Smoking risk and the likelihood of quitting among African-American female light and heavy smokers

While African-American females are more likely to be light smokers compared to their counterparts of other racially classified social groups (RCSGs), they are more likely to carry a heavier burden of smoking-related morbidity and mortality. Thus, it is critical that African-American female light smokers are targeted to engage in smoking cessation. Research has revealed that African-American women are less likely to have a successful quit attempt following a cessation intervention than females from other RCSGs. It has been postulated that the low smoking cessation rates among African-American female light smokers may be due to the lack of appropriate psychosocioculturally tailored cessation interventions that address issues of stress and coping that explain why they smoke and continue to smoke that may differ from their heavy smoker counterparts. The purpose of this study was to ascertain whether African-American female light smokers differed from their heavy smoker counterparts on psychosociocultural stress and coping factors. Findings revealed no differences in the sociodemographic variables of age, income, education and BMI; in the psychosociocultural measures of acculturative stress, race-related stress and coping; or in the smoking characteristics of menthol smoking status, cotinine level and CYP2A6 metabolic functioning between light and heavy smokers. However, the study found that African-American female light smokers take longer to smoke their first cigarette of the day, have a lower smoking risk, are more likely to quit, and exhibit lower carbon monoxide levels than African-American female heavy smokers. The current study suggests that other than the obvious factors of greater likelihood of quitting, lower smoking risk, longer latency to smoke and lower carbon monoxide levels, specific smoking cessation programs may not need to be differentially psychosocio-culturally tailored for African-American female light smokers compared to their heavy-smoking counterparts.     

Cigarette smoking and attitudes toward quitting among black patients

A sample of 1,388 black patients attending the medical clinic of a general public hospital were interviewed regarding smoking habits and attitudes toward quitting. Current smokers constituted 30% of respondents of both sexes, and approximately half of the sample were ex-smokers. Rates of current smoking were lower, and cessation rates higher, among older individuals and men. Two thirds of current smokers expressed a desire to quit, and of those an equal proportion wanted to participate in a formal cessation program. A majority of smokers reported attempting to quit on their own, and most had made more than one attempt. Given the large burden from cigarette-related disease in the black population, and the current absence of effective primary prevention efforts, smoking intervention in the clinical setting will remain an important obligation of health providers caring for black patients. This article demonstrates moderately high smoking prevalence rates of black individuals already under care for chronic illness, and a concomitant high level of desire to quit. The absence of effective programs appears to be the obstacle preventing significant progress in this important area of health promotion.     

Barriers to quitting smoking among medically ill smokers

Few studies examine predictors of smoking cessation among medically ill smokers, despite their high smoking prevalence. We prospectively examined barriers to smoking cessation in medically ill smokers, with age as a hypothesized moderator. Participants were smokers (N = 237, M (age) = 56.1, 53.6% females) receiving home-based nursing care. Baseline self-report questionnaires assessed barriers to cessation (demographics, smoking history, psychosocial, and medical factors). Smoking status was biochemically verified at 2- and 6-months post-intervention. Compared with younger smokers, older smokers had significantly lower levels of nicotine dependence, stress, and depressed mood and a greater prevalence of smoking-related diseases. Older smokers were more likely to achieve biochemically verified abstinence at 6-month follow-up (7.8%) than younger smokers (3.1%) though this difference was not significant. Higher levels of depressed mood and lower levels of perceived stress were associated with a greater likelihood of cessation at both follow-up points, but only for younger smokers. For younger smokers, higher self-efficacy to quit and the presence of a smoking-related disease increased the odds of abstinence. These findings could help guide treatment development for this high-risk group of smokers.     

Smoking among schoolchildren

As part of its health education programme, the Irish Cancer Society sponsored studies of the smoking habits of Dublin schoolchildren in the late 1960s and early 1970s. It was decided to review the situation a decade later, and accordingly the Health Education Bureau, the Medico-Social Research Board and the Irish Cancer Society funded a survey of smokers among Dublin post-primary schoolchildren in 1981.

The prevalance of smoking among schoolchildren is still at a high level, and the main change over the last 10 years has been the fact that girls have almost caught up with the boys. It was hard to evaluate the effect of health education over the decade. Although many of the `smoking' students wanted to give up smoking the reason was not long-term health. In fact, concentrating on the `cancer/shorten life' effects of smoking may be counterproductive and anti-smoking campaigns should perhaps stress the immediate benefits of giving up smoking-better breathing, increased ability for sport, saving of money, and so on.

     

Factors influencing adherence among Irish haemodialysis patients

Objective

Adherence to dietary and fluid restrictions among haemodialysis patients with end stage renal failure (ESRD) is a multi-factorial concept. This study seeks to assess the predictive value of demographic and psychological variables in non-adherence.

Methods

A multi-centre cross sectional design assessed 50 haemodialysis patients on self reported adherence, attitudes towards dietary restrictions, quality of life, depression and anxiety. Adherence to fluid and dietary restrictions was measured objectively using potassium (K), phosphorus (PO₄) and inter-dialytic weight gain (IDWG) parameters.

Results

62% of patients were non-adherent with at least one aspect of the treatment regime. Regression analysis revealed age as significantly associated with adherence, in particular IDWG, with younger patients displaying poorer adherence.

Conclusion

Younger patients may experience greater difficulty integrating complex treatment demands into their lifestyles, and non-adherence may be a consequence of the severe lifestyle limitations imposed by the haemodialysis treatment regime.

Practice implications

Individualised interventions may be more effective than traditional methods of adherence monitoring in reducing the non-adherent behaviour.     

Salivary testosterone and body composition among Ariaal males

To determine if testosterone is negatively related to acute and/or chronic nutritional status among men in a subsistence society, saliva samples and anthropometric measures were compared among nomadic and settled Ariaal pastoralists of northern Kenya. Fifty‐six nomadic men and 62 settled men facing drought conditions, estimated ages 22–96 years, were sampled. Measures included height, weight, four skinfolds, and %body fat by bioelectric impedance (BIA). Saliva samples were assayed for testosterone using radioimmunoassay. Overall, both body mass index (BMI) (avg. = 17.8 ± 6.0 kg/m²) and salivary testosterone (T) levels (avg. am value = 176.8 ± 74.8 pmol/l) were low compared to values from Western populations. Comparison of the two subpopulations revealed no significant difference in height, weight, BMI, or lean body mass. However, nomadic males exhibited significantly smaller skinfolds. Evening, but not morning, salivary T values differed between the subpopulations. Age‐related changes in body composition included a significant decline in BMI with age, related to loss of body fat, but with little change in lean body mass. Age‐related declines in BMI and %body fat were more pronounced among the nomadic males. am salivary T values declined with age; again, the decline was significantly greater among nomadic males. pm salivary T levels showed no significant decline with age. When controlled for residence and age, salivary T was positively related to %body fat and WHR ratio, but not lean body mass. These results provide evidence that salivary T is related to acute nutritional status among males in an energetically stressed subsistence population, in accordance with life history theories of somatic allocation. Am. J. Hum. Biol. 15:697–708, 2003. © 2003 Wiley‐Liss, Inc.     

Religious involvement and health status among African-American males.

Previous studies document the importance of religious involvement in African-American communities. This study examines the extent to which religious involvement is associated with health status among African-American males. The data come from a community sample of 537 males residing in a major US urban area. Three indicators of religious involvement were used: denominational affiliation, frequency of church attendance, and overall religiosity. Measures of health status included a self-assessment of physical health, depressive symptoms, self-reported hypertension, cigarette smoking, and daily drinking of alcohol. The results show significant associations between selected indicators of religious involvement and measures of health status. Fewer depressive symptoms are associated with having a denominational affiliation, while no or low frequency of church attendance is associated with current smoking and daily drinking. Implications for health-related interventions with African-American males are discussed in light of these findings.     

青少年吸烟者的吸烟水平及其影响因素分析

目的考察不同吸烟水平青少年的特点及其影响因素。方法采用问卷调查的方法对211个吸烟的青少年进行调查。结果①14％的青少年经常吸烟,男生经常吸烟的人数显著地多于士生;②青少年的不同吸烟水平与同伴吸烟行为和态度、同伴直接和常规压力、父母吸烟态度以及青少年自身抵制技能、吸烟认识显著相关;③同伴吸烟行为和直接压力显著地预测青少年的不同吸烟水平。结论青少年吸烟者中大多数人偶尔吸烟,青少年的吸烟程度与同件因素关系紧密,青少年吸烟干预方案应将同伴因素列为最重要的干预成分。     

Age-related changes in testosterone and SHBG among Turkana males.

To determine age-related changes in biologically available testosterone (T) among men in a subsistence society and their relationship to energetic status, T, sex hormone binding globulin (SHBG) and anthropometric measures were compared among nomadic and settled Turkana pastoralists of northern Kenya. Hormonal measures were available for 104 nomadic men and 72 settled men, estimated ages 20-90 years. Comparison of the two subpopulations revealed significantly higher blood T (32.7+/- 15.1 vs. 23.4+/-15.2 nM) and SHBG (53.8+/- 19.5 vs. 39.7+/- 20.nM) but not free testosterone index (FTI) (65.6+/- 39.3 vs.66.3+/- 45.9) among the nomads. Total blood T did not exhibit a significant linear decline with age in either subgroup, while SHBG values showed a significant linear increase among the nomads. When controlled for energetic status, FTI showed a significant decrease with age among the nomads, but not the settled males. Total blood T was negatively associated with waist circumference among the nomads, but not the settled males. FTI showed a marginally significant negative association with waist circumference, suprailiac skinfold, and % body fat among the nomads but no associations with body composition among the settled group. These results add additional evidence that T is related to energetic status under conditions of negative energy balance and suggest that cross-population variation in the slope of age-related declines in free serum T and salivary T may be related to energetic status through the effects of SHBG.     

Relationships between Household Smoking Restrictions and Intention to Quit Smoking among Korean American Male Smokers in California

This cross-sectional study examined the relationships between household smoking restrictions and intentions to quit smoking among Korean American male smokers in California. We used data from the California Korean American Tobacco Use Survey (CKATUS), which was conducted in 2004 using computer-assisted telephone interviewing. Among the 2,545 respondents who participated in the CKATUS, the 387 male smokers who answered a question assessing their intention to quit smoking were included in the final analyses. In univariable analyses, smokers who reported having household smoking restrictions were more likely to intend to quit smoking as compared with those who did not (P<0.01). Other independent correlates of having an intention to quit smoking were being less than 50 yr of age, having spent more than 50% of one''s life in the US, being assimilated, and having other smokers in the household. In a multiple logistic regression analysis, the significant correlates of having an intention to quit smoking were household smoking restrictions (complete or partial restriction vs. no restriction on smoking; odds ratio, 2.54; 95% confidence interval, 1.22-5.28) and absence of other smokers in the household. In conclusion, smoking restrictions in the household are associated with an intention to quit smoking among Korean American male smokers in California.     

Smoking and mortality among older men and women in three communities

BACKGROUND. Although cigarette smoking is the leading avoidable cause of premature death in middle age, some have claimed that no association is present among older persons. METHODS. We prospectively examined the relation of cigarette-smoking habits with mortality from all causes, cardiovascular causes, and cancer among 7178 persons 65 years of age or older without a history of myocardial infarction, stroke, or cancer who lived in one of three communities: East Boston, Massachusetts; Iowa and Washington counties, Iowa; and New Haven, Connecticut. At the time of the initial interview, prevalence rates of smoking in the three communities ranged from 5.2 to 17.8 percent among women and from 14.2 to 25.8 percent among men. During five years of follow-up there were 1442 deaths, 729 due to cardiovascular disease and 316 due to cancer. RESULTS. In both sexes, rates of total mortality among current smokers were twice what they were among participants who had never smoked. Relative risks, as adjusted for age and community, were 2.1 among the men (95 percent confidence interval, 1.7 to 2.7) and 1.8 among the women (95 percent confidence interval, 1.4 to 2.4). Current smokers had higher rates of cardiovascular mortality than those who had never smoked (as adjusted for age and community, the relative risk was 2.0 [95 percent confidence interval, 1.4 to 2.9] among the men and 1.6 [95 percent confidence interval, 1.1 to 2.3] among the women), as well as increased rates of cancer mortality (relative risk, 2.4 [95 percent confidence interval, 1.4 to 4.1] among the men and 2.4 [95 percent confidence interval, 1.4 to 3.9] among the women). In both sexes, former smokers had rates of cardiovascular mortality similar to those of the participants who had never smoked, regardless of age at cessation, whereas the rates for all cancers, as well as smoking-related cancers, remained elevated among men who had once smoked. CONCLUSIONS. Our prospective findings indicate that the mortality hazards of smoking extend well into later life, and suggest that cessation will continue to improve life expectancy in older people.     

The causes of the excess males among pre-term and post-term births

Dear Sir, Zeitlin et al (2002) reproduced data from a large number ofsamples which confirm that there is a male excess among pretermbirths. They also provided data from four original datasetson the topic. However these authors reported two exceptionsto this generalization. First, they reported that there wasno such male excess among spontaneous-onset births after IVF;and second, they reported     

Courtship among males due to a male-sterile mutation inDrosophila melanogaster

Drosophila melanogaster males carrying the fruitless mutation have been studied in their interactions with males and females. Mutant males—expressing a single recessive factor on the third chromosome—court mutant or wild-type males about 7 times more frequently than wild-type males court each other. Courtship by a fruitless male of a wild-type male is sustained and takes up an amount of time almost 100 times greater than the courtship interactions recorded between two normal males. While the mutant males do court females in a sustained manner, they attempt to copulate in less than 1% of the trials, never do copulate, and are thus behaviorally sterile. Fruitless males, when interacting with other males, are deficient in their degree of rejection responses, but this defect is not sufficient to explain the abnormal male-male interactions. The mutants stimulate wild-type males to court them with a frequency which is about 5 times higher than that observed between normal males. Fruitless males can stimulate other males to court them even when the former have been etherized or cut into pieces.This research was supported by Grant GM-21473 from the U.S. Public Health Service.