (p = .009), readiness to quit in the next month (p = .04), greater perceived smoking prevalence (p = .007), not identifying as smokers (p < .001), less perceived harm of smoking (p < .001), greater concern about smoking health risks (p = .01), and less favorable attitudes toward smoking restrictions (p < .001). Among current smokers, higher scores were related to greater smoking frequency (p = .02), not identifying as smokers (p < .001), and less perceived harm of smoking (p < .001), controlling for sociodemographics. This scale, demonstrating good psychometric properties, highlights potential intervention targets for prevention and cessation, as it relates to smoking, risk perception, and interest in quitting.

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.

Support for smoke-free policy, and awareness of tobacco health effects and use of smoking cessation therapy in a developing country

BackgroundPreventing an epidemic increase in smoking prevalence is a major challenge for developing countries. Ghana, has maintained a low smoking prevalence despite the presence of cigarette manufacturing for many decades. Some of this success may have been contributed by cultural factors and attitudes. We have studied public awareness of health risks, attitudes to smoke-free policy, tobacco advertising/promotion and other factors in a Ghanaian population sample.MethodsWe used two-stage cluster randomized sampling to study household members aged 14 and over in a representative household sample in the Ashanti Region of Ghana.Results6258 people, 88% of those eligible, took part in the study. Knowledge of health risks of smoking and passive smoking was high; radio was the main source of such information. Most people work and/or spend time in places where smoking is permitted. There was very strong support (97%) for comprehensive smoke-free legislation, particularly among Christians and Muslims. Despite the advertising ban, a third of respondents (35%), particularly in urban areas, had noticed advertising of tobacco or tobacco products, on the radio (72%) and television (28%). Among smokers, 76% had attempted to quit in the last 6 months, with the main sources of advice being friends and spouses. Use of nicotine replacement therapy was very rare. Low levels of health awareness were seen in females compared with males (Adjusted Odds Ratio (AOR); 0.51, 95% CI 0.39-0.69, p < 0.001). High levels of health awareness was seen among Traditionalists compared with Christians AOR; 2.16 95% CI 0.79-5.94, p < 0.05) and the relatively well educated (AOR; 1.70 95% CI 1.12-2.58, p < 0.05) and those living in rural areas (AOR 1.46 95% CI 1.14-1.87, p = 0.004).ConclusionAwareness of health risks and support for smoke-free policy are high in Ghana. Exposure to tobacco advertising or promotion is limited and most smokers have tried to quit. Whether these findings are cause or effect of current low smoking prevalence is uncertain.

Young adult smokers’ perceptions of cigarette pack innovation, pack colour and plain packaging

In jurisdictions where most forms of marketing tobacco are prohibited by law, such as the United Kingdom (UK), the tobacco industry is increasingly turning to innovative packaging to promote their products. Using focus group research we explored perceptions of packaging innovation (including cigarette packs with novel shapes and method of opening), and also plain packaging (all branding removed), among 54 young adult smokers aged 18–35 years, recruited in Glasgow, Scotland. We also examined smokers’ perceptions of pack and plain pack colour. It was found that packs with novel methods of opening, for instance, like a lighter or book, were considered to have a negligible impact upon brand selection, particularly among males. However, a small, narrow ‘perfume’ type pack created enormous interest among females and was perceived very favourably, being considered a fashion accessory and indeed one that helped minimise the health risks of smoking. Coloured plain packs (white, green, light blue, red) without a brand name, any brand descriptors or tar or nicotine levels, were identified by almost all smokers as signalling product strength. Consistent with past research the removal of branding from packs reduced the attractiveness and promotional appeal of the pack, with dark brown ‘plain’ packs perceived as more unappealing than light brown and dark and light grey packs by all groups. Dark brown non-branded packaging for tobacco products would help reduce the promotional appeal of the pack and ensure that pack colour does not provide consumers with false comfort about the health risks of smoking.

Effectiveness of a Smoking Cessation Program for Peripheral Artery Disease Patients: A Randomized Controlled Trial

Conclusions: Many long-term smokers with peripheral artery disease (PAD) are willing to engage in an intensive smoking cessation program. A smoking cessation program with intensive intervention is more effective than minimal care. Summary: Only one randomized trial has evaluated the effectiveness of smoking cessation programs. This trial (Gavin K, et al, Int J Nurs Stud 2001;38:91-105) evaluated the effectiveness of a nurse-conducted smoking cessation education program using nicotine gum. There was a difference between the intervention and control group's self-reported number of cigarettes smoked. However, biomarkers of tobacco use (urinary cotinine and expired carbon monoxide) provided conflicting results with the self-reported number of cigarettes smoked. Given that cigarette smoking is the most important risk factor for development of progression of PAD, the current study was designed to test the effectiveness of an intensive smoking cessation program in patients with PAD. The authors first sought to determine whether PAD patients were willing to enroll in such a program. The second objective was to examine the effectiveness of the program. Participants, who were recruited as outpatients, were identified as having lower extremity PAD from medical records and were also identified as cigarette smokers. They were randomly assigned to minimal intervention or an intensive tailored PAD-specific counseling intervention. Surveys were completed at baseline and at 3 and 6 months. Reported 7-day prevalent smoking abstinence was confirmed by carbon monoxide or cotinine levels. Of 687 outpatients identified as probable smokers with lower extremity PAD, 232 met eligibility requirements for this study and 124 (53% of those eligible) enrolled in the study. Participants were receptive to counseling. They received a median of 8.5 counseling sessions (range, 0-18). Those participants who had been assigned to the intensive intervention group were more likely to have confirmed abstinence from cigarette smoking at the 6-month follow-up: 21.3% in the intensive group vs 6.8% in the minimal intervention group (χ2 = 5.21; P = .023). Comment: Many patients with PAD who are smokers are interested in quitting and are receptive to a formal smoking cessation program. Those who chose to participate in the study almost universally indicated an understanding of the health risks of smoking. There was a high desire to quit cigarette smoking, as evidenced by the high level of engagement in the counseling sessions by those assigned to intensive intervention. The participants in this study were highly motivated to quit, but only about one-fifth of those in the intensive intervention group were able to quit. The study indicates the importance of more intensive intervention in achieving abstinence from cigarette smoking. Perhaps most importantly, it points out the best we have to offer to achieve smoking cessation is still woefully inadequate, even for motivated patients.

Modifying Effect of Suicidal Ideation on the Relationship Between Asthma and Cigarette Use Behaviors Among Korean Adolescents

ObjectivesAlthough cigarette smoking is known to be related to the exacerbation of asthma symptoms, several studies have indicated that the prevalence of cigarette smoking among asthmatic adolescents is similar to or even higher than that among non-asthmatic adolescents. The aim of this study was to evaluate the relationship between asthma and cigarette use behaviors and whether or not the presence of suicidal ideation modifies this relationship among Korean adolescents.MethodsWe analyzed data from the 2008 Korea Youth Risk Behavior Web-based Survey, which included a nationally representative sample of middle and high school students. Multiple logistic regression models were used to calculate odd ratios and 95% confidence intervals of cigarette use behaviors among current asthmatics, former asthmatics, and non-asthmatics, after adjusting for gender, grade, school records, socioeconomic status, current alcohol use, and suicidal ideation.ResultsOf 75 238 study participants, 3.5% were current asthmatics and 4.5% were former asthmatics. Compared with non-asthmatics, asthmatics were more likely to report current cigarette use, frequent and heavy cigarette use, and cigarette use before 13 years of age. There were statistically significant interactions between asthma and suicidal ideation in cigarette use behaviors.ConclusionsThis study demonstrated that asthmatic adolescents are more likely than non-asthmatic adolescents to engage in cigarette use behaviors and the presence of suicidal ideation is an effect modifier of the relationship between asthma and cigarette use behaviors. Particular attention should be paid to the awareness of health risks of cigarette smoking and mental health problems among asthmatic adolescents.

Cigarette Smoking Reduction and Changes in Nicotine Dependence

The relationship of nicotine dependence (ND) to smoking behavior and cessation has been well characterized. However, little is known about the association between smoking reduction (SR) and ND. We retrospectively evaluated the lifetime prevalence and extent of SR and whether ND as assessed by a modified Fagerström Test for Nicotine Dependence (FTND) score without cigarettes per day (CPD) and time-to-first cigarette changed with reductions in CPD. As part of the Collaborative Study of the Genetics of Nicotine Dependence (COGEND), 47,777 individuals from 2 mid-Western metropolitan areas were identified for a community-based telephone screening, yielding 6,955 current daily smokers ages 25-44 years (European-American, n = 5,135 and Black, n = 1,820). The FTND was administered to measure current ND and peak ND in respondents whose current daily CPD is lower than their reported lifetime peak. About 44% (n = 3,077) of the sample reported reducing their smoking from their lifetime peak, with a mean reduction of 14.4 CPD (SD = 8.9) or a 54.0% reduction compared with peak smoking. Controlling for peak smoking and years smoked, the magnitude of SR was associated with declines in ND excluding the direct contribution of CPD. Self-reported SR was associated with reduced levels of ND. The impact of this reduction on smoking cessation and health risks and smoking cessation requires further study, particularly given the retrospective nature of the present dataset.

Public crack cocaine smoking and willingness to use a supervised inhalation facility: implications for street disorder

BackgroundThe health risks of crack cocaine smoking in public settings have not been well described. We sought to identify factors associated with public crack smoking, and assess the potential for a supervised inhalation facility to reduce engagement in this behavior, in a setting planning to evaluate a medically supervised crack cocaine smoking facility.MethodsData for this study were derived from a Canadian prospective cohort of injection drug users. Using multivariate logistic regression we identified factors associated with smoking crack cocaine in public areas. Among public crack smokers we then identified factors associated with willingness to use a supervised inhalation facility.ResultsAmong our sample of 623 people who reported crack smoking, 61% reported recently using in public locations. In multivariate analysis, factors independently associated with public crack smoking included: daily crack cocaine smoking; daily heroin injection; having encounters with police; and engaging in drug dealing. In sub analysis, 71% of public crack smokers reported willingness to use a supervised inhalation facility. Factors independently associated with willingness include: female gender, engaging in risky pipe sharing; and having encounters with police.ConclusionWe found a high prevalence of public crack smoking locally, and this behavior was independently associated with encounters with police. However, a majority of public crack smokers reported being willing to use a supervised inhalation facility, and individuals who had recent encounters with police were more likely to report willingness. These findings suggest that supervised inhalation facilities offer potential to reduce street-disorder and reduce encounters with police.