Waterpipe Tobacco Smoking on a U.S. College Campus: Prevalence and Correlates

PURPOSE: Waterpipe tobacco smoking is reported to be growing in popularity, particularly among college students. This study examined the prevalence of waterpipe tobacco smoking prevalence and perceptions in a university-based population. METHOD: This was a cross-sectional Internet-based survey of first-year university students, which examined waterpipe tobacco smoking and other tobacco use, risk perceptions, influences, and perceived social acceptability. RESULTS: Waterpipe tobacco smoking within the past 30 days was reported by 20% (151/744). Relative to never users, users were more likely to perceive waterpipe tobacco smoking as less harmful than cigarette use. CONCLUSIONS: Because waterpipe tobacco smoking is increasing in prevalence and because it can involve toxicant inhalation at even greater levels than with cigarette smoking, it represents a growing public health issue.     

Smoking and life expectancy among U.S. veterans.

Life expectancies were estimated for selected groups of smokers, ex-smokers, and nonsmokers based on the results of a 16-year mortality follow-up of 198,820 U.S. veterans. Life expectancy varied inversely with number of cigarettes smoked per day. The most pronounced differences were between nonsmokers and heavy cigarette smokers (40+ per day). These differences in life expectancy were greatest at the younger ages--nearly 9 years at ages 35 and 40. Life expectancies for cigarette smokers varied directly with age began smoking. For all ages, differences in life expectancy between nonsmokers and ex-cigarette smokers who stopped for other than doctor's orders were less than those between nonsmokers and current cigarette smokers. Results in the present study clearly confirmed Hammond's earlier findings.     

Examining Interpretations of Graphic Cigarette Warning Labels Among U.S. Youth and Adults

Few studies have examined how diverse populations interpret warning labels. This study examined interpretations of 9 graphic cigarette warning labels (image plus text) proposed by the U.S. Food and Drug Administration among a convenience sample of youth (ages 13–17) and adults (18+) across the United States. Participants (N = 1,571) completed a cross-sectional survey. Participants were asked to select 1 of 3 plausible interpretations (1 preferred vs. 2 alternative) created by the research team about the particular consequence of smoking addressed in each warning label. Participants also rated each label for novelty, counterarguing, perceived effectiveness, and harm. Smokers reported their thoughts of quitting, self-efficacy, and motivation to quit. Although at least 70% of the sample chose the preferred interpretation for 7 of 9 labels, only 13% of participants chose all 9 preferred interpretations. The odds of selecting the preferred interpretation were lower among African Americans, among those with less education, and for labels perceived as being more novel. Smokers reported greater counterarguing and less perceived effectiveness and harms than nonsmokers, but results were not consistent across all labels and interpretations. The alternative interpretations of cigarette warning labels were associated with lower perceived effectiveness and lower perceived harms of smoking, both of which are important for motivating quit attempts.     

Smoking and causes of death among U.S. veterans: 16 years of observation

In a 16-year mortality followup of some 293,000 insured U.S. veterans, specific causes of death were studied in relation to smoking status. The main results confirmed earlier findings.Mortality ratios for cigarette smokers as compared with nonsmokers were 1.73 for all causes of death, 1.58 for all cardiovascular diseases, 2.12 for all cancers, and 4.31 for all respiratory diseases. The highest ratios (those greater than 5.0) were observed for cor pulmonale, aortic aneurysm, emphysema and bronchitis, cancer of the pharynx, cancer of the esophagus, cancer of the larynx, and cancer of the lung and bronchus. The greatest excess in deaths in terms of observed numbers minus expected was found for the cardiovascular diseases, in particular for coronary heart disease.Mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians'' orders were much lower compared with nonsmokers than the mortality ratios for current cigarette smokers: 1.21 for all causes, 1.15 for all cardiovascular diseases, 1.39 for all cancers, and 2.08 for all respiratory diseases. For most causes of death, the mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians'' orders varied inversely with the number of years of cessation. For some diseases, the mortality risk for the ex-cigarette smoker returned to normal almost immediately after the cessation of smoking, whereas for others, the return to normal was more gradual. The first group included stroke and the combined category of influenza and pneumonia; the second group included cardiovascular diseases as a whole and coronary heart disease. For still other diseases, although the mortality ratio declined with the length of time smoking was discontinued, substantial excess risks remained even after 20 years of cessation. In this third group were aortic aneurysm, bronchitis and emphysema, and lung cancer—diseases with very high mortality ratios for current cigarette smokers. Parkinson''s disease remained the one disease that clearly exhibited a negative association with cigarette smoking.     

Correlates of seasonal flu vaccination among U.S. home health aides

Introduction

Home health aides (HAs) receive limited training and reach many older patient populations highly susceptible to influenza virus. We sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.

Methods

We analyzed data from the 2007 U.S. National Home Health Aide Survey, a nationally representative sample of HAs reporting on occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n = 3377).

Results

Seasonal flu vaccine receipt was low among all types of HAs (43.9%). After adjustment for socio-demographic indicators (i.e. age, gender, race and health insurance), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to licensed nursing assistants (adjusted odds ratio, AOR = 0.42, 95% CI [0.20–0.85]; 0.41, [0.17–0.99]; 0.50, [0.26–0.97], and 0.53, [0.26–0.99], respectively).

Conclusion

Targeted effective vaccination campaigns are needed to improve vaccination rates among home health aides.     

Smoking policies in U.S. hospitals: current status

Hospitals can and should restrict cigarette smoking to promote a healthy environment and to exemplify health promoting behavior. Questionnaires to determine policies and programs relating to smoking were sent to the administrative heads of 360 randomly selected hospitals across the nation. Returns were received from 330 hospitals for a response rate of 91.7%. Only 1.2% of the hospitals surveyed totally banned smoking. Visitors, patients who smoked, and physicians were seen as most resistant to smoking restrictions. The majority of hospitals (56.0%) continued to sell cigarettes on the premises. States whose economies are involved with tobacco are more permissive than the others to a significant degree. Since the hospital administration is the primary force in implementing smoking policy, the smoking behavior of the administrator may affect institutional smoking policies. It does affect their attitude about hospital employee smoking and the health professional's responsibility about smoking to a significant degree. Thus, hospitals are not demonstrating leadership in creating safe nonsmoking environments for the patients, nor in offering smoking education programs to the community.     

Smoking,heavy drinking,and depression among U.S. middle-aged and older adults

ObjectiveTo examine the relationship between smoking, heavy drinking and depression among U.S. middle-aged and older adults.MethodIndividual-level data came from 1992–2012 waves of the Health and Retirement Study. Smoking was ascertained from self-reported cigarette smoking status at the time of interview. Heavy drinking was defined as one or more drinks per day on average or four or more drinks on any occasion in the past three months for women, and two or more drinks per day on average or four or more drinks on any occasion in the past three months for men. Depression was defined as scoring three and above on the eight-item Center for Epidemiologic Studies Depression Scale. Cox proportional hazards regressions were performed to examine the relationship between smoking, heavy drinking and depression.ResultsCompared to non-smokers, smokers free from depression and heavy drinking at baseline were 20% (95% confidence interval: 12–28%) and 34% (20–50%) more likely to develop depression and engage in heavy drinking during follow-up period, respectively. Compared to non-depressed participants, participants with depression who were nonsmokers and non-heavy drinkers at baseline were 41% (14–74%) and 18% (6–31%) more likely to smoke and engage in heavy drinking during follow-up, respectively. Compared to non-heavy drinkers, heavy drinkers who were nonsmokers at baseline were 60% (26–104%) more likely to smoke during follow-up.ConclusionHealth promotion programs in midlife and older age should be mindful of the associations between smoking, heavy drinking and depression in order to improve intervention effectiveness.     

Psychosocial Correlates of Experience and Intention to Receive Colorectal Cancer Screening: A Cross-Sectional Study Among East African Men in the U.S.

Journal of Prevention - Cancer screening is an important approach to reducing disease burden. The rate of colorectal cancer (CRC) screening among immigrants in the U.S. is very low. Our...     

Prevalence,Predictors, and Psychosocial Mechanism of Cancer Information Avoidance: Findings from a National Survey of U.S. Adults

ABSTRACT

The current study examined the prevalence, predictors, and psychosocial mechanism of cancer information avoidance (CIA). With a nationally representative sample, we sought to confirm the prevalence of CIA among Americans. Studies, based on crisis decision theory, have shown that a lack of personal or interpersonal resources to manage threat-related information leads to information avoidance. Cancer information overload (CIO) and cancer fatalism are known predictors of CIA, and these factors were viewed as a lack of personal resources. We measured interpersonal resources by an individual’s network size. Then, to suggest a psychosocial mechanism of CIA, we tested how those personal resources interacted with interpersonal resources. A two-wave longitudinal survey was conducted using a nationally representative sample of U.S. adults (N = 795 at Wave 1 and 626 at Wave 2). Approximately, 4–5 out of 10 adults had low to high levels of CIA, and they avoided the Internet more than any other source. Items that positively predicted CIA included male gender, being non-Hispanic white, and CIO. Family and personal cancer history negatively predicted CIA. However, the positive relationship between CIO and CIA existed only for people with fewer close friends (i.e., a smaller network size). The lack of personal resources did not lead to CIA for those who had more interpersonal resources that could help them manage threat-related information. The results suggest that social support protects individuals from the emotional stress of cancer information exposure, confirming the buffering model of social support.     

Correlates of sunburn experiences among U.S. adults: results of the 2000 National Health Interview Survey

OBJECTIVE: The purpose of this study was to determine the rate of sunburns in the U.S. adult population and the correlates of sunburns. METHODS: Data from the 2000 National Health Interview Survey Cancer Control Module were used to calculate the number of sunburns (0, 1, 2, or > or = 3) experienced during the past year by age, sex, race/ethnicity, and skin sensitivity to sun exposure. The relationship between no sunburns vs. one or more sunburns and additional demographic, health, and behavioral factors for adults who self-identify as white Hispanic or white non-Hispanic was assessed using general linear contrasts. Multivariate logistic regression modeling was conducted to determine the most important covariates associated with sunburns. All analyses were weighted for the complex sampling design. RESULTS: The study data suggest that overall, 18.5% (95% confidence interval [CI] 17.9, 19.1) of U.S. adults experience one sunburn a year, 9.7% (95% CI 9.3, 10.1) experience two, and 8.0% (95% CI 7.6, 8.4) experience > or = 3 sunburns. The data also indicate that adults who self-identify as white non-Hispanic experience sunburns more frequently than (in order of prevalence) those who identify as American Indian/Alaska Native, white Hispanic, Asian/Pacific Islander, or black. Sunburns were found to be more common among men than among women, more common among younger age groups than among older age groups, and more common among those with skin more prone to sunburn than among those with skin less prone to sunburn. Among individuals who self-identify as white Hispanic or white non-Hispanic, protective behaviors associated with lower rates of one or more sunburns in multivariate analyses are staying in the shade (odds ratio [OR] 0.73, 95% CI 0.66, 0.80) and wearing long-sleeved shirts (OR 0.86, 95% CI 0.75, 0.99). CONCLUSIONS: Many American adults have one or more sunburns per year. Methods to protect from sun exposure may not be used as needed to prevent sunburn.     

中国11省市成年人吸烟和被动吸烟情况调查

目的了解中国成年人群的吸烟和被动吸烟流行水平,为有针对性的制定控烟措施提供基础资料。方法于2005—2007年采用多阶段整群抽样在全国11个省市城区和农村分层抽取符合条件的成年人群作为本次研究的受试对象。分析指标包括总吸烟率、现在吸烟率、开始吸烟年龄、吸烟者平均每日吸烟量、戒烟率和被动吸烟率。结果在44773名受试者中,人群的总吸烟率为27.3%,现在吸烟率为22.3%。男性的总吸烟率为59.7%,女性为3.8%。男性50～55岁组和45～50岁组总吸烟率最高(分别为65.7%,65.6%),女性年龄越大,总吸烟率越高。人群戒烟率仅为17.9%。过去1年中,不吸烟的受试者中39.4%处于被动吸烟状态,其中9949人(30.9%)每天至少1次处于被动吸烟状态。女性被动吸烟者率(43.6%)高于男性(24.0%)。城区受试者的总吸烟率为25.1%,被动吸烟率为37.2%,均低于农村(分别为29.4%,41.7%)。结论吸烟率与2002年调查数据相比变化不大,被动吸烟水平有明显下降,但人群戒烟率仍然不高。我国的人群吸烟状态和被动吸烟状态仍处于高水平,烟草控制面临巨大挑战。     

Prevalence and Correlates of Depression Among New U.S. Immigrants

Although immigrants comprise one of the fastest growing segments of society, information on their adjustment to life in the US remains limited. The present study examined the prevalence of depression and associated correlates among a national sample of immigrants newly admitted to legal permanent residence to the US. Data were derived from the baseline adult cohort of the New Immigrant Survey, a national representative sample of immigrants who had obtained legal permanent residence between May and November 2003. Approximately 3 % of respondents met criteria for probable depression in the past 12 months. Respondents who were female, younger in age, in the US for a longer period of time, and exposed to political violence in their country of origin were more likely to meet criteria for probable depression. Both pre-immigration and resettlement related factors were associated with probable depression. Further research is needed to better understand how processes in the country of origin and in the resettlement country influence the adjustment of immigrants.     

Correlates of toenail zinc in a free-living U.S. population

OBJECTIVE: No prior studies have reported on dietary correlates of toenail zinc, an easily collected biomarker of zinc status. The study aim was to identify dietary and other factors that influence toenail zinc in a healthy population, in order to understand the usefulness of this biomarker in public health studies. DESIGN: Cross-sectional comparison of toenail zinc with questionnaire measures of demographic and behavioral factors, dietary intake and supplement use. SETTING: Western Washington State, US. SUBJECTS: 106 men and 106 women, who are participants in a large cohort study, of whom 66% used multivitamins or individual supplements containing zinc. RESULTS: Increased toenail zinc concentrations were associated with increased dietary zinc intake (adjusted difference in toenail zinc between those in the highest quartile of intake vs. lowest = 11.0 ppm, p for trend = 0.03), with the association primarily among men. Borderline associations of increased toenail zinc were found with decreased vegetable intake (p=0.08) and increased body mass index (p=0.11). Supplemental zinc and intake of phytic acid, alcohol, iron (from food or supplements) did not influence toenail zinc. CONCLUSION: Toenail zinc concentrations vary with dietary zinc intake, even in a healthy population with presumably little zinc deficiency.     

Correlates of underutilization of colorectal cancer screening among U.S. adults,age 50 years and older

BACKGROUND: Although effective screening for colorectal cancer (CRC) exists, only 37% of incident CRC are diagnosed at a localized stage at which treatment is effective. We identified demographic and other characteristics of adults (> or = 50 years old) who reported no CRC screening. METHODS: We calculated the prevalence of never having had a fecal occult blood test and/or a sigmoidoscopy or colonoscopy by age, sex, and other factors using the 1999 Behavioral Risk Factor Surveillance System data. RESULTS: CRC screening tests were underutilized across all segments of the population. Underutilization was highest in persons aged 50-64 years and those with lower education and a lack of health insurance and preventive services. CONCLUSIONS: The data indicate that large proportions of average-risk adults across various sociodemographics and behavioral factors are not utilizing recommended CRC screening tests. There is a need to increase the awareness of the importance of utilizing effective CRC screening tests for the early detection of colorectal cancers.     

Recommendations to Improve Health Risk Communication: Lessons Learned from the U.S. Public Health Service

The growth in the public's concern over a variety of environmental health risks has placed new requirements and demands on U.S. Public Health Service (PHS) agencies for information that describes and explains the nature of risk in clear and comprehensible terms. Experience has shown, however, that merely disseminating information without reliance on communication principles can lead to ineffective health messages and public health actions. This article presents the findings of a study conducted by the Subcommittee on Risk Communication and Education of the Environmental Health Policy Committee (EHPC), PHS, on how PHS agencies are communicating information about health risk; how effective these communications have been; and what specific principles, strategies, and practices best promote effective health risk communication. The purpose of the Subcommittee's study was to develop specific recommendations that would help PHS decision makers and health risk communicators improve the effectiveness of health information provided to, and received from, the public. The study suggests fundamental principles drawn from a series of case studies from PHS agencies abouthow bestto plan and carry outrisk communication activities.     

Demographic and Psychosocial Profile of Smoking Among Pregnant Women in Lebanon: Public Health Implications

Objectives: To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. Methods: A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. Results: The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22, 4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77, 5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98, 8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02–1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40, 137.4)]. Conclusion: Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods.