Knowledge of smoking-related risks and opinions on tobacco control by smoking status and education level in Japan

OBJECTIVE: We aimed to examine knowledge of smoking-related risks and opinions on tobacco control by smoking status and education level in Japan. METHODS: We conducted a questionnaire survey in 2002 on a random sample of residents aged 20 to 79 years in two neighboring districts of northern Japan. In a total sample of 7,136, we analyzed data from 5,638 (79.0%) subjects (2,659 men and 2,979 women). RESULTS: The length of education was positively associated with knowledge of smoking-related risks. Compared to current smokers, past male smokers and never female smokers were more likely to know about the harm of passive smoking. As for causal links between smoking and lung cancer, stroke, and low birth weight, those who had been educated longer tended to be more aware of the associations in both sexes. Compared to current smokers, past and never smokers of men and past smokers of women were more likely to know that smoking contributes to low birth weight, but no difference was observed between current and never female smokers in this regard. Opinions on tobacco control were associated with both smoking status and education level; past and never smokers compared to current smokers and those who were educated longer tended to be affirmative about tobacco control. CONCLUSION: Knowledge of smoking is largely associated with education, but opinions on tobacco control are dependent on both smoking status and education.     

A population survey in Ontario regarding restrictive measures on smoking: relationship of smoking status to knowledge, attitudes and predicted behaviour

A population survey of Ontario residents regarding knowledge of the health effects of smoking, attitudes towards restrictive measures, and predicted behaviour was carried out. Telephone responses of 490 current, 290 former, and 581 never smokers were compared. For both active and passive smoking, never smokers were most knowledgeable about health effects, former smokers being less knowledgeable, and current smokers least so. While a majority of each smoking status group supported some restriction on smoking in all 13 settings examined, there were consistent differences among the groups as to degree. Never and former smokers were in close agreement and were more restrictive in their attitudes than current smokers. Prohibition was more strongly favoured by all groups for health and day care facilities, schools, stores, and local transit systems than for other settings. While a majority of smokers thought there would be compliance with restrictions, non-smokers were less optimistic. Smokers were less likely than non-smokers to see a role for governments in enactment; municipal involvement was favoured over other levels by all groups. No group indicated much support for enforcement by police. These findings remained when multivariate analyses controlling for inter-group differences in sociodemographic characteristics were carried out.     

Smoking habits and smoking cessation among North Carolina nurses

A 1987 questionnaire survey of a 1% random sample (n = 356) of registered nurses in North Carolina provided data on the smoking habits and smoking cessation. Fifty-six percent were never smokers; 19% were current smokers. Among the ever smokers, 31% had quit smoking for at least one year. Twenty-two percent of the former smokers had smoked less than 5 years and 39% less than 10 years before quitting. Anecdotal notes from never smokers suggested that their major deterrent to smoking was their own parents smoking. Concerns about the addictive smoking behavior and health effects of smoking observed in their parents as well as concerns about potential health risks to themselves deterred them from smoking. Concerns about the adverse consequences of smoking was the most influential factor influencing smoking cessation and reduction of cigarette smoking. Friends' and family's encouragement to stop smoking was the most influential external factor motivating nurses to quit or reduce cigarette consumption. Fifty-seven percent of the former smokers quit smoking after one or two attempts while 53 of the current smokers had tried to quit 3 or more times - 90% had tried at least once to quit smoking; however, only 18% of the current smokers had abstained for more than one year during any of their attempts to quit. Implications of the results include: (1) smoking cessation programs for nurses in the workplace may have considerable impact since the majority of nurses who smoke are tying to quit; (2) relapse prevention strategies need to be an integral part of such smoking cessation programs including involvement of family and friends to support the smokers in their cessation efforts.     

Rapid reduction in coronary risk for those who quit cigarette smoking

The objective of this study was to determine the rate of the decline in risk of a major coronary event after quitting cigarette smoking. It was a population-based case-control study of men and women aged 35 to 69 years in Newcastle, Australia, and men and women aged 35 to 64 years in Auckland, New Zealand, between 1986 and 1994. Cases were 5,572 people identified in population registers of coronary events and controls were 6,268 participants in independent community-based risk factor prevalence surveys from the same study populations. There was a rapid reduction in risk after quitting cigarette smoking. The risk of suffering a major coronary event for men who were current cigarette smokers was 3.5 (95% CI 3.0–4.0) times higher than the risk for never smokers but this fell to 1.5 (95% CI 1.1–1.9) for men who had quit for 1–3 years. Women who were current cigarette smokers were 4.8 (95% CI 4.0–5.9) times more likely to suffer a major coronary event than never smokers and this fell to 1.6 (95% CI 1.0–2.5) for women who had quit for 1–3 years. Those who had quit cigarette smoking for 4–6 years or more had a similar risk to never smokers. These results reinforce the importance of smoking cessation. The public health message is that the benefit of giving up smoking occurs rapidly.     

Demographics and cigarette smoking among women

BACKGROUND. A population-based sample of 893 white women ages 25 to 59 years from five San Francisco, California, Bay Area counties were queried about their demographic characteristics, height, reported weight at age 25, cigarette smoking history, and oral contraceptive and sunscreen use. METHODS. Multiple logistic regression techniques were used to analyze the data. Forty-three percent of the women in the sample had never smoked more than 100 cigarettes, while 27% were current and 30% were former smokers. Separated or divorced women were more likely to have ever smoked. RESULTS. Women who were less educated, single, separated, or divorced or had smoked between 10 and 30 cigarettes per day were less likely to quit smoking. Women with less education and a longer history of smoking smoked more cigarettes per day. Women who had never smoked were more likely to use sunscreen and to report their weight as slightly less at age 25 than were smokers.     

吸烟与帕金森病关系的病例对照研究

目的　探讨吸烟与帕金森病 (PD)的关系。方法　采用以人群为基础的病例对照研究 ,调查在北京地区 55岁以上PD患病率调查中确诊及 2 0 0 2年 8月至 2 0 0 3年 1月在北京协和医院帕金森研究中心诊治的病例共 1 1 4例 ;以及性别、民族及居住地与其匹配的对照 2 0 5名。结果　吸烟与PD呈显著负相关联。以非吸烟者为对照 ,曾经吸烟者、现在吸烟者和过去吸烟者患PD的危险性低于对照 ,OR值分别为 0 .49(95 %CI:0 .30～ 0 .79)、0 .44(95 %CI :0 .2 3～ 0 .86)和 0 .54(95 %CI:0 .30～0 .96)。此外 ,对吸烟者分别按吸烟年限≥ 2 0年和 <2 0年、戒烟年限≥ 2 0年和 <2 0年以及吸烟量分层和logistic回归分析 ,其负相关联依然存在并具有剂量反应关系的趋势 (P <0 .0 5)。结论　吸烟与PD存在负相关联 ,今后应着重开展有关生物学依据的研究     

Do Dutch 11-12 years olds who never smoke,smoke experimentally or smoke regularly have different demographic backgrounds and perceptions of smoking?

BACKGROUND: Most adolescent smokers start smoking before the age of twelve. Little is known about the behavioural smoking determinants of Dutch primary school children. METHODS: A cross-sectional study was carried out on a sample of students from the final year of 143 Dutch primary schools. A total of 3700 students (mean age = 11.6 years) completed a questionnaire based on the ASE model, measuring the attitude, social influences and self-efficacy expectations concerning smoking. RESULTS: Students were categorized as never smokers (64.3%), experimental smokers (28.0%), and regular smokers (7.8%). Multinomial logistic regression analyses showed that never smokers were younger, and were more often female, religious and from two-parent families than experimental smokers. Never smokers perceived more disadvantages, long-term physical consequences, more negative social norms and less pressure regarding smoking, higher self-efficacy expectations towards non-smoking, and had fewer parents, siblings or best friends who smoked. Looking at differences between experimental and regular smokers showed that experimental smokers received less pocket money. They also perceived more disadvantages, fewer advantages, more negative social norms and less pressure towards smoking, higher self-efficacy expectations towards non-smoking, and were less likely to be surrounded by friends, peers, family or teachers who smoked. Generally, the low scores for physical consequences and risk perception regarding addiction were striking. CONCLUSIONS: Smoking prevention aimed at primary schoolchildren should consider the different smoking categories, with their specific motives and influences. For instance, the influences on smoking initiation of parents, siblings and best friends suggest more comprehensive programmes aimed at the entire family. Youngsters' ignorance of addiction needs more attention.     

Discrepancies between self-reported smoking and carboxyhemoglobin: an analysis of the second national health and nutrition survey.

Environmental, self-report, and demographic factors mediated the relationship between self-reported cigarette smoking and carboxyhemoglobin among 2114 smokers and 3918 nonsmokers. Self-reported nonsmokers with carboxyhemoglobin levels between 2% and 3% were more likely to be self-reported ex-smokers, to live in a larger community, and to be younger, less educated, and male than were self-reported nonsmokers with carboxyhemoglobin levels of less than 2%. Self-reported nonsmokers with strong evidence of cigarette consumption (carboxyhemoglobin level greater than 3%) were more likely to be self-reported ex-smokers, younger, less educated, and non-White than were nonsmokers with carboxyhemoglobin levels of less than 2%.     

Changes in the smoking behaviour, knowledge and opinion of medical students, 1972–1981

To examine changes in medical students' smoking behaviour, knowledge and opinion over the last decade, a survey first conducted at the University of Manchester Medical School in 1972 was repeated in 1981.A postal questionnaire was sent to 1163 students, of whom 1112 (96%) replied. A substantial decline in cigarette smoking among medical students has occurred. This largely follows trends in the general population, medical education itself having made little contribution to the change. In 1972, 29% of students were cigarette smokers compared with 17% in 1981. The fall in cigarette smoking was more marked among men students rather than women, older rather than younger students, clinical rather than pre-clinical students. Cigarette consumption had also decreased as had the use of cigars and pipes among male students. The decline was already evident prior to students beginning their medical studies. A smaller expansion of smoking experience at medical school had occurred among the 1981 students, but, as in 1972, those who took up smoking or increased their consumption exceeded those who gave up or cut down. In 1981 the likelihood of taking up smoking or becoming a regular smoker at medical school was somewhat greater for women students than for men, although the numbers concerned were small. The survey reconfirmed the importance of the social environment in smoking behaviour.Modest changes had occurred in knowledge and opinion about smoking. Both the accuracy and scope of knowledge of students about the health hazards increased between 1972 and 1981, particularly among clinical students, who remained considerably better informed than their pre-clinical colleagues. As in 1972, knowledge had little impact on smoking behaviour. By 1981 nine out of ten students regarded smoking as a major risk to health, both clinical students and smokers being more likely to take this view than in 1972. Almost all students, irrespective of their smoking behaviour, found the evidence linking smoking to serious illness to some extent convincing, and by 1981 a somewhat greater proportion, 60%, found it very convincing, the tendency to do so increasing as they progressed through their course.     

Cigarette smoking and completed suicide among middle-aged men: a population-based cohort study in Japan

PURPOSE: To clarify whether cigarette smoking was associated with completed suicide in a cohort of middle-aged Japanese men. METHODS: A total of 45,209 out of 57,714 men, aged 40 to 69 years, in nine public health centers across Japan responded to a self-administered questionnaire that included questions regarding their smoking history. The questionnaire was distributed in 1990 (Cohort I) and in 1993 and 1994 (Cohort II). By the end of 2000, 173 suicides were identified by death certificates. RESULTS: After adjusting for potential confounders, current smokers had a marginally higher risk of suicide than never smokers. Current smokers with more than 60 pack-years of cigarette smoking had a more than two-fold higher risk of suicide than never smokers (pooled multivariate relative risk=2.1; 95% confidence interval, 1.1, 4.0), but a significant dose-response relationship between pack-years of smoking and suicide was not found. The risk of suicide increased significantly with increasing numbers of cigarettes smoked per day (p for trend=0.036). Smoking status, duration of quitting, duration of smoking, and age at the start of smoking were not significantly associated with suicide risk. CONCLUSION: Our results suggest that heavy smoking, particularly a large number of cigarettes per day at baseline was associated with an increased risk of suicide independent of several potential confounders.     

Health behaviors, risk factors, and health indicators associated with cigarette use in Mexican Americans: results from the Hispanic HANES.

BACKGROUND: Cigarette smokers often engage in other, potentially deleterious, health behaviors. Such behaviors have not been well documented in Mexican American smokers. METHODS: Data from the Southwestern sample of the Hispanic Health and Nutrition Examination Survey (HHANES) were employed to investigate differences in health behaviors, risk factors and health indicators between cigarette smokers and nonsmokers among Mexican Americans. Differences between those smoking less than 10 and 10 or more cigarettes per day were also examined by age group and gender. RESULTS: Positive associations between smoking status and heavy coffee and alcohol consumption were found across gender and age groups. Less consistent was the finding that smokers weighed less than nonsmokers. Lower systolic and diastolic blood pressures in middle-aged smokers, and higher levels of depressive symptomatology among smoking women were found. Those smoking 10 or more cigarettes per day were more likely to report heavy coffee consumption, with younger men reporting greater activity limitation due to poor health. Middle-aged men and women in the 10+ category were generally in better health than lighter smokers. CONCLUSIONS: Modest associations between cigarette smoking, health behaviors and risk factors found in other studies were confirmed in this Mexican American population. Few significant associations between smoking and health status were noted.     

THE SMOKING HABITS AND ATTITUDES OF NURSES

The demographic and social characteristics, attitudes to smokers and smoking, and knowledge about smoking were surveyed in 988 (81.3%) of 1,215 trainee and trained nurses in four locations in Perth, Western Australia. Male and female nurses were similar with 51% never having smoked regularly, 17% being ex-smokers and 32% current smokers. In comparison with Australian woman in general, there were less current smokers and more ex-smokers among female nurses. Female nurses smoked substantially more than Australian female doctors. The majority of nurses who had ever smoked (68%) began smoking between ages 15 and 19 years, 26% began in the first year of their nursing training and 26% smoked their first cigarette in the nurses' quarters. The knowledge of nurses about the health effects of smoking was similar to that of Australian doctors as were their opinions regarding their role in setting a non-smoking example to others. A substantial majority supported either a complete ban on smoking, or its restriction to especially segregated areas in aeroplanes, buses, trains, hospitals and cinemas.     

The epidemiology of cigarette smoking in Hong Kong Chinese women

BACKGROUND: Smoking in women is a well-recognized public health problem. In many developed countries, cigarette smoking is now the single most important preventable cause of premature death in women. There are relatively few data on the epidemiology of cigarette smoking in Asian women, and this study examined the prevalence of and factors predisposing Chinese women to smoke cigarettes in Hong Kong. METHOD: A territory-wide random telephone survey of 26,716 households in Hong Kong was conducted. A total of 1064 current smokers and 291 ex-smokers were identified in these household, and in-depth interviews of 791 current smokers, 221 ex-smokers, and 1012 controls were conducted. RESULTS: The prevalence of cigarette smoking was 4.5% in women who were 25 years or younger, 2.6% in women aged 46-65 years, and 2.2% in women aged 65 years or older. Sixty-four percent of current smokers started when they were 19 years or younger. The main reasons for the initiation of cigarette smoking were the influence of friends, curiosity, feeling bored, or being idle. Current smokers and ex-smokers tended to have positive images of women who smoked. The following risk factors were found to be significant for cigarette smoking: less than university education, unemployment, being divorced, having a husband who smoked, and a low score on the perceived harms of cigarette smoking. CONCLUSION: Cigarette smoking is more prevalent in younger women in Hong Kong; and psychosocial issues should be addressed to prevent future epidemics.     

Community attitudes to bans on smoking in licensed premises

Abstract: Information about public attitudes to the restriction of smoking in licensed premises could provide an impetus for a campaign to address the failure of the industry to improve the health of its employees and the public. A probability sample of 816 people was surveyed to determine community attitudes to the introduction of bans on smoking in licensed premises. A total ban on smoking was supported by 20 per cent and provision of special smoking areas by 65 per cent, and 15 per cent wanted no bans. More-educated people, white-collar workers, nonsmokers and those who went to licensed premises less than weekly were more likely to support bans than were the less educated, blue-collar workers, smokers, and those who went to licensed premises at least weekly. The less educated, smokers and those who went to licensed premises at least weekly were most likely to perceive that the introduction of smoking bans would reduce their patronage of licensed premises. Nonsmokers and those with more than 12 years of education were more likely to report that their patronage would increase if bans were introduced than were smokers and the less educated. The introduction of bans on smoking in licensed premises would result in only a small loss of patronage after accounting for potential increases from supporters of bans. The effect of the bans is likely to be felt most strongly among the less educated, smokers and regular patrons.     

Stages of change and other factors in 'light' cigarette smokers

BACKGROUND: It has become well known that 'light' cigarettes are deceiving in fostering the attitude that they are 'safer' or less health damaging than regular cigarettes. The goal of this study is to analyse the smoking of 'light' cigarettes according to the progress over the stages of change to stop or reduce smoking. METHODS: A sample representing the general population of a northern German region aged 18 to 64 was drawn (T1, N=4075). 1520 smokers of 'light' and regular cigarettes were identified by a face-to-face interview and reassessed longitudinally by questionnaire 30 months later (T2, n=913). RESULTS: At baseline smokers of 'light' cigarettes, in particular males, were more likely to be contemplators or preparators in terms of smoking cessation. Those who smoked 'light' cigarettes were more likely to have made a quit attempt, were more likely to be female, at younger age, never married, higher educated and less nicotine dependent compared to smokers of regular cigarettes. The follow-up data shows that males who smoked 'light' before or changed to 'light' cigarettes were more likely to contemplate or to prepare quitting, had more often tried a quit attempt and stopped smoking more often. CONCLUSION: The results suggest that 'light' cigarettes especially by males are used for reasons of reducing or quitting smoking. It is concluded that as such they deceive the smoker and potentially hinder the process of reducing or quitting.     

The joint influence of parental modeling and positive parental concern on cigarette smoking in middle and high school students

Abstract: The purpose of the study was to examine the interaction between parental smoking status and parental attitudes, as measured by positive parental concern, on the risk of adolescent cigarette smoking. Parental smoking and parental concern about smoking were measured in a cross-sectional study of 37,244 students, a random sample of Maryland middle and high school students, who were current or never smokers. Parental concern was classified into 3 levels: strict, moderate, and minimal. The likelihood of youths being current smokers was positively associated with both parental smoking (both versus neither parent smokes: odds ratio [OR] 3.4, 95% confidence interval [CI] 3.1-3.7) and parental concern about smoking (minimal versus strict concern: OR 2.3, 95% CI 2.1-2.4). Youths with parents who did not smoke and with strict concern had the lowest likelihood of smoking. In comparison to this group, after adjustment for other social influences the likelihood of being a current smoker was more than 5 times greater among boys (OR 5.8, 95% CI 4.5-7.4) and girls (OR 5.2, 95% CI 4.1-6.5) whose parents both smoked and were minimally concerned about smoking. Current smoking in youths was independently associated with both parental smoking and less parental concern. When these 2 factors were jointly considered, the prevalence of current smoking in youths increased both with exposure to parental modeling and reduced parental concern about smoking. The results indicate that minimal parental concern about smoking worsens the risk due to parental modeling. Parental modeling and parental attitudes act synergistically to exacerbate the likelihood of smoking. (J Sch Health. 2006;76(8):402-407)     

Demographic and health characteristics of elderly smokers: results from established populations for epidemiologic studies of the elderly

Although smoking has been shown to be associated with excess morbidity and mortality, most studies have focused on young and middle-aged rather than elderly smokers. We examined the demographic characteristics and physical and psychological health of elderly cigarette smokers in four population-based studies (N = 3,673, 3,811, 2,811, and 4,165) of persons 65 years of age and older. Although there was substantial geographic variation in the percentages of smokers, the demographic and health characteristics of smokers were similar across the sites. Most women had never smoked, but most men were former or current smokers. The percentage of never smokers was highest in the "oldest old." Among the elderly ever smokers, men were more likely to have quit than women, and the relative percentage of former smokers increased with age. Current smokers were generally more likely to consume alcohol than never smokers. In this age group, cigarette smoking was typically associated with higher rates of physical disease and symptoms, poorer self-perceived health status, and higher levels of depressive symptoms. Based on these four large geographically diverse population surveys, cigarette smoking remains an important health burden and public health challenge among the elderly.     

Lower use of dental services among long term cigarette smokers

STUDY OBJECTIVE: Given the advanced stage of most oral cancer cases at diagnosis, it is hypothesised that a significant proportion of higher risk adults do not visit a dentist annually. The study objectives were to assess whether long term smokers were less likely to visit the dentist. DESIGN: Data from the 1998 Massachusetts Behavioral Risk Factor Surveillance System, a population-based, random digit dial telephone health survey, were used to evaluate whether adults at higher risk of oral cancer attributable to long term cigarette smoking were less likely to go to the dentist, controlling for socioeconomic, demographic, and health related characteristics. PATIENTS: A representative sample of 2119 Massachusetts adults aged 35 and older. MAIN RESULTS: Adults who were long term smokers were less likely than never smokers to have visited the dentist in the previous year (adjusted OR = 0.69, 95% confidence intervals (CI) = 0.48, 0.99). Moreover, adults who were at higher risk from both long term smoking and low fruit and vegetable consumption were even less likely to visit the dentist than adults with neither risk factor (adjusted OR = 0.39, 95% CI = 0.22, 0.68). Among long term smokers, the likelihood of a yearly examination decreased with increasing smoking duration and amount smoked per day. CONCLUSIONS: These findings support the hypothesis that adults at higher risk of oral cancer attributable to long term cigarette smoking are less likely to have routine dental examinations, even controlling for socioeconomic and health related differences.     

A survey on attitudes towards passive smoking among schoolchildren and students in Switzerland

The attitudes and reactions to passive smoking as well as the attitudes to active smoking have been investigated among schoolchildren and students in Zurich. 183 13-year-old children, 203 16-year-old children, and 367 23-year-old students were interviewed by a questionnaire. The most interesting results are as follows: -- Significantly more of the younger children (81%) than of the elder children (70%) and the students (70%) dislike passive smoking. -- Significantly more nonsmokers dislike passive smoking than smokers. -- The subjects whose parents smoke dislike passive smoking less than the subjects whose parents do not smoke. -- 80% of the students, 64% of the elder children, and 82% of the younger children complain of one or more kinds of irritations due to passive smoking. The most common impairment is eye irritation, followed by cough and nose irritation. -- More nonsmokers complain of irritations than smokers. -- There is no significant difference between girls and boys as for the reactions to passive smoking.     

Cigarette smoking behavioral distinctions between experimental nonadopters and adopters in children and adolescents--a consideration of transitional smoking experience: the Bogalusa Heart Study

A cigarette-smoking questionnaire to examine behavior, attitudes, and beliefs related to cigarette use was administered to children, ages 8-17, in a biracial community. Children who experimented with cigarettes but did not adopt the habit (experimental nonadopters) and children who continued to smoke (adopters) were identified and characterized. Follow-up behavior was examined 2 years later. Adopters were more likely to have smokers as friends and family members, more likely to have purchased their first cigarettes, more likely to believe smoking to be pleasurable for themselves and others, and less likely to consider smoking harmful. Adopters who maintained smoking behavior 2 years later had, during the initial survey, reported having more friends who also smoked and were more likely to believe smoking to be enjoyable. Experimental nonadopters were more likely to try the first cigarette alone, reported having fewer friends and family members who smoked, and believed greater health risks to be associated with cigarette use. Experimental nonadopters who maintained nonsmoking behavior 2 years later, especially in the older cohort, exhibited higher agreement with the negative consequences of cigarette smoking (health beliefs) and theories concerning smoking behavior of others.