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.     

Belgian heart disease prevention project: comparison of self-reported smoking behaviour with serum thiocyanate concentrations.

At the end of a multifactorial cardiovascular preventive trial serum thiocyanate was measured in random samples of 1035 cases and 1087 controls. A cut-off point 0.45 mg/dl (77.6/mumol/l) gave a sensitivity of 82.1% among the cigarette smokers in the control group and a specificity of 91.0% among the non-smokers. When the intervention and control groups are compared in terms of self-reported smoking behaviour non-significant differences in mean thiocyanate concentration are observed for those who never smoked, ex-cigarette smokers, actual cigarette smokers, and in four different cigarette smoking categories. Our results fail to confirm the reported pessimistic views concerning the validity of self-reported smoking behaviour in subjects taking part in intervention trials.     

Natural killer activity and its changes among participants in a smoking cessation intervention program--a prospective pilot study of 6 months' duration

We examined the effect of smoking cessation on natural killer (NK) activity of peripheral blood lymphocytes in terms of a prospective study of 27 Japanese subjects who participated in a smoking cessation intervention program. This program was delivered by means of group-counseling offering 7 sessions of about 2 hours over 6 months to help smokers to discontinue the habit. Thirteen subjects ceased smoking (quitters), while 14 continued to smoke (cigarette smokers). NK activity before the intervention was correlated positively with age (correlation coefficient=0.46, P<0.05). NK activity remained almost constant among quitters, comparing the activity before and after the intervention, while it decreased among cigarette smokers although it was not statistically significant. In the subgroup analysis, NK activity increased among those aged less than 65 years, or urine cotinine levels over 800 ng/ml before the intervention, especially among quitters, but there were no statistical significances. Multiple regression analysis showed changes in NK activity were correlated significantly only with age (standard regression coefficient=-0.44, P<0.05). These findings suggest that smoking cessation intervention programs might have been more effective for younger than elder subjects in consideration of NK activity.     

Academic performance and social factors related to cigarette smoking by schoolchildren.

Factors which may influence boys and girls aged between 10 and 121/2 years to start smoking were studied. Information was obtained from 491 schoolchildren, their parents, and headteachers. In their own view and that of their headteachers children who did not smoke were academically better than smokers. Children who smoked were more likely than non-smokers to have a parent and siblings of the same sex who smoked. No association was found between the child's own smoking and that of parents and siblings of the opposite sex. Smokers were more likely to have friends who smoked. Most children did not think smoking was enjoyable or desirable and many thought it bad for health, irrespective of their own smoking habits. The majority thought people of their own age smoked to show off.     

A study of serum thiocyanate concentrations in office workers as a means of validating smoking histories and assessing passive exposure to cigarette smoke

Patients in clinical practice often falsely report their smoking status. To see if this was so in occupational surveys we have validated smoking histories (using a serum thiocyanate assay) in 206 randomly sampled office workers who completed a smoking questionnaire administered by a doctor. Past and present cigarette consumption was determined with an assessment of exposure to passive cigarette smoke at home and at work in the non-smokers. Serum thiocyanate concentrations were measured by the ferric nitrate method. All smoking groups showed mean thiocyanate concentrations greater than non-smokers except those smoking five or fewer cigarettes a day. There was a significant increase in plasma thiocyanate with increasing smoking (p less than 0.01). Non-smokers with and without exposure to passive smoke could not be separated by thiocyanate concentration. In our hands serum thiocyanate concentrations identified moderate and heavy smokers but could not distinguish between non-smokers, light smokers, and passive smokers. Fourteen non-smokers had serum thiocyanate concentrations higher than 70 mumol/l which were still raised on a repeat sample. On a further questionnaire two admitted to smoking. To help confirm non-smoking status, expired carbon monoxide levels were also checked in this group. One person had a level of 22 ppm and subsequently admitted to smoking. In the others the levels were less than or equal to 10 ppm. Using a combination of serum thiocyanate assay and exhaled breath carbon monoxide levels, non-smoking was confirmed in 98% of those stating that they were non-smokers. In non-smokers exposure to passive cigarette smoke was much more likely to occur at work than at home.     

A study of serum thiocyanate concentrations in office workers as a means of validating smoking histories and assessing passive exposure to cigarette smoke.

Patients in clinical practice often falsely report their smoking status. To see if this was so in occupational surveys we have validated smoking histories (using a serum thiocyanate assay) in 206 randomly sampled office workers who completed a smoking questionnaire administered by a doctor. Past and present cigarette consumption was determined with an assessment of exposure to passive cigarette smoke at home and at work in the non-smokers. Serum thiocyanate concentrations were measured by the ferric nitrate method. All smoking groups showed mean thiocyanate concentrations greater than non-smokers except those smoking five or fewer cigarettes a day. There was a significant increase in plasma thiocyanate with increasing smoking (p less than 0.01). Non-smokers with and without exposure to passive smoke could not be separated by thiocyanate concentration. In our hands serum thiocyanate concentrations identified moderate and heavy smokers but could not distinguish between non-smokers, light smokers, and passive smokers. Fourteen non-smokers had serum thiocyanate concentrations higher than 70 mumol/l which were still raised on a repeat sample. On a further questionnaire two admitted to smoking. To help confirm non-smoking status, expired carbon monoxide levels were also checked in this group. One person had a level of 22 ppm and subsequently admitted to smoking. In the others the levels were less than or equal to 10 ppm. Using a combination of serum thiocyanate assay and exhaled breath carbon monoxide levels, non-smoking was confirmed in 98% of those stating that they were non-smokers. In non-smokers exposure to passive cigarette smoke was much more likely to occur at work than at home.     

Determinants of quitting smoking.

Factors associated with quitting smoking were examined in 3,778 male and 1,486 female ever-smoking patients hospitalized with non-tobacco-related conditions interviewed between 1977 and 1985. Quitters were defined as those who had stopped smoking at least one year prior to admission. More than 80 per cent of male and female quitters had stopped more than five years prior to diagnosis. The lifetime quit rate (no. ex-smokers/no. ever smokers) X 100 was higher in males than in females, and in both sexes the quit rate increased with increasing age, education level, and occupational level. Jews had higher quit rates compared to non-Jews, and Whites had higher quit rates than Blacks. Those who were divorced or separated had lower quit rates than those who were not. In both sexes, light smokers and heavy smokers had elevated quit rates. The quit rate also increased with increasing interval between waking and smoking the first cigarette of the day. Logistic regression models were used to adjust simultaneously for the role of different variables.     

Prediction of smoking behavior in Japanese young adults

Eighty-eight second grade students of a senior high school in Saitama prefecture in Japan participated in a prospective study to predict cigarette smoking behavior 3.5 years later. Predictor variables include sex, knowledge, beliefs and attitudes toward smoking, previous smoking behavior, and smoking behavior of their families. Stepwise discriminant analyses revealed that 90% of the smokers and 65% of the non-smokers were correctly classified. In this model, previous smoking behavior proved to be the best predictor. Attitude toward adult male's smoking, sex and smoking behavior of subjects' families were also related. These four variables explained 35% of the variance in smoking behavior. As for stepwise discriminant analyses among those who had not smoked at baseline, 78% of the smokers and 76% of the non-smokers were correctly classified. Attitude toward adult male's smoking, sex, knowledge about long-term effects of cigarette smoking and smoking behavior of their families entered the model in this order. These four variables explained 37% of the variance. Implications of this study for smoking prevention programs in Japan are discussed.     

长沙市大学生尝试吸烟者吸烟行为演变及影响因素分析

目的 分析长沙市大学生尝试吸烟者吸烟行为演变及影响因素.方法 采用问卷调查方式在长沙市的高校大学生中进行调查,选择1个月前尝试过吸烟者为研究对象,然后根据现在是否吸烟将研究对象分成两组,再应用单因素x2检验和多因素logistic回归模型对影响现在吸烟的因素进行分析.结果 1550名过去尝试吸烟者中,477名现在吸烟,现在吸烟率为30.8％(95％CI:28.5～ 33.1).logistic回归分析结果显示:本科二批录取学生(OR=2.367)和本科三批录取学生(OR=2.562)较本科一批录取学生的现在吸烟率高,体育艺术专业学生(OR=2.456)较文科生高,父亲为干部的学生(OR=1.602)较父亲为工人的学生高;男性(OR=7.386)、每月零用钱多(OR=1.139)、家人吸烟者多(OR=1.801)、对吸烟好处持肯定态度(OR=1.140)是过去尝试吸烟者现在吸烟的危险因素,吸烟致病的相关知识掌握好(OR=0.806)对过去尝试吸烟者现在是否吸烟具有保护作用.结论 大学生尝试吸烟者可能演变为规律吸烟,其影响因素主要有学校类别、专业类别、性别、父亲职业、每月零用钱多少、家人吸烟情况、对吸烟的认识及对吸烟好处的认可态度等.     

Pulmonary function in relation to cigarette smoking and smoking cessation. MRFIT Research Group.

BACKGROUND. More than half of the subjects in the MRFIT smoked at baseline and 10% of the subjects stopped smoking permanently during the first year of the trial. In this report, rates of decline in forced expiratory volume in 1 sec (FEV1) are compared for early permanent quitters and smokers who continued to smoke throughout the trial. METHODS. Since pulmonary function testing was not standardized across all centers until the third annual visit cycle, change in FEV1 is examined over the latter half of the trial; the level of FEV1 is analyzed cross-sectionally at the midpoint of the trial. Analyses are limited to 4,926 subjects who never used beta-blockers or smoked cigars, cigarillos, or pipes during the trial and who had annual FEV1s measured over 2-4 years in the latter half of the trial. RESULTS. Quitters during the first 12 months experienced smaller declines in FEV1 over the latter half of the trial than continuing smokers, with -50.7 ml/year versus -59.0 ml/year, respectively, adjusted for the level of FEV1 (P = 0.05). Cross-sectionally, those who had never smoked, former smokers, quitters, and continuing smokers showed a gradient of decreasing FEV1, and all four smoking groups were significantly different from each other (P less than 0.05). CONCLUSIONS. These data suggest that if a middle-aged, healthy smoker stopped smoking permanently, he could expect his FEV1 to deteriorate at a more gradual rate 3-4 years after stopping smoking than a similar smoker who continued to smoke. No information was available for the complete MRFIT cohort on the pulmonary function effects immediately following smoking cessation.     

The social definition of women''s smoking behaviour

The history of women's smoking behaviour is one of changing normative definitions. Recent trends have been explained in terms of the symbolic value of smoking, representing for women freedom and independence. This view is emphasised by advertising. However, other evidence suggests the continued existence of an older, more negative cultural stereotype. A two-part study of young women undergoing professional training for nursing and teaching throws some light on the way in which female smoking behaviour is currently socially interpreted. The first phase indicated that among the minority of parents who had expressed their attitudes towards their daughter's smoking in relation to sex-role norms, smoking was presented as unacceptable for women. More than half the sample perceived a negative cultural stereotype to be operating in contemporary society and two-thirds recognised its existence in the past. This stereotype presents smoking as a male behaviour and hence inappropriate for women. Women who do smoke are liable to be labelled as having unfeminine or degrading attributes. The stereotype operated more strongly in the general social background rather than in reference to personal relationships and hence its influence on contemporary behaviour is likely to be limited. It was rejected as out-dated or a male belief by some but nevertheless it represented the personal opinion of others. In terms of a more favourable definition the female smoker was perceived in terms of an elegant/sophisticated dimension and in relation to an extrovert personality. The view of sample members that the growing acceptability of women's smoking was related to social change indirectly supported the view that sees smoking as symbolic of independence. Those who saw smoking in neutral terms, i.e. as not having sex-role attributes, perceived smoking in this sense as normal social behaviour for men and women alike. The second phase suggested that smokers and non-smokers have divergent views about the image of the female smoker. The non-smoker's image was based on the older cultural stereotype ('unladylike'), whereas the smokers were more likely to take a view corresponding to the perspective that sees women's smoking as symbolic of social change and greater independence ('liberated'). The non-smokers had a clear and positive image of 'girls who don't smoke' ('feminine'), whereas for smokers the female non-smoker lacked a distinctive identity. The study thus suggests that traditional concepts of appropriate female behaviour continue to inhibit smoking among some women, whereas others perceive it as an aspect of independent behaviour.(ABSTRACT TRUNCATED AT 400 WORDS)     

Exposure to brand-specific cigarette advertising in magazines and its impact on youth smoking

BACKGROUND: Despite the potential influence of cigarette advertising on youth smoking, few studies have characterized brand-specific magazine advertising exposure among youths or examined its impact on youth smoking behavior. METHODS: A longitudinal youth survey was conducted to assess baseline exposure to brand-specific cigarette advertising in magazines and to measure subsequent smoking behavior. The sample comprised 1,069 Massachusetts youths, ages 12-15 years at baseline in 1993, and 627 of these youths who were interviewed after 4 years. RESULTS: Five brands accounted for 81.8% of the gross impressions for magazine advertising among Massachusetts youths. These same brands accounted for 88.4% of the brand market share among 12- to 15-year-old smokers nationally in 1993. The levels of brand-specific advertising exposure in the sample were highly correlated with these national brand market shares (r = 0.96, P = 0. 0002). Among the cohort, baseline brand-specific exposure to cigarette advertising in magazines was highly correlated with brand of initiation among new smokers (r = 0.93, P = 0.0001), brand smoked by current smokers (r = 0.86, P = 0.0004), and brand whose advertisements attracted attention the most (r = 0.87, P = 0.0002). CONCLUSION: By documenting a relationship between brand-specific magazine advertising exposure and brand of smoking initiation among new smokers, this study provides strong new evidence that cigarette advertising influences youth smoking.     

Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania

An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.     

Cessation of smoking after myocardial infarction in women. Effects on mortality and reinfarctions

Among 262 women with a first myocardial infarction discharged alive from hospital in G?teborg, Sweden between 1968 and 1977, 161 (61%) were smokers at the time of infarction. Postinfarction smoking was established after three months. In relation to smoking status three months after the infarction, subsequent survival and reinfarction rate were calculated by comparing those who smoked before infarction and later stopped (52%) with those who continued to smoke after the infarction (48%). There were no differences in preinfarction characteristics between quitters and continuing smokers. Women who stopped smoking after the infarction had higher serum enzymes during the acute phase than those who continued to smoke. The cumulative five-year survival rate was 85% among those who stopped smoking compared to 73% among those who continued to smoke (p less than 0.05). No significant difference was found in the cumulative reinfarction rate between the two groups with different smoking habits.     

Postpartum return to smoking among usual smokers who quit during pregnancy

BACKGROUND: Many women stop smoking while they are pregnant, but the majority resume smoking in the postpartum. The objective is to describe postpartum tobacco use of women who quit during pregnancy and factors predicting postpartum smoking relapse. METHODS: Secondary analysis of two surveys of new mothers. Survey A conducted in three maternity hospitals, including 685 women interviewed after birth and who answered a postal questionnaire at 5 months postpartum; survey B conducted in four 'départements' (administrative areas), including 636 women who answered a postal questionnaire at 6 months postpartum. Response rates were respectively 90% and 68%. Smoking status was recorded for three time periods: before pregnancy, during pregnancy, and at 5-6 months. Social characteristics and preventive behaviour were compared for regular smokers who had quit smoking during pregnancy and those who had not, and among quitters, who had resumed smoking postpartum and those who had not. RESULTS: In survey A, 37% were smokers before pregnancy, 34% of them stopped during pregnancy, and among the latter, 48% had resumed smoking 5-6 months after delivery. In survey B, the percentages were respectively 43, 54 and 57%. The most predictive factor of postpartum smoking relapse was the partner's smoking behaviour. CONCLUSION: Return to smoking after delivery is frequent, but nearly half of the regular smokers who had stopped during pregnancy were still non-smokers 5-6 months after the birth. However, to increase this proportion, interventions need to include partners, especially if they are smokers.     

Characteristics of tobacco smoking in schools in Andorra]

1600 schoolchildren aged 13 to 18 answered an anonimus, self administered questionnaire, in a cross sectional study to estimate the prevalence of cigarette smoking in the high grades schools in Andorra. 46.6% answered they did smoke cigarettes, either daily (11.2%) or occasionally (35.4%). Ten per cent of actual smokers did already smoke at age 10, and 50% at age 13. More girls (48.8%) than boys (44.4%) smoked (p less than 0.05) but boys smoked a greater number of cigarettes (p less than 0.001). Ninety five percent smoked Virginia tobacco, and little more than 50% used filter tipped cigarettes. Two thirds of smokers inhaled the smoke of cigarettes; this was more common among daily smokers. Again two thirds of smokers answered they would be prepared to quit smoking. 31% of those who had tried smoking said they believed they would smoke in the future, while only 5.6% of those that never smoked previously said so (p less than 0.001). Actual smokers answered they believed that they would not smoke in the future much less often than non smokers. Parents let boys smoke more than girls when the children started doing so, particularly before age thirteen and after age fifteen. These are the first available data about the community studied describing some features of its cigarette smoking habit. Their knowledge may well help to plan disease protection and health promotion developments addressed to youngsters in Andorra.     

‘Waiting until they got home’: Gender,smoking and tobacco exposure in households in Scotland

The introduction in March 2006 of legislation banning smoking in public places in Scotland raised concerns that smokers would smoke more at home and so increase the exposure of those living with them to tobacco smoke. Drawing on interviews from two qualitative studies conducted after the implementation of the legislation, this article uses a gendered analysis to explore where and why smokers, who lived with non-smokers including children, continued to smoke in their homes. Although very few people attributed any increased home smoking to being a direct consequence of the legislation, many who already smoked there continued, and most women reported little or no disruption to their home smoking post-legislation. Also, because of the changing social environment of smoking, and other life circumstances, a minority of women had increased their levels of home smoking. Compared to the men in these studies, women, particularly those who didn’t work outside the home, had restricted social lives and thus were less likely to have smoked in public places before the legislation and spent more time socialising in the homes of other people. In addition, women with children, including women who worked outside their homes, were more likely to spend sustained periods of time caring for children compared to fathers, who were more likely to leave the home to work or socialise. Although home smoking was linked to gendered caring responsibilities, other issues associated with being a smoker also meant that many women smokers chose to keep smoking in their homes.     

Personality scores and smoking behaviour. A longitudinal study.

The personality scores at 16 years of age of 2753 people, all members of the National Survey of Health and Development, were related, in a follow-up study, to cigarette smoking behaviour in their young adult years. Survey members who recorded high neuroticism scores were found to be more likely to smoke than those with low scores and, among the smokers, deep inhalers formed the most neurotic group. Extraverts were more likely to smoke than introverts, the mean extraversion score being greatest for the male smokers with a high daily consumption of cigarettes. The personality scores were found to have some power in predicting changes in smoking behaviour. Neurotics and extraverts who had not started to smoke by the time of completing the personality inventory at 16 were more likely than the stable and introverted to take up the habit subsequently. Among survey members who were regular smokers at the time of completing the personality inventory the proportion giving up smoking by the time they reached the age of 25 years was related to consumption level recorded at 20 years and the personality scores recorded at 16, stable extraverts among the men being most likely to stop smoking.     

Adolescents' perceptions of print cigarette advertising: a case for counteradvertising

Cigarette smoking is a major preventable cause of serious chronic disease. The majority of smokers begin smoking during their adolescent years. Print cigarette advertising plays an influential role in encouraging young people to smoke. Eight hundred and forty-three middle/junior high-school-aged students from a large midwestern metropolitan area participated in this study of adolescents' recognition of and belief in messages associated with print cigarette advertising. Results indicated no significant difference between smokers and nonsmokers in their recognition of messages associated with print cigarette advertising. However, smokers and nonsmokers differed significantly in the degree to which they believed the messages communicated by print cigarette advertising. Consistent with social cognitive theory, students who smoke at least occasionally were more likely to believe messages conveyed by print cigarette ads than were students who had never smoked. Implications of these findings for research and practice are discussed, including specification of guidelines for effective counteradvertising.