Berlin's medical students' smoking habits, knowledge about smoking and attitudes toward smoking cessation counseling

Background  

Diseases associated with smoking are a foremost cause of premature death in the world, both in developed and developing countries. Eliminating smoking can do more to improve health and prolong life than any other measure in the field of preventive medicine. Today's medical students will play a prominent role in future efforts to prevent and control tobacco use.     

Occupational and worksite norms and attitudes about smoking cessation.

The relationship of worksite and occupational norms about smoking to workers' attitudes toward smoking cessation was studied in a defined population. From smokers identified in a self-administered questionnaire circulated to all employees of 10 worksites in suburban Minneapolis, 447 smokers were randomly selected and interviewed. Attitudes and social norms about smoking cessation were compared by occupation and worksite using analysis of covariance, controlling for age, sex, and education. Similarly, the relationships of social norms to attitudes were examined using multiple regression analysis. Interest in quitting smoking, confidence in the ability to quit, and coworker support of prior quit attempts were equally pervasive among workers from blue collar and white collar occupations. Yet substantial differences between worksites in attitudes and norms about smoking cessation suggest the importance of the unique social milieu of individual worksites. Of particular importance is the impact of coworker discouragement of prior quit attempts, which varied across worksites and was directly related to confidence in the ability to quit and the desire to seek formal help in future quit attempts. These findings point to the relevance of intervention programs aimed at changing worksite norms about smoking and smoking cessation.     

Cognitive factors associated with smoking initiation in adolescents

OBJECTIVE: To study the association between cognitive factors of the behavioral change model "Attitude Self Efficacy" (ASE) at different phases of smoking initiation among adolescents. METHODS: We carried out a cross-sectional survey among students in the second grade of Compulsory Secondary Education (13-14 years old) from Cornellà de Llobregat (Barcelona, Spain) in 2000 to obtain information on cognitive factors and smoking. Logistic regression analysis was used to investigate the variables associated with smoking (odds ratio [OR] of experimenters vs. non-smokers and of smokers vs. experimenters). RESULTS: The prevalence of daily smoking was 22.9% (95% CI, 16.5%-29.3%) among boys and 36.2% (95% CI, 29.7%-42.6%) among girls. Factors associated with experimenting (vs. non-smoking) were: attitudes to smoking (disagreement with smoke-free areas [OR = 3.46; 95% CI, 1.65-7.24], agreement with smoking promotion [OR = 3.42; 95% CI, 1.42-8.28]), and subjective norms (perceiving friends as smokers [OR = 2.50; 95% CI, 1.17-5.35]). The variables associated with regular smoking (vs experimenting) belong to: self-efficacy and attitudes to smoking. CONCLUSIONS: Focussing on subjective norms and smoking attitudes with programs targetted younger ages seems appropriate, since these factors are more closely associated with the experimenting phase. Encouraging skills to refuse cigarettes offered by friends is appropriate at a more advanced age, since this determinant is associated with the change from experimenting to regular smoking.     

Hong Kong Chinese parental attitudes towards vaccination and associated socio-demographic disparities

BackgroundMost previous studies on parental attitudes towards vaccination focused on a disease-specific vaccine. In this study we describe general attitudes towards vaccination in Chinese parents and associated socio-demographic disparities.MethodsData were collected from a random sample of 1996 Hong Kong Chinese parents by telephone interviews (response rate 60%). Multiple linear regression analysis was performed.ResultsMost parents believed vaccination to be effective (91.6%) and beneficial (78.7%), though many considered optional vaccines unimportant (39.5%) and unnecessary (62.1%). Demographic characteristics associated with parental negative attitudes to vaccination included being female, born in Hong Kong, married, having fewer children, and children ever experienced vaccination side effects. Lower personal income and religious affiliation were associated with more hesitant attitudes towards optional vaccines.ConclusionSegments of the population hold significantly negative attitudes towards vaccination and optional vaccines, suggesting a need for targeted efforts on vaccination communication in these groups.     

Association of infant alimentary and respiratory illness with parental smoking and other environmental factors.

The incidences of alimentary and respiratory illnesses were observed during the first year of life in 1565 infants born in Tayside during 1980. Significant correlations (p less than 0.05) were found between each of these outcomes and parental smoking, maternal age, social class, method of infant feeding, and heating fuels. Multiple logistic regression indicated a significant independent effect of parental smoking was related separately to alimentary and to respiratory outcomes, the relative risks being of similar strength.     

Social influences, and attitudes and beliefs associated with smoking among border Latino youth

BACKGROUND: Adolescent smoking rates have declined among all ethnic groups since the late 1990s. However, despite the recent declines and intervention efforts, today smoking remains a serious problem among youth, with a quarter of adolescents being current smokers by the time they complete 12th grade. This problem is particularly prevalent among Latino youth, who have among the highest rates of lifetime and past-30-day use. The purpose of this study was to examine the association between psychosocial factors and the smoking behavior of Latino youth living along the Mexico-US border. METHODS: A convenient sample of 2471 middle and high school Latino students was surveyed in fall 2000. Logistic regression analysis was used to examine the association between study risk factors and youth smoking behavior. RESULTS: The strongest predictor of lifetime and past-30-day smoking was peer influence; however, the strength of the association was greater with recent use. There were also differences in the influence of family and attitudes and beliefs between the 2 groups. CONCLUSIONS: These differences need to be taken into consideration to guide development of tailored prevention and control interventions aimed at this specific group. These efforts should address social influences to smoke, particularly those from peers; promote changes in attitudes and beliefs toward smoking; increase understanding of the addictive nature of nicotine; and provide development of skills young people need to resist social and environmental pressures to smoke. Strict control and enforcement measures are needed to completely eliminate the sale of cigarettes to minors.     

Mental retardation associated with parental smoking and alcohol consumption before, during, and after pregnancy.

METHODS. In an epidemiologic study, parental alcohol consumption and smoking before, during, and after pregnancy were studied as possible risk factors for mental retardation in offspring. The parents of 306 mentally retarded children (cases) and 322 physically handicapped children (referents) were interviewed about their lifestyle habits from 3 months preconception to 6 months postnatal. RESULTS. Odds ratios with 95% confidence intervals were calculated as risk indicators. For fathers who smoked a pipe or cigars, an odds ratio of 2.4 (95% CI: 1.2-5.1) was observed. Maternal alcohol consumption was increased among the case mothers with risk ratios ranging from 1.7 (95% CI: 1.2-2.3) preconception to 1.4 (95% CI:1.0-2.0) during the fetal period. These risks were more pronounced for the mothers who consumed greater than or equal to 3 drinks/day once or twice a week. CONCLUSIONS. This study suggests that paternal smoking and maternal alcohol consumption are risk factors for mental retardation in offspring.     

Systems and individual factors associated with smoking status: evidence from HINTS

OBJECTIVES: To examine the association of health care access/use, trust of physician advice, and depressive symptoms with the ability to sustain smoking cessation. METHODS: Data from a nationally representative sample were used to compare current smokers (n = 1246), sustained quitters (n = 1502), and never smokers (n = 3277). RESULTS: Sustained quitters reported fewer depressive symptoms (OR = 0.92) and were more likely to have health insurance (OR = 1.75) and a usual source of care (OR= 1.40) that they had seen within the last year (OR = 2.16) and that they were more likely to trust (OR = 1.40). CONCLUSIONS: Identification of these factors may inform providers' efforts to target and assist in smoking cessation.     

大学生社交性吸烟行为及吸烟影响因素研究

目的了解大学生社交性吸烟行为的发生情况并探讨认知态度对大学生启动吸烟的影响。方法采用分层随机抽样方法,对某市579名高校大学生进行社交性吸烟行为、吸烟认知态度、家庭环境和应对方式的调查。采用χ2检验、单因素方差分析和回归分析进行统计分析。结果被调查者总体吸烟率为19.6%,其中社交性吸烟者占全部吸烟者的18%。对吸烟行为的认知态度和同伴影响与社交性吸烟行为呈正相关(r=0.264,P=0.000;r=0.428,P=0.000);社交场合的饮酒行为与社交性吸烟行为呈正相关(r=0.220,P=0.000)。年龄、同伴影响、社交场合的饮酒行为是大学生启动吸烟行为危险因素,其中社交场合递烟是启动吸烟的重要危险因素(OR=6.284,95%CI:3.213-12.287)。结论社交性吸烟行为在大学生中较为普遍,更容易受到认知态度和社交群体行为的影响。     

The moderating role of parental smoking on their children's attitudes toward smoking among a predominantly minority sample: a cross-sectional analysis

Background  

In general having a parent who smokes or smoked is a strong and consistent predictor of smoking initiation among their children while authoritative parenting style, open communication that demonstrates mutual respect between child and parent, and parental expectations not to smoke are protective. It has been hypothesized that parental smoking affects their children's smoking initiation through both imitation of the behavior and effects on attitudes toward smoking. The goals of the current analysis were to examine these two potential mechanisms.     

Perceived smoking norms,socioenvironmental factors,personal attitudes and adolescent smoking in China: a mediation analysis with longitudinal data

PurposeTo gather information on inter-relationships among risk factors affecting adolescent smoking for tobacco control in China, the world’s largest tobacco producer and consumer.MethodLongitudinal data were collected six months apart in 2003 from 813 students in grades 7, 8, 10, and 11 from two schools in Beijing, China. Linear regression was used to assess both the direct effect from predictor variables (smoking among influential others, pro-tobacco media, and attitudes toward smoking) on cigarette use and the indirect effect mediated through the perceived smoking norms (percentage of smokers among peers).ResultsAmong the 803 subjects (mean age of 15.5 years, SD = 1.7; 52.1% female), 18.3% of males and 1.7% of females smoked in the past 30 days. Smoking among influential others (best friends, father, mother, male teachers, female teachers, and adults in general) and perceived positive psychological and social rewards from smoking at baseline were associated with number of cigarettes smoked at follow-up, whereas exposure to pro-tobacco media was not significantly associated with smoking. The mediated effect was greater for adult smoking (70% to 90%) than for best friend smoking (11% to 16%).ConclusionSmoking among influential others and attitudes toward smoking influence adolescent smoking both directly and indirectly. The finding of the indirect effect mediated through perceived smoking norms expands our knowledge on smoking etiology. Effective adolescent smoking intervention programs in China need to include a component targeting adult smoking to reduce perceived smoking norms.     

Analysis of factors associated with adolescent smoking by a follow-up survey

One hundred and seventy-four second year senior high school students (106 males and 68 females) participated in a questionnaire survey to analyze factors associated with smoking. The questionnaire consisted of variables on family smoking, beliefs regarding smoking, knowledge about the dangers of smoking, etc. Smoking behavior about three and a half year later, when the subjects had become adults (twenty years old), was then investigated. The relationships between their behavior and the variables obtained in the earlier research were analyzed in detail. The results were as follows: 1) Family smoking was related to smoking behavior at the stage of second year of senior high school for males and to smoking onset after second year of senior high school for females. 2) Self-prediction regarding future smoking was related to both smoking behavior during senior high school and smoking onset in the future. Almost all beliefs regarding smoking was related to smoking behavior at the second year of senior high school, however, these beliefs were not effective in predicting future behavioral change. 3) Knowledge about the dangers of smoking was related to neither the smoking behavior at the stage of senior high school nor behavioral change in the future.     

Prevalence and factors associated with difficulty and intention to quit smoking in Switzerland

Background  

recent data indicate a slight decrease in the prevalence of smoking in Switzerland, but little is known regarding the intention and difficulty to quit smoking among current smokers. Hence, we aimed to quantify the difficulty and intention to quit smoking among current smokers in Switzerland.     

Lifetime parental smoking history and cessation and early adolescent smoking behavior

BACKGROUND: Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. METHODS: A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. RESULTS: Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. CONCLUSIONS: Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.     

Knowledge and attitudes about smoking in medical students before and after a tobacco seminar

A 3-hour seminar on tobacco was introduced to second year (pre-clinical) medical students in Hong Kong in 1994. The differences in knowledge and attitudes were measured by a self-administered and anonymous questionnaire with 14 items before the seminar (n = 145), and again 2 weeks after the seminar (n = 151). The students also completed an evaluation form at the end of the seminar. Before the seminar, the students were most deficient in their knowledge on the exact magnitude of the risks from smoking and on the risks from smoking relative to the risks from air pollution and asbestos. After the seminar, their knowledge increased significantly (   P < 0.005  ). As for attitudes, in the pre-test 35% strongly agreed that tobacco advertising should be completely banned, and 50% did so in the post-test (   P = 0.02  ). The corresponding figures for banning of all forms of tobacco promotion were 26% and 43% (   P < 0.005  ). In the pre-test, one in four students strongly disagreed that doctor's advice to their patients to stop smoking is totally ineffective, with this proportion increasing to 70% in the post-test (   P < 0.005  ). The majority of the students stated that the seminar was useful. The preclinical medical curriculum should, at the very least, include a tobacco seminar. Our survey shows that it is effective in improving students' knowledge and attitudes on tobacco control.     

School breakfast program participation and parental attitudes

To determine whether or not parental perceptions about the School Breakfast Program (SBP) are associated with SBP participation among low-income children, the attitudes of low-income parents toward a newly-implemented SBP in Lawrence, Massachusetts were surveyed. Self-administered surveys were sent home to the parents of 1086 children; response rate was 70%. Sixty percent of respondents reported that their child ate breakfast at school. Children were significantly more likely to be participants than non-participants if they were Hispanic as opposed to white, non-Hispanic, if they shared in the decision as to where they would eat breakfast, and if they were eligible for free meals as opposed to reduced-price meals.Parents of participants were significantly more likely than parents of non-participants to feel the SBP would save them time or energy and family food money, and that it was good for children to eat with their classmates. As might be expected, participants' parents were significantly less likely to feel that children should only eat breakfast at home with the family. Additional research is needed to address factors that prevent low-income children who wish to participate in an SBP from doing so. In addition to student and family characteristics, future research should investigate school characteristics, program operations, the effectiveness of program promotion, and the role of nutrition education.