Psychosocial risk factors for tobacco use among adolescents with asthma

OBJECTIVE: To determine the prevalence of smoking among adolescents with asthma and smoking's psychosocial risk factors (environmental smoking exposure, autonomy, depression). METHOD: Participants were 2,039 adolescents with asthma and 2,039 matched controls from the Add Health study. RESULTS: The prevalence of ever smoking among adolescents with asthma was 56%. Among ever smokers with asthma, the prevalence of current smoking was 48%, and the prevalence of current smokers having made a recent attempt to stop smoking was 57%. Having parents who have smoked, exposure to friends who smoke, and depression were significant psychosocial risk factors for ever smoking. Asthma and exposure to friends who smoke were significantly associated with current smoking, and attempts to stop smoking were significantly associated with asthma and depression. CONCLUSIONS: Psychosocial risk factors for smoking among adolescents with and without asthma appear similar. Research on the role of illness in tobacco control is warranted.     

Prevalence,distribution, and social determinants of tobacco use in 30 sub-Saharan African countries

Background

Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants.

Methods

We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for ‘current smoking’ (cigarettes, pipe, cigars, etc.) and ‘current SLT use’ (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country.

Results

Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers).

Conclusions

Prevalence of smoking among women was much lower than in men, although the social patterns of tobacco use were similar to those in men. Tobacco control strategies should target the poor, not/least educated, and agricultural and unskilled workers, who are the most vulnerable social groups in sub-Saharan Africa.

     

The prevalence of waterpipe tobacco smoking among Polish youths

IntroductionWaterpipe smoking is gaining popularity among the youth in Poland and is evaluated for the first time in this work. The authors address the social and demographic factors that motivate young people to smoke and attempt to determine which of them contribute to habit formation.Material and methodsThe data were collected among school and university students in Poland during a global survey on various forms of tobacco use. Multivariable regression models were applied for odds-ratio evaluation. The data concern waterpipe and cigarette smoking habits.ResultsThe survey was completed by 19,097 respondents. The survey included 144 schools and 32 universities from 16 voivodeships in Poland. Respondent gender exhibited the highest ORs (95% Cl), both in the case of current and ever WP users: 2.11 (2.10–2.12) and 2.16 (2.15–2.17), respectively. The other important factor was a place of living: 1.83 (1.82–1.84) and 2.17 (2.16–2.18), respectively. All ORs were statistically significant for p = 0.05.ConclusionsThe prevalence of tobacco smoking among Polish youths is high. Waterpipe tobacco smoking was found to be the second most popular habit after cigarette smoking. Moreover, young smokers use other non-tobacco products in waterpipes, and drink alcohol during smoking sessions. Many young people try waterpipe smoking without previous experience with cigarettes.     

Saliva cotinine and thiocyanate: Chemical indicators of smokeless tobacco and cigarette use in adolecents

Recent attempts to measure smoking behavior using chemical tests may have been confounded by the use of smokeless tobacco. An objective measure of smokeless tobacco use is needed, particularly among adolescents who may not provide accurate self-reports of tobacco usage. Saliva cotinine was used to distinguish self-reported tobacco users from nonusers and a combination of saliva cotinine and thiocyanate (SCN) tests was used to distinguish smokers from smokeless tobacco users. The subjects were 471 students in grades 7 through 11 who lived in a high-tobacco production area. Approximately 89% of reported nonusers had no detectable cotinine and 99% of nonusers had levels <25 ng/ml. Of those who had used tobacco within the last 12 hr, 95% had detectable levels of cotinine. Samples that tested positive for cotinine were also tested for SCN. Eighty-six percent of smokers and 74% of mixed users had SCN values of >1000 mol/liter, while only 14% of smokeless users had SCN values at that level. The combination of cotinine and SCN was effective in distinguishing smokers from smokeless users but was not effective in distinguishing mixed use from the other two types of use.Funded by the National Cancer Institute CA 44004-01.     

Evaluation of the influence of tobacco smoking on pulmonary function in youg men

According to WHO estimates in the early 1990s there were around 1.100 million smokers in the world, about one third of the global population over 15 years of age. The aim of the study was to evaluate tobacco influence on pulmonary function tests in young healthy men. The study was performed on 3004 subjects 18-23 years old. The subjects were divided into two groups, smokers (S n = 1726) and non-smokers (NS n = 1278). Each subject had spirometry and body pletysmography done. The analysis of influence of smoking on pulmonary function tests showed statistically significant decrease of TLC, FEV1, FEV1%/VC, PEF and FEF50 in the smokers' group. Percentage of people with airflow limitation (FEV1%VC < 85% N, FEV1 < 80% N, FEF50 < 70% N) was two times higher than in the non-smokers' group. In conclusion: smoking significantly increases the number of subjects with airflow limitation among healthy young males in Poland.     

Using an online survey to assess knowledge of HIV in general and testing specifically among black and white college students

BACKGROUND: Although there have been studies examining HIV knowledge among college population, current study is the first providing comparable information on HIV knowledge in general and testing specifically via online surveys among black and white college students. METHODS: Blacks (N=222) were recruited from 15 historically black college and universities (HBCUs) and whites (N=335) from a traditionally white institution. RESULTS: The majority of the students were aged 18-24 years. Reliability of the overall knowledge scale showed good internal consistency for both samples (alpha=0.70). Students overall scored higher on items related to HIV/AIDS in general (81.5% correct) and lower on items related to HIV testing (71.6% correct), with no significant difference between groups. However, blacks rated significantly higher on their subjective (or "perceived") HIV general knowledge (item mean 3.55 vs. 3.26) and testing specific knowledge (item mean 3.13 vs. 2.54) (p<0.01). Results showed that blacks were 6.9 times more likely to have been tested for HIV. Subjective HIV testing knowledge (OR=2.9) and nonheterosexual orientation (OR=3.2) were also significant predictors to prior testing behavior. CONCLUSIONS: The knowledge scale assessed via the Internet demonstrated satisfactory reliabilities among diverse college students. Data showed that HBCU black students perceived significant higher knowledge levels, despite results showing similar knowledge scores as white students. Results have implications on HIV prevention among students attending their race/ethnic dominant institutions.     

Hypothesis: tobacco use is a risk factor in rheumatoid arthritis

Rheumatoid arthritis (RA) has been described in 3000-5000 year-old skeletal remains from North America by Rothschild, Turner and DeLuca (1). RA was first described unambiguously in Europeans in 1800 (1). Tobacco was introduced into Europe from the New World in the 1600s, and Rothschild, Turner and DeLuca include tobacco among variables that could be responsible for the appearance of RA in Europe. Primary and secondary exposure to tobacco smoke could be etiological, along with other causal variables. Tokuhata found cigarette smoking correlated with reduced fertility in women (2). I have hypothesized that RA is a disease with initial symptoms to the gamete and gonad (3). The hypothesis predicts a significant positive correlation between primary and secondary exposure to smoking and RA.     

Uptake of tobacco smoke constituents on exposure to environmental tobacco smoke (ETS)

Summary For the purpose of risk evaluation, passive smoking is frequently regarded as low-dose cigarette smoking. However, since the physical, chemical and biological properties of mainstream smoke (MS), which is inhaled by the smoker and environmental tobacco smoke (ETS), which is breathed by the passive smoker are quite different, risk extrapolation from active smoking to passive smoking is of doubtful value. In a series of experimental exposure studies we compared the uptake of tobacco smoke constituents by active and passive smoking. The results show that biomarkers which were found to be elevated after experimental ETS exposure, such as nicotine and cotinine in plasma and urine as well as thioethers in urine, indicate gas-phase exposure in passive smokers, but particle-phase exposure in active smokers. Biomarkers which should indicate the uptake of particle-bound, genotoxic substances with ETS, such as urinary mutagenicity, metabolites of polycyclic aromatic hydrocarbons (PAH) and DNA adducts, were not found to be elevated even after extremely high ETS exposure. From these results we conclude that a risk evaluation for passive smoking on the basis of dosimetric data is currently not possible.Abbreviations 1-ABP 4-aminobiphenyl - BaA benzo(a)anth-racene - BaP benzo(e)pyrene - BE butanol extraction - BeP benzo(e)pyrene - CO carbon monoxide - COHb carboxyhae-moglobin - DABS DNA binding substances - DRZ diagonal radioactive zone - ETS environmental tobacco smoke - GC gas chromatography - GC/MS gas chromatography coupled to mass spectrometry - HPLC high performance liquid chromatography - HPMA 3-hydroxypropylmercapturic acid - MS mainstream smoke - NNK 4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone - NNN N-nitrosonornicotine - NO_xa nitrogen oxides (NO/NO₂) - PAH polycyclic aromatic hydrocarbons - PhIP 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine - P1 nuclease P1 - RSP respirable particles     

Acculturation and Cigarette Smoking Among African Americans: Replication and Implications for Prevention and Cessation Programs

We report a replication of a 1996 study on the role of acculturation in smoking among African American adults. Results with the current sample were nearly identical to the prior ones: smokers tended to be traditional and nonsmokers acculturated, with nearly 70% of Black smokers in both studies being highly traditional in their cultural orientation. Given that coming from a highly traditional Black family was a strong predictor of smoking in both studies, we suggest that new smoking prevention and cessation programs might be culturally tailored for Blacks by focusing on smoking as a familywide issue.     

Cultural diversity in the predictors of adolescent cigarette smoking: The relative influence of peers

A culturally diverse sample of 4375 adolescents completed a self-report inventory assessing their current amount of smoking, and several psychosocial predictors of smoking (e.g., depression, anger, stress, smoking among peers, etc). Results revealed that Whites smoke more than Blacks, Asians, and less acculturated Latinos but not more than highly acculturated Latinos. Stepwise regression analyses of the predictors of smoking found significant ethnic and acculturation differences in the relative predictive power of 18 well-known risk factors. Smoking among peers was the best predictor of smoking for White adolescents (accounting for 23.5% of the variance) but accounted for only 15% of the variance for Latino youth, 9.6% of the variance for Asian youth, and none of the variance for Black youth. Results are discussed in terms of their implications for smoking prevention programs that focus on resisting peer influences.This research was supported by NIDA Grant R01DA6307 to Brian Flay.     

Prevalence and correlates of tobacco use among Russian cancer patients: Implications for the development of smoking cessation interventions at a cancer center in Russia

This study examined the rate of smoking among 399 cancer patients in Russia and assessed correlates of tobacco use and readiness to quit smoking. The results indicated that (a) 41.6% of patients were smokers; and (b) smokers were likely to be male, have lung or colorectal cancer, exhibit low levels of knowledge concerning the negative effects of smoking, report a low level of advantages to quitting smoking and a high level of disadvantages to quitting smoking, show low perceived risk for the adverse effects of smoking, and exhibit high fatalistic beliefs. Though certain findings converge well with data collected from U.S. samples of cancer patients, these results can guide the development of smoking interventions that address the specific needs of Russian cancer patients. In sum, this study fills a critical gap in knowledge concerning the epidemic of tobacco use in Russia and broadens research regarding tobacco use by cancer patients from the United States to the Russian Federation. Support for this study was provided by National Institutes of Health grant CA95678 (R. Schnoll) and by a U.S. federal appropriation to the American-Russian Cancer Alliance.     

Lower sperm counts following prenatal tobacco exposure

BACKGROUND: Recent findings have indicated that prenatal exposure to tobacco smoke may cause lower sperm concentration in ejaculates of adult men. To extend the research on this hypothesis we investigated the dose-dependency of the association, controlling for other prenatal exposures. METHODS: From 1987 to 1996, four separate occupational semen studies were conducted at three centres in Denmark. A total of 945 men provided semen and blood samples, and information on reproductive and lifestyle factors. In 2004, we collected data on the maternal smoking habits during pregnancy from 522 mothers of the participating men. RESULTS: Adjusting for study subgroup, abstinence time and other factors, we found statistically non-significant differences in mean sperm concentrations: 65.0 x 10(6)/ml [95% confidence interval (CI) 51, 81] among sons of non-smokers; 59.1 x 10(6)/ml (95% CI 46, 75) among sons of mothers who had smoked 1-10 cigarettes/day; and 57.7 x 10(6)/ml (95% CI 40, 81) among those whose mothers had smoked >10 cigarettes/day. The former group had a higher odds ratio (OR) for oligozoospermia (sperm concentration < or =20 x 10(6)/ml) of 1.5 (95% CI 0.9, 2.8), the latter group an OR of 2.6 (95% CI 1.2, 5.8). CONCLUSION: We observed a dose-dependent association between prenatal tobacco exposure, lower sperm concentration and higher risk of oligozoospermia.     

Impact of smoke-free law on tobacco consumption in Chandigarh: A community-based study

Background and Objectives: Tobacco use is a major public health issue today and it is expected that 650 million smokers will die prematurely due to tobacco use. On 15 July 2007, Chandigarh became the first city to go smoke-free. However, there is no data on the impact of smoke-free law. The objective of the present study was therefore to study the pattern and prevalence of tobacco use and to examine the impact of smoke-free law in Chandigarh. Materials and Methods: Total sample comprised of 3000 subjects. Socio-demographic data sheet along with initial two questions from the General questionnaire were administered on each individual. In addition, all the tobacco users underwent administration of the Fagerstrom test for nicotine dependence or the Fagerstrom test for smokeless tobacco (smokeless tobacco users). Results: There were 43.9% tobacco users in the sample of 3000 subjects. Out of these tobacco users, 357 (11.9%) were pure smokers and 370 (12.3%) were using smokeless tobacco and 590 (19.6%) used both. The mean number of cigarettes/bidis smoked per day was 14 (+8.64) and the mean age of starting smoking was 19.41 (SD + 4.5 years).73.2% of population was aware about implementation of smoke-free law and all the participants (100%) reported smoking in public places. 43.4% smokers reported thoughts of quitting nicotine. Interpretation and Conclusion: Although the prevalence of tobacco use in Chandigarh is lower than the national average but the rates are still alarming and need attention. The findings of this study will help in designing tobacco control strategies and understanding the epidemiology of tobacco related health burden.     

Is Skin Color a Marker for Racial Discrimination? Explaining the Skin Color–Hypertension Relationship

It is widely assumed that dark-skinned Blacks have higher rates of hypertension than their lighter-skinned cohorts because the former experience greater racial discrimination. However, there is no empirical evidence linking skin color to discrimination. This study tested the extent to which skin color is associated with differential exposure to discrimination for a sample of 300 Black adults. Results revealed that dark-skinned Blacks were 11 times more likely to experience frequent racial discrimination than their light-skinned counterparts; 67% of subjects reporting high discrimination were dark-skinned and only 8.5% were light-skinned. These preliminary findings suggest that skin color indeed may be a marker for racial discrimination and highlight the need to assess discrimination in studies of the skin color–hypertension relationship.     

Addressing tobacco use disorder in smokers in early remission from alcohol dependence: The case for integrating smoking cessation services in substance use disorder treatment programs

Despite the declining overall rate of cigarette smoking in the general population in the United States, the prevalence of smoking is estimated to be as high as 80% among treatment-seeking alcoholics. The serious adverse health effects of tobacco and heavy alcohol use are synergistic and recent evidence suggests that smoking slows the process of cognitive recovery following alcohol abstinence. In addition, substantial evidence shows that treatment for tobacco dependence does not jeopardize alcohol abstinence. In this paper, we focus on the impact and treatment implications of tobacco dependence among treatment-seeking alcoholics through a review of five areas of research. We begin with brief reviews of two areas of research: studies investigating the genetic and neurobiological vulnerability of comorbid tobacco and alcohol dependence and studies investigating the consequences of comorbid dependence on neurobiological and cognitive functioning. We then review literature on the effects of smoking cessation on drinking urges and alcohol use and the effectiveness of smoking cessation interventions with alcoholic smokers. Finally, we offer recommendations for research with an emphasis on clinical research for enhancing smoking cessation outcomes in this population.     

Investigation of the effect of brain-derived neurotrophic factor (BDNF) polymorphisms on the risk of late-onset Alzheimer's disease (AD) and quantitative measures of AD progression

BDNF is a functional candidate gene for AD, owing to its role in neuronal development and survival. The Val66Met (G196A), along with another C270T polymorphism has been associated with AD, however, the effects seem to be inconsistent across studies. We examined the association of the G196A and C270T polymorphisms with sporadic late-onset AD (LOAD) in a large American White cohort of 995 AD cases and 671 controls and an American Black cohort of 64 AD cases and 45 controls. We also examined the association of these polymorphisms with quantitative measures of AD progression, including age at onset (AAO), disease duration and Mini-Mental State Examination (MMSE) scores. No significant difference in allele, genotype or estimated haplotype frequencies was observed between AD cases and controls within the American White and Black cohorts for the G196A and C270T polymorphisms. However, the frequency of the 196*A allele was significantly lower in American Black subjects compared to Whites. While MMSE scores were significantly lower in C270T/CT carriers compared to C270T/CC subjects only among American Blacks, no such effect was observed among American Whites. The BDNF polymorphisms did not affect AAO or disease duration measures in American Whites or Blacks. Our finding does not support any association between the BDNF/G196A or C270T polymorphism and the risk of sporadic LOAD among American Whites or Blacks. The significant effect of the C270T polymorphism observed on MMSE scores among American Blacks needs to be further explored in a larger cohort.     

The prevalence of tobacco smoking among Polish Pallotins priests and seminarians of Seminary in Ołtarzew

There is a lack of studies evaluating the prevalence of smoking habit among Polish priests. Due to difficulties in receiving permission from catholic authorities to perform questionnaire study we attempted to assess the prevalence of cigarette smoking among priests from one religious congregation. The aim of the study was also to analyze factors influencing smoking habits in this group. The anonymous questionnaire was sent to all Polish Pallotins and students of Pallotin Seminary in O?tarzew. Only one fourth of them--138 subjects in the age from 20 to 92 yrs (mean age 37.7 yrs)--answered the questionnaire. Among them were 72 priests aged 27-92 yrs. (mean age 50.7 yrs) and 66 students in the age 20-41 yrs (mean age 23.7 yrs.). The rate of current smokers among priests was 13.9%, including 11.1% of daily smokers and 2.8% occasional smokers. The rates of daily and occasional smokers among Seminary students were 4.5% and 6.1%, respectively. Cigarette smoking in the past was reported by 26,4% of priests--8.3% of them had smoked daily, remaining subjects had smoked occasionally. Most of responders considered the fifth commandment of the Decalogue as sufficient reason for abstaining from cigarette smoking. The majority of current smokers attempted to stop smoking, mainly because of wholesome reasons. Near a half of smoking priests and over three fourth of smoking students felt embarrassed to smoke in company of laymen. Every tenth priest and every third student hide his smoking habit from other priests. The study showed low prevalence of cigarette smoking in priests, what resulted mainly from religious reasons.     

Depressive Symptoms and Smoking among US Black Adults: Absence of a Relationship

Depressive symptoms play a major role in cigarette smoking among US White adults, but it is not known if this holds for US Blacks. Hence, the relationship between depressive symptoms and smoking was examined among 520 US Black adults sampled from 10 randomlyselected community census tracts. Results revealed no relationship between depression and smoking, but education levels did contribute; Black high school drop-outs were four times more likely than Black college graduates to be smokers.     

Environmental tobacco smoke and the epidemic of asthma in children: the role of cigarette use.

BACKGROUND: Asthma is the most common chronic disease affecting youth worldwide. The prevalence of asthma has increased at least 3-fold during the past several decades. The reason for this increase remains unknown. Objective: To examine one possible factor that may be affecting the increase in prevalence of asthma among youth. METHODS: Data on the incidence of asthma among youth were aggregated using the National Health Interview Survey (sample of 4,500 children) and were compared on an ecologic level with data on cigarette consumption in the United States from 1900 to 2003 from the American Lung Association. RESULTS: Our results suggest a parallel increase in the rates of cigarette use among adults and asthma in children. These findings show an increase in cigarette use during the past 4 birth cohorts, with subsequent leveling off at a population level with a progressively more prominent increase in cigarette use among women in the United States. CONCLUSION: We present one possible factor that may be contributing to the epidemic of childhood asthma. We hypothesize that (1) there has been a marked increase in smoking during the past century, (2) this increase in smoking has resulted in a substantial increase in exposure to environmental tobacco smoke among children, and (3) increased exposure to environmental tobacco smoke has contributed to the increase in childhood asthma. Data on trends in cigarette use among adults and asthma prevalence among children during the past century are presented as ecological evidence in support of this hypothesis. Future studies will be needed to confirm these findings with community-level analyses in a variety of geographic regions.