Smoking-related Health Consequences Research Articles

Predicting risk of lung function impairment and all-cause mortality using a DNA methylation-based classifier of tobacco smoke exposure

BackgroundThe Epigenetic Smoking Status Estimator (EpiSmokEr) predicts smoking phenotypes based on DNA methylation at 121 CpG sites. ObjectiveEvaluate associations of EpiSmokEr-predicted versus self-reported smoking phenotypes with lung function and all-cause mortality in a cohort of older adults. MethodsThe prospective Normative Aging Study collected DNA methylation measurements from 1999 to 2012 with follow-up through 2016. The R package EpiSmokEr derived predicted smoking phenotypes based on DNA methylation levels assayed by the Illumina HumanMethylation450 Beadchip. Spirometry was collected every 3–5 years. Airflow limitation was defined as forced expiratory volume in 1 s/forced vital capacity <0.7. Vital status was monitored through periodic mailings. ResultsAmong 784 participants contributing 5414 person-years of follow-up, the EpiSmokEr-predicted smoking phenotypes matched the self-reported phenotypes for 228 (97%) never smokers and 22 (71%) current smokers. In contrast, EpiSmokEr classified 407 (79%) self-reported former smokers as never smokers. Nonetheless, the EpiSmokEr-predicted former smoking phenotype was more strongly associated with incident airflow limitation (hazard ratio [HR] = 3.15, 95% confidence interval [CI] = 1.50–6.59) and mortality (HR = 2.11, 95% CI = 1.56–2.85) compared to the self-reported former smoking phenotype (airflow limitation: HR = 2.21, 95% CI = 1.13–4.33; mortality: HR = 1.08, 95% CI = 0.86–1.36). Risk of airflow limitation and death did not differ among self-reported never smokers and former smokers who were classified as never smokers. The discriminative accuracy of EpiSmokEr-predicted phenotypes for incident airflow limitation and mortality was improved compared to self-reported phenotypes. ConclusionsThe DNA methylation-based EpiSmokEr classifier may be a useful surrogate of smoking-induced lung damage and may identify former smokers most at risk of adverse smoking-related health effects.

Association Between Tobacco Retailer Density and Smoking Among Adults With Diabetes and Serious Mental Illness in New York State.

IntroductionSmoking prevalence is high among adults with comorbid diabetes and serious mental illness. This population is at elevated risk of smoking-related health consequences and premature death. We focused on the community environment and investigated the association between tobacco retailer density and smoking in this population.MethodsWe obtained individual-level data from the 2017 Patient Characteristics Survey, a medical record–based survey of patients served by the public mental health system in New York State. We computed the density of state-authorized tobacco retailers at the 3-digit zip code level.ResultsThe data included 19,492 adults (aged ≥18) with comorbid diabetes and serious mental illness. Of these, 55.6% resided in New York City, 53.1% were female, 38.1% were non-Hispanic White, 30.7% were non-Hispanic Black, 25.2% were Hispanic, and 38.1% were smokers, including electronic cigarette users. The density of tobacco retailers (range, 6.1–16.4 per 10,000 population) was positively associated with smoking (odds ratio = 1.05; 95% CI, 1.03–1.07) after adjusting for sex, race or ethnicity, education, employment, health insurance coverage, obesity, and region (New York City vs outside New York City). We observed no interaction between region and tobacco retailer density.ConclusionFindings of this study suggest that allocating more smoking cessation resources to zip code areas with a high density of tobacco retailers, especially in rural areas, along with supporting policy change to reduce tobacco retailor density, may mitigate the negative health consequences of smoking among people with comorbid diabetes and serious mental illness.

Prevalence and predictors of midwakh smoking among male students of Qassim University, Al-Qassim, Saudi Arabia.

INTRODUCTIONNovel tobacco products are becoming more popular in the Middle East and especially in Saudi Arabia. We studied the prevalence of midwakh pipe (tobacco smoking pipe) use among students at Qassim University and evaluated factors associated with midwakh pipe usage.METHODSA cross-sectional study was conducted using a self-administered questionnaire to collect the data. The participants were male students from Qassim University, Al-Qassim, Saudi Arabia. Data were collected over the period from May to June 2018. A multivariable logistic regression model was used to identify sociodemographic factors and smoking history related to midwakh smoking.RESULTSA total of 316 responses were collected; 7.9% (n=25) were midwakh smokers at some point, and 3.8% (n=12) were current midwakh smokers. Multivariable logistic regression indicated that the significant predictors of midwakh smoking among male university students were having a friend who is a tobacco or midwakh smoker, and consuming other forms of tobacco other than midwakh.CONCLUSIONSHaving midwakh smoking friends, having friends smoking any other form of tobacco, and being a smoker could predict the use of midwakh among university male students in Saudi Arabia. Interventions are required to control this behavior to prevent smoking-related health consequences.

Cadmium, Smoking, and Human Blood DNA Methylation Profiles in Adults from the Strong Heart Study.

Background:The epigenetic effects of individual environmental toxicants in tobacco remain largely unexplored. Cadmium (Cd) has been associated with smoking-related health effects, and its concentration in tobacco smoke is higher in comparison with other metals.Objectives:We studied the association of Cd and smoking exposures with human blood DNA methylation (DNAm) profiles. We also evaluated the implication of findings to relevant methylation pathways and the potential contribution of Cd exposure from smoking to explain the association between smoking and site-specific DNAm.Methods:We conducted an epigenome-wide association study of urine Cd and self-reported smoking (current and former vs. never, and cumulative smoking dose) with blood DNAm in 790,026 CpGs (methylation sites) measured with the Illumina Infinium Human MethylationEPIC (Illumina Inc.) platform in 2,325 adults 45–74 years of age who participated in the Strong Heart Study in 1989–1991. In a mediation analysis, we estimated the amount of change in DNAm associated with smoking that can be independently attributed to increases in urine Cd concentrations from smoking. We also conducted enrichment analyses and in silico protein–protein interaction networks to explore the biological relevance of the findings.Results:At a false discovery rate (FDR)-corrected level of 0.05, we found 6 differentially methylated positions (DMPs) for Cd; 288 and 17, respectively, for current and former smoking status; and 77 for cigarette pack-years. Enrichment analyses of these DMPs displayed enrichment of 58 and 6 Gene Ontology and Kyoto Encyclopedia of Genes and Genomes gene sets, respectively, including biological pathways for cancer and cardiovascular disease. In in silico protein-to-protein networks, we observed key proteins in DNAm pathways directly and indirectly connected to Cd- and smoking-DMPs. Among DMPs that were significant for both Cd and current smoking (annotated to PRSS23, AHRR, F2RL3, RARA, and 2q37.1), we found statistically significant contributions of Cd to smoking-related DNAm.Conclusions:Beyond replicating well-known smoking epigenetic signatures, we found novel DMPs related to smoking. Moreover, increases in smoking-related Cd exposure were associated with differential DNAm. Our integrative analysis supports a biological link for Cd and smoking-associated health effects, including the possibility that Cd is partly responsible for smoking toxicity through epigenetic changes. https://doi.org/10.1289/EHP6345

Examining Age as a Potential Moderator of Response to Reduced Nicotine Content Cigarettes in Vulnerable Populations.

IntroductionYoung adults (aged 18–24 years) have a higher smoking prevalence than younger and older age groups and young adulthood is an important developmental period during which long-term behavior patterns like cigarette smoking are established. The aim of the current study was to examine how young adult smokers with additional vulnerabilities to smoking respond to reduced nicotine content cigarettes.MethodsThis is a secondary analysis of a double-blind, within-subject experiment conducted with 169 cigarette smokers recruited from populations with comorbid psychiatric conditions or socioeconomic disadvantage assessing acute effects of research cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g). Participants were dichotomized by chronological age (18–24 vs. ≥25 years). Across 14 laboratory sessions effects of nicotine content were examined on measures of relative reinforcing efficacy (Cigarette Purchase Task [CPT] and Concurrent Choice testing), subjective effects, craving/withdrawal, and smoking topography. Repeated measures analysis of variances were used to examine potential moderating effects of age.ResultsYoung adults exhibited lower demand for reduced nicotine content cigarettes than older adults across three of five CPT indices (ps < .05). No differences by age were observed on other measures of reinforcing efficacy, subjective effects, craving/withdrawal, or smoking topography where effects generally decreased as an orderly function of decreasing nicotine content (ps <.05).ConclusionOverall, these findings suggest that reducing the nicotine content of cigarettes would decrease the addiction potential of cigarette smoking in young adult smokers as much or perhaps more than older adult smokers from populations at increased vulnerability to smoking, addiction, and smoking-related health consequences.ImplicationsReducing the nicotine content in cigarettes to lower addiction potential of smoking has been proposed as a means to improve overall population health. It is imperative to examine how young adults may respond to a nicotine reduction policy. We saw minimal evidence that age moderates acute response and where there was evidence it was in the direction of reduced nicotine content cigarettes having less addictive potential among young versus older adults (eg, steeper decreases in demand for very low nicotine content cigarettes among young versus older adults). Overall, a nicotine reduction policy has the potential to reduce smoking across age groups.

Smoking Across the Menopausal Transition in a 10-Year Longitudinal Sample: The Role of Sex Hormones and Depressive Symptoms.

Current cigarette smoking rates among older women remain problematic, especially given that this population experiences increased smoking-related health consequences. Despite these increased health concerns, little research to date has explored smoking patterns across the menopausal transition (pre-, early-peri-, late-peri-, and postmenopausal) or the effect of unique factors such as sex hormones and depression during this transition. This study used 10 yearly waves of data from the Study of Women's Health Across the Nation, a longitudinal dataset. Data included 1397 women endorsing ever smoking regularly at baseline. Random-effects logistic regression models were used to examine smoking transitions. Although there were no associations between menopausal transition stage and smoking behavior, increased estradiol was associated with an increased likelihood of quitting regular smoking (eg, transitioning from regular smoking to non-regular or no smoking; odds ratio [OR] = 1.28), whereas increased testosterone was associated with an increased likelihood of relapsing to regular smoking (eg, transitioning from former or nonregular smoking to regular smoking OR = 2.56). Depression was associated with increased likelihood of continued smoking (OR = 0.97) and relapse (OR = 1.03). The results emphasize the need to develop interventions to target initiated or continued smoking among women across the menopausal transition and specifically highlight the importance of developing treatments that target depressive symptoms in this population. In addition, although singular hormone measures were associated with smoking behavior, there is a need for future study of dynamic changes in hormones, as well as the impact of progesterone on smoking behaviors across the menopausal transition. To date, no studies have examined smoking behaviors across the menopausal transition. In this study, although menopausal transition status was not significantly related to transitions in smoking behavior, important relationships between sex hormones and depression were observed. Increased estradiol was associated with an increased likelihood of quitting regular smoking, whereas increased testosterone was associated with an increased likelihood of relapsing to regular smoking behavior. Higher depression scores were related to continued smoking and relapse to regular smoking behavior. These results highlight the need to develop interventions to target smoking cessation among women across the menopausal transition.

Awareness of smoking in adolescents with inflammatory bowel disease.

Inflammatory bowel disease (IBD) is long life disease that results from an interaction between a polygenetic predisposition and environmental factors, including smoking. The aim of this study was to evaluate beliefs about and awareness of smoking among adolescents with IBD compared to healthy controls. Patients with IBD, Crohn's disease (CD) and ulcerative colitis (UC), and healthy controls were asked to complete a questionnaire on demographic data and smoking status. The questionnaire also included data on beliefs and awareness of smoking-related health effects, including effects on IBD. A total of 139 IBD patients and 108 controls were enrolled in the study. Of the IBD patients, 17/139 (12.2%) were smokers compared to 18/108 (16.7%) of controls (p=0.3). Patients with IBD were nine times more likely to be everyday smokers than occasional smokers (OR=9.2, 95% CI: 1.9- 45.1, p=0.004). No difference was found between patients with CD and UC in their answers to the question of whether "smoking increases the risk for surgery in your type of IBD" (17/28 (60.7%) vs. 10/29 (34.5%), respectively (p=0.047). More patients with CD than UC were aware of the risks of smoking on their disease: extra-intestinal manifestations and disease exacerbation, OR=11.3 (95% CI: 4.1 - 30.9; p=0.000) and OR=19.3 (95% CI: 6.7 - 55.1; p=0.000), respectively. The data obtained demonstrated that adolescents with CD are much more aware of the role of smoking on CD than are their peers with UC; however, this awareness is still unsatisfactory. Therefore, there is an unmet need to implement better anti-smoking strategies for this group of patients.

Characteristics associated with perceived interrelations of pain and smoking among people living with HIV

ABSTRACTPersons living with HIV/AIDS (PLWH) have very high prevalences of both cigaret smoking and pain, yet little is known about the relationship between smoking and pain for PLWH. The current study examines the perceived interrelations between pain and smoking and participant characteristics (i.e., demographics, heavier versus lighter smoking, current pain severity, depression, anxiety symptoms) in a sample of 101 current cigaret smoking adult PLWH in the Bronx, New York. Participants completed assessments of demographics, smoking behaviors, psychiatric symptoms, and pain severity. Interrelations of pain and smoking were measured using the 9-item Pain and Smoking Inventory (PSI) total score and three domain scores (pain as a motivator for smoking, smoking to cope with pain, and pain as a barrier for smoking cessation). Significant associations were found between greater current pain severity and greater endorsement of overall perceived interrelations between pain and smoking, pain as a motivator for smoking, and smoking to cope with pain. Greater anxiety symptoms were significantly associated with greater endorsement of overall perceived interrelations between pain and smoking, pain as a motivator for smoking, and smoking to cope with pain. Understanding the perceived relations between smoking and pain, as well as associated factors such as anxiety and pain severity, may help to guide interventions for PLWH who smoke in order to reduce the high prevalence of smoking and significant smoking-related health consequences.

Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity–Attraction Differences

The purpose of this study is to determine the past-year prevalence estimates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder based on sexual identity among U.S. adults, and to examine potential variations in these estimates by age, race/ethnicity, and sexual identity-attraction concordance/discordance. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions collected data via in-person interviews with a cross-sectional nationally representative sample of non-institutionalized adults (response rate=60.1%) and analyses for the present study were conducted in 2017. Any past-year nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were most prevalent among sexual minority-identified adults compared with heterosexual-identified adults, with notable variations based on sex, age, race/ethnicity, and sexual identity-attraction discordance. Elevated rates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder among sexual minorities were most prevalent among younger lesbian women and gay men, and all age groups of bisexual men and women. The odds of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were significantly greater among sexual identity-attraction discordant women and significantly lower among sexual identity-attraction discordant men. These findings provide valuable new information about sexual minority subgroups, such as self-identified bisexual older adults and sexual identity-attraction discordant women, that appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking. Additional attention is warranted to examine these high-risk subpopulations prospectively and, if the results are replicated with larger samples, this information can be used to target smoking-cessation and lung cancer screening efforts.

Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service.

Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians.

A whole-blood transcriptome meta-analysis identifies gene expression signatures of cigarette smoking.

Cigarette smoking is a leading modifiable cause of death worldwide. We hypothesized that cigarette smoking induces extensive transcriptomic changes that lead to target-organ damage and smoking-related diseases. We performed a meta-analysis of transcriptome-wide gene expression using whole blood-derived RNA from 10,233 participants of European ancestry in six cohorts (including 1421 current and 3955 former smokers) to identify associations between smoking and altered gene expression levels. At a false discovery rate (FDR) <0.1, we identified 1270 differentially expressed genes in current vs. never smokers, and 39 genes in former vs. never smokers. Expression levels of 12 genes remained elevated up to 30 years after smoking cessation, suggesting that the molecular consequence of smoking may persist for decades. Gene ontology analysis revealed enrichment of smoking-related genes for activation of platelets and lymphocytes, immune response, and apoptosis. Many of the top smoking-related differentially expressed genes, including LRRN3 and GPR15, have DNA methylation loci in promoter regions that were recently reported to be hypomethylated among smokers. By linking differential gene expression with smoking-related disease phenotypes, we demonstrated that stroke and pulmonary function show enrichment for smoking-related gene expression signatures. Mediation analysis revealed the expression of several genes (e.g. ALAS2) to be putative mediators of the associations between smoking and inflammatory biomarkers (IL6 and C-reactive protein levels). Our transcriptomic study provides potential insights into the effects of cigarette smoking on gene expression in whole blood and their relations to smoking-related diseases. The results of such analyses may highlight attractive targets for treating or preventing smoking-related health effects.

Social cohesion and the smoking behaviors of adults living with children

IntroductionThe smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. MethodsData from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. ResultsOverall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR=0.92; 95% CI=0.85–0.99) and reduced odds of living in a household in which smoking is allowed (AOR=0.84; 95% CI=0.75–0.93), after controlling for sociodemographic characteristics. ConclusionsAmong adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults.

Smoking behaviour and knowledge of the health effects of smoking in patients with inflammatory bowel disease.

The detrimental effect of smoking on development and progression of Crohn's disease (CD) is generally accepted. To evaluate the awareness of smoking risks in a Belgian inflammatory bowel disease (IBD) population. In the out-patient clinic of a tertiary referral centre, 625 consecutive patients with CD, 238 patients with ulcerative colitis (UC) and 289 non-IBD controls, filled out a simple questionnaire. This questionnaire included data on smoking behaviour and awareness of smoking-related health effects, including effects on IBD. At diagnosis, more CD patients were active smokers compared to UC (40% vs. 17%, P<0.001). Remarkably, smoking cessation rates after diagnosis were similar for CD and UC (both 56%, P=0.997). The great majority recognised a detrimental influence of smoking on general health (98-99%), lung cancer (95-97%), myocardial infarction (89-92%) and stroke (78-87%). Although CD patients more frequently acknowledged risks of smoking on their disease, only 37% were aware of a link with CD development, 30% of increased surgical rates and 27% of increased post-operative CD recurrence. Active smokers more frequently denied an increased risk of surgery and higher post-operative CD recurrence. Intriguingly, within the active smokers with CD, those not willing to quit smoking most often denied a potential bad influence of smoking. Taking into account disease duration, previous surgery, education level, working status and nicotine dependence, we were unable to define specific subgroups of patients requiring extra education. Although patients with Crohn's disease were better informed on the detrimental effects of smoking, the awareness rate was still low.

Predictors of wanting to quit in a national sample of Aboriginal and Torres Strait Islander smokers.

To describe factors that predict wanting to quit smoking in a national sample of Aboriginal and Torres Strait Islander people. The Talking About The Smokes (TATS) project used a quota sampling design to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. Baseline survey data were collected from 1643 current smokers between April 2012 and October 2013. Wanting to quit smoking. More than two-thirds of smokers (70%) said they want to quit. Many factors were associated with wanting to quit, including past quitting activity. Interest in quitting was lower among men and smokers from economically disadvantaged areas, but there was no difference by age, remoteness or other measures of economic disadvantage. Attitudes and beliefs negatively associated with wanting to quit included enjoying smoking and believing quitting to be very difficult, and those positively associated included regretting ever starting to smoke, perceiving that local Aboriginal and Torres Strait Islander community leaders disapprove of smoking, believing non-smokers set a good example to children, worrying about future smoking-related health effects and believing quitting to be beneficial. Reporting support from family and friends was predictive of wanting to quit, but factors related to smoking in the social network were not. Associations with health and wellbeing were mixed. While most tobacco control policy exposure variables were positively associated with wanting to quit, two - receiving advice to quit from a health professional, and recall of targeted anti-tobacco advertising - appeared to have an effect that extended beyond influencing relevant attitudes and beliefs. Interest in quitting among Aboriginal and Torres Strait Islander smokers appears to be influenced by a broad range of factors, highlighting the importance of taking a comprehensive approach to tobacco control. Advice from health professionals and targeted advertising appear to be important intervention strategies.

A comprehensive examination of hookah smoking in college students: Use patterns and contexts, social norms and attitudes, harm perception, psychological correlates and co-occurring substance use

The practice of waterpipe smoking (hookah) has rapidly increased in popularity among young adults yet burgeoning research suggests that its use is associated with nicotine dependence and other negative smoking-related health consequences. Moreover, descriptive studies indicate that consumers may hold the belief that hookah smoking is safer than smoking cigarettes. The current study extended previous work by conducting a comprehensive assessment of patterns and contexts of hookah use, psychological correlates of use, co-occurring substance use as well as social norms and health perceptions surrounding the practice. Participants were 143 ethnically diverse undergraduate students at a large urban US university. Approximately half of the sample (48%) reported life-time use of hookah and 22% reported use within the past 30days. Relative to cigarette smoking, hookah smoking was associated with less perceived harm and addiction potential and higher social approval. Participants who reported life-time hookah use, as compared to those who did not, perceived less associated harm, had a greater number of friends who had tried and approved of hookah, were more likely to use cigarettes, marijuana, and alcohol and in higher frequencies and quantities and were at higher risk for problem tobacco and alcohol use. Among participants who were not current smokers, those with hookah experience were more likely to endorse intent to try a cigarette soon. Hookah users did not differ from non-users on measures of trait anxiety, depression and impulsivity though they were more likely to drink alcohol for coping, social and enhancement purposes than non-users. Implications are discussed for public health initiatives to educate young adults about the potential consequences of hookah smoking.

Statement of Retraction: Ortendahl M, Näsman P. “Quitting smoking is perceived to have an effect on somatic health among pregnant and non-pregnant women”

The Editors and Publisher would like to inform the readers the following article has been retracted from publication in The Journal of Maternal-Fetal & Neonatal Medicine:Ortendahl M, Näsman P. Quitting smoking is perceived to have an effect on somatic health among pregnant and non-pregnant women. J Matern Fetal Neonatal Med. 2008;21:239–246. (doi:10.1080/14767050801924829).This article has been found to reproduce content to a high degree of similarity, without appropriate attribution or acknowledgement by the authors, from the following original article:Ortendahl M, Näsman P. Perception of Smoking-Related Health Consequences among Pregnant and Non-Pregnant Women. Am J Addict. 2007;16:521--527. (doi:10.1080/10550490701643088)The text in the manuscript published in The Journal of Maternal-Fetal & Neonatal Medicine was found to be almost word-for-word identical to the text published in the American Journal of Addictions. The data presented in all 4 tables is also essentially the same, but just presented in a different layout.The authors have been fully co-operative with our investigations and agree with the Editors and Publisher on this course of action to correct the redundancy in the literature record.The journal’s policy in this respect is clear: The Journal of Maternal-Fetal & Neonatal Medicine considers all manuscripts on the strict condition that they have been submitted only to The Journal of Maternal-Fetal & Neonatal Medicine, that they have not been published already, nor are they under consideration for publication or in press elsewhere.The Journal of Maternal-Fetal & Neonatal Medicine published this article in good faith, and on the basis of signed statements made by the corresponding author regarding the originality of their work. The article is withdrawn from all print and electronic editions.Gian Carlo Di Renzo and Dev Maulik(Editors-in-Chief)Anna Treadway(Head of Journals Publishing, Informa Healthcare)

Mass media campaigns designed to support new pictorial health warnings on cigarette packets: evidence of a complementary relationship

BackgroundIn Australia, introduction of pictorial health warnings on cigarette packets was supported by a televised media campaign highlighting illnesses featured in two of the warning labels—gangrene and mouth cancer.MethodsTwo studies...

Racial disparities in smoking knowledge among current smokers: Data from the health information national trends surveys

Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

Perception of Smoking‐Related Health Consequences among Pregnant and Non‐Pregnant Women

The objective was to examine the perception of smoking-related health consequences and its relationship to pregnancy and intent to quit. Over a two-week period, pregnant and non-pregnant women, intending and not intending to quit smoking, rated the probability for smoking-related health consequences to occur, given continuing to smoke and quitting smoking. Pregnant women who did not intend to quit smoking exhibited the lowest estimated probability for the smoking-related health consequences to occur if they continued smoking. For all women, there was a statistically significant estimated effect of quitting smoking. Renewed attention needs to be given to perceptions of health risks of smoking, especially among pregnant women.

Sociocultural factors associated with cigarette smoking among women in Brazilian worksites: a qualitative study

This study examined the contextual factors associated with smoking initiation and cessation among women in Brazilian worksites (Curitiba, Paraná, Brazil). A total of 22 focus groups were conducted among 108 women in private and public worksites. The most frequently endorsed negative factors that contributed to smoking initiation included exposure to smoking-prompting behaviors through family members, peer pressure, media and easy access/low cost of cigarettes. Positive factors that served as protective mechanisms against initiation included smoking-related health effects and strong influence from parents and family members. The most salient negative factors associated with smoking cessation included stress/anxiety-relieving benefits, weight control, access/low cost of cigarettes, being around smokers and risk-exempting beliefs. Positive factors included smoking restrictions at home and workplace and concerns about appearance. Current and former smokers reported that they had never received any assistance from their physicians to quit smoking, nor did they rely on smoking cessation programs or aids or believe in their effectiveness. There are specific contextual factors that contribute to smoking initiation/cessation among women in Brazilian worksites which have important clinical, research and policy implications.