Maternal factors, obstetric history and smoking stage of change.

BACKGROUND: Maternal smoking is known to be associated with low educational status, low social class and younger age groups. The aim of this study was to determine if maternal smoking and stage of change relating to smoking is associated with other maternal variables such as intention to breastfeed and attend antenatal classes, having a planned pregnancy, previous obstetric history and child health problems. METHOD: A cross-sectional survey was carried out of all women who attended antenatal clinics at the Leicester Royal Infirmary NHS Trust over a two-week period. The data comprised 254 completed questionnaires. Results Intention to breastfeed was more common among non-smokers as shown by smoking status (p < 0.001) and smoking stage of change (p < 0.05). Having a planned pregnancy was more common among non-smokers as determined by smoking status (p < 0.001) and stage of change (p < 0.05). Intention to attend antenatal classes showed no significant relationship with smoking status but the majority of those planning to attend antenatal classes were in the action-maintenance stage (p< 0.05). Previous obstetric complications were not associated with either smoking status or stage of change. Smokers were more likely to have at least one child with asthma (p < 0.05) or respiratory infections (p < 0.001). Having at least one child with asthma or respiratory infections was more common among precontemplators (p < 0.05). CONCLUSION: Smoking stage of change should be assessed in antenatal care so that appropriate information can be offered to pregnant smokers. The development and evaluation of stage-specific smoking cessation materials should offer considerable benefits to maternal and infant health.     

成人吸烟者家庭健康功能、抑郁状况与烟草依赖的关系

目的  探究中国核心家庭中的成人现在吸烟者家庭健康功能、抑郁状况与烟草依赖的关系。方法  以核心家庭中≥18岁的现在吸烟者为研究对象,调查人口学、家庭健康功能、抑郁水平及烟草依赖状况。采用二分类logistic回归分析模型分析烟草依赖的影响因素,采用结构方程模型分析家庭健康功能、抑郁状况与烟草依赖的关系。结果  纳入的707例现在吸烟者,以轻度烟草依赖为主640例,占90.5%,重度烟草依赖者67例,占9.5%。logistic回归分析模型分析显示,已婚、第1次吸烟年龄＜18岁、过去12个月每天饮酒、抑郁水平高、缺乏家庭外部社会支持与重度烟草依赖存在关联(均有P＜0.05)。结构方程模型显示,家庭健康资源可能通过影响抑郁水平间接影响烟草依赖状况(β=-0.246,P＜0.001)。结论  家庭健康功能既与烟草依赖直接相关,也可能通过抑郁水平间接影响烟草依赖状况。     

广州市工厂职工吸烟行为与尼古丁依赖性调查

目的 调查工厂职工吸烟行为和尼古丁依赖性,为控烟提供科学依据.方法 横断面调查广州市668名不同工作类型工厂职J二的吸烟行为和尼古丁依赖性,后者采用国际问卷FTND进行评价;尼古丁依赖性与某些因素的相关性采用logistic回归分析.结果 (1)曾吸烟率男性65.0%(348/535,其中经常吸55.5%,偶吸5.4%,戒烟4.1%),女性3.0%(4/133);男性一线工人、安全主任目前吸烟率分别为67.6%和64.5%.(2)男性经常吸和偶吸者轻度尼古丁依赖分别占66.7%和89.7%;经常吸烟者烟龄越长尼古丁依赖性越高,一线工人和安全主任尼古丁依赖性较高.结论 男性工人和安全主任的吸烟率较高,但轻度尼古丁依赖者占大部分,可作为首期戒烟干预的首选对象.     

Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey

Background  

The Fagerstr?m Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND.     

Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey

Background

Linkage to care after HIV diagnosis is associated with both clinical and public health benefits. However, ensuring and monitoring linkage to care by public health departments has proved to be a difficult task. Here, we report the usefulness of routine monitoring of CD4 T cell counts and plasma HIV viral load as measures of entry into care after HIV diagnosis.

Methods

Since July 1, 2006, the San Francisco Department of Public Health (SFDPH) incorporated monitoring initial primary care visit into standard HIV public health investigation for newly diagnosed HIV-infected patients in select clinics. Entry into care was defined as having at least one visit to a primary HIV care provider after the initial diagnosis of HIV infection. Investigators collected reports from patients, medical providers, laboratories and reviewed medical records to determine the date of the initial health care visit after HIV diagnosis. We identified factors associated with increased likelihood of entering care after HIV diagnosis.

Results

One -hundred and sixty new HIV-infected cases were diagnosed between July 1, 2006 and June 30, 2007. Routine surveillance methods found that 101 of those cases entered HIV medical care and monitoring of CD4 T cell counts and plasma HIV viral load confirmed entry to care of 25 more cases, representing a 25% increase over routine data collection methods. We found that being interviewed by a public health investigator was associated with higher odds of entry into care after HIV diagnosis (OR 18.86 [1.83–194.80], p =.001) compared to cases not interviewed. Also, HIV diagnosis at the San Francisco county hospital versus diagnosis at the county municipal STD clinic was associated with higher odds of entry into care (OR 101.71 [5.29–1952.05], p <.001).

Conclusion

The time from HIV diagnosis to initial CD4 T cell count, CD4 T cell value and HIV viral load testing may be appropriate surveillance measures for evaluating entry into care, as well as performance outcomes for local public health departments' HIV testing programs. Case investigation performed by the public health department or case management by clinic staff was associated with increased and shorter time to entry into HIV medical care.     

南宁市成年吸烟者的尼古丁依赖性及影响因素的研究

目的 探讨南宁市成年吸烟者尼古丁依赖水平及影响因素。方法 对南宁市不同职业的成年吸烟者进行抽样调查,采用尼古丁依赖标准评估量表（fagerstrom test for nicotine dependence,FTND）国际问卷评估南宁市成年吸烟者尼古丁依赖水平,通过Logistic回归分析及列线图模型探索南宁市成年吸烟者尼古丁依赖性的影响因素。结果 调查对象共有1 178名南宁市成年吸烟者,开始吸烟的平均年龄为（19.33±4.90）岁,84.29%吸烟者为尼古丁低依赖者,尼古丁依赖评分均值为（3.18±1.94）分。Logistic回归分析发现,学历中等、开始吸烟年龄早及烟龄长是吸烟者尼古丁高度依赖的危险因素。结论 南宁市居民吸烟者中尼古丁高度依赖情况所占比例较低;学历水平、开始吸烟年龄及烟龄等因素与吸烟者尼古丁依赖程度有关。     

Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States

OBJECTIVES: We describe the epidemiology of smoking behaviors in a national young adult sample and identify common and unique demographic, social, and psychological correlates of daily smoking and lifetime and current nicotine dependence by race/ethnicity. METHODS: Data are from the National Longitudinal Survey of Adolescent Health, wave III. Dependence was measured by the Revised Fagerstr?m Test for Nicotine Dependence. Logistic regressions were estimated. RESULTS: Hispanic ethnicity, low education, parental and peer smoking, novelty seeking, early age of smoking onset, and pleasurable initial smoking experiences are significantly correlated with daily smoking and lifetime nicotine dependence. Depressive symptoms are uniquely associated with lifetime and current dependence. Few factors are highly associated with current dependence. Initial sensitivity to smoking has a significantly greater impact on daily smoking than on dependence. Correlates of smoking behaviors are mostly common across racial/ethnic groups, although parental and peer smoking are significant for Whites and Hispanics but not for African Americans. CONCLUSIONS: There are more common than unique correlates of each smoking stage and across racial/ethnic groups. Primary prevention and interventions addressing the factors tested could be uniform for most chronic smokers irrespective of dependence status and race/ethnicity.     

天津市居民吸烟现况及吸烟者尼古丁依赖状况

目的了解天津市居民吸烟现况及现在吸烟者尼古丁依赖状况,为制定控烟政策及相应干预措施提供参考依据。方法采用多阶段随机抽样方法抽取天津市城区的成年居民1 993人,对其吸烟情况、尼古丁依赖状况等方面进行调查。结果天津市居民现在吸烟率为26.2%,男性现在吸烟率为46.0%,女性现在吸烟率为5.0%,差异有统计学意义(χ2=494.02,P<0.01);青年人现在吸烟率(19.0%)低于中年人(39.5%)和老年人(39.0%);文化程度越低吸烟率越高,小学及以下居民的现在吸烟率高达41.0%,大专及以上居民仅为17.7%;现在吸烟者尼古丁依赖评测量表(FTND)平均得分为(3.92±2.72)分,中年吸烟者尼古丁依赖严重,平均得分为(4.41±2.86)分;文化程度低、开始吸烟年龄小、家庭或工作场所对吸烟没有限制、吸烟频率高的吸烟者,尼古丁依赖程度较严重(P<0.01)。结论天津市居民吸烟现况及尼古丁依赖状况不容乐观;采用FTND定量分析现吸烟者的尼古丁依赖程度,有助于进一步采取针对性措施进行健康干预。     

Association between behavioral intention and actual change for physical activity, smoking, and body weight among an employed population

OBJECTIVE:: To examine the association of behavioral intention with subsequent behavioral change in a worksite setting for three health behaviors, increasing physical activity, quitting smoking, and losing weight. METHODS:: Two-year health risk appraisal data came from one multistate company. Behavioral intention was captured in the 2004 health risk appraisal, and behavioral change was measured by comparing health behaviors in 2004 and 2005. Multivariate logistic regression was used to study the intention-behavior relationship. RESULTS:: A positive association with intention for change was found in increasing physical activity level (P = 0.0002) and quitting smoking (P = 0.018). Nevertheless, a negative relationship was observed in reducing weight (P = 0.003). CONCLUSIONS:: A positive intention-behavior change relationship was found in two of the three behaviors. Individuals may benefit from differential wellness programming based on their intention for change and health risks.     

Cigarette smoking: knowledge, attitudes and behaviour in an adult population in Italy

The study explores knowledge, attitudes, and behaviour regarding cigarette smoking and related factors in an adult population. A total of 935 parents of children attending the eighth class of ten randomly selected primary schools in Catanzaro (Italy) received a questionnaire consisting of questions on demographic and socioeconomic characteristics, knowledge, behaviour and attitudes about cigarette smoking. Six hundred and sixty-nine parents returned the questionnaire, with a response rate of 71.5%. Knowledge of risk associated to smoking was significantly higher in more educated subjects and in past smokers compared to current. Current and past smokers were respectively 39.6% and 17.2%, and current smokers were younger, not married, less prone to consider smoking as a major risk for their health and more likely to live with other smokers compared to past and never smokers. Females of higher education were more likely to be current smokers, whereas male current smokers were more likely to be less educated compared to past or never smokers. The results strongly recommend the provision of accurate information about the health consequences related to smoking, with a more intensive involvement of health care providers, particularly targeted to women and younger age groups.     

Prosthetic treatment in the adult French population: Prevalence and relation with demographic,socioeconomic and medical characteristics

BackgroundThe aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dentures in a representative sample of adults living in France.MethodsThe data were obtained from the 2002–2003 Decennial Health Survey, a cross-sectional study of a representative sample of the population living in France, which included 29,679 adults. Information was collected by interview. The variables collected were fixed denture, removable denture, age, gender, number of children, area of residence, nationality, educational attainment, family social status, employment status, annual household income per capita, supplementary insurance, chronic disease, eyesight problems/glasses, hearing problems/hearing aids. Multinomial logistic regression models were used to study the relationship between prosthetic treatment and demographic, socioeconomic and medical characteristics unadjusted, adjusted for age and adjusted for all the characteristics.ResultsThe prevalence of prosthetic treatment was 34.6% (95% confidence interval (CI): [34.1; 35.2]) for fixed prosthetic dentures and 13.8% (95% CI: [13.4; 14.2]) for removable prosthetic dentures. We showed a gradient between educational attainment and removable dentures; the odds ratio adjusted for all the variables (aOR) associated with no or primary education compared to post-secondary education was 2.56; 95% CI: [2.09; 3.13]. When annual household income per capita was low, subjects were less likely to report fixed dentures (aOR = 0.68; 95% CI: [0.62; 0.75]) than those with high annual household income per capita. Individuals without insurance less often reported fixed dentures than those with private insurance. Those reporting chronic disease were less likely to report fixed dentures (aOR = 0.87; 95% CI: [0.79; 0.95]) but more likely to report removable dentures (aOR = 1.29; 95% CI: [1.17; 1.43]) than those without chronic disease.ConclusionThis study reveals social, economic and medical inequalities in fixed and removable prosthetic treatment among adults in France.     

Motives for smoking cessation are associated with stage of readiness to quit smoking and sociodemographics among German industrial employees

PURPOSE: To test the relationships among particular motives for smoking cessation, stage of readiness to quit (preparation or contemplation), and sociodemographic characteristics. DESIGN: A cross-sectional study to examine attitudes toward and use of health promotion at the worksite, using a self-administered questionnaire. SETTING: Two German metal companies. SUBJECTS: Of 1641 responding employees (response rate 65% in company A and 44% in company B), 360 smokers who intended to quit immediately (n = 105) or in the near future (n = 255) were analyzed. MEASURES: The questionnaire comprised of sociodemographic characteristics, smoking behavior, smoking history, readiness to quit smoking, motives to quit, such as coworkers' complaints and health-related or financial concerns. Chi-squared tests and multiple logistic regression analyses were performed. RESULTS: Health-related reasons (94%) predominated financial (27%) or image-related (14%) reasons for smoking cessation. Participants in the cessation preparation group were more likely to report an awareness of being addicted (79.6% vs. 58.2%; p < .001) and the negative public image (22.5% vs. 11.6%; p < .01) as reasons for quitting compared with those in the contemplation group. In multivariable regression models, the motives for smoking cessation, including reduced performance, family's and coworkers' complaints, pregnancy/children, and negative public image, but not health-related and financial concerns, differed significantly by gender, age, marital status, education, and occupational status. CONCLUSIONS: Motives for smoking cessation vary according to the individual's level of readiness to quit and sociodemographic background.     

Occurrence of perfluorinated substances in an adult German population in southern Bavaria

Objectives Perfluorinated compounds (PFCs) are a large group of chemicals produced for several decades and widely used for many industrial and consumer applications. Because of their global occurrence in different environmental media, their persistence, and their potential to bioaccumulate in organisms they are of toxicological and public concern. Methods In the present study, the internal exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) in 356 human plasma samples collected from an adult population in Germany in 2005 is quantified. Results We were able to detect the target analytes in all plasma samples and observed a significant correlation between the PFOS and PFOA concentrations. In female participants, the levels of PFOS and PFOA ranged between 2.5–30.7 (median: 10.9 μg/l) and 1.5–16.2 μg/l (median: 4.8 μg/l), respectively. In males we observed concentrations from 2.1 to 55.0 μg/l (median: 13.7 μg/l) for PFOS and from 0.5 to 19.1 μg/l (median: 5.7 μg/l) for PFOA. A significant correlation between both PFOS and PFOA concentrations and gender was observed. We also found increased levels of the PFCs with increasing age of the participants, but this association reached statistical significance among females only. Conclusions Our data agree well with results of other recent studies in Europe and suggest that the current exposure of the adult German population is lower than the exposure of the US and Canadian population. The sources of human exposure are currently not well understood. Toxicological implications are restricted to animal studies and occupational investigations not adequate for quantitative risk assessment in humans. Overall, more scientific research is necessary to characterize the body burden of PFCs (especially for relevant subsets of the population) and the main sources and routes, which are responsible for human exposure and possible health implications of these compounds.     

The relationship of stage of change for smoking cessation to stage of change for fruit and vegetable consumption and physical activity in a health plan population

PURPOSE: The purpose of this study was to examine the relationship between stage of change for smoking cessation and stage of change for (1) fruit and vegetable consumption and (2) physical activity. DESIGN: The data come from a cross-sectional telephone survey administered to a stratified random sample of health plan members (n = 9675). SETTING: This study was conducted at a mixed-model health plan with approximately 1 million adult members. SUBJECTS: Respondents were adults age 18 and older, who were randomly selected from five health plan product groups: commercial fully insured, commercial self-insured, two publicly subsidized plans, and Medicare supplemental insurance. Response rates ranged from 74.7% to 90.1% across these groups. MEASURES: The assessment included demographics and stage of change for smoking cessation, physical activity, and fruit and vegetable intake. Bivariate relationships among variables were analyzed with the use of contingency tables. Ordered logistic regression was used to examine the effects of stage of change for fruit and vegetable consumption and physical activity on stage of change for smoking while controlling for other factors. RESULTS: Stage of change for smoking is more clearly related to stage of change for fruit and vegetable consumption (chi2 = 161.3, p < .001; Cramer's V = .11, p < .001) than to stage of change for physical activity (chi2 = 89. 7, p < .001; Cramer's V = .08, p < .001). However, stage of change for fruit and vegetable consumption and physical activity are not strong predictors of stage of change for smoking. CONCLUSIONS: This study indicates that stage of change for both fruit and vegetable consumption and physical activity are independent constructs from stage of change for smoking cessation.     

The association between degree of nicotine dependence and other health behaviours. Findings from a German general population study.

BACKGROUND: To investigate the association between degree of nicotine dependence and unhealthy nutrition, lack of physical activity, and hazardous alcohol drinking. METHODS: Data with respect to cigarette and alcohol consumption, nutrition, and physical activity was collected in a representative general population sample (N = 4.075). RESULTS: Smokers with high compared to moderate and low degrees of nicotine dependence consume unhealthy foods more frequently, report less physical activity and more hazardous alcohol drinking. CONCLUSION: From a public health point of view, special secondary preventive interventions for smokers with high nicotine dependence and additional unhealthy behaviours are necessary.     

六城市成年吸烟者尼古丁依赖状况

目的了解6城市市区成年吸烟者尼古丁依赖水平和其相关因素。方法采用多阶段抽样法,分别在北京、沈阳、上海、长沙、广州和银川6个城市各抽取800名成年吸烟者,采用人户调查的方式进行问卷调查。结果调查对象尼古丁依赖水平（HSI）为2.5±1.7,其中男性2.5±1.7,女性1.9±1.7,低于发达国家。影响尼古丁高度依赖的因素主要有性别、年龄、学历、吸烟年数、健康意识和购烟平均价格。男性（OR=2.352）、教育程度低的吸烟者更容易出现尼古丁高度依赖,并且随着学历降低,高度依赖的程度逐渐增高（以大专、大学及以上为对照,中学、中专人群的OR值为1.417,小学或以下人群的OR值为1.853）;烟龄超过10年的吸烟者依赖程度更高（OR=4.519）;认为吸烟对自己的健康没有影响（OR=1.345）和认为吸烟有益健康的人群（OR.=2.419）、购烟平均价格为每盒4元以下的人群更容易出现高度依赖（OR=1.635）。结论我国吸烟者的尼古丁依赖评分（HSI）比发达国家低。在我国,男性、高年龄、教育程度低、烟龄超过10年、健康意识低、购烟平均价格低的人群更容易出现尼古丁高度依赖。