Cigarette smoking for weight loss or control among adolescents: gender and racial/ethnic differences.

PURPOSE: To describe gender and racial/ethnic differences in the prevalence of cigarette smoking for weight loss or control in an adolescent population-based sample, and relationships among heavy smoking, weight concerns and smoking to lose or control weight. METHODS: Anonymous questionnaires were administered to 81,247 9th and 12th grade public school students across the state of Minnesota in 1998. Variables of interest included smoking frequency, weight concerns, and smoking for weight loss or control. Logistic regression analyses were used to estimate the odds of smoking to lose or control weight by race/ethnicity and gender, and to evaluate the relationships between smoking to lose or control weight and heavy smoking, perceptions of overweight, and weight concerns by race/ethnicity and gender. RESULTS: With the exception of black females, female smokers of different racial/ethnic groups were as likely as white girls to smoke for weight loss or control. Compared to white male smokers, American Indian and Asian American male smokers were more likely to smoke for weight loss or control, and black, Hispanic, and mixed race male smokers were equally likely to smoke for weight loss or control. Heavy smokers, smokers who perceived themselves as overweight or were weight-concerned were significantly more likely to report smoking as a weight control method. CONCLUSIONS: Smoking for weight control is prevalent across many race/ethnic groups and both genders among adolescents.     

Characteristics of cigarette smoking and quitting among university students in Syria

BACKGROUND: No study to date in Syria has documented the smoking and quitting characteristics in a representative sample of university students, and this study aims to fill this void. DESIGN: In 2003, a cross-sectional survey was carried out among students at Aleppo University using an interviewer-administered questionnaire. Overall, 587 students participated in the study (278 males, 309 females; mean age, 21.8 +/- 2.1 years; response rate, 98.8%). Experiences and attitudes related to smoking and quitting were assessed for two popular forms of tobacco use in Syria-cigarettes and narghile (waterpipe). RESULTS: Current cigarette smoking was reported by 30.9% of male and 7.4% of female students and daily smoking by 24.8% of male and 5.2% of female students. Narghile smoking was seen among 25.5% of men and 4.9% of women, mostly on an occasional basis. More than half of current smokers (56%) believed they could quit cigarettes, 75.2% were interested in quitting, and 78% of those had made a quit attempt in the past year. Important correlates of cigarette smoking among students were being older, male, and smoking narghile, while being older and from a poorer family were associated with increased interest in quitting. Interestingly, peers' smoking was associated with current smoking among students, but inversely with their willingness to quit. CONCLUSIONS: Cigarette smoking is mainly a problem of male students, whose narghile smoking is likely to be dramatically increasing as well, sometimes practiced as a substitute for cigarettes. The findings that most smokers in this sample are interested in quitting smoking and have tried unsuccessfully to do so indicate that cessation support for youths in this country is urgently needed.     

中国／WHO控烟能力建设社区子项目上海地区一年效果评估

目的　评价中国/WHO控烟能力建设合作项目(社区控烟子项目)在上海市长宁区新华街道社区居民控烟能力建设实施一年的效果,探索今后社区的控烟方法。方法　按照中国/WHO控烟能力建设合作项目(社区控烟子项目)总体安排,统一问卷、统一时间,按照人口2 %的样本量随机抽取2 0～6 0岁社区居民,对其烟草使用和控烟方面的知识、态度和行为及对戒烟服务的需求和获得情况进行了调查与分析。结果　社区男性居民吸烟率高于女性,干预前后居民吸烟率分别为35 1%和4 2 8% ,干预期间社区居民男性吸烟人群戒烟成功率为10 6 % ,以5 5岁以上年龄段、离退休人员、大专以上学历、家庭人均月收入>2 5 0 0元人群中戒烟成功率最高。戒烟失败的主要原因是缺乏意志力,其次是来自周围吸烟者的影响;84 %以上的调查对象都认为吸烟、被动吸烟有害健康,且吸烟者、不吸烟者、戒烟者正确认知率依次增高;干预后男性调查对象劝阻朋友或家人吸烟、表示戒烟后永不吸烟比干预前有明显提高(P <0 0 1) ,且能主动寻求戒烟服务(P <0 0 5 ) ;去治疗机构就医时医务人员主动向男性调查对象介绍戒烟方法和技巧干预后多于干预前(P <0 0 1) ,有显著性差异。结论　对新华街道社区居民实施控烟教育与培训等综合性措施是有效的,提升了社区居民的控烟能     

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.     

中国三城市男性吸烟者的社会规范与戒烟行为的关系

【目的】了解中国男性戒烟相关社会规范的现状及其与戒烟意愿、戒烟尝试等戒烟行为之间的关系。【方法】基于横断面研究,于2013年8-11月在上海、南宁、牡丹江三个地区抽取成年男性现在吸烟者进行问卷调查,收集基本信息、每日吸烟量、戒烟意愿、戒烟尝试和戒烟相关社会规范等资料。建立单因素、多因素logistic回归模型分别分析戒烟相关社会规范与戒烟意愿、戒烟尝试的关系。共获得有效问卷3621份,总有效率95.8%。【结果】吸烟者感知到的戒烟相关社会规范较低,很少能从家人、朋友及其他身边的人获得戒烟的劝谏与建议。社会规范得分每提高1分,则吸烟者的戒烟意愿可能性增加69%(OR为1.69,95%CI为1.48~1.94),吸烟者戒烟尝试的可能性增加86%(OR为1.86,95%CI为1.66~2.08)。【结论】戒烟相关社会规范是吸烟者产生戒烟意愿、戒烟尝试的独立预测因子。今后的控烟干预策略应该致力于创建鼓励戒烟的社会规范。     

Predictors of attempted quitting and cessation among young adult smokers

BACKGROUND: This study compared young adult nonsmokers (n = 1216), light smokers (n = 406), and regular smokers (n = 360) on demographic, psychosocial, and behavioral characteristics, as well as identified predictors of attempted quitting and 6-month cessation among regular smokers. METHOD: Participants were recruited from middle schools in 1985 (age 13) and assessed repeatedly through 2001 (age 29). Mail surveys were used to obtain information on smoking status and hypothesized predictors of cessation at age 23, and quit attempts and cessation occurring between ages 23-39 among regular smokers. Logistic regression analysis was used to identify predictors of quit attempts and 6-month cessation. RESULTS: Among initial smokers, 76% attempted to quit and 26% quit for 6 months or longer between ages 23-29. Higher rates of substance use, illegal activity, poor mental health, and victimization were found among regular smokers than nonsmokers and lighter smokers at age 23. However, multivariate analyses indicated that these problems were less relevant to quitting than social transitions and interpersonal factors, demographics (e.g., race/ethnicity), and health status. CONCLUSIONS: Different risk and protective factors are relevant to understanding why smokers attempt to quit versus why they are able to quit for 6 months or longer. We discuss implications of these findings for cessation interventions and programs for young adults.     

Weight and smoking cessation among low-income African Americans

BACKGROUND: Concerns about weight gain have been a commonly cited barrier to cessation among white, affluent, female populations, but less is known about this relationship among minority smokers and those with low incomes. Although smoking cessation is strongly encouraged for this population, it often leads to weight gain. Cultural differences in weight standards and the high prevalence of weight-related health conditions (e.g., hypertension and diabetes) may influence concerns about smoking cessation-related weight gain. METHODS: A secondary analysis of low-income African-American smokers (n=367) from a randomized intervention trial was conducted to explore the association of weight concerns with comorbidities and smoking cessation. RESULTS: Less than one quarter of participants were considered concerned about weight, defined as having high general concern about weight and high expectation of post-cessation weight gain. Those for whom weight gain could be riskiest--obese participants--were least concerned about gaining weight. Further, weight concerns were not associated with successful smoking cessation, quit attempts, confidence in quitting, or desire or readiness to quit. CONCLUSIONS: Because post-cessation weight gain may be a serious health threat for this population, but weight gain was not a concern for these smokers, smoking-cessation interventions for low-income African-American smokers may need to incorporate weight-gain education and prevention.     

Intention to quit smoking, attempts to quit, and successful quitting among Hong Kong Chinese smokers: population prevalence and predictors

PURPOSE: To assess the prevalence of each step in the smoking-cessation process (intention to quit, attempts to quit, and successful quitting) and to examine the factors associated with them among Chinese smokers. DESIGN: A cross-sectional survey of subjects from randomly selected households. SETTING: Four thousand one hundred forty-two households in Hong Kong. SUBJECTS: A total of 11,779 persons, aged 15 years or older, were enumerated (response rate = 74.0%). MEASURES: A validated structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background, smoking habits, and workplace attitude to smoking. The predictors for successful quitting, past quitting attempts, and intention to quit were assessed by chi2 tests and multiple logistic regression. RESULTS: Of the respondents, 14.4% were current smokers, 7.5% were ex-smokers, and 78.1% were nonsmokers. Of the daily smokers, 52% intended to quit. The factors associated with quitting were being married, being in the student/retired/others category, being older, having received higher education, not smoking to kill time, and smoking because of curiosity. Being married and not smoking to kill time were associated with past quitting attempts. Being male, married, and not smoking to kill time were associated with the intention to quit smoking. CONCLUSION: The findings of this study indicate that differing predictors may contribute to the different transitional stages of smoking cessation. Population-based smoking-cessation programs should take these predictors into consideration in the design of interventions.     

Heavy smoking among a sample of employed women.

Understanding the phenomenon of heavy smoking among women and factors related to it is of considerable public health importance. Whereas lighter smokers have been more successful in their cessation attempts, the percentage of smokers who smoke more than 25 cigarettes per day has increased in recent years. This article examines the hypothesis that, compared to lighter smokers, female heavy smokers will report more responsiveness to internal cues to smoke, less interest in quitting, more difficulty with previous cessation attempts, more uncertainty about cessation strategies, and more concern about weight gain as a result of quitting. We collected data in 1984 through a self-administered survey completed by 874 women employed as nurses in acute care, chronic care, and home care nursing in Worcester, Massachusetts; we base our analyses on data collected from 158 light and moderate smokers and 67 heavy smokers. Our findings suggest that, compared to lighter smokers, heavy smokers may depend more on nicotine and are likely to respond to a broader array of cues to smoke, factors that appear to contribute to heavy smokers' greater difficulties with quitting. These female heavy smokers are just as likely as lighter smokers to have made previous attempts to quit and want to quit just as much. Major barriers to quitting for female heavy smokers include a lack of confidence in their ability to quit, insufficient tools to succeed with cessation attempts, and fear that weight gain will accompany quitting.     

Ages at Initiation of Cigarette Smoking and Quit Attempts Among Women: A Generation Effect

OBJECTIVES: This study sought to determine whether the age at initiation of regular cigarette smoking and the likelihood of quitting smoking through age 35 differ among women from younger versus older generations. METHODS: Annual population-based, random surveys (total of 3676 female residents of Geneva, Switzerland, aged 35-74 years) were conducted from 1992 to 1998. RESULTS: Women younger than 55 years were more likely to be past or current smokers, began smoking earlier (median age < 20 years), and smoked more cigarettes per day than older women, yet attempted to quit smoking more often before age 35 (log-rank P <.001). CONCLUSIONS: Young female smokers have a higher propensity to quit smoking compared with older women. Encouraging young smokers to quit-in addition to preventing nonsmokers from starting-may be an important facet of reducing cigarette smoking prevalence among adolescents.     

上海市五区结核病患者吸烟现况调查

目的了解上海市五区结核病患者的吸烟、被动吸烟现状,为今后对结核病患者进行戒烟干预提供信息。方法采用方便整群抽样选取上海市5个区2008年登记在册的所有年龄≥14岁的新登菌阳结核病患者进行问卷调查。结果有效调查的1019名结核病患者中,每日吸烟率为30.3%,其中男性为44.3%,女性为0.9%;确诊为结核病时,男性的标化现在吸烟率和标化吸烟率分别为58.0%,78.7%,女性的标化现在吸烟率和标化吸烟率分别为1.3%,3.5%;85.5%的现在吸烟者为中重度吸烟者。61.9%的现在吸烟者表示"打算在一个月内戒烟",仍有19.8%表示"对戒烟没有兴趣"。男性、年龄在40～59岁、初高中文化程度、低收入水平、在婚的沪籍人口吸烟率较高。结核病患者的被动吸烟率为55.8%,其中男性56.4%,女性55.3%,差别无统计学意义。结论结核病患者的标化现在吸烟率和标化吸烟率较高。     

医科大学生吸烟心理与行为分析

为了解医科大学生吸烟情况及心理、行为状态，笔者于1993年5～11月对本校1303名医科大学生进行了吸烟现况调查。其吸烟率为14．58％（男生为29．34％，女生为1．31％）；男生吸烟率有随年级升高而上升的趋势；吸第一支烟的年龄多数在14～19岁之间；影响学生的吸烟的主要因素有生源、心理和行为等。     

Smoking visibility,perceived acceptability,and frequency in various locations among youth and adults

OBJECTIVES: This study tests whether there is an association between high visibility of smoking, perceived acceptability of smoking, and where youth smoke. METHODS: Surveys of 9,762 students in grades 8-10 and 1,586 parents in 15 Minnesota communities asked about the frequency of and opinions of adult and youth smoking in various indoor and outdoor public places. Chi-square analysis and ANOVAs compared smokers and nonsmokers. RESULTS: More smoking than nonsmoking youth reported often seeing adults and teens smoking in all locations. Forty-two percent of students often noticed adults and 35% often noticed teens smoking outdoors, also the most frequent location where teens report smoking. Students perceived adult and teen smoking as more acceptable in restaurants, recreation centers, and outdoor gathering places. More student smokers than nonsmokers believe that smoking is acceptable for both adults and teens. Of the parent sample, 52% often observed adults and 36% often observed youth smoking outdoors. Nonsmoking parents observed adult and teen smoking more often than parents who smoke. CONCLUSIONS: The data support an association between the frequency that youth observe smoking in various locations and the perception that smoking is socially acceptable by smoking status. Policies that restrict smoking in various locations will reduce both visibility and perceived acceptability of smoking in those locations.     

Smoking and mental health: cross-sectional and cohort studies in an occupational setting in Japan

BACKGROUND: The relationship between smoking and mental health remains unclear. METHODS: We carried out a cross-sectional study and a cohort study on the possible association of smoking and mental health in 782 workers. Using a questionnaire including the 30-item General Health Questionnaire (GHQ-30) and items related to the smoking state, the association between smoking and mental health was evaluated separately in males and females. The subjects were classified into smokers and nonsmokers, and changes in the GHQ score during a 2-year follow-up period were evaluated. To control potential confounding factors, multiple regression analyses were performed. RESULTS: The cross-sectional study showed no difference in the GHQ score between smokers and nonsmokers among males but a significantly higher GHQ score for smokers than nonsmokers among females. This difference among females was confirmed to be significant by multiple regression analysis. The 2-year cohort study showed a decrease in the GHQ score in each group and no reduction in the difference in the GHQ score between smokers and nonsmokers among females. CONCLUSIONS: No difference was observed in mental health between smokers and nonsmokers in males. However, in females, smokers showed poorer mental health than nonsmokers, and this difference remained unchanged even after 2 years.     

Tobacco use among high school students in Buenos Aires, Argentina

OBJECTIVES: This study assessed the prevalence and correlates of tobacco use among high school students in Buenos Aires, Argentina. METHODS: Anonymous, self-administered questionnaires were given to 3909 8th and 11th graders in a stratified random sample of 49 public and private schools. The instrument included items from American surveys, translated and validated among Argentinean teens. Multiple logistic regression analysis was used to estimate possible effects on smoking behavior of environment, students' personal characteristics, and their knowledge, beliefs, and attitudes regarding smoking. RESULTS: Of 8th and 11th graders, 20% and 43%, respectively, were classified as current smokers. Overall, 29% of males and 32% of females were current smokers. Students attending public schools were more likely to smoke than those in private schools (P < .05). Current smoking was associated with having a best friend who smokes, reporting that more than 50% of friends of the same sex smoke, having positive attitudes and beliefs toward smoking, and having a positive intention to smoke within the next year (all P < .001). CONCLUSIONS: Over 20% of the 8th graders in our sample were current smokers; prevention efforts must therefore start early.     

Involuntary smoking in a workplace situation--discomfort of nonsmokers and interpersonal awareness of smokers]

A questionnaire survey was conducted to examine the socio-behavioral interaction between smokers and nonsmokers in a workplace situation. A socio-behavioral interaction is hypothesized to be centered around the subjective discomfort such as 'bothered feelings' towards involuntary smoking among nonsmokers. Study subjects were 1,134 nonsmokers and 1,457 smokers working in 21 small-scale production companies in Japan. Among nonsmokers, a combined 93.3% reported 'perceived exposure to smoking', 'always', 'often', or 'sometimes' compared to 6.6% reporting 'never'. Similarly, 74.6% experienced 'bothered feelings' 'sometimes', 'always', or 'often' compared to 25.3% reporting 'never'. A combined total of 39.4% expressed their discomfort to smokers 'sometimes', 'often', and 'always' compared to 60.6% who 'never' did. In contrast, 59.1% of smokers responded that they smoked with consideration of nonsmokers' presence (interpersonal awareness) 'sometimes', 'often', and 'always' compared to 41.0% for 'never'. 'Bothered feelings' among nonsmokers was significantly lower among those with past smoking history and correlated positively with 'perceived exposure to smoking' (rs = 0.22, p less than 0.001) and with 'expression of discomfort among both male (rs = 0.32, p less than 0.001) and female nonsmokers (rs = 0.34, p less than 0.001). Among male smokers 'interpersonal awareness' was significantly higher for those with less cigarette consumption and with past history of smoking cessation. A regression analysis was performed using mean scores calculated for smokers and nonsmokers of each workplace. Lower 'bothered feelings' of nonsmokers significantly correlated with higher 'interpersonal awareness' of smokers (r = -0.59, p less than 0.005). These finding imply the presence of socio-behavioral interactions between smokers and nonsmokers and thus suggest the significance of workplace education on involuntary smoking.     

广州市城乡结合部初中生吸烟行为特点的调查

目的:了解城乡结合部青少年吸烟行为的特点。方法:用自填式调查表对6所中学3 956名初中生进行流行病学调查。结果:初中生的尝试吸烟率为20.4%(男30.4%,女8.9%),不规律吸烟率14.7%(男21%,女7.7%),规律吸烟率5.7%(男9.4%,女1.2%)。吸烟率在不同性别和年级间存在差异,不同生源地的初中生吸烟率也有所区别。大部分尝试吸烟行为发生于10~14岁,初吸烟年龄中位数为12岁。吸第一支烟最主要的原因是“好奇尝试(70.3%),最主要的影响人是同伴(46.3%)。73%的规律吸烟者在过去1个月吸过烟,27%的只吸了1~5天。现在吸烟者的日均吸烟量平均值为5.12支,中位数为3支。46.6%的吸烟者只将烟雾吸入口腔。获得香烟的主要方式是别人给的,吸烟主要发生于伙伴聚会时。59%的规律吸烟者曾经戒过烟,主要是由于健康的缘故,戒烟成功率为28.8%。48.9%的现在吸烟者表明目前有戒烟的打算。结论:城乡结合部已成为烟草流行的重灾区,此趋势在青少年已有所表现。青少年控烟工作要联合政府、社会、家庭和学校等方多力量,结合其心理特征开展诸如同伴教育、提供戒烟辅助等有效措施。     

Patterns of cigarette and smokeless tobacco use among children and adolescents

Although cigarette and smokeless tobacco use are recognized as major problems among school-age youth, few nationwide or statewide data exist on the prevalence and patterns of use. To determine the patterns of tobacco use among children and adolescents in Missouri, self-report information was obtained from a representative sample of 5,431 students in grades 5, 8, and 12. Both cigarette smoking and smokeless tobacco use were more common among males than females for each grade level except the 12th, where 30% of females and 28% of males had smoked during the previous week. Smoking prevalence was considerably lower among blacks than whites. Smokeless tobacco use was rare among both blacks and females. Smokeless tobacco use was more common than cigarette smoking in rural areas, where 17% of 8th-grade males and 31% of 12th-grade males had used smokeless tobacco during the previous week. The mean age at first use of cigarettes was slightly lower in the rural than the urban area, whereas the mean age of initial smokeless tobacco use was more than a year earlier in the rural area. Data regarding the perceived difficulty of quitting smoking and quit rates suggested that adolescent females have more difficulty quitting smoking than males. Male smokeless tobacco users appeared to be more addicted than male cigarette smokers. Smokeless tobacco brand preference indicated that users may switch to progressively stronger types of smokeless tobacco as they get older and a nicotine tolerance is developed. The current study emphasizes the urgent need for carefully targeted tobacco prevention and cessation efforts among school-age youth.     

Healthy behaviors, lifestyle, and reasons for quitting smoking among out-of-school youth.

STUDY OBJECTIVE: To investigate the relationships among healthy behavior, healthy values, social influences, and quitting smoking in adolescents not attending school. DESIGN: Following screening procedures, young smokers independently completed a self-report questionnaire administered by trained staff. SETTING: Vocational (TAFE) colleges and Commonwealth Employment Offices (CES) from varying socioeconomic localities were selected as sites to intercept smoking adolescents on their attitudes about quitting smoking. SUBJECTS: Youth attending vocational colleges or CES. RESULTS AND CONCLUSIONS: There were no differences between the two groups of smokers (vocational students and unemployed youth). The decision to quit smoking among these youth is based on a number of factors including social and personal reasons. Health-oriented values were found to be more highly associated with quitting behavior than social influences. Programs for smoking cessation need to be focused on an overall health and improvement approach rather than only a quit-smoking approach.