Smoking Propensity Research Articles

E-cigarette and waterpipe use in two adolescent cohorts: cross-sectional and longitudinal associations with conventional cigarette smoking

Alternative tobacco products are increasing in popularity. An important question is whether their use is associated with or even leads to conventional smoking, but large-scale (European) studies are scarce. In two cohorts of Dutch adolescents (Cohort I n = 6819, mean age = 13.8 SD = 1.1, 48.2% female; Cohort II n = 2758, mean age = 17.3 SD = 1.8, 61.3% female), we investigated use of electronic (e)-cigarettes with nicotine, e-cigarettes without nicotine and waterpipe. Generalized estimating equation modelling was conducted with ever conventional smoking as the dependent variable (0 = no, 1 = yes) and ever alternative tobacco use as the independent variable, correcting for clustering within schools, age, sex and education in both cohorts. In a subsample (n = 2100), the association between alternative tobacco use at baseline and conventional smoking 6 months later was tested, taking into account smoking propensity (based on personality, susceptibility to peer pressure and smoking intentions). Ever use prevalence was 13.7% for e-cigarettes with nicotine, 29.4% for e-cigarettes without nicotine and 22.1% for waterpipe in Cohort I and 12.3, 27.6 and 45.3% respectively in Cohort II. Ever smokers had tried alternative tobacco products more often than never smokers. Among never-smoking adolescents at baseline, alternative tobacco use predicted ever smoking 6 months later (e-cigarettes with nicotine OR 11.90 95% CI 3.36–42.11; e-cigarettes without nicotine OR 5.36 95% CI 2.73–10.52; waterpipe OR 5.36 95% CI 2.78–10.31). This association was strongest for adolescents with a low baseline risk of smoking. Experimenting with alternative tobacco products is common among Dutch youth. Alternative tobacco use predicts (future) smoking, especially among adolescents with a low smoking propensity.

Patient characteristics of smokers undergoing lumbar spine surgery: an analysis from the Quality Outcomes Database.

OBJECTIVE In this analysis the authors compare the characteristics of smokers to nonsmokers using demographic, socioeconomic, and comorbidity variables. They also investigate which of these characteristics are most strongly associated with smoking status. Finally, the authors investigate whether the association between known patient risk factors and disability outcome is differentially modified by patient smoking status for those who have undergone surgery for lumbar degeneration. METHODS A total of 7547 patients undergoing degenerative lumbar surgery were entered into a prospective multicenter registry (Quality Outcomes Database [QOD]). A retrospective analysis of the prospectively collected data was conducted. Patients were dichotomized as smokers (current smokers) and nonsmokers. Multivariable logistic regression analysis fitted for patient smoking status and subsequent measurement of variable importance was performed to identify the strongest patient characteristics associated with smoking status. Multivariable linear regression models fitted for 12-month Oswestry Disability Index (ODI) scores in subsets of smokers and nonsmokers was performed to investigate whether differential effects of risk factors by smoking status might be present. RESULTS In total, 18% (n = 1365) of patients were smokers and 82% (n = 6182) were nonsmokers. In a multivariable logistic regression analysis, the factors significantly associated with patients' smoking status were sex (p < 0.0001), age (p < 0.0001), body mass index (p < 0.0001), educational status (p < 0.0001), insurance status (p < 0.001), and employment/occupation (p = 0.0024). Patients with diabetes had lowers odds of being a smoker (p = 0.0008), while patients with coronary artery disease had greater odds of being a smoker (p = 0.044). Patients' propensity for smoking was also significantly associated with higher American Society of Anesthesiologists (ASA) class (p < 0.0001), anterior-alone surgical approach (p = 0.018), greater number of levels (p = 0.0246), decompression only (p = 0.0001), and higher baseline ODI score (p < 0.0001). In a multivariable proportional odds logistic regression model, the adjusted odds ratio of risk factors and direction of improvement in 12-month ODI scores remained similar between the subsets of smokers and nonsmokers. CONCLUSIONS Using a large, national, multiinstitutional registry, the authors described the profile of patients who undergo lumbar spine surgery and its association with their smoking status. Compared with nonsmokers, smokers were younger, male, nondiabetic, nonobese patients presenting with leg pain more so than back pain, with higher ASA classes, higher disability, less education, more likely to be unemployed, and with Medicaid/uninsured insurance status. Smoking status did not affect the association between these risk factors and 12-month ODI outcome, suggesting that interventions for modifiable risk factors are equally efficacious between smokers and nonsmokers.

Uwarunkowania skłonności do palenia papierosów. Wyniki modelowania równań strukturalnych

According to the age-period-cohort projection of lung cancer incidence (ICD-10 codes C33-C34), smoking prevention will be crucial for both men and women longevity. Lung cancer remains the main cancer cause of death among males in Poland. In 2014 the number of deaths in Poland caused by lung cancer among men was more than twice as high as for women. The study is focused on identification of attitudes influencing the propensity to smoke, which is performed by structural equation modelling (SEM) based on weighted least squares means and variance adjusted (WLSMV) estimation. Good fit of the presented models is demonstrated by RMSEA, NNFI and CFI values. Reliability of scales is assessed by ordinal alpha and ordinal theta coefficients.&#x0D; Commitment to learning in childhood exhibits the highest standardized effect on propensity to smoke, which is an argument for youth smoking prevention. Structural equation model was estimated for men and women separately because of gender differences in smoking determinants. A strong character, individualism and self-reliance are the factors, which increase smoking propensity among males. These can be treated as features of masculinity and are not statistically important determinants of being a smoker for females. Depressive disorders, being a victim of violence as adults are statistically significant determinants of smoking among women.

E-cigarette use is differentially related to smoking onset among lower risk adolescents

ObjectiveE-cigarette use has been linked to onset of cigarette smoking among adolescents, but some commentators have suggested that this simply reflects high-risk adolescents being more likely to use e-cigarettes and...

Chronic Smoking, Trait Anxiety, and the Physiological Response to Stress

ABSTRACTBackground and Objectives: Both chronic smoking and trait anxiety have been associated with dysregulations in psychobiological stress response systems. However, these factors have not been studied in conjunction. We expected trait anxiety and smoking status to attenuate stress reactivity. Furthermore, we expected an allostatic load effect resulting in particularly attenuated stress reactivity in high-anxious smokers. In addition, high-anxious smokers were expected to exhibit increased urges to smoke in response to stress. Methods: 115 smokers and 37 nonsmokers, aged 18–64 years, completed a laboratory session including mental stressors such as evaluated public speaking and mental arithmetic. Trait anxiety was assessed using Spielberger's State–Trait Anxiety Inventory. Cardiovascular autonomic indices, salivary cortisol, and the desire to smoke were measured at baseline, during stressors, and at recovery. Results: Regression analyses showed that smokers exhibited attenuated cardiovascular stress responses in comparison to nonsmokers. Higher trait anxiety predicted attenuated systolic blood pressure responses to stress. No interaction effect of smoking status and trait anxiety was found in stress response measures. Higher trait anxiety predicted an increased desire to smoke in response to stress among smokers. Conclusion: Results indicate that both smoking status and trait anxiety are associated with blunted sympatho-adrenal cardiovascular stress reactivity. Elevated urges to smoke in response to stress found among smokers with high trait anxiety suggest an important role of anxiety in smoking propensity and relapse.

A Propensity Scoring Approach to Characterizing the Effects of Maternal Smoking During Pregnancy on Offspring's Initial Responses to Cigarettes and Alcohol.

When examining the effects of prenatal exposure to maternal smoking during pregnancy (MSDP) on later offspring substance use, it is critical to consider familial environments confounded with MSDP. The purpose of this study was to examine the effect of MSDP on offspring's initial reactions to cigarettes and alcohol, which are indicators of future substance-use related problems. We tested these effects using two propensity score approaches (1) by controlling for confounding using the MSDP propensity score and (2) examining effects of MSDP across the MSDP risk distribution by grouping individuals into quantiles based on their MSDP propensity score. This study used data from 829 unrelated mothers with a reported lifetime history of smoking to determine the propensity for smoking only during their first trimester (MSDP-E) or throughout their entire pregnancy (MSDP-T). Propensity score analyses focused on the offspring (N=1616 female twins) of a large subset of these mothers. We examined the effects of levels of MSDP-E/T on offspring initial reactions to their first experiences with alcohol and cigarettes, across the distribution of liability for MSDP-E/T. MSDP-E/T emerged as significant predictors of offspring reactions to alcohol and cigarettes, but the effects were confounded by the familial liability for MSDP. Further, the unique MSDP effects that emerged were not uniform across the MSDP familial risk distribution. Our findings underscore the importance of properly accounting for correlated familial risk factors when examining the effects of MSDP on substance related outcomes.

Smoking Peer Effects Among Adolescents: Are Popular Kids More Influential?

In this paper I analyze adolescent peer effects on cigarette consumption while considering the 'popularity' of peers. The analysis is based on AddHealth data, a four wave panel survey representative of American high-school students. The data include the social network of each school, which we use to measure peers' popularity from network centrality measures, in particular weighted-eigenvector centrality. We use lagged peers' behavior at the grade level to alleviate potential homophilic confounds, and we include school fixed effects to control for contextual confounds. We find that most of the aggregate peer effects regarding cigarette smoking come from the smoking propensity of the 20% most popular kids, suggesting a mediation from social status. This effect persists seven and thirteen years later (wave 3 and 4 of the data). Indeed, the smoking propensity of the bottom 80% seems to have a negative influence on the probability of smoking in the long run (wave 3 and 4). These results hint to the importance of knowing not only the smoking propensity within a school but also the place of the smokers within the social hierarchy of the school.

Long-Term Effects of Tobacco Prices Faced by Adolescents.

Tobacco taxes in Canada varied markedly across time and across regions in the early 1990s. We exploit this variation to estimate the long reach of prices faced in adolescence on smoking behavior roughly a decade later in early to mid-adulthood. Results from a variety of econometric approaches suggest that there is a small but detectable long-run effect of price faced during adolescence. A 10% increase in prices faced during adolescence, holding contemporaneous prices constant, leads to roughly a 1% reduction in adult smoking propensity and intensity. The results are somewhat sensitive to specification and to how price during adolescence is measured.

Working time and cigarette smoking: Evidence from Australia and the United Kingdom

Cigarette smoking is a risk factor in a range of serious diseases, including cardiovascular disease, cancer, stroke and type II diabetes. Theory suggests that working long hours will increase smoking propensities among workers. Consequently there is a significant body of evidence on the relationship between working time and smoking. Results, however, are inconsistent and therefore inconclusive. This paper provides new evidence on how working time affects smoking behaviour using nationally representative panel data from Australia (from 2002 to 2011) and the United Kingdom (from 1992 to 2011). We exploit the panel design of the surveys to look at within-person changes in smoking behaviour over time as working time changes. In contrast to most previous studies, this means we control for time invariant aspects of personality and genetic inheritance that may affect both smoking propensities and choice of working hours. We find that working long hours tends to increase the chances that former smokers will relapse, reduce the chances that smokers will quit and increase cigarette consumption among regular smokers, and that these effects tend to become more pronounced for workers who usually work very long hours (50 or more hours a week) compared to those who work moderately long hours (40–49 h a week).

Genetic variants in nicotine addiction and alcohol metabolism genes, oral cancer risk and the propensity to smoke and drink alcohol: a replication study in India.

BackgroundGenetic variants in nicotinic acetylcholine receptor and alcohol metabolism genes have been associated with propensity to smoke tobacco and drink alcohol, respectively, and also implicated in genetic susceptibility to head and neck cancer. In addition to smoking and alcohol, tobacco chewing is an important oral cancer risk factor in India. It is not known if these genetic variants influence propensity or oral cancer susceptibility in the context of this distinct etiology.MethodsWe examined 639 oral and pharyngeal cancer cases and 791 controls from two case-control studies conducted in India. We investigated six variants known to influence nicotine addiction or alcohol metabolism, including rs16969968 (CHRNA5), rs578776 (CHRNA3), rs1229984 (ADH1B), rs698 (ADH1C), rs1573496 (ADH7), and rs4767364 (ALDH2).ResultsThe CHRN variants were associated with the number of chewing events per day, including in those who chewed tobacco but never smoked (P = 0.003, P = 0.01 for rs16969968 and rs578776 respectively). Presence of the variant allele contributed to approximately 13% difference in chewing frequency compared to non-carriers. While no association was observed between rs16969968 and oral cancer risk (OR = 1.01, 95% CI = 0.83– 1.22), rs578776 was modestly associated with a 16% decreased risk of oral cancer (OR = 0.84, 95% CI = 0.72– 0.98). There was little evidence for association between polymorphisms in genes encoding alcohol metabolism and oral cancer in this population.ConclusionThe association between rs16969968 and number of chewing events implies that the effect on smoking propensity conferred by this gene variant extends to the use of smokeless tobacco.

Gender differences in cigarette consumption in Turkey: Evidence from the Global Adult Tobacco Survey

ObjectiveThe aim of this study is to examine the potential factors associated with both smoking participation and the level of cigarette consumption in Turkey from a gender perspective, the understanding of which are crucial to the formulation and implementation of anti-smoking policies. MethodsThe Global Adult Tobacco Survey for 2008 is used in the analysis. Since the dependent variable, the number of cigarettes smoked per day, consists of nonnegative integer values, Negative Binomial and Zero-inflated Negative Binomial models are used as an estimation methodology. The zero-inflated model allows the interpretation of smoking propensity and smoking intensity behaviours separately. ResultsThe main findings of this study are twofold. First, the factors affecting the smoking behaviour of males and females are different. Second, there are also differences between the factors affecting the decisions of whether to smoke and how much to smoke for both genders. Cigarette prices, for example, affect the level of cigarette consumption of females but not of males whereas pro-cigarette marketing affects the decision of how much to smoke for males with no effect on female smoking. ConclusionsThe findings highlight the importance of gender differences in cigarette consumption. Overall, education programs, cigarette taxation and tobacco advertising bans have different effects on each gender whereas social interaction is important for cigarette smoking behaviour of both genders. The anti-smoking policies can be more effective if policy makers take into account gender differences in both smoking propensity and intensity.

One last puff? Public smoking bans and smoking behavior

This paper investigates the short-term effects of public smoking bans on individual smoking behavior. In 2007 and 2008, state-level smoking bans were gradually introduced in all of Germany's federal states. We exploit this variation to identify the effect that smoke-free policies had on individuals’ smoking propensity and smoking intensity. Using rich longitudinal data from the German Socio-Economic Panel Study, our difference-in-differences estimates show that the introduction of smoke-free legislation in Germany did not change average smoking behavior within the population. However, our estimates point to important heterogeneous effects. Individuals who go out more often to bars and restaurants did adjust their smoking behavior. Following the ban, they became less likely to smoke and also smoked less.

The effect of lone motherhood on the smoking behavior of young adults

We provide evidence that living with an unmarried mother during childhood raises smoking propensities for young adults in Germany.

One Last Puff? Public Smoking Bans and Smoking Behavior

This paper investigates the short-term effects of public smoking bans on individual smoking behavior. In 2007 and 2008, state-level smoking bans were gradually introduced in all of Germany's sixteen federal states. We exploit this variation in the timing of state bans to identify the effect that smoke-free policies had on individuals' smoking propensity and smoking intensity. Using rich longitudinal data from the German Socio-Economic Panel Study, our difference-in-differences estimates show that the introduction of smoke-free legislation in Germany did not change average smoking behavior within the population. However, our estimates also point to important heterogeneous effects. Groups that go out more often, and hence are more exposed to the constraints of public smoking bans in everyday life, did adjust their smoking behavior. Specifically, we find that young, unmarried individuals, men, and those living in urban areas are groups that are both less likely to smoke and smoke less intensively following the introduction of public smoking bans. Furthermore, effects on individual smoking habits proved stronger in states that had more strict smoking bans. Public smoking bans, therefore, have important health benefits over and above the reduction in exposure of non-smokers to second-hand smoke that is their immediate and prime objective.

One Last Puff? - Public Smoking Bans and Smoking Behavior

This paper investigates the short-term effects of public smoking bans on individual smoking behavior. In 2007 and 2008, state-level smoking bans were gradually introduced in all of Germany's federal states. We exploit this variation to identify the effect that smoke-free policies had on individuals’ smoking propensity and smoking intensity. Using rich longitudinal data from the German Socio-Economic Panel Study, our difference-in-differences estimates show that the introduction of smoke-free legislation in Germany did not change average smoking behavior within the population. However, our estimates point to important heterogeneous effects. Individuals who go out more often to bars and restaurants did adjust their smoking behavior. Following the ban, they became less likely to smoke and also smoked less.

One Last Puff? Public Smoking Bans and Smoking Behavior

This paper investigates the short-term effects of public smoking bans on individual smoking behavior. In 2007 and 2008, state-level smoking bans were gradually introduced in all of Germany's sixteen federal states. We exploit this variation in the timing of state bans to identify the effect that smoke-free policies had on individuals' smoking propensity and smoking intensity. Using rich longitudinal data from the German Socio-Economic Panel Study, our difference-in-differences estimates show that the introduction of smoke-free legislation in Germany did not change average smoking behavior within the population. However, our estimates also point to important heterogeneous effects. Groups that go out more often, and hence are more exposed to the constraints of public smoking bans in everyday life, did adjust their smoking behavior. Specifically, we find that young, unmarried individuals, men, and those living in urban areas are groups that are both less likely to smoke and smoke less intensively following the introduction of public smoking bans. Furthermore, effects on individual smoking habits proved stronger in states that had more strict smoking bans. Public smoking bans, therefore, have important health benefits over and above the reduction in exposure of non-smokers to second-hand smoke that is their immediate and prime objective.

Estimating Peer Effects in Adolescent Smoking Behavior: A Longitudinal Analysis

To empirically quantify the role of peer social networks in explaining smoking behavior among adolescents. We follow adolescents over time to examine whether the role of adolescent peers persists in affecting individual behaviors as adolescents transition into adulthood. Using longitudinal data of a nationally representative sample of adolescents we use a multivariate structural model with school-level fixed effects to account for the problems of contextual effects, correlated effects, and peer selections to purge the potential biases from the estimates of peer influence. Our peer group measures are drawn not only from the nomination of close friends but also from classmates. Smoking prevalence among the peer groups were constructed using the peers' own reports of their cigarette consumption. Controlling for parent level characteristics and other demographic parameters, we find that a 10% increase in the proportion of classmates who smoke will increase the likelihood of smoking by more than 3%. Also, an increase in smoking rates among an individual's close friends by 10% will increase the likelihood of smoking by 5%. We find evidence to show that the influence of close friends from adolescence years continue to have an impact on smoking propensities even when a transition into adulthood is made. Our findings support the literature reporting that peer effects are important determinants of smoking even after controlling for potential biases in the data and that these effects persist into adulthood. Effective policy aimed at reducing smoking rates among adolescents would consider these long-lasting peer effects.

The Effect of Lone Motherhood on the Smoking Behaviour of Young Adults

We provide evidence that living with an unmarried mother during childhood raises smoking propensities for young adults in Germany.

The Effect of Lone Motherhood on the Smoking Behaviour of Young Adults

We provide evidence that living with an unmarried mother during childhood raises smoking propensities for young adults in Germany.

A susceptibility locus for lung cancer maps to nicotinic acetylcholine receptor subunit genes on 15q25

Lung cancer is the most common cause of cancer death worldwide, with over one million cases annually. To identify genetic factors that modify disease risk, we conducted a genome-wide association study by analysing 317,139 single-nucleotide polymorphisms in 1,989 lung cancer cases and 2,625 controls from six central European countries. We identified a locus in chromosome region 15q25 that was strongly associated with lung cancer (P = 9 x 10(-10)). This locus was replicated in five separate lung cancer studies comprising an additional 2,513 lung cancer cases and 4,752 controls (P = 5 x 10(-20) overall), and it was found to account for 14% (attributable risk) of lung cancer cases. Statistically similar risks were observed irrespective of smoking status or propensity to smoke tobacco. The association region contains several genes, including three that encode nicotinic acetylcholine receptor subunits (CHRNA5, CHRNA3 and CHRNB4). Such subunits are expressed in neurons and other tissues, in particular alveolar epithelial cells, pulmonary neuroendocrine cells and lung cancer cell lines, and they bind to N'-nitrosonornicotine and potential lung carcinogens. A non-synonymous variant of CHRNA5 that induces an amino acid substitution (D398N) at a highly conserved site in the second intracellular loop of the protein is among the markers with the strongest disease associations. Our results provide compelling evidence of a locus at 15q25 predisposing to lung cancer, and reinforce interest in nicotinic acetylcholine receptors as potential disease candidates and chemopreventative targets.