Correlates of Smoking Cessation Among Filipino Immigrant Men

A survey on tobacco use among 318 Filipino immigrant men aged 40–75 years was conducted in Los Angeles, California. Those who reported more English language use with their family, friends and neighbors (OR = 1.31) and who lived in households with complete smoking prohibition (OR = 3.82) were more likely to be successful in quitting smoking. Those who endorsed more positive beliefs on physical and social consequences of smoking (OR = 0.69) and who had mostly smoking friends (OR = 0.37) were less likely to be successful in quitting smoking. Our findings suggest that prohibiting smoking in households, creating social networks of non-smokers, and education or counseling are important components of a smoking cessation intervention for Filipino immigrant men.     

Nutritional Epidemiology of Antenatal Smoking Cessation Among Japanese Women

This study compared the nutritional status before pregnancy, as well as dietary profiles and biomarkers during first trimester, between never-smokers and antenatal quitters among Japanese women. One hundred fifty pregnant women (79 never-smokers and 71 antenatal quitters) from two obstetrics and gynecology clinics were recruited in Japan. Subjects' prepregnancy nutritional status was indicated by their body mass index (BMI). In the first trimester, their dietary profiles were assessed by the Brief Diet-History Questionnaire (BDHQ) and pregnancy outcomes were screened by biomarker tests. Generalized linear regression was used to examine the differences of energy-adjusted dietary intakes and biomarker results between the two smoking groups, with adjustment of maternal age, BMI, gestation week, and parity. The results showed that antenatal quitters were more likely to have a prepregnancy underweight status than never-smokers. During the first trimester, antenatal quitters had significantly higher intakes of unsaturated fatty acids and antioxidants (vegetable lipids and isoflavone), and lower intakes of total cholesterol than never-smokers. Moreover, antenatal quitters had a significantly higher level of serum homocysteine (6.36 nmol/mL vs 4.88 nmol/mL) than never-smokers. In conclusion, antenatal quitters are more likely to have a poor nutritional status before pregnancy than never-smokers. Quitting smoking before pregnancy and having a good nutritional profile during the trimester may not sufficiently reverse the adverse effects of former smoking behaviors on pregnancy outcomes.     

长沙市10家无烟医院创建效果评价

目的对长沙市10家医院开展控烟干预工作,评价控烟效果,为创建无烟医院提供依据。方法开展以政策制定、健康教育、氛围营造为主的控烟干预活动,干预前后采用问卷调查医务人员吸烟和被动吸烟相关知识、态度和行为的变化,评价干预效果。结果干预后,目标人群现在吸烟率由16.8%下降至13.7%,对于吸烟以及被动吸烟危害的认识也有所提高。医务人员更认为自身应在控烟工作中发挥表率作用,在日常工作中主动帮助患者戒烟。同时,在实际诊疗工作中主动询问病人吸烟习惯的医务人员比例也得到提高。结论无烟医院创建有利于提高医务人员对烟草及被动吸烟危害的认识,降低医务人员自身吸烟率以及促进其主动对患者进行控烟干预。无烟医院创建经验值得在其他行业进行推广。     

Implementation of Workplace-Based Smoking Cessation Support Activities and Smoking Cessation Among Employees: The Finnish Public Sector Study

Objectives. We investigated the relationship between implementation of workplace smoking cessation support activities and employee smoking cessation.Methods. In 2 cohort studies, participants were 6179 Finnish public-sector employees who self-reported as smokers at baseline in 2004 (study 1) or 2008 (study 2) and responded to follow-up surveys in 2008 (study 1; n = 3298; response rate = 71%) or 2010 (study 2; n = 2881; response rate = 83%). Supervisors’ reports were used to assess workplace smoking cessation support activities. We conducted multilevel logistic regression analyses to examine changes in smoking status.Results. After adjustment for sociodemographic characteristics, number of cigarettes smoked per day, work unit size, shift work, type of job contract, health status, and health behaviors, baseline smokers whose supervisors reported that the employing agency had offered pharmacological treatments or financial incentives were more likely than those in workplaces that did not offer such support to have quit smoking. In general, associations were stronger among moderate or heavy smokers (≥ 10 cigarettes/day) than among light smokers (< 10 cigarettes/day).Conclusions. Cessation activities offered by employers may encourage smokers, particularly moderate or heavy smokers, to quit smoking.Smoking bans are increasingly used to reduce smoking and exposure to secondhand smoke. Bans have been widely implemented in the European Union countries, and the Centers for Disease Control and Prevention predicts that by 2020 or sooner, all US states will have laws banning smoking in all indoor areas of private-sector work sites, restaurants, and bars.1 Smoke-free work environments are associated with higher smoking cessation rates.2,3Workplaces are often the setting for efforts to promote smoking cessation. Beyond workplace smoking restrictions and campaigns to reduce smoking, employers offer various types of support for smoking cessation, including support groups, nicotine replacement therapy, other pharmacological treatments, and financial incentives.4 A review of workplace interventions showed strong evidence that interventions directed toward individual smokers, such as individual and group counseling and pharmacological treatment, increase the likelihood of smoking cessation.4 By contrast, there was only limited evidence that participation in cessation programs can be increased by competitions and incentives.5Another review showed that worksite-based multicomponent programs involving incentives and competitions in combination with other interventions can be effective.6 Similarly, a recent study conducted at a large company revealed that financial incentives significantly increase cessation rates.7 Self-help interventions and social support have been found to be less effective.4It is not clear whether the effectiveness of interventions varies according to initial smoking intensity, that is, number of cigarettes smoked per day. Hyland et al.8 suggested that low-level smokers may have different intervention needs than heavier smokers. Most studies have been limited by small sample sizes or have been conducted in a small number of work sites, so the extent to which findings are generalizable to other populations and settings is uncertain.In a large sample of smokers from more than 1000 public-sector work units, we examined whether employer-offered smoking cessation support activities were associated with a higher likelihood of quitting smoking independently of a number of other factors, including sociodemographic characteristics, work-related factors, health status, and health behaviors. In addition, we examined whether the effects of smoking cessation support activities on smoking cessation varied according to prior smoking intensity.     

广州不同性质学校初中生吸烟KAP比较

目的 比较广州地区公立、厂办和民营3类学校初中生吸烟相关KAP的异同,为有针对性地开展控烟健康教育提供依据。方法 用自制问卷对广州市黄埔区6所公立、厂属和私立中学的3957名初中生进行横断面调查,内容包括一般人口学特征、吸烟相关知识、态度和行为。结果 调查应答率为95．6％。3类学校学生的性别、年龄和户口地分布有统计学差别;吸烟与健康相关知识得分民营〉公立〉厂办,差异均有显著性;吸烟与健康相关态度得分,正向态度为厂办〉公立〉民营,负向态度为公立〉厂办〉民营,态度总分为厂办〉公立〉民营,其中正向态度得分在3类学校学生中的差异无显著性。而负向态度得分和态度总分在3类学校学生中的差异有显著性。所调查初中生的尝试吸烟率为20．5％,每周吸烟率为5．1％,每日吸烟率为3．5％,尝试吸烟率、每周吸烟率和每日吸烟率均为民营〉公立〉厂办．且尝试吸烟率的差异有显著性。结论 民营学校初中生吸烟与健康知识相对缺乏、态度趋向负面且吸烟行为发生率明显偏高,应成为目前学校控烟工作的重点对象。     

The Impact of Quitting Smoking on Weight Among Women Prisoners Participating in a Smoking Cessation Intervention

Objectives. We examined the impact of smoking cessation on weight change in a population of women prisoners.Methods. Women prisoners (n = 360) enrolled in a smoking cessation intervention; 250 received a 10-week group intervention plus transdermal nicotine replacement.Results. Women who quit smoking had significant weight gain at 3- and 6-month follow-ups, with a net difference of 10 pounds between smokers and abstainers at 6 months. By the 12-month follow-up, weight gain decreased among abstainers.Conclusions. We are the first, to our knowledge, to demonstrate weight gain associated with smoking cessation among women prisoners. Smoking cessation interventions that address postcessation weight gain as a preventative measure may be beneficial in improving health and reducing the high prevalence of smoking in prisoner populations.Smoking and obesity are the 2 major causes of mortality and morbidity in the United States.^1,2 Although smoking is the leading preventable cause of death, resulting in approximately 440 000 deaths each year,³ obesity is a growing epidemic and is the second leading cause of preventable death, resulting in more than 300 000 deaths annually.^4,5 Whereas smoking rates have declined from their peak in the 1960s, obesity rates have been steadily climbing each year, and obesity is expected to soon eclipse smoking as the most preventable cause of mortality in the United States.¹The relationship between smoking and weight is complex, and the mechanisms by which smoking influences weight are not fully understood. Smoking affects weight by increasing metabolic rate and decreasing caloric absorption, which is thought to help suppress appetite.⁶ Sympathoadrenal activation by nicotine is thought to be primarily responsible for the metabolic effect of smoking.⁷ Smoking is also associated with increased energy expenditure.⁸ Smoking a single cigarette also decreases caloric consumption by 3% within 20 minutes.⁹Compared with light smokers and nonsmokers, heavy smokers tend to have greater body weight, which likely reflects a clustering of risk behaviors (i.e., little physical activity and poor diet) and increased insulin resistance and accumulation of abdominal fat.^6,10,11 Overall, smokers tend to be less physically active than nonsmokers, which may confound explanations of weight differences between smokers and nonsmokers.¹²Most studies on weight and smoking have reported postcessation weight gain. Smoking cessation has been associated with approximately 10 pounds of weight gain after 1 year of abstinence,¹³ suggesting that health benefits from smoking cessation may be mitigated to some degree by increased health risks associated with weight gain.¹⁴ To prevent or reduce weight gain, those administering cessation programs are recommended to integrate follow-up support for weight control, provide regular body weight measurement, provide recommendations for dietary change, and encourage increased physical activity.¹⁴ Despite concerns about weight, few studies have systematically investigated weight gain following smoking cessation, particularly with underserved populations such as prisoners.Correctional populations especially are vulnerable to the negative health consequences of smoking. Smoking rates are 3 to 4 times higher among correctional populations than among the general population, and smoking is normative within the correctional environment.^15–17 Smoking prevalence is 70% to 80% among male and female prisoners,^15–20 while almost half (46%) of adolescents in juvenile justice are daily smokers.²¹ This compared to about 21% of adults in the general population who are current smokers.²² However, in the research literature, the emphasis on smoking prevalence, prevention, cessation, and policies is much greater among other populations than it is among criminal justice populations—despite the human, health, and economic costs that occur in prison and in the community.^20,23In addition to the larger prevalence of smoking in prisons, there is less access to interventions for smoking cessation in correctional facilities. Lack of resources amplifies the negative health risks associated with smoking, such as heart, circulatory, and respiratory problems. Over the past 2 decades, correctional facilities in the United States have implemented tobacco-control policies ranging from restrictions on indoor smoking to complete tobacco bans.²⁴ Tobacco restrictions and bans have not succeeded in suppressing smoking, and reduced access to programs and materials that might increase long-term smoking cessation have paralleled them.^16,17,24,25We recently conducted a randomized controlled trial of smoking cessation with women prisoners and found 7-day point prevalence cessation rates comparable to those seen in community smoking cessation interventions.¹⁵ The intervention combined nicotine replacement with a 10-week group therapy intervention.²⁶ The community-tested intervention was modified for the prison environment and included a discussion of weight gain and weekly monitoring of weight during the intervention and follow-up assessments.¹⁵ Point prevalence quit rates for intervention participants were 18% at end of treatment, 17% at 3-month follow-up, 14% at 6-month follow-up, and 12% at 12-month follow-up, compared with less than 1% at these same time points for control participants.¹⁵ We examined differences in weight change over time for (1) women in the intervention condition compared with women in the control condition and (2) women in the intervention condition who quit smoking compared with those who continued to smoke. To our knowledge, ours is the first study to conduct such a trial among women prisoners.     

Racial/Ethnic Disparities in the Receipt of Smoking Cessation Interventions During Prenatal Care

To explore racial/ethnic disparities in the receipt of optimal smoking cessation counseling during prenatal care. We used data from Oregon’s perinatal surveillance system, the Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) from 2000 to 2001. A stratified random sample of postpartum women were asked questions about events before, during and after pregnancy, including smoking and provision of smoking cessation counseling. The weighted response rate was 78.8% (n = 3,895). Receipt of a clinician protocol for smoking cessation intervention, called the Five A’s (Ask, Advise, Assess, Assist, Arrange), was the outcome of interest. In the Oregon PRAMS survey, we asked women about three of the Five A’s (Ask, Advise, Assist). Of 594 first trimester pregnant smokers, the majority were asked and advised about smoking by a prenatal care provider. However, a substantial proportion of women did not receive assistance to quit and only 42.2% received all three steps. Significant racial/ethnic variations were found only in the Assist step. Compared to non-Hispanic (NH) White women, NH American Indian women had lower odds (adjusted odds ratio [ORa]: 0.45; 95% confidence interval [95% CI] 0.24, 0.85) of receiving all three steps. In contrast, NH Black women had increased odds of receiving all three steps (ORa: 2.43; 95% CI 1.16, 5.10). We conclude that there is a need for prenatal care providers to address tobacco use, especially to Assist quitting, with all pregnant smokers. Healthcare systems should implement system prompts and supports for providers to remind them to address tobacco use with pregnant smokers.     

Smoking Cessation and Relapse Among Pregnant African-American Smokers in Washington,DC

Smoking is the single most preventable cause of perinatal morbidity. This study examines smoking behaviors during pregnancy in a high risk population of African Americans. The study also examines risk factors associated with smoking behaviors and cessation in response to a cognitive behavioral therapy (CBT) intervention. This study is a secondary analysis of data from a randomized controlled trial addressing multiple risks during pregnancy. Five hundred African-American Washington, DC residents who reported smoking in the 6 months preceding pregnancy were randomized to a CBT intervention. Psycho-social and behavioral data were collected. Self-reported smoking and salivary cotinine levels were measured prenatally and postpartum to assess changes in smoking behavior. Comparisons were made between active smokers and those abstaining at baseline and follow-up in pregnancy and postpartum. Sixty percent of participants reported quitting spontaneously during pregnancy. In regression models, smoking at baseline was associated with older age, <a high school education and illicit drug use. At follow-up closest to delivery, smoking was associated with lower education, smoking and cotinine level at baseline and depression. At postpartum, there was a relapse of 34%. Smokers postpartum were significantly more likely to smoke at baseline and use illicit drugs in pregnancy. Mothers in the CBT intervention were less likely to relapse. African-American women had a high spontaneous quit rate and no response to a CBT intervention during pregnancy. Postpartum mothers’ resolve to maintain a quit status seems to wane despite their prolonged period of cessation. CBT reduced postpartum relapse rates.     

Effects of Smoking Reduction and Cessation on Birth Outcomes in a Scheduled Gradual Reduction Cessation Trial

Maternal and Child Health Journal - Smoking during pregnancy can affect infant birthweight. We tested whether an intervention that promoted scheduled gradual reduction improved birth outcomes among...     

Predictors of Smoking Cessation Among College Students in a Pragmatic Randomized Controlled Trial

Prevention Science - An effective strategy to quit smoking should consider demographic aspects, smoking-related characteristics and psychological factors. This study examined potential predictors...     

Effect of Vaccination Coordinators on Socioeconomic Disparities in Immunization Among the 2006 Connecticut Birth Cohort

Objectives. We examined socioeconomic status (SES) disparities and the influence of state Immunization Action Plan–funded vaccination coordinators located in low-SES areas of Connecticut on childhood vaccination up-to-date (UTD) status at age 24 months.Methods. We examined predictors of underimmunization among the 2006 birth cohort (n = 34 568) in the state’s Immunization Information System, including individual demographic and SES data, census tract SES data, and residence in an area with a vaccination coordinator. We conducted multilevel logistic regression analyses.Results. Overall, 81% of children were UTD. Differences by race/ethnicity and census tract SES were typically under 5%. Not being UTD at age 7 months was the strongest predictor of underimmunization at age 24 months. Among children who were not UTD at age 7 months, only Medicaid enrollment (adjusted odds ratio [AOR] = 0.6; 95% confidence interval [CI] = 0.5, 0.7) and residence in an area with a vaccination coordinator (AOR = 0.7; 95% CI = 0.6, 0.9) significantly decreased the odds of subsequent underimmunization.Conclusions. SES disparities associated with underimmunization at age 24 months were limited. Efforts focused on vaccinating infants born in low SES circumstances can minimize disparities.Recognizing disparities among population segments can be helpful in identifying barriers and delivering successful public health interventions. Disparities in early childhood vaccinations in the United States among socioeconomic and demographic groups have been described in previous analyses, with certain studies reporting successes in narrowing disparities.1,2 A few studies have examined disparities and risk factors for underimmunization by assessing the influence of census tract characteristics on individual children’s vaccination status.3 This approach is potentially useful because census tract poverty level has been demonstrated to be the most consistently discriminating area measure for monitoring socioeconomic inequalities in health.4 Analytic approaches, including census tract attributes and individual risk factors for underimmunization, allow for a comprehensive examination of health disparities in early childhood vaccinations.In 1993, the Centers for Disease Control and Prevention helped lead a national effort to improve early childhood vaccination rates, the Child Immunization Initiative (CII).5 This effort followed the national measles epidemic in 1989 to 1991, which was particularly severe among infants and preschool-aged children in poorer urban areas.6 Each state and large city receiving Centers for Disease Control and Prevention vaccinations cooperative agreement funding, including Connecticut, was required to develop an Immunization Action Plan (IAP) to improve early childhood vaccination levels. Implemented in 1993, the Connecticut IAP called for funding to support an early childhood vaccination coordinator position for the cities and health districts (i.e., groupings of towns served by a single local health department) with the largest populations of Medicaid and Special Supplemental Nutrition Program for Women, Infants, and Children recipients, both markers of low socioeconomic status (SES). To the extent that funding permitted, the state also established outreach worker positions. The rationale for this design derived, in part, from the finding that children in poor urban areas of Connecticut had a much higher risk of measles during the 1989 to 1991 epidemic and from the results of several surveys of school children that retrospectively examined the vaccination status of first-grade students when they were aged 3 and 24 months. These surveys demonstrated substantial disparities in early childhood vaccination levels between children living in urban and nonurban areas and found a much higher probability of underimmunization among children attending public-sector clinics (e.g., community health centers).7 Use of public-sector clinics and living in urban areas in Connecticut are both markers of low SES.The role of the vaccination coordinator is to ensure that all infants born to city or health district residents are assigned to a patient-centered medical home (i.e., a comprehensive primary care provider), all providers have reminder–recall systems, all infants appearing to be out of care because of missed vaccinations are identified and returned to care, and provider-specific evaluation and feedback is provided. The size of the IAP program has fluctuated over time, reaching its peak in 2006. During 2006, 66% of the population in Connecticut was included in IAP areas staffed by 16 full-time vaccination coordinators and 10 outreach staff. The possible benefit of having dedicated vaccination coordinators in towns with large populations of Medicaid and Special Supplemental Nutrition Program for Women, Infants, and Children recipients in Connecticut has never been assessed formally.The Connecticut Immunization Registry and Tracking System (CIRTS) is the state’s Immunization Information System. Development of CIRTS began in 1994, and the system has been operational statewide for all children born in Connecticut since 1998. All providers are required to report to CIRTS all vaccinations administered to children aged 6 years and younger residing in Connecticut.8 In addition to vaccination information, the CIRTS database contains demographic information (e.g., address, sex, and race/ethnicity) and maternal information (e.g., age at delivery and educational level) regarding each child. CIRTS also contains Medicaid status, generated from periodic matches with the state Medicaid database. CIRTS has been used by IAP-funded cities and health districts to identify children not up-to-date (UTD) with vaccinations at age 7 and 19 months and to recommend follow-up attention.     

Predictors of Spontaneous Smoking Cessation Among Chinese Men Whose Wives are Pregnant

This is an exploratory study to identify the predictors that Chinese men will spontaneously quit smoking during their wives' pregnancy. Smoking husbands who accompanied their non-smoking pregnant wives to an antenatal clinic were invited to complete a questionnaire soliciting information regarding their smoking behaviours, perceptions of support received from their wives, and motivating factors for quitting smoking. A total of 74 men were recruited. Two-thirds (67.6%) were daily smokers, had started smoking under the age of 18 (66.2%), and smoked 6-15 cigarettes (48.6%) a day. Nearly one-third of the smoking husbands (n = 50, 67.6%) reported that their wife was the person who provided them with the necessary main support in quitting. Nearly a quarter (18 out of 74, 24.3%) of the husbands indicated that they quit smoking during their wives' pregnancy. Those more likely to quit were the 'occasional smokers' (61.1% vs. 38.9%), those who craved cigarettes a few hours after getting up (0% vs. 100%), those who were confident in their ability to quit (77.8% vs. 22.2%), and those who had previously attempted to quit (88.9% vs. 11.1%). The level of negative support from wives to quit smoking was significantly related to men's quitting (55.6% vs. 44.4%). The results of this study identified the husbands most likely to spontaneously quit smoking during their wives' pregnancy as those who were occasional smokers, were confident about smoking cessation, and reported their wives as being bothered by smoke.     

Reasons for Smoking Cessation Among a Random Sample of North Carolina Nurses

The purpose of this study was to assess selected correlates of successful smoking cessation among a random sample of 600 professional nurses in North Carolina. A questionnaire utilizing multiple choice and/or Likert responses was mailed to a 1 % sample of all active and inactive nurses registered with the N. C. Board of Nursing. Respondents were categorized as former, current, and never smokers. Emphasis on morbidity, mortality, and decreased respiratory function appears to have had the greatest impact on smoking cessation. Approximately half indicated the pressure from family and friends to stop smoking was a reason for their smoking cessation. Recommendations for individual and institutional interventions that will contribute to smoking cessation are identified.     

Tobacco Use and Interest in Smoking Cessation Among Latinos Attending Community Health Fairs

Health fairs are vital for reaching underserved Latinos providing access to health services including smoking cessation. The purpose of this study is to describe tobacco use and interest in smoking cessation among Latino smokers attending community health fairs. We surveyed 262 self-identified Latinos attending health fairs; we assessed smoking behavior and attitudes of 53 (20.2%) current smokers. Smokers were mostly uninsured (98.1%), male (54.7%), recent immigrants (96.2%) with limited English proficiency (60.4% spoke Spanish at home), and were mainly light (86.3%) and nondaily (58.7%) smokers. Although most participants attempted to quit smoking at least once in the past year, only 5.0% of current smokers reported ever using cessation medication and 94.3% were unaware of free-telephone counseling. The majority of smokers were ready to quit within 30 days and were interested in participating in cessation programs. Health fairs provide a unique opportunity to address smoking cessation among underserved Latinos with limited knowledge of access to, and use of effective cessation services.     

Socioeconomic and Racial/Ethnic Disparities in Unintended Pregnancy Among Postpartum Women in California

Objective: We examined social disparities in unintended pregnancy among postpartum women to better understand 1) the role of socioeconomic factors in racial/ethnic disparities and 2) factors that might explain both socioeconomic and racial/ethnic disparities in the risk for unintended pregnancy among women who give birth. Methods: We used 1999 and 2000 data from a statewide-representative mail and telephone survey of postpartum women in California (N = 7044). We examined associations between unintended pregnancy and race/ethnicity (African American, Asian or Pacific Islander, U.S.-born Latina, foreign-born Latina, European or Middle Eastern), three socioeconomic factors (poverty status, maternal education, paternal education), and several potential explanatory factors. Results: Overall, racial/ethnic disparities in unintended pregnancy were reduced by the three socioeconomic factors individually and collectively (e.g., reducing higher unadjusted odds for African Americans from 3.4 to 1.9); additional adjustment for marital status age, parity, insurance, language, abuse, sense of control, and interaction between marital status and race/ethnicity (each independently associated with unintended pregnancy) reduced the socioeconomic disparities (e.g., reducing odds for the poorest women from 4.1 to 2.3). Although reduced, significant racial/ethnic and socioeconomic disparities remained after adjustment, but generally only among married women. Results for Latinas appeared to vary by nativity, with foreign-born Latinas being at lower odds and U.S.-born Latinas being at higher odds of unintended pregnancy. Conclusions: Racial/ethnic disparities in unintended pregnancy are partly explained by the socioeconomic factors we measured. Several additional factors were identified that suggest possible directions for policies and programs to help reduce social disparities in unintended pregnancy among childbearing women.     

Perspectives on Smoking Cessation in Northern Appalachia

This study applies qualitative research methods to explore perspectives on cessation among smokers/former smokers recruited from an area of Northern Appalachia. Six focus groups, stratified by age group (18–39 years old and 40 years and older), were conducted among participants (n = 54) recruited from community settings. Participants described varied interest in and challenges with quitting smoking. Smokers 40 years and older more readily endorsed the health risks of smoking and had greater interest in quitting assistance. Participants expressed frustration with the US government for allowing a harmful product (e.g., cigarettes) to be promoted with minimal regulation. Use of social media was robust among both age groups; participants expressed limited interest in various social media/technology platforms for promoting smoking cessation. Findings from this understudied area of northern Appalachia reflect the heterogeneity of this region and contribute novel information about the beliefs, attitudes, and experiences of current and formers smokers with regard to cessation.     

Socioeconomic Disparities in Sleep Duration Among Veterans of the US Wars in Iraq and Afghanistan

We characterized socioeconomic disparities in short sleep duration, which is linked to multiple adverse health outcomes, in a population-based sample of veterans of the US wars in Iraq and Afghanistan who had interacted with the Minneapolis VA Health Care System. Lower reported household assets, lower food security, greater reported discrimination, and lower subjective social status were significantly (P < .05) related to less sleep, even after adjusting for demographics, health behaviors, and posttraumatic stress disorder diagnosis. Assisting veterans to navigate social and socioeconomic stressors could promote healthful sleep and overall health.Inadequate sleep is common, with just more than 1 in 4 adults in the United States reporting that they average 6 or less hours of sleep per night.1 Short sleep duration (commonly defined as < 6–8 hr per day) has been linked to serious health problems, including injury,2–4 cardiovascular disease and associated risk factors,5–14 poor mental health,15–19 and all-cause mortality.20–27 Disparities exist in which Blacks28–32 and those who are of lower socioeconomic status (SES)33 are at increased risk for sleep deficiency. Military members and veterans, especially those who have been deployed, appear to be at greater risk for short sleep duration.34–37 This risk may relate to aspects of the deployment cycle such as irregular schedule and shift work, stress, mental health issues such as posttraumatic stress disorder (PTSD), and injury. Of further concern is that short sleep duration and its risk factors may be part of a mutually reinforcing cycle. Indeed, research has indicated that predeployment short sleep duration may contribute to the development of PTSD.38,39In this study, we sought to characterize socioeconomic disparities in short sleep duration among veterans who served in the US wars in Iraq or Afghanistan and to test whether, independent of other known risk factors, socioeconomic obstacles, such as having low income or experiencing discrimination, are linked to short sleep duration.     

盐酸安非他酮的戒烟效果

目的初步评价盐酸安非他酮戒除烟瘾的有效性和安全性。方法 43名受试者口服盐酸安非他酮缓释片150～300mg/d,疗程7周,观察12周。分别于服药前,服药后4周及12周进行问卷调查。结果 4周时的戒烟率为20.9%(9/43),12周时为34.9%(15/43)。随着服药时间延长,日吸烟量逐渐减少。烟草依赖自评量表结果显示12周时,各种戒断症状的发生率较4周时明显下降。观察期间出现的不良反应包括恶心(16.2%)、呕吐(2.3%)、异常梦境(4.7%)和情绪改变(7.0%)。没有受试者因为不良反应而停药。结论盐酸安非他酮对戒除烟瘾有一定的疗效,并且具有良好的安全性和可耐受性。