Is smoking delayed smoking averted?

Antismoking efforts often target teenagers in the hope of producing a new generation of never smokers. Teenagers are more responsive to tobacco taxes than are adults. The author summarizes recent evidence suggesting that delaying smoking initiation among teenagers through higher taxes does not generate proportionate reductions in prevalence rates through adulthood. In consequence, the impact of taxes on smoking among youths overstates the potential long-term public health effects of this tobacco control strategy.     

One last puff? Public smoking bans and smoking behavior

This paper investigates the short-term effects of public smoking bans on individual smoking behavior. In 2007 and 2008, state-level smoking bans were gradually introduced in all of Germany's federal states. We exploit this variation to identify the effect that smoke-free policies had on individuals’ smoking propensity and smoking intensity. Using rich longitudinal data from the German Socio-Economic Panel Study, our difference-in-differences estimates show that the introduction of smoke-free legislation in Germany did not change average smoking behavior within the population. However, our estimates point to important heterogeneous effects. Individuals who go out more often to bars and restaurants did adjust their smoking behavior. Following the ban, they became less likely to smoke and also smoked less.     

Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.     

Education and smoking: were Vietnam war draft avoiders also more likely to avoid smoking?

We use the Vietnam war draft avoidance behavior documented by Card and Lemieux [Card, D., Lemieux, T., May 2001. Did draft avoidance raise college attendance during the Vietnam war? American Economic Review 91 (2), 97-102] as a quasi experiment to infer causation from education to smoking and find strong evidence that education, whether measured in years of completed schooling or in educational attainment categories, reduces the probability of smoking at the time of the interview, more particularly the probability of smoking regularly. However, while we find that more education substantially increases the probability of never smoking, our instrumental procedure yields imprecise estimates of the effect of education on smoking cessation. Potential mechanisms linking education and smoking are also explored.     

Do patients' preferences predict smoking cessation?

BACKGROUND: Social cognitive theories (e.g., ASE-model) propose that smoking cessation can be accomplished by changing underlying cognitive determinants such as attitudes, social influence, and self-efficacy. Others have argued that people's preferences for a health state can also predict behavior. In this study, preferences constitute the degree to which one is willing to give up a valuable good, that is survival, to obtain a desirable behavior (e.g., to quit smoking). The aim of this study is to investigate the impact of cognitive determinants and patients' preferences on the prediction of smoking cessation. METHODS: Data were collected as part of a randomized clinical trial. Smoking outpatients (N = 217) with cardiovascular disease were included. At baseline (T0), socio-demographic and clinical characteristics were measured. Social cognitions (pros of quitting, pros of smoking, social influence, and self-efficacy) and preferences (using a paper time trade-off measure (TTO)) were assessed at T1 (1 week). Smoking cessation was assessed at T2 (8 weeks). RESULTS: Logistic regression analysis showed that socio-demographic (P = .92) and clinical (P = .26) factors did not predict smoking cessation, whereas social cognitions (P = .02) and preferences did (P = .00). On average, quitters are willing to give up an appreciable amount of survival years in order to quit smoking. CONCLUSION: Preference for quitting was the strongest single predictor of smoking cessation.     

Is passive smoking increasing cancer risk?

Although the amounts of environmental tobacco smoke absorbed by passive smokers are small in comparison to those absorbed by active smokers, the fact that (almost) everybody in modern society is exposed makes it an important public health problem. The many published epidemiologic studies are all consistent with a 30% increase in the risk of lung cancer. This increase is plausible in relation to the exposure levels derived from various biological dose indicators. The risks of passive smokers are, of course, smaller than those of active smokers, but it is generally accepted that involuntary risks should be much smaller than those that are self-inflicted. Even a relative risk for lung cancer of 1.3 due to passive smoking would constitute an increase on the order of 1 in 1,000 in the lifetime risk. Normally, this level would be considered "unacceptable," and preventive measures should be taken.     

Are fewer women smoking during pregnancy?

OBJECTIVE: To determine whether pregnancy-smoking rates have changed in last decade. METHODS: Retrospective cohort study of 67,395 pregnancies in Kansas City over 2 epochs, 1993-1997 and 1998-2002, using computer files of birth certificates. RESULTS: Overall pregnancy-smoking rates decreased from 18.1% (95% CI=17.7-18.5%) to 14.2% (13.8-14.5%). Among smokers, there was a distribution shift toward light smoking; light [39% (38.9-40.3%) vs 49% (47.6-50.4%)], moderate [36.8% (34.8%-38.8%) vs 34.4% (32.1-36.7%)], and heavy [23.1% (21.9-26.3%) vs 16.6% (14-19.1%)]. CONCLUSIONS: The results suggest decreasing heavier smoking. However, the trend toward light smoking suggests decreasing self-reporting. These findings highlight the dilemma in using self-reports for public health policy and emphasize the importance of antismoking socialization for all pregnancies.     

Is there an impact of public smoking bans on self-reported smoking status and exposure to secondhand smoke?

Background  

Implementation of smoke free policies has potentially substantial effects on health by reducing secondhand smoke exposure. However little is known about whether the introduction of anti-smoking legislation translates into decreased secondhand smoke exposure. We examined whether smoking bans impact rates of secondhand smoke exposure in public places and rates of complete workplace smoking restriction.     

How do residents prioritize smoking cessation for young "high-risk" women? Factors associated with addressing smoking cessation

BACKGROUND: Sixty-seven percent of physicians report advising their smoking patients to quit. Primary care residents' priorities for preventive health for a young "high-risk" female are unknown. Factors related to residents addressing smoking also need examining. METHODS: One hundred residents completed a survey about preventive health issues for a woman in her 20s "who leads a high-risk lifestyle." Residents indicated which topics they would address, and the likelihood that they would address each of 12 relevant preventive health topics, their outcome expectancies that the patient would follow their advice on each topic, their confidence that they could address the topic, and perceived barriers for addressing the topic. RESULTS: Residents listed STD prevention most frequently. Drug use and smoking cessation were second and third most frequently listed. Residents who believed that the patient would follow their advice were more likely to list smoking cessation than residents who had lower outcome expectancies for that patient. Higher barriers were negatively related to addressing smoking cessation. CONCLUSIONS: When time is not a barrier, residents are likely to address smoking cessation. Teaching residents how to incorporate this subject into their clinical practice is needed. Raising residents' outcome expectancies may increase their likelihood of addressing smoking cessation.     

Urinary monohydroxylated phenanthrenes and hydroxypyrene – the effects of smoking habits and changes induced by smoking on monooxygenase-mediated metabolism

Objectives: Internal polycyclic aromatic hydrocarbon (PAH) exposure is usually studied by determining 1-hydroxypyrene in urine. In many studies, increased urinary levels of 1-hydroxypyrene have been found in smokers compared with non-smokers. The disadvantage of this procedure, however, is that it is based on only one substance. Therefore, in our study, urine specimens from smokers and non-smokers were tested for four monohydroxylated phenanthrenes in addition to 1-hydroxypyrene. Subjects and methods: Spot urine samples from 288 non-smokers and 100 smokers were analysed for 1-, 2-, 3- and 4-hydroxyphenanthrene and 1-hydroxypyrene by a very sensitive high performance liquid chromatography (HPLC) method with fluorescence detection. The detection limit of the method is 5 ng metabolite/l urine. The data were calculated on a creatinine basis (ng/g creatinine). Results: Highly significant differences and dose-response relationships with regard to cigarettes smoked per day were found for 2-, 3- and 4-hydroxyphenanthrene and 1-hydroxypyrene, but not for 1-hydroxyphenanthrene. When the ratio of the sum of hydroxyphenanthrenes to 1-hydroxypyrene, and the ratio of 1- and 2-/3- and 4-hydroxyphenanthrene were taken into consideration, significant negative dose-response relationships to the numbers of cigarettes smoked per day, were found. Conclusion: 1-Hydroxypyrene as well as 2-, 3- and 4-monohydroxylated phenanthrenes in urine may be used as parameters to detect PAH exposure from cigarette smoking. Moreover, 3,4-oxidation of phenanthrenes was found to be enhanced in smokers, with a significant dose-response relationship. This phenomenon is thought to be caused by an induction of the CYP 1A2 (or CYP 3A4) monooxygenase system in smokers. Therefore, it may be recommended that monohydroxylated phenanthrenes be analysed in order to assess the balance between the PAH-metabolising cytochrome isoforms, and the activity or induction of cytochrome P450 isoforms, respectively. Received: 12 May 2000 / Accepted: 1 November 2000