Tobacco-related Risk Factors Research Articles

Canadians’ knowledge of cancer risk factors and belief in cancer myths

BackgroundMany untrue statements about cancer prevention and risks are circulating. The objective of this study was to assess Canadians’ awareness of known cancer risk factors and cancer myths (untruths or statements that are not completely true), and to explore how awareness may vary by sociodemographic and cognitive factors.MethodsCancer myths were identified by conducting scans of published, grey literature, and social media. Intuitive-analytic thinking disposition scores included were actively open- and close-minded thinking, as well as preference for intuitive and effortful thinking. A survey was administered online to participants aged 18 years and older through Prolific. Results were summarized descriptively and analyzed using chi-square tests, as well as Spearman rank and Pearson correlations.ResultsResponses from 734 Canadians were received. Participants were better at identifying known cancer risk factors (70% of known risks) compared to cancer myths (49%). Bivariate analyses showed differential awareness of known cancer risk factors (p < 0.05) by population density and income, cancer myths by province, and for both by ethnicity, age, and all thinking disposition scores. Active open-minded thinking and preference for effortful thinking were associated with greater discernment. Tobacco-related risk factors were well-identified (> 90% correctly identified), but recognition of other known risk factors was poor (as low as 23% for low vegetable and fruit intake). Mythical cancer risk factors with high support were consuming additives (61%), feeling stressed (52%), and consuming artificial sweeteners (49%). High uncertainty of causation was observed for glyphosate (66% neither agreed or disagreed). For factors that reduce cancer risk, reasonable awareness was observed for HPV vaccination (60%), but there was a high prevalence in cancer myths, particularly that consuming antioxidants (65%) and organic foods (45%) are protective, and some uncertainty whether drinking red wine (41%), consuming vitamins (32%), and smoking cannabis (30%) reduces cancer risk.ConclusionsWhile Canadians were able to identify tobacco-related cancer risk factors, many myths were believed and numerous risk factors were not recognized. Cancer myths can be harmful in themselves and can detract the public’s attention from and action on established risk factors.

Tobacco Industry Marketing Exposure and Commercial Tobacco Product Use Disparities among American Indians and Alaska Natives

Background: Non-Hispanic American Indians and Alaska Natives (NH AI/AN) have the highest commercial tobacco use (CTU) among U.S. racial/ethnic groups. Tobacco marketing is a risk factor, however few studies examine it among NH AI/AN. Objective: We identified prevalence of tobacco industry marketing exposure and correlates of CTU among NH AI/AN compared to other racial/ethnic groups. Methods: Data were from wave 1 (2013–2014; N = 32,320) of the Population Assessment of Tobacco and Health Study, analyzing self-reported exposure to tobacco ads from stores, tobacco package displays, direct mail and email marketing. Correlates of CTU were identified and interactions between racial/ethnic groups and tobacco marketing were assessed. Results: NH AI/AN (n = 955) had a higher prevalence of exposure to retail tobacco ads (64.5% vs 59.3%; p < 0.05), mail (20.2% vs.14.3%; p < 0.001) and email (17.0% vs.10.6%; p < 0.001) marketing than NH Whites (n = 19,297). Adjusting for tobacco use and related risk factors, exposure to email marketing remained higher among NH AI/AN than NH Whites. Interactions between racial/ethnic groups and marketing exposures on CTU were nonsignificant. CTU was higher among NH AI/AN than NH Whites and among adults who reported exposure to tobacco ads, mail, and email marketing. Conclusions/importance: There is higher tobacco marketing exposure in stores and via mail for NH AI/AN. Email marketing exposure was higher, even after controlling for tobacco-related risk factors. The tobacco industry may be targeting NH AI/AN through emails, which include coupons and other marketing promotions. Culturally relevant strategies that counter-act tobacco industry direct marketing tactics are needed to reduce disparities in this population.

Online tobacco marketing among US adolescent sexual, gender, racial, and ethnic minorities

IntroductionThe tobacco industry has previously targeted sexual/gender and racial/ethnic minorities with focused campaigns in traditional, offline marketing. We assess whether these populations report more engagement with online tobacco marketing compared with heterosexual and non-Hispanic white youth. MethodsData were from 8015 adolescents sampled between 2014 and 2015 in the nationally-representative Population Assessment for Tobacco and Health (PATH) Study. Engagement with online tobacco marketing within the past year was assessed through eight forms of engagement. A weighted logistic regression model was fit with engagement as outcome and socio-demographic and psychosocial characteristics, internet-related and substance use behavior, tobacco-related risk factors, tobacco use status, and prior engagement with online tobacco marketing as covariates. ResultsAccounting for other covariates including tobacco use status and prior engagement with online tobacco marketing, the odds of past-year engagement were higher for sexual minority males (aOR = 1.57; 95% CI: 1.05–2.35) compared to straight males and higher for sexual minority females (aOR = 1.45; 95% CI: 1.13–1.87) compared to straight females. The odds of past-year engagement were also higher for Hispanics (aOR = 1.31; 95% CI: 1.11–1.56) and non-Hispanic Blacks (aOR = 1.42; 95% CI: 1.14–1.77) compared to non-Hispanic Whites. ConclusionsSexual/gender and and racial/ethnic minority youth reported higher engagement with online tobacco marketing than their heterosexual and non-Hispanic white peers, respectively.

Smoking behavior among third year dental students in Latin American countries: prevalence, perceptions, and risk factors.

To examine the association between tobacco-related risk factors and smoking among third-year dental students in Latin American countries. Logistic regression models were used to analyze Global Health Professions Student Survey (GHPSS) data. Of 5 605 respondents, 33% smoked and 45% had been exposed to secondhand smoke during the previous month, 34% smoked in school buildings during the past year, and 85% had never received formal training in smoking cessation. Smoking was significantly associated with male sex; Bolivian, Chilean, or Mexican nationality; exposure to secondhand smoke; lacking self-perception of being a "role model" for patients; and not believing that health professionals who smoke are less likely to advise patients to quit smoking. All dental schools should encourage tobacco-free policies and offer cessation services. Cessation training must be incorporated into dental curricula to include dental professionals in the battle against the tobacco epidemic.

Tobacco Use and Exposure Among Youth Undergoing Cancer Treatment

IntroductionAdolescents with cancer are susceptible to the health consequences associated with secondhand smoke exposure (SHSE) and tobacco use. The present study compared tobacco use, exposure, and risk factors between patients and population peers. MethodSelf-reported data on tobacco use, SHSE, and tobacco-related risk factors were drawn from a pediatric oncology hospital and the National Youth Tobacco Survey. Conditional logistic regression was used to estimate odds ratios for patients and control subjects. ResultsPatients were as likely to have tried tobacco and report home SHSE as control subjects. Patients were more likely to report car SHSE, less likely to report that SHSE is harmful, and less likely to report home smoking bans. DiscussionPatients experienced SHSE, tobacco use, and tobacco-related risk factors at rates greater than or equal to control subjects. These results provide support for consideration of intervention targets, health status, and delivery mechanisms, particularly by health care providers, when developing comprehensive tobacco control strategies.

Is there indeed a difference between smokers' and nonsmokers' lung cancer? A single-institute prospective study of 489 patients from India.

e12004 Background: Lung cancer in nonsmokers as a separate category ranks as the seventh most common cause of cancer deaths worldwide. This study aimed to identify clinically meaningful differences in epidemiologic and patient characteristic in never-smokers with non-small cell lung cancer (NSCLC) as compared to smokers in India. Methods: All consecutive patients registered in the thoracic working group from November 2008 to November 2009 were interviewed with the help indigenously designed questionnaire. Detailed patient history, disease staging on the basis of imaging, histopathologic subtype of carcinoma, and treatment plan were entered in SPSS-14. Results: For the 489 patients, see Table for results. Nonsmokers patients had a trend of higher history of tuberculosis, advanced stage at presentation, bilateral disease, and were in peripheral location (p=NS). Anti-Koch's treatment delayed diagnosis by 3.7 months in nonsmokers and 4.2 months in smokers (p=0.45). There was no significant correlation between incidence of nonsmoker's lung cancer and the place of residence, preexisting comorbidities, clinical features, past history of tuberculosis, location of the primary tumor, site of metastasis. All patients were offered the same treatment irrespective of the smoking status. Conclusions: The increasing incidence of lung cancer in nonsmokers is alarming. Definite epidemiologic differences exist between never-smokers and smokers in terms of age, sex, histology, and history of smokeless tobacco. Successful prevention and treatment of lung cancer requires acceptance that this is not a single disease. Future concerted efforts should focus on conducting to further delineate underlying biologic differences, identify potential non–tobacco-related risk factors and further refine treatment strategies for these groups of patients. Variables Smokers Nonsmokers p value (Pearson's test) No. of patients 234 (48%) 255 (52%) Age Median 59 53 0.000 Sex Male 58.2% 41.8% 0.000 Female 11.9% 88.1% Histology Small cell ca 9.8% 5.5% p = 0.001 Squamous cell 29.9% 16.1% Adeno ca 33.3% 42.4% Smokeless tobacco 50 (37.6%) 83 (62.4%) p = 0.004 No significant financial relationships to disclose.

A comparison of tobacco-related risk factors between preadolescents with and without cancer

To compare preadolescents with and without cancer on current smoking status, future intentions to smoke, and tobacco-related risk factors, as well as to explore the relationship between cancer status and tobacco-related variables with intentions. Ninety-four preadolescents undergoing treatment for cancer and a matched comparison sample of 190 participants without cancer, ages 8 to 11 years, completed questionnaires about their smoking habits, intentions to smoke and tobacco-related psychosocial risk factors. No preadolescents with cancer and only two preadolescents without cancer reported current smoking. Compared to healthy nonsmoking preadolescents, nonsmokers with cancer were approximately one-half as likely to report future intentions to smoke. Intention to smoke was better predicted by variables most proximal to smoking including older age, being male, not having cancer, having close friends who smoke, parental smoking, and lower perceived vulnerability for tobacco-related illnesses. In the model examining distal variables, preadolescents who were more rebellious, older, and without cancer were more likely to report future smoking intentions. Although future intentions to smoke differed according to cancer status, the relationship between tobacco-related risk factors and future smoking intentions appeared to be similar among preadolescents with and without cancer. Smoking prevention and tobacco-related health risk education should begin during the elementary years, a time prior to smoking initiation and the development of solidified smoking attitudes. The diagnosis and treatment of pediatric cancer may provide an excellent opportunity for health care providers to begin communicating anti-smoking messages and health risk counseling to their young patients and families.

A Comparison of Tobacco-Related Risk Factors Between Adolescents With and Without Cancer

To compare adolescents with and without cancer on current smoking status, intentions to smoke, and tobacco-related risk factors. Ninety adolescents undergoing treatment for cancer (median time since diagnosis was 2.4 months) and a comparison sample of 279 adolescents without cancer, ages 12 to 18 years, completed questionnaires that asked about their smoking habits, intentions to smoke, and tobacco-related psychosocial risk factors. Approximately 2% of adolescents with cancer and 22% of adolescents without cancer reported current smoking. Compared to nonsmoking adolescents without cancer, nonsmoking adolescents with cancer were one third less likely to report intentions to smoke. No significant interactions were detected between group (having cancer or not) and each of the tobacco-specific and psychosocial variables tested in two separate multivariable models. Intentions to smoke were best predicted by variables most proximal to smoking. Adolescents who smoked in the past and who had lower tobacco knowledge and greater perceived instrumental value were more likely to report intentions to smoke. Adolescents who were less optimistic were also more likely to intend to smoke. Tobacco-related risk factors for intentions to smoke appeared to be similar among adolescents with and without cancer. Implications of these findings for tobacco control among adolescents with cancer are discussed.