Health beliefs and smoking behavior.

Smoking histories and beliefs about smoking were obtained on 120 ex- and current smokers. Ex-smokers view smoking as a serious health problem, did not report having a physician recommend they stop, and feel personally susceptible to its adverse effects. Moderate smokers (0-10/day) also view smoking as serious, but do not see themselves as vulnerable to its adverse effects. The data suggest that certain attitudes can discriminate between groups of current smokers, as well as smokers from ex-smokers.     

Electroencephalographic characterization of cigarette smoking behavior.

The rewarding properties of used and abused substances are related to their ability to modulate central processes subserving mood, cognition, and behavior. Research into the motivationally relevant factors mediating substance use and abuse among human beings, including tobacco smoking, can strategically benefit from the utilization of noninvasive brain function measures that are able to probe the neurobiology of brain states in concert with substance ingestion. This paper reviews investigations from my laboratory with the use of neuroelectric tools, by means of quantitative electroencephalography, for the purpose of characterizing the central response to cigarette smoking. Prominent in these strategies is the acute smoking paradigm, whereby measures are focused on the profiling of central responsivity to smoke inhalation from a single cigarette and administration of test doses of nicotine. Complementing this approach are studies (1) in which receptor antagonists are administered in an attempt to explore putative transmitter systems regulating the acute smoking-induced electroencephalographic response and (2) in which electroencephalographic profiles of acute smoking are compared with electroencephalographic profiles resulting from administration of single doses of psychotropic substances. Completing these studies are attempts to monitor the electrocortical correlates of repeated smoking exposure and smoking deprivation, which, together with investigations examining smoker vs. nonsmoker differences and the effects of chronic life-long smoking, provide objective insights into the neuroelectrophysiology underlying the smoking habit.     

Study of smoking behavior in asbestos workers.

BACKGROUND: Asbestos exposure and concomitant cigarette smoking markedly increase the risk of lung cancer and contribute to the prevalence and severity of pulmonary interstitial fibrosis. METHODS: A cross-sectional survey of 214 asbestos workers was initiated to determine the prevalence of smoking and their readiness to quit smoking using the stage of change theory. RESULTS: The study was comprised of 61 never smokers (28.5%), 118 ex-smokers (55.1%), and 35 current smokers (16.4%). Reasons for smoking cessation in ex-smokers included perception of ill-health (51%) and knowledge of smoking-asbestos hazards (3.4%). Stage of change of current smokers revealed: precontemplation (26.5%), contemplation (35%), preparation (29%), and action (8.8%). Current smokers had the highest prevalence of small airway obstruction on spirometry. CONCLUSIONS: A detailed smoking history during medical surveillance activities will enable the occupational physician to identify asbestos workers who have difficulty quitting and to develop a system in which such individuals can be referred to comprehensive smoking cessation programs.     

Total indoor smoking ban and smoker behavior.

METHODS. To assess smoking policy support and effects, 1,083 hospital employees (203 smokers) were surveyed by anonymous questionnaire 1 year after the announcement (5 months after implementation) of a new total indoor smoking ban. A second follow-up, limited to smoker respondents only, was conducted 2 years postannouncement. RESULTS. A total indoor smoking ban was supported by the vast majority of nonsmokers (89%) and ex-smokers (86%) and by nearly half of the then-smoking population (45%). Consistent with previous reports, the smoking ban was associated with a significant decrease in cigarette use during work hours, particularly among moderate to heavy smokers. However, the ban did not result in increased institutional quit rates. Light smokers (< 10 cig/day), compared with heavy smokers (> or = 30 cig/day), were more likely to support the no-smoking policy and had fewer problems observing the ban. They were also less apt to report a decrease in work productivity. CONCLUSION. A total indoor smoking ban had little effect on overall institutional quit rates. Heavy smokers will, predictably, experience the greatest difficulty complying with a total indoor nonsmoking policy.     

Initiation of cigarette smoking and subsequent smoking behavior among U.S. high school students

BACKGROUND: Most adult smokers report trying their first cigarette before age 18 years. Understanding the impact of smoking initiation at young ages may help public health policy makers and practitioners improve strategies to prevent or delay adolescent cigarette smoking. METHODS: This paper examined age of initiation of cigarette smoking and subsequent patterns of smoking among U.S. high school students 16 years of age and older (N = 13,858). We used data from the 1991-1997 national Youth Risk Behavior Surveys, conducted by the Centers for Disease Control and Prevention. RESULTS: The majority of students 16 years of age and older (60.4%) reported ever having smoked a whole cigarette, and 11.1% initiated smoking at age 10 years or younger. Age of smoking initiation was significantly related to current frequent smoking, daily smoking, and whether students had ever smoked daily. A younger age of smoking initiation was associated with smoking more cigarettes per day than was initiating at an older age. CONCLUSIONS: Delaying the onset of smoking may affect the likelihood of becoming addicted to nicotine and smoking heavily. For students who are already addicted to nicotine, smoking cessation programs are needed.     

Comparing the smoking behavior of veterans and nonveterans.

OBJECTIVES: The authors analyzed self-reported questionnaire data from the 1987 National Medical Expenditure Survey (NMES) to determine the smoking patterns of veterans. METHODS: Using NMES data, the authors compared veterans versus nonveterans overall, women veterans versus women nonveterans, Vietnam-era veterans versus other veterans, and veterans whose usual source of medical care was the Department of Veterans Affairs (VA) system versus veterans who received care elsewhere. RESULTS: The likelihood of ever having smoked cigarettes was higher for veterans than for nonveterans and for women veterans than for women nonveterans. The prevalence of current smoking was higher for veterans than for nonveterans and higher for those seeking care within the VA system than for other veterans. CONCLUSIONS: Given the enormous health care costs associated with smoking, health promotion efforts should be developed to reduce the high rate of smoking among veterans--especially those who are consumers of VA health care.     

Sociocultural factors associated with smoking behavior by Puerto Rican adolescents in Boston.

This study examined cigarette smoking among Puerto Rican adolescents in the Boston area in its sociocultural context by describing who uses cigarettes, and by identifying factors that encourage or discourage cigarette use. The study, conducted from 1986-87, used two approaches. The first was to survey 605 Puerto Rican households with adolescents 11-20 years old. Households were identified from a random sample of census blocks in five neighborhoods. In each household, interviews were completed with one adolescent and his or her female caretaker. The second approach was to conduct ethnographic interviews with 40 adolescents selected through a purposive sample of survey respondents from three of the study neighborhoods. Bivariate and multivariate statistical analyses were used to examine the relationships between smoking behavior and characteristics of the adolescents. The results of these analyses were examined in light of the ethnographic data. Overall, 13.7% reported smoking in the month preceding the interview. Smoking was most prevalent among males 17-20. Patterns of smoking were associated with teens' social networks. The Puerto Rican adolescents in this study were more likely to smoke when their friends and household members smoked, if they participated in recreational activities such as sports or unsupervised games, and if they were not in school. These effects varied according to the gender of the respondent.     

Interpersonal awareness and smoking behavior in the workplace.

A questionnaire survey was conducted in small-scale production companies in Japan to examine "interpersonal awareness" and smoking behavior in the workplace. Interpersonal awareness (IA) of smokers is defined as awareness of other people's presence when smoking. Study participants were 1048 smokers and 744 nonsmokers, contrasted by worksite: office or production. Controlling for selected baseline variables, office work smokers, who smoked more in the workplace than production work smokers (77.4% vs 51.6%, p < .001), had a higher IA in the workplace (75.5% vs 58.9%, p < .001) but did not differ in IA at home (69.7% vs 66.0%). In male smokers of both worksites, degree of IA in the workplace correlated positively with that at home (rs = .36, p < .001, office; rs = .45, p < .001, production), and daily cigarette consumption correlated negatively with degree of IA at home (rs = -.44, p < .001, office; rs = -.17, p < .001, production). A predilection for smoking more at home than in the workplace correlated with higher IA in the workplace for male office smokers (rs = -.21, p < .01). In contrast, a predilection for smoking more at home than in the workplace correlated with lower degree of IA at home for production smokers of both sexes (rs = 20, p < .001, male; rs = .53, p < .05, female). Interpersonal awareness is deemed an important behavioral factor for smoking workers.     

Modifying smoking behavior of teenagers: a school-based intervention.

Tenth grade health classes in three high schools received a special program focusing on the immediate physiological effects of cigarette smoking and the social cues influencing adoption of the smoking habit, and classes in two control schools received standard information on the long-term effects of smoking. Only subjects in the special program reported a decrease in smoking from pre to post-test; they also scored higher than controls on a knowledge test. Carbon monoxide levels were significantly lower for subjects in the special group at post-test.     

医院禁烟政策对医生吸烟行为的影响

目的研究2008年中国医院的禁烟政策及其对医生吸烟行为的影响。方法在全国31个省（自治区、直辖市）和新疆生产建设兵团,每地选择省会城市1个,地级市1个,县级市（县城）1个,在每个项目点使用两阶段随机抽样方法抽取医生进行面对面问卷调查。使用SPSS13.0统计软件进行卡方检验,P〈0.05为差异有统计学意义。结果本次调查发现中国有60.4%的医院制定了全面禁烟的政策,35.8%的医院有部分禁烟的政策,3.8%的医院无任何禁烟政策。但是在有全面禁烟政策的医院只有39.8%医院能够很好实施全面禁烟的政策。在能够实施全面禁烟的医院中,医生的现在吸烟率低于那些不能很好执行禁烟政策的医院,而医生的戒烟率、计划戒烟率、支持全面禁烟政策的比例均高于那些不能很好执行禁烟政策的医院。结论目前能够达到全面禁烟的医院比例依然较低,医院全面禁烟政策的实施能够改变医生的吸烟行为。     

Gender differences in smoking behavior

This paper investigates gender differences in smoking behavior using data from the German Socio-economic Panel (SOEP). We develop a Blinder-Oaxaca decomposition method for count data models, which allows to isolate the part of the gender differential in the number of cigarettes daily smoked that can be explained by differences in observable characteristics from the part attributable to differences in coefficients. Our results reveal that the major part of the gender smoking differential is attributable to differences in coefficients indicating substantial differences in the smoking behavior between men and women.     

Smoking behavior and attitudes toward smoking among hospital nurses.

We examined smoking prevalence, smoking behavior, and attitudes toward smoking in hospitals in 1,380 respondents among 1,719 registered nurses in a large urban teaching hospital. In this group, current prevalence of smoking in hospital nurses (22 per cent) was less than women in the general population (29 per cent). Smoking nurses were more likely than nonsmokers to hold attitudes which potentially reduce their efficacy in helping patients to stop smoking.     

Menthol vs nonmenthol cigarettes: effects on smoking behavior.

OBJECTIVES. The purpose of this study was to examine intraindividual differences in smoking behavior between smoking regular and mentholated cigarettes. METHODS. Healthy male smokers (n = 29) smoked either a regular or a mentholated cigarette in two separate sessions 1 week apart. Commercial brands with comparable tar, nicotine, and CO content were used. Smoking behavior was constrained by fixed 15-second interpuff intervals, but puff volume and number of puffs were unconstrained. RESULTS. When smoking the non-mentholated brand of cigarettes, participants smoked 22% more puffs and had 13% higher mean volumes per puff than they did when smoking the mentholated brand of cigarettes. The aggregate 39% excess exposure to cigarette smoke in the regular-cigarette condition was not accompanied by commensurate excesses in expired carbon monoxide or in physiological measures normally correlated with nicotine exposure. CONCLUSIONS. These findings parallel differences in physiological correlates of exposure to nicotine found in cross-sectional comparisons of African-American and White smokers and are consistent with the results of emerging laboratory investigations.     

Transition through stages of smoking: the effect of gender and self-concept on adolescent smoking behavior.

PURPOSE: To determine whether self-concept, gender, and age are significant factors in an adolescent's transition through stages of smoking to regular smoking. METHODS: A questionnaire composed of 29 items (nine questions pertaining to smoking behavior and 20 to four self-concept variables: physical, family, social, and peer self-concept) was administered to 368 randomly selected high school adolescents (188 males and 180 females) aged 12-17 years during regular contact (roll call) time. RESULTS: Overall, 40.5% of the sample had tried tobacco (excluding chewing tobacco) (42.8% of females and 38.3% of males). Although prevalence of smoking varied according to the stage of smoking, it increased with age. With reference to self-concept, Scheffe post hoc contrasts revealed a statistically significant difference between physical self-concept and the remaining measures of self-concept (peer, family, and social) and at each stage of smoking. The effect for male students was less than for females. CONCLUSION: Programs aimed at prevention and intervention should incorporate strategies which are commensurate with female lifestyles and the more positive aspects that individuals might experience on quitting.     

Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea.

BACKGROUND. The association of secondary amenorrhea with extreme forms of substance use, weight control, and exercise in nonrepresentative samples raises questions as to whether adolescents in the general population who engage in these behaviors are at increased risk for secondary amenorrhea. We examined the prevalence and behavioral correlates of secondary amenorrhea in a county-wide high school population of 2544 girls aged 13 to 18. METHODS. A survey questionnaire, which elicited menstrual history as well as weight history, weight control practices, level of exercise, and use of cigarettes, wine, and beer, was administered during school hours; absentees were also surveyed. The completion rate was 91%. RESULTS. The 1-year prevalence of secondary amenorrhea was 8.5%. Secondary amenorrhea was associated with smoking one or more packs of cigarettes per day (adjusted relative risk [RRa] = 1.96, 1.21-3.10), with multiple binge-eating behaviors in combination with laxative use or self-induced vomiting (RRa = 4.17, 2.54-6.32), and with weight fluctuation due to weight control (RRa = 2.59, 1.33-4.79). There was no association between amenorrhea and alcohol consumption or exercise level. CONCLUSIONS. Estimates of attributable risk are provided and indicate that bulimic behaviors and cigarette smoking may result in a considerable excess of cases of secondary amenorrhea in an adolescent population.     

The impact of pregnancy on women's prenatal and postpartum smoking behavior.

We report patterns of prenatal smoking cessation and postpartum relapse for a large urban population of pregnant women. We examined associations between sociodemographic factors and prepregnancy, pregnancy, and early postpartum smoking behavior. Forty-one percent of women smoking before pregnancy quit smoking during pregnancy. Sociodemographic factors important in predicting smoking cessation during pregnancy, as determined through logistic regression analyses, differed significantly for white and black women. Among white women, education, age, and parity were important predictors of cessation, whereas among black women, only intention to breastfeed was a significant predictor of smoking cessation during pregnancy. Early postpartum smoking relapse rates differed by ethnicity. Twenty-eight percent of white women and 46% of black women who had quit during pregnancy relapsed within 6-12 weeks postpartum. Using logistic regression, we found formula feeding to be the most important predictor of early postpartum smoking relapse for both white and black women.