The health-related quality of life of male and female heavy smokers

Summary. Objectives: Heavy smokers are a segment of the smoking population who are at increased risk of smoking-related morbidity and least likely to achieve cessation. This study identifies the impact of heavy smoking on quality of life by gender and describes the subpopulation for improved targeting.Methods: South Australian representative population data (n = 3010) was used to compare the health-related quality of life status of male and female heavy smokers as assessed by the SF-36.Results: Of the smoking population 18% were classified as heavy smokers. There was a clear dose response relationship between amount smoked and deteriorating quality of life for all female smokers. Female heavy smokers were found to be significantly more impaired on all health-related quality of life dimensions, when compared to male heavy smokers.Conclusions: The association of smoking with impaired quality of life is more marked in females than in males. There is a need to identify female smokers as a distinct target group in smoking cessation initiatives and programs.

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Zusammenfassung. Gesundheitsbezogene Lebensqualität von starken Rauchern und RaucherinnenFragestellung: Starke Raucher sind ein Segment der rauchenden Bevölkerung, das eine erhöhte raucherbezogene Morbidität aufweist und am wenigsten wahrscheinlich einen Rauchstopp schafft. Die Studie identifiziert den Einfluss von starkem Rauchen auf die Lebensqualität nach Geschlecht und beschreibt Untergruppen, um diese besser für Programme und Initiativen zu gewinnen.Methoden: Südaustralische repräsentative Bevölkerungsdaten (n = 3010) wurden benutzt, um die gesundheitsbezogene Lebensqualität, gemessen mit dem SF-36, von starken Rauchern und Raucherinnen zu vergleichen.Ergebnisse: 18% der rauchenden Bevölkerung wurde als starke Raucher klassifiziert. Es gibt eine klare Dosis-Wirkung-Beziehung zwischen Anzahl gerauchter Zigaretten und Verschlechterung der Lebensqualität bei Frauen. Starke Raucherinnen sind auf allen Dimensionen der gesundheitsbezogenen Lebensqualität signifikant beeinträchtigter als starke Raucher.Schlussfolgerung: Die Beziehung zwischen Rauchen und beeinträchtigter Lebensqualität ist bei Frauen ausgeprägter als bei Männern. Raucherinnen müssen als eindeutige Zielgruppe in Rauchstopp-Programmen und -initiativen identifiziert werden.

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Résumé. Qualité de vie et santé des hommes et femmes gros fumeursObjectifs: Les gros fumeurs représentent un segment de la population qui ont un risque élevé de maladie en lien avec le tabagisme et qui sont les moins susceptibles darrêter de fumer. Cette étude identifie limpact du fait de beaucoup fumer sur la qualité de vie (selon le sexe), et décrit une sous-population de gros fumeurs afin de les cibler plus efficacement.Méthodes: Des données populationnelles représentatives de lAustralie du Sud (n = 3010) ont été utilisées pour comparer la qualité de vie et la santé dhommes et de femmes considérés comme des gros fumeurs (selon le test SF-36).Résultats: Parmis les fumeurs, 18% ont été considérés comme des gros fumeurs. Il y avait chez les fumeuses une relation dose-réponse claire entre le niveau de tabagisme et la détérioration de la qualité de vie. Comparées aux hommes, les femmes se sont révélées plus touchées dans toutes les dimensions de leur qualité de vie.Conclusions: Lassociation entre le tabagisme et une qualité de vie détériorée est plus marquée chez les femmes que chez les hommes. Il est nécessaire didentifier les fumeuses comme un groupe-cible spécifique pour des interventions et des programmes de cessation tabagique.

     

Smoking Cessation and Quality of Life: The Effect of Amount of Smoking and Time Since Quitting

BACKGROUND: Knowledge of the impact of smoking cessation on health-related quality of life may be important in encouraging smokers to quit. We determined whether the difference in quality of life between ex- and current smokers is influenced by amount of smoking or time since quitting. METHODS: Data were collected within a cross-sectional study among a random sample of the general population in The Netherlands. Health-related quality of life was measured with the RAND-36 questionnaire (adapted from SF-36). Smoking behavior was assessed with a self-administered questionnaire. Adjusted differences in quality of life scores between ex- and current smokers were tested with multivariate analysis of variance, among 9,660 men and women aged 20-59 years, without history of tobacco-related chronic diseases. RESULTS: Ex-smokers reported significantly higher quality of life scores than current smokers. This was more pronounced for mental health, especially for role functioning limitations due to emotional problems (difference 6.5 points; P < 0.0001), than for physical health dimensions. Differences were generally larger between ex- and current heavy smokers than between ex- and current light or moderate smokers (P trend <0.05 when ex-smokers had quit <5 or > or =10 years ago). No significant trend was observed with time since quitting. CONCLUSIONS: Generally, the higher the amount of smoking, the higher were quality of life differences between ex- and current smokers.     

Associations between behavioural risk factors and smoking,heavy smoking and future smoking among an Australian population-based sample

IntroductionTobacco smoking co-occurs with behavioural risk factors including diet, alcohol use and obesity. However, the association between behavioural risk factors and heavy smoking (> 20 cig/day) compared to light–moderate smoking is unknown. The link between behavioural risk factors and future smoking for both ex and current smokers is also unknown. This study sought to examine these relationships. It is hypothesised that behavioural risk factors will be more strongly associated with heavy smoking.MethodData from Wave 7 (2007) of the Household and Labour Dynamics in Australia (HILDA) survey was analysed using logistic regression to determine relationships between diet (fruit and vegetable consumption, and unhealthy diet choices), alcohol consumption, obesity and physical activity with light–moderate smoking and heavy smoking. The association between these risk factors and future smoking (2008) was assessed for current and ex-smokers (2007).ResultsObese respondents were less likely to be light/moderate smokers (RRR: 0.53; 95% CI: 0.43, 0.66) but not heavy smokers. Those who consume confectionary weekly were less likely to be light/moderate smokers (RRR: 0.73; 95% CI: 0.61, 0.87), but not heavy smokers. Smokers in 2007 were more likely to continue smoking in 2008 if they consumed 1–4 drinks per occasion (OR: 2.52; 95% CI: 1.13, 5.62). Ex-smokers in 2007 were less likely to relapse in 2008 if they consumed recommended levels of both fruit and vegetables (OR: 0.31; CI: 0.10, 0.91).ConclusionThe relationships between heavy smoking and behavioural risk factors differ from moderate–light smoking. Future primary care interventions would benefit from targeting multiple risk factors, particularly for heavy smokers.     

Effects of smoking and smoking cessation on life expectancy in an elderly population in Beijing, China, 1992-2000: an 8-year follow-up study

Background

We assessed the effects of smoking and smoking cessation on life expectancy and active life expectancy among persons aged 55 years or older in Beijing.

Methods

This study included 1593 men and 1664 women who participated in the Beijing Longitudinal Study of Aging, which commenced in 1992 and had 4 survey waves up to year 2000. An abridged life table was used to estimate life expectancy, in which age-specific mortality and age-specific disability rates were adjusted by using a discrete-time hazard model to control confounders.

Results

The mean ages (SD) for men and women were 70.1 (9.25) and 70.2 (8.72) years, respectively; mortality and disability rates during follow-up were 34.7% and 8.0%, respectively. In both sexes, never smokers had the highest life expectancy and active life expectancy across ages, as compared with current and former smokers. Current heavy smokers had a shorter life expectancy and a shorter active life expectancy than light smokers. Among former smokers, male long-term quitters had a longer life expectancy and longer active life expectancy than short-term quitters, but this was not the case in women.

Conclusions

Older adults remain at higher risk of mortality and morbidity from smoking and can expect to live a longer and healthier life after smoking cessation.Key words: smoking, smoking cessation, life expectancy, active life expectancy, elderly population, discrete-time hazard model     

Association of smoking status and health-related quality of life: difference among young,middle-aged,and older adults in Shandong,China

Purpose

Few studies explored the relationship between smoking status and health-related quality of life (HRQOL) among adults in China. This study aims to explore the relationship between smoking status and HRQOL among adults (18?+) and examine whether there is a difference in this relationship among young, middle-aged, and older adults in China.

Methods

A total of 23,021 respondents were included in this study. The HRQOL is measured by EQ-5D-3L. The smoking status is divided into never smokers, current smokers, and former smokers. Tobit regression and Logistic regression are employed to explore the association between smoking status and HRQOL. The interaction term is included to explore the difference among young, middle-aged, and older adults.

Results

This study finds smoking status is significantly associated with HRQOL. An interaction analysis shows that the association between smoking status and HRQOL is significantly different among young, middle-aged, and older adults (P?<?0.05). The smoking status is only significantly associated with HRQOL in middle-aged and older adults, but not for young adults. Compared with never smokers, former smokers report significantly lower EQ-5D-3L utility value in middle-aged adults (coefficient?=????0.089; 95%CI???0.128 to???0.050), current smokers report significantly higher EQ-5D-3L utility value in older adults (coefficient?=?0.041; 95%CI 0.005 to 0.076).

Conclusions

This study demonstrates a significant association between smoking status and HRQOL among adults in China, and there is a difference in this relationship among young, middle-aged, and older adults. The government should take efforts to formulate a variety of measures to control tobacco use among adults.

     

Smoking ban policies and their influence on smoking behaviors among current California smokers: A population-based study

ObjectiveTo assess whether smoking ban policies are associated with smoking reduction and quit attempts among California smokers.MethodsData were examined for 1718 current smokers from follow-up telephone interviews conducted in 2011 of persons previously identified as smokers in a representative sample of the adult population of California. Population weighted logistic regressions controlling for demographic and other variables were used to evaluate the association between smoking ban policies (home, work, and town) and changes in tobacco use (past year quit attempt or reduction in smoking rate).ResultsLiving in a home with a total ban was significantly associated with smoking reduction (adjusted odds ratio, AOR: 2.4, 95% CI: 1.4–4.2) and making a quit attempt (AOR: 2.3, 95% CI: 1.3–3.9) compared to living in a home with no home ban. Self-reported perception of an outdoor ban in one's city/town was associated with smoking reduction (AOR: 1.7, 95% CI: 1.02–2.7) and making a quit attempt (AOR: 1.8, 95% CI: 1.05–2.9).ConclusionThese results indicate that smoking bans not only protect nonsmokers from the harms of secondhand smoke, but are also associated with smoking reduction and cessation.     

Smoking-Related Cue-Induced Brain Activation in Adolescent Light Smokers

PurposeTo examine using functional magnetic resonance imaging whether adolescents with low levels of nicotine exposure (light smokers) display neural activation in areas shown to be involved with addiction in response to smoking-related stimuli.Design/Setting/ParticipantsA total of 12 adolescent light smokers (aged 13–17, who smoked 1–5 cigarettes per day) and 12 nonsmokers (ages 13–17, never smoked a cigarette) from the San Francisco Bay Area underwent functional magnetic resonance imaging scanning. During scanning, the adolescents were shown photographic blocks of smoking and control cues. Smoking cues comprised pictures of individuals smoking cigarettes and smoking-related objects such as lighters and ashtrays. Neutral cues comprised images of everyday objects and individuals engaged in daily activities.FindingsFor smokers, smoking cues elicited greater activation than neutral cues in the mesolimbic reward circuit (left anterior cingulate: t = 7.04, p < .001; right hippocampus: t = 6.37, p < .001). We found activation from smoking cues versus neutral cues within both the left and right frontal medial orbital regions (t = 5.09, p < .001 and t = 3.94, p = .001, respectively). Nonsmokers showed no significant difference in activation between smoking-related cues and neutral cues.ConclusionOur finding that smoking cues produced activation in adolescent light smokers in brain regions, similar to that seen in adult and teenage heavy smokers, suggests that adolescents exhibit heightened reactivity to smoking cues even at low levels of smoking. This article adds to the existing published data by suggesting that nicotine dependence may begin with exposure to low levels of nicotine, thus underscoring the need for early intervention among adolescent smokers.     

Cigarette smoking behaviors among adults with serious mental illness in a nationally representative sample

PurposeThis study updates nationally representative information on cigarette smoking behaviors among adults with mental illness, particularly serious mental illness (SMI), to serve as a new benchmark for smoking cessation initiatives.MethodsData are from the 2008–2012 National Surveys on Drug Use and Health. Prevalence estimates for past month daily smoking, heavy smoking, mean cigarettes consumed per day, nicotine dependence, past month quit ratio, and proportion of cigarettes consumed are presented by mental illness status.ResultsAdults with SMI were more likely than adults with any mental illness (AMI) but not SMI and adults without mental illness to engage in smoking behaviors. Adults with AMI but not SMI were more likely to engage in all smoking behaviors compared with adults without mental illness. The past month quit ratio was significantly lower among adults with SMI and among adults with AMI but not SMI than among adults without mental illness. Adults with SMI comprised 6.9% of past month smokers but consumed 8.7% of all cigarettes.ConclusionsAdults with mental illness engage in more smoking behaviors and are less likely to quit than adults without mental illness. In this high-risk population, continued efforts to promote smoking cessation are needed.     

Characterization of the smoking habit among high school students in Syria

Objectives: To establish an accurate estimate of the prevalence of smoking among high school students in Aleppo–Syria and to characterize the smoking habit in this age group. Design: A cross-sectional survey was performed, in which a self-administered questionnaire was distributed to 10th, 11th and 12th graders. Subjects: A sample of 1587 students (784 males; mean age 16 years, and 803 females; mean age 15.9 years) was studied. This sample was drawn from 16 schools randomly selected from a total of 73 schools in the city. Results: The prevalence of current smoking was 15.9% for males and 6.6% for females. The prevalence of daily smoking was 2.4% for males and 0.5% for females. Almost all smoking categories increased with age and grade. Forty seven percent of male daily smokers were heavy smokers. Peer influence was evident in all stages of the smoking process, especially for males. Parental smoking was also an important associated factor. The combination of parental and siblings smoking was the strongest predictor of the smoking status of the surveyed (OR: 4.4; 95% CI: 2.7–7). Thirty eight percent of male smokers and 47.2% of female smokers smoke out of boredom. Fifty one percent of male smokers were introduced to smoking by a friend. Forty percent of male smokers buy their cigarettes, while 56.6% of female smokers obtain their cigarettes from home. Logistic regression analyses showed that parental and siblings smoking were the most important predictors of ever trying to smoke or current smoking among male and female students. Conclusions: Our study shows that smoking is more frequent in male than female students. Parental and sibling smoking are the most important factors associated with smoking in this population, and peer influence is important particularly in the smoking initiation stage. Pattern of smoking and associated factors differed substantially between males and females in this study.     

Adolescent smoking and the social capital of local communities in three counties in Romania

ObjectiveTo identify the effect of social capital on adolescent smoking.MethodA stratified random sample of 1313 7th and 8th grade students from three counties in Transylvania, Romania, completed a self-administered questionnaire on smoking-related knowledge, attitudes and behaviours. The impact of social capital was measured (personal and community activities, school achievements and smoking-related knowledge). Multivariate multinomial logistic regression models were used to measure the association between social participation and smoking.ResultsExperimenting with smoking was mostly related to knowledge about smoking, academic performance and second-hand tobacco smoke exposure at home. The strongest risk factor of adolescent smoking was the smoking behaviour of classmates: those who reported a significant proportion of smokers among their classmates were nine times more likely to smoke themselves than in other cases (adjusted odds ratio [aOR]: 9.05). Those who considered smoking to be harmless were 4 times more likely to be smokers than those who considered this behaviour to be dangerous (aOR: 4.28). Poor academic results increased adolescents’ smoking (aOR: 3.22 and 2.66). The odds were significantly higher for smoking, if they had an active social life (aOR: 2.54). Regular church attendance proved to be a protective factor (aOR: 0.45).ConclusionsSeveral social capital factors can play a role in adolescent smoking. The organization and the development of community activities aimed at prevention must strengthen the factors related to the community's social capital to reduce the likelihood of teenage smoking.     

Perceived risks and reasons to smoke cigarettes during pregnancy among Alaska native women

Objective: The purpose of this study was to explore perceptions of the risks of smoking and reasons Alaska Native women give for smoking during pregnancy.

Design: A total of 118 women (54 smokers, 64 non-smokers) enrolled in a biomarker study and completed a baseline interview asking about their concerns regarding tobacco use while pregnant and reasons why pregnant women might smoke during pregnancy. Responses were collapsed into six categories of perceived risks of smoking and eight categories of reasons to smoke during pregnancy.

Results: The majority of both pregnant non-smokers and smokers (72.6% and 60.4%) agreed that smoking during pregnancy could negatively impact the health of their baby. However, non-smokers were more likely than smokers (77.4% vs. 58.5%) to view smoking during pregnancy as a risk factor for the baby’s development (p?=?.029). Both non-smokers and smokers identified addiction as a reason for smoking during pregnancy (82.8% and 63%); however, non-smokers were more likely than smokers to state this was a reason for use (p?=?.015). Seventy-three percent of the entire sample reported a reason to smoke in pregnancy was to help manage negative affect.

Conclusion: Results from this work may be helpful in advancing research by identifying targets for intervention specific to Alaska Native women receiving prenatal care in Anchorage, Alaska.     

Life expectancies of cigarette smokers and nonsmokers in the United States

This research employs the National Health Interview and the National Mortality Followback Surveys to calculate life expectancies by age and sex for white nonsmokers, former smokers, and current smokers in the United States in 1986. In general, life expectancies are higher for never smokers than for former smokers, and higher for former smokers than for current smokers. Heavy smokers have lower life expectancies than persons with all other smoking statuses; indeed, compared to never smokers, heavy smokers at age 25 can expect at least a 25% shorter life. Gender differences in life expectancies were found to persist even with the elimination of smoking. Differences in life expectancy by sex thus appear to be due, in part, to cigarette smoking, but also to occupational, environmental, and sociodemographic factors.     

中国10个地区30~79岁成年人被动吸烟行为特征分析

目的 描述中国慢性病前瞻性研究（CKB）项目10个地区非吸烟人群被动吸烟行为特征的地区和人群分布差异。方法 分析10个地区317 486名30~79岁非吸烟者在基线调查时的被动吸烟行为信息,描述其被动吸烟行为特征的地区和人群分布差异。结果 按照全国人口普查结果进行标化,我国成年人被动吸烟率为56.7%,与吸烟者共同居住率为66.5%,其中农村高于城市。周被动吸烟频率、周被动吸烟累计时长、日均被动吸烟时长具有明显的地区差异,城市地区的周被动吸烟累计时长随周被动吸烟频率的增加而增加,女性中湖南省的周被动吸烟频率较高,但周被动吸烟累计时长较低,日均被动吸烟时长最低,河南省却与之相反;与吸烟者共同居住者的被动吸烟率是从未共同居住者的2.27倍（95% CI：2.24~2.29）,且在女性中关联更强（OR=2.61,95% CI：2.58~2.64）,而在男性中二者无关（OR=1.01,95% CI：0.95~1.06）。女性除日均被动吸烟时长小于男性外,其余指标均大于男性;且年龄较小、文化程度较低者的多数被动吸烟指标较高;家庭年收入较低者的被动吸烟率和与吸烟者共同居住率较低,但日均被动吸烟时长较高;女性在婚者的被动吸烟率、与吸烟者共同居住率较高,男性与之相反。结论 CKB项目10个地区非吸烟人群的被动吸烟率、周被动吸烟频率、周被动吸烟累计时长和日均被动吸烟时长以及与吸烟者共同居住率、共同居住年限均存在明显的地区和人群分布差异。     

Impact of smoking on the social gradient in health expectancy in Denmark

STUDY OBJECTIVE: Health expectancy is arrived at by dividing life expectancy into average lifetime in different states of health. The purpose of the study was to estimate health expectancy among never smokers and smokers in groups at high, medium, and low educational levels in Denmark. DESIGN: Life tables for never smokers and smokers with a high, medium, and low educational level were constructed on the basis of Statistics Denmark registers and combined with data from the Danish Health Interview Survey 2000. Health expectancy was calculated by Sullivan's method. MAIN RESULTS: Life expectancy at age 30 differs on average by 8.5 years between never smokers and heavy smokers. Expected lifetime in self rated good health was 39.4 years for a never smoking man corresponding to 82.0% of the rest of his life. For male lifelong heavy smokers these figures were reduced to 27.3 years and 69.2%. The proportion of expected lifetime in self rated good health was 89.5% and 71.3% among male never smokers and lifelong heavy smokers with a high educational level, respectively; and the proportion among male never smokers and heavy smokers with a low educational level was 73.4% and 63.6%, respectively. Similar results were seen as regards expected lifetime without longstanding illness. For women the social gradient in health expectancy was intensified among smokers. CONCLUSIONS: Within each educational group smoking reduces expected lifetime in a healthy state. The social gradient in health expectancy cannot be explained by a reverse social gradient in smoking prevalence.     

Tobacco smoking in relation to pain in a national general population survey

BACKGROUND: We examined whether smoking status including heavy smoking (20 or more cigarettes per day) is related to the number of pain locations and intensity of pain. METHODS: A probability sample of the German national population aged 18 to 79 including 7124 participants (response proportion: 61.4%) was used. All individuals underwent a health examination between 1997 and 1999. Ordinal logistic regression analyses were performed with number of pain locations and pain intensity as dependent variables which had been assessed by questionnaire. RESULTS: Former and current heavy smokers had higher odds for greater numbers of pain locations and for moderate and intense pain than never smokers after adjustment for analgesic medicament use and behavior-related risk factors. Female former heavy smokers had an adjusted odds ratio (OR) of 1.6 (95% confidence interval, CI, 1.2-2.2) and male former heavy smokers had an adjusted OR of 1.4 (CI 1.1-1.8) for higher numbers of pain locations compared to never smoking women and men respectively (female current smokers: OR 1.4, CI 1.0-1.9; male current smokers: OR 1.3, CI 1.1-1.7). CONCLUSION: The findings suggest that former and current heavy smokers are more likely to report more pain locations and more intense pain than never smokers.     

The health-related quality-of-life of never smokers, ex-smokers, and light, moderate, and heavy smokers.

BACKGROUND: Health related quality-of-life is recognized as an important health outcome measure; how ever, it may also have a significant application in smoking reduction and cessation programs. METHODS: Representative population data (n = 3010) was used to compare the quality-of-life status of differ ent smoking categories with never smokers. RESULTS: Statistically significant differences in mean quality-of-life scores, as measured by the SF-36 health status questionnaire, were observed between never smokers, as the reference group, ex-smokers, all smokers, and light, moderate, and heavy smokers. Heavy smokers also scored significantly lower than both other groups of smokers, scoring as low as the 29th percentile of the population on the general health dimension and lower than the 36th percentile of the population on all the mental health dimensions. CONCLUSIONS: The design of public health smoking cessation programs should consider the varying characteristics of different segments of the smoking population. The advantages of improved quality-of-life may strengthen the argument for encouraging heavier smokers to become light smokers as a precursor to total cessation.     

Nicotine replacement therapy and other interventions for pregnant smokers: Pregnancy Risk Assessment Monitoring System, 2009–2010

BackgroundCurrent U.S. guidelines recommend consideration of nicotine replacement therapy (NRT) for pregnant smokers if behavioral therapies fail, only under close supervision of a provider, and after discussion of known risks of continued smoking and possible risks of NRT. The percentage of pregnant smokers offered NRT by their prenatal care providers is unknown.PurposeThe study aims to calculate the percentage of pregnant smokers offered cessation intervention and NRT and assess independent associations between selected maternal characteristics and being offered NRT.MethodsData were analyzed from the 2009–2010 Pregnancy Risk Assessment Monitoring System from four states that asked about provider practices for prenatal smoking cessation. Adjusted prevalence ratios were calculated to examine associations between being offered NRT, selected maternal characteristics, and smoking level. Variables used in adjusted models were based on factors associated with smoking cessation during pregnancy from prior literature and included race, age, education, insurance type, and stress.ResultsOf 3559 women who smoked 3 months before pregnancy, 77.4% (95% CI: 74.2, 80.3) of 3rd trimester smokers and 42% (95% CI: 38.5, 46.4) of women who quit smoking during pregnancy were offered at least one cessation method. Among smokers, 19.1% (95% CI: 16.5, 22.1) were offered NRT and of these, almost all (94%) were offered another cessation method.ConclusionsOne in five pregnant smokers was offered NRT. About a quarter of pregnant smokers did not receive any interventions to stop smoking. There may still be reluctance to provide NRT to pregnant women, despite known harms of continued smoking during pregnancy.     

Associations between smoking prevalence, stages of change, cigarette consumption, and quit attempts across the United States

BACKGROUND: We tested whether across the 50 U.S. States, smoking prevalence was associated with smoking behavior among smokers. METHODS: We used published data on smoking prevalence, cigarette consumption, and quit attempts by State from the Behavioral Risk Factor Surveillance System (BRFSS) for 1993, 1996, and 1999, and published data on the distribution of smokers by stage of change in each State from the Current Population Survey (CPS). Data were weighted for the population size in each State. RESULTS: For 1993, we found no statistically significant association between smoking prevalence and stages of change. For 1996 and 1999, across the 50 States, each additional percentage point in smoking prevalence was associated with, respectively, 0.62% and 1.19% more smokers in the "precontemplation" stage, that is, smokers not intending to quit smoking (both P < 0.01), with, respectively, 0.82% and 1.21% more "heavy" smokers who smoked 21-40 cigarettes per day (both P 相似文献   

Cigarette smoking and 9/11-related posttraumatic stress disorder among World Trade Center Health Registry enrollees, 2003–12

ObjectiveNumerous studies have observed higher rates of smoking among adults with mental health conditions. We examined posttraumatic stress disorder (PTSD) and smoking over a 7–9 year period among adults with firsthand exposure to the 9/11 attacks enrolled in the World Trade Center Health Registry.MethodData were collected at three waves: W1 (2003–04), W2 (2006–07), and W3 (2011–12). Enrollees aged ≥ 25 at W1 and who completed all three waves (n = 34,458) were categorized by smoker-type: non-smoker, non-daily (smoked some days in last 30 days), light (1–10 cigarettes per day (CPD)), or heavy (11 + CPD). Enrollees who smoked at W1 but not W3 were considered to have quit. PTSD was defined as a score of ≥ 44 on the PTSD Checklist—Civilian Version.ResultsSmoking declined significantly from W1 (12.6%) to W3 (9.2%). Smoking prevalence was higher among enrollees with PTSD. In multivariable models, odds of quitting were 25–39% lower among heavy, light, and non-daily smokers with PTSD compared to those without.ConclusionPTSD was associated with reduced odds of quitting regardless of smoker-type. Disaster-exposed smokers with PTSD are likely in need of more supportive services in order to abstain from smoking.     

Small-group discussions on menthol cigarettes: listening to adult African American smokers in Atlanta, Georgia

Objective. In 2002, the First Conference on Menthol Cigarettes brought together researchers from diverse backgrounds to summarize what is known about menthol cigarettes and the people who smoke them, and to identify areas of needed research on menthol cigarettes. Since the conference, PubMed reports 24 articles, including the conference proceedings, on menthol cigarettes and African Americans. Many of the articles address epidemiological or biomedical topics. While there has been some focus on social influences and marketing issues, more research and a greater focus on this topic are needed.

Design. To stimulate research on a population disproportionately burdened by the health effects of smoking, we conducted small-group discussions in 2005 with adult African American smokers in Atlanta, Georgia. Each group discussion focused on a different topic: smoking behavior and preferences, perceptions of social influences, health effects and perceived harmfulness of menthol, quitting menthol cigarette smoking, or the influence of marketing and advertising of menthol cigarettes.

Results. Themes emerged from the discussions: (1) emulation of black culture by white youth and racial integration of neighborhoods and communities may have modified the perception that African Americans smoke menthol cigarettes and whites smoke non-menthol cigarettes; (2) non-menthol cigarette smokers were thought to be ‘hardcore’ smokers with less interest in quitting; (3) switching to non-menthol cigarettes was discussed as a way of quitting cigarettes for habitual menthol smokers; and, (4) smoking menthol cigarettes was thought to lead to fewer negative health effects.

Conclusion. Some topics suggested by the participants warrant further investigation. More research is needed to assess the pervasiveness of these beliefs and their potential utility for smoking cessation interventions.