综合评价法在明确中学生吸烟影响因素主导效应中的运用

目的了解深圳市光明新区中学生吸烟情况及影响因素的分布,并对特定人群进行分类,为针对性开展中学生吸烟干预提供依据.方法:运用分层整群抽样法对深圳市光明新区学校544名中学生进行吸烟状况,烟草有关知识,态度和行为,周围环境控烟情况等调查,SAS9.0软件进行分析.结果:深圳市光明新区中学生尝试吸烟率为15.1 %,吸烟率为3.13%.多因素非条件logistic回归分析:女性(OR=0.50, 95%CI:0.26~0.96)为尝试吸烟的保护性因素(P<0.001),好朋友吸烟(OR=1.88, 95%CI:1.08~3.27),具有好朋友给烟肯定会吸意愿(OR=3.11, 95%CI:2.12~4.54),年龄增加(OR=1.33, 95%CI:1.04~1.69)均增加了尝试吸烟的危险因素,CHAID法决策树分析显示,好朋友给烟肯定会吸和男性分别能对50.0%(41/82) 和36.6%( 30 /82) 的尝试吸烟者进行准确分类.尝试吸烟人群中,吸烟者与非吸烟者多因素非条件logistic回归分析,好朋友给烟肯定会吸(OR=8.38, 95%CI:2.27~30.93),父母未告诫不要吸烟(OR=12.29, 95%CI:1.21~34.73)是吸烟的危险因素,而认为吸烟会减少体重(OR=0.25, 95%CI:0.07~0.87)是保护因素;类平均法聚类分析显示,好朋友给烟是否会吸和父母是否告诫不要吸烟将吸烟者分为三类,其中为父母告诫不要吸烟但好朋友给烟会吸者占64.71%(11/17).结论:新区中学生吸烟状况比较严重,对影响尝试吸烟,吸烟的独立影响因素进行分类分析以确定特定因素及特定人群,而进行相应干预将更有助于提高新区中学生控烟效果.     

Factors associated with smoking progression among Spanish adolescents

Smoking onset takes place in the early years of adolescence, and can be seen as a progression through stages of preparation, trying, experimentation, regular smoking and nicotine dependence or addiction. The objective of this study is to identify 1-year predictors of smoking consolidation among occasional smokers (experimenters) and of cessation among all smokers. A questionnaire developed to monitor trends in smoking and other health-related behaviors was administered in the spring of 1992 and again 1 year later (1993). The survey was carried out in six large, private schools in Barcelona and Raimat, in the Lleida province, in Catalonia (Spain). In total, 1460 schoolchildren aged 12-19 responded to both the baseline and follow-up questionnaires; 1236 questionnaires (84.7%) were matched through a personal code and were used for the longitudinal study. At the baseline survey 28% of the schoolchildren were regular smokers and 17.1 % were occasional smokers, with no differences by gender. At the follow-up survey, progression from occasional to regular smoking was observed in 42% of the girls and 22.7% of the boys. Other predictors of consolidation included drinking alcohol (OR = 3.1; 95% CI = 1.1-10.1) and reporting the intention to smoke in the future (OR = 2.5; 95% CI = 1.3-4.9). Among all the smokers at the baseline, predictors of cessation were smoking occasionally (versus regularly) (OR = 4.9; 95% CI = 2.8-8.6), negative attitudes regarding smoking (OR = 3.3; 95% CI = 1.9-5.4), reporting no intention to smoke in the future (OR = 2.2; 95% CI = 1.3-3.8), gender (OR for boys = 2.1; 95% CI = 1.2-3.6), receiving weekly pocket less than 1000 ptas (OR = 1.7; 95% CI = 1.1-5.3) and age (OR for being 15 and younger = 1.6; 95% CI = 1.1-4.9). We conclude that consolidation of smoking is twice as likely among girls than among boys. Intention to smoke seems to be a good predictor of future behavior, while attitudes may predict cessation, but not consolidation. Available pocket money seems to be a strong risk factor for smoking at this age.     

Factors Contributing to Regular Smoking in Adolescents in Turkey

PURPOSE: The objectives of this study were to determine the levels of lifetime cigarette use, daily use, and current use among young people (aged 15-19 years) and to examine the risk factors contributing to regular smoking. METHODS: The number of students was determined proportionately to the numbers of students in all the high schools in the province of Trabzon in Turkey. The data were gathered using the questionnaire method. A total of 4666 students participated in the study. The chi-square test and logistic regression analysis were used in data analysis. RESULTS: Of the 4666 students who took part in the study, the level of lifetime cigarette use was 38.2% (n = 1796), that of lifetime daily cigarette use was 10.5% (n = 491), and that of current cigarette use was 9.5% (n = 447). Male students (P < .0005), those whose mothers were smokers (P < .0005), those whose fathers smoked (P = .005), those whose siblings smoked (P<.0005), those whose friends smoked (P < .0005), those whose teachers smoked (P = .001), and low achievers in school (P < .0005) stated that they significantly smoked on a more regular basis. According to the results of the logistic regression analysis, the following risk factors were statistically significant: male students smoked 3.02 times (95% CI 2.20-4.16) more than females, those whose mothers were smokers smoked 1.57 times (95% CI 1.09-2.28) more than those whose mothers were not, those whose friends were smokers smoked 2.42 times (95% CI 1.73-3.39) more than those whose friends were non-smokers, poor achievers in school smoked 2.62 times (95% CI 1.97-3.49) more than high achievers, and those without poor grades smoked 1.75 times more (95% CI 1.23-2.40), the risk rising 1.06 times (95% CI 1.01-1.11) with earlier age at first experimentation. The risk of daily cigarette use was observed to decline by 0.91 times (95% CI 0.84-0.98) with increasing numbers of siblings. CONCLUSION: Effective smoking prevention programs should take into account the dominant influence of peer groups in the onset and continuation of smoking.     

Smoking among adolescents in Northern Greece: a large cross-sectional study about risk and preventive factors

ABSTRACT: BACKGROUND: The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents. METHODS: We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one. A parental signed informed consent was obtained using an informative leaflet about adolescent smoking RESULTS: The main findings of the study were: a) 14.2% of the adolescents (mean age+/-SD: 15.3+/-1.7 years) reported regular smoking (24.1% in the age group 16--18 years), b) 84.2% of the current smokers reported daily use, c) students who live in urban and semirural areas smoke more frequently than those in rural areas, d) students in technically oriented schools smoke twice as frequent compared to those in general education, e) risk factors for smoking: male gender, low educational level of parents, friends who smoke (OR: 10.01, 95%CI: 8.53-11.74, p<0.001), frequent visits to internet cafes (OR:1.53, 95%CI: 1.35-1.74, p<0.001), parents, siblings (OR:2.24, 95%CI: 1.99-2.51, p<0.001) and favorite artist (OR:1.18, 95%CI: 1.04-1.33, p=0.009) who smoke, f) protective factors against smoking: participation in sports (OR:0.59, 95%CI: 0.53-0.67, p<0.001), watching television (OR:0.74, 95%CI 0.66-0.84, p<0.001) and influence by health warning messages on cigarette packets (OR:0.42, 95%CI: 0.37, 0.48, p<0.001). CONCLUSIONS: Even though prevalence of cigarette smoking is not too high among Greek adolescents, frequency of everyday cigarette use is alarming. We identified many social and lifestyle risk and preventive factors that should be incorporated in a national smoking prevention program among Greek adolescents.     

Analysis of factors related to smoking initiation and continued smoking in young adolescents

OBJECTIVE: To analyse the determining of the acquisition and later consolidation of the tobacco consumption in young adolescents. MATERIAL AND METHOD: Longitudinal study of three years of duration (2000-2002). Subjects were students of secondary education between 13 and 14 years old at the beginning of the study. The research was performed in Gran Canaria Island with a final sample of 745 subjects. Models of conditional binary election were considered for longitudinal data where the dependent variable reflects decisions of the adolescents through time, with regard to the probability of beginning to smoke, "beginning model", and the probability of being occasional or habitual smoker, "experimentation model". RESULTS: In the last year, 57% of the young teenagers surveyed use tobacco, a 25% more than in the first year, some of them, 9% on a daily basis. In the "beginning model" the determining of the tobacco consumption are interest in studies (odds ratio [OR] = 0.27; 95% confidence interval (CI), 0.08-0.87 and OR = 0.14; 95% CI, 0.03-0.58 for the students having enough and much interest in studies, respectively), to have a smoker as the best friend (OR = 7.44; 95% CI, 2.59-21.4), the alcohol consumption (OR = 11.82; 95% CI, 4.96-28.2 and OR=15.42; 95% CI, 4.68-50.7 for youngs who drink alcohol occasionally or frequently) and having more pocket money (euros per week) (OR = 1.13; 95% CI, 1.07-1.19). For the "experimentation model", to have a smoker as the best friend (OR = 7.01; 95% CI, 2.96-16.5), the alcohol consumption (OR = 5.71; 95% CI, 1.98-16.4 and OR = 5.22; 95% CI, the 1.56-17.5 for youngs who drink alcohol occasionally or frequently) and the number of years since the student started smoking (OR = 1.44; 95% IC, 1.11-1.86). CONCLUSIONS: Our study emphasizes, peer group effect, drinking alcoholic beverages and lack of interest in studies as factors associated to the tobacco consumption.     

Attitudes and knowledge about naloxone and overdose prevention among detained drug users in Ningbo, China

Background

The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents.

Methods

We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one. A parental signed informed consent was obtained using an informative leaflet about adolescent smoking.

Results

The main findings of the study were: a) 14.2% of the adolescents (mean age+/?SD: 15.3+/?1.7 years) reported regular smoking (24.1% in the age group 16–18 years), b) 84.2% of the current smokers reported daily use, c) students who live in urban and semirural areas smoke more frequently than those in rural areas, d) students in technically oriented schools smoke twice as frequent compared to those in general education, e) risk factors for smoking: male gender, low educational level of parents, friends who smoke (OR: 10.01, 95%CI: 8.53-11.74, p<0.001), frequent visits to internet cafes (OR:1.53, 95%CI: 1.35-1.74, p<0.001), parents, siblings (OR:2.24, 95%CI: 1.99-2.51, p<0.001) and favorite artist (OR:1.18, 95%CI: 1.04-1.33, p=0.009) who smoke, f) protective factors against smoking: participation in sports (OR:0.59, 95%CI: 0.53-0.67, p<0.001), watching television (OR:0.74, 95%CI 0.66-0.84, p<0.001) and influence by health warning messages on cigarette packets (OR:0.42, 95%CI: 0.37, 0.48, p<0.001).

Conclusions

Even though prevalence of cigarette smoking is not too high among Greek adolescents, frequency of everyday cigarette use is alarming. We identified many social and lifestyle risk and preventive factors that should be incorporated in a national smoking prevention program among Greek adolescents.     

Cigarette smoking among medical college students in Wuhan, People's Republic of China.

BACKGROUND: This study examined cigarette smoking among a sample of medical college students in Wuhan, People's Republic of China. Specific cultural factors associated with cigarette smoking in China were discussed and issues which need to be studied in the future are presented. METHODS: A self-administrated questionnaire was administered to a sample of 1,611 medical students in 1995. Smoking status was based on self-reported use of cigarettes within the preceding 180 days. Information about demographic characteristics, home residence, annual family income, and smoking status of family members was also obtained. RESULTS: A total of 1,540 (1,201 males and 339 females) completed and returned the questionnaires (response rate 95.6%). None of the 339 female students surveyed reported cigarette smoking. A total of 37.7% (95% confidence interval (CI) = 35.0-40.5%) of the male medical students were current smokers, and 5. 3% (95% CI = 4.0-6.6%) were former smokers. The mean age of beginning to smoke was 16.5 years (95% CI = 8.7-24.3 years). The major reasons for first smoking were stress (42.8%, 95% CI = 38.2-47. 4%), curiosity (34.4%, 95% CI = 29.6-38.4%), and loneliness (33.7%, 95% CI = 28.7-37.4%). Multivariate analyses suggested that age, college year, and having a family member who smoked were significantly associated with cigarette smoking. CONCLUSIONS: The results indicated a need to provide comprehensive tobacco use prevention programs among medical students.     

Predicting Adolescent Smoking

Two hundred and ninety-seven seventh grade students (143 males and 154 females) participated in a prospective study to predict adolescent cigarette smoking behavior one year later. Predictor variables included 10 survey items assessing the smoking behavior of students' friends and family, students' school behavior and beliefs about smoking and students' intentions to smoke in the future. The one-year follow-up survey was administered under "bogus pipeline" conditions to enhance the validity of self-reported smoking status by including the collection of saliva thiocyanate samples. Univariate analyses indicated that smokers differed from nonsmokers on a number of measures and that there were few sex differences on either the survey variables or on smoking status. Stepwise discriminant function analyses revealed that it was possible to accurately predict the onset of adolescent cigarette smoking by combining the survey variables. The three variables that consistently accounted for the greatest proportion of the variance were number of friends who smoke, intentions to smoke in the future and percent of older siblings who smoke. The implications of this work for programs intended to prevent adolescent smoking are discussed.     

Factors associated with smoking and the intention to smoke in secondary school pupils: results of the ESFA project in Barcelona, Spain

Objective: To describe the factors asssociated with smoking and intention to smoke among a representative sample of first-grade pupils of secondary education (12-13 years old) in Barcelona.Subjects and methods: 37 secondary schools were randomly selected to evaluate the impact of a European-wide smoking prevention program (European Smoking prevention Frame Approach, ESFA project). In these schools, 1041 pupils of first grade of secondary education responded to a questionnaire designed at the University of Maastricht to study life-style attitudes and behaviours, mainly smoking.Results: 9.8% of boys and 12.6% of girls declared to smoke either regulary or ocasionally. Among the no-smokers, 61.4% of the boys and 73.3% of the girls reported to have the intention to smoke in the future. Among the boys, factors associated with smoking included social norms (odds ratio [OR] = 2.5; 95% confidence interval [CI]: 1.2-5.2), smoking by siblings (OR = 2.4; 95% CI, 1.1-5.2), attitudes against smoking (OR = 0.3; 95% CI, 0.1-0.6), practicing some sports in the leisure time (OR = 0.3; 95% CI, 0.1-0.7) and having more available pocket money (OR = 3.2; 95% CI, 1.5-6.8). Intention to smoke was only related to attitudes (OR = 0.3; 95% CI, 0.2-0.5). Among girls, smoking was associated to perceived pressure to smoke (OR = 2.5; 95% CI, 1.2-5.0), consumption by friends (OR = 6.0; 95% CI, 2.4-15.4) and attitudes against smoking (OR = 0.2; 95% CI, 0.1-0.4), while intention was only associated to attitudes (OR = 0.4; 95% CI, 0.2-0.6) and hanging out in the street in the leisure time (OR = 2.2; 95% CI, 0.3-3.5).Conclusions: The results stress the need to deal simultaneoulsy with the different factors associated to smoking initiation and attitude shaping, including cognitive factors, environmental factors, and patterns of leisure time utilization.     

Patterns and predictors of tobacco smoking cessation: A hospital-based study of pregnant women in Lebanon

OBJECTIVES: To describe patterns of cigarette and narghile (hubble-bubble or water-pipe) smoking before and during pregnancy and identify predictors of successful smoking cessation. METHODS: A survey was conducted on 4660 pregnant women who delivered single live births between September 1st, 2001 and December 31st, 2002 at five hospitals in Beirut, Lebanon. Women were classified into four groups according to patterns of tobacco use before and during pregnancy: 1) consistent non-users, 2) successful quitters, 3) unsuccessful quitters and 4) consistent users. RESULTS: High education (OR = 2.03, 95% CI: 0.99-4.15), adequate prenatal care (OR = 1.72, 95% CI: 1.02-2.91) and mild smoking at baseline (OR = 2.35, 95% CI: 1.36-4.09) were main determinants of successful cigarette smoking cessation, whereas successful quitters of narghile use were more likely to be nulliparous (OR = 1.80, 95% CI: 1.08-2.99) or to have a nonsmoking partner (OR = 7.57, 95 % CI: 2.31-24.78). CONCLUSIONS: Different populations should be targeted when designing smoking cessation interventions for cigarette and narghile users.     

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.     

Epidemiological survey on smoking habit among young students in Sardinia. A cross sectional study

The study reports the prevalence of cigarette smoking among 11401 high school Sardinian students. The prevalence of smokers (40.2%) significantly differs between gender (41.1% males and 38.4% females). Males have an early initiation of smoking with an evident addictive effect by age. 54.3% are daily smokers and 21.4% smoke 15 or more cigarettes per day. More than 50% smoke to look grown-up and to be accepted by the group. Besides age (OR=1.10; 95%CI: 1.06-1.15), other factors are associated with smoke: low education level of father (OR=1.08; 95%CI: 1.02-1.15), no maternal support (OR = 1.73; 95%CI: 1.17-2.54), to have at least one smoker cohabitant (OR=1.66; 95%CI: 1.54-1.80) and alcohol drinking (OR=3.46; 95%CI: 3.04-3.93). The smokers' knowledge on smoke topics significantly differ from non smokers. Our results suggest the need of community preventive interventions, diversified for specific target populations, to modify the students' behaviours so that they respect their own health and that of their fellow citizens.     

Smoking frequency among current college student smokers: distinguishing characteristics and factors related to readiness to quit smoking

Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1-5 days, 10.5% (n = 281) smoked 6-29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (β = 0.63, 95% CI 0.57-0.69) and more frequent other tobacco use (β = 0.04, 95% CI 0.02-0.05), drinking (β = 0.04, 95% CI 0.02-0.07) and binge drinking (β = 0.09, 95% CI 0.06-0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers.     

The influence of friends, family, and older peers on smoking among elementary school students: low-risk students in high-risk schools

BACKGROUND: This study examined how older smoking peers at school and the smoking behaviour of friends and family members are related to youth smoking. METHODS: Multi-level logistic regression analysis was used to examine correlates of ever smoking in a sample of 4286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada (2001). RESULTS: Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker [OR 1.05, 95% CI 1.02 to 1.08]. A low-risk student (no family or friends who smoke) was almost three times more likely to try smoking if he/she attended an elementary school with a relatively high prevalence of senior students who smoke than if he/she attended a school with a low prevalence of senior students who smoke. CONCLUSION: Low-risk grade 6 and 7 students are at significantly greater risk of smoking if they attend an elementary school with a relatively high prevalence of smoking among senior students. Prevention programs should target both at-risk schools and at-risk students.     

Smoking cessation intervention practices in Chinese physicians: do gender and smoking status matter?

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported "initiation and/or advice" smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with "initiation and/or advice" were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China.     

A period of increased susceptibility to cigarette smoking among high school students

Cross-sectional surveys of randomly selected high school students were conducted in October 1999 and in May 2000 to measure awareness of youth-led tobacco prevention efforts. A secondary goal of the surveys was to learn about tobacco use and attitudes. Respondents who never smoked cigarettes were asked if they had made a firm commitment to not smoke, and respondents who had not made such a commitment were considered susceptible. Among ninth graders, susceptibility increased from 31% in October to 47% in May, while susceptibility decreased from October to May for students in more advanced grades (p = 0.03, interaction of linear trends). Susceptibility was more common among students who felt smoking produced social benefits (OR 1.59, 95% CI 1.22-2.08) or who were tolerant of tobacco company behavior (OR 1.65, 95% CI 1.23-2.21), and less common among students who felt short-term adverse effects of cigarette smoking on health or hygiene were important to them (OR 0.74, 95% CI 0.56-0.97). Further studies should confirm the increase in susceptibility and its underlying mechanisms. Whether associated with ninth grade or with the first year in a new school, this previously unrecognized period of heightened susceptibility might represent an important opportunity for prevention.     

Correlates of smoking in pregnant women in six Brazilian cities

OBJECTIVE: To evaluate sociodemographic and lifestyle correlates of smoking in pregnant women sampled from hospitals. METHODS: A cross-sectional study was conducted in 5,539 pregnant women aged 20 or more who sought medical attention in prenatal clinics of affiliate hospitals of the Brazilian National Health System in the cities of Manaus, Fortaleza, Salvador, Rio de Janeiro, S?o Paulo, and Porto Alegre from 1991 to 1995. Interviews were conducted using a standardized questionnaire that covered sociodemographics and smoking habits before and during pregnancy. Current smoking was defined as smoking at least one cigarette/day, former smoking as reporting having smoked at least one cigarette/day but having quit, and never smoking as never having smoked one cigarette/day. RESULTS: Smoking during pregnancy was associated with lower education (OR=2.13; CI 95%: 1.76-2.57) and greater parity (OR=1.84; CI 95%: 1.53-2.21). Positive associations were also found with increased gestational age and alcohol consumption. No significant association was found with skin color or occupation status. A protective effect was observed for women married or living with a partner (OR=0.55 CI 95%: 0.42-0.72). Having Manaus' women as a reference, Porto Alegre's women showed the greatest risk for smoking in pregnancy (OR=5.00; CI 95%: 3.35-7.38), followed by S?o Paulo's (OR=3.42; CI 95%: 2.25-5.20), Rio de Janeiro (OR=2.53; CI 95%: 1.65-3.88) and Fortaleza's (OR=2.56; CI 95%: 1.74-3.78). CONCLUSIONS: The study findings are similar to those described in the literature regarding education, parity, and marital status. However, no association with skin color was seen in the multivariate analysis. Former smokers had sociodemographic characteristics more similar to non-smokers than former smokers.     

Maternal Exposures to Cigarette Smoke,Alcohol, and Street Drugs and Neural Tube Defect Occurrence in Offspring

Objectives Cigarettes, alcoholic beverages, and street drugs contain substances potentially toxic to the developing embryo. We investigated whether maternal cigarette smoking, secondhand smoke exposure, and alcohol or street drug use contributed to neural tube defect (NTD) occurrence in offspring. Methods We conducted a population-based case-control study among Mexican American women who were residents of the 14 Texas counties bordering Mexico. Case women had an NTD-affected pregnancy and delivered during 1995–2000. Control women were those who delivered live born infants in the same study area, without an apparent congenital malformation, randomly selected by year and facility. We interviewed women in person, 1–3 months postpartum, to solicit relevant information. Results Nonsmoking mothers exposed to secondhand smoke during the first trimester had an NTD odds ratio (OR) of 2.6 (95% confidence interval (CI) = 1.6, 4.0) compared to those who neither smoked nor were exposed to secondhand smoke. Compared to the referent, the OR among women who smoked less than half a pack a day during the first trimester was 2.2 (95% CI = 1.0, 4.8) and 3.4 (95% CI = 1.2, 10.0) among those who smoked a half pack or more. Adjustment for maternal age, education, body mass index, and folate intake had a negligible effect on results. Alcohol and street drug use had no relation to NTD risk when adjusted for cigarette smoking. Conclusions This study suggests that cigarette smoke including secondhand exposure is not only hazardous to the mother but may also interfere with neural tube closure in the developing embryo.     

Cigarette smoking behavior among US Latino men and women from different countries of origin

OBJECTIVES: This study sought to compare smoking behavior among Latino men and women from different countries of origin. METHODS: A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. RESULTS: A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High ac culturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00-1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. CONCLUSIONS: Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex.     

Nasopharyngeal carcinoma in Malaysian Chinese: occupational exposures to particles, formaldehyde and heat

BACKGROUND: During 1990-1992, 282 Chinese residents of Selangor and the Federal Territory, Malaysia with histologically confirmed nasopharyngeal carcinoma (NPC) were interviewed about occupational history, diet, alcohol consumption, and tobacco use, as were an equal number of Malaysian Chinese population controls, pair-matched to cases by age and sex. METHODS: Exposures to 20 kinds of workplace substances, solar and industrial heat, and cigarette smoke, were analysed by univariate and multivariate methods. RESULTS: Nasopharyngeal carcinoma was associated with occupational exposures to construction, metal and wood dusts; motor fuel and oil; paints and varnishes; certain other chemicals; industrial heat; solar heat from outdoor occupations; certain smokes; cigarette smoking; and childhood exposure to parental smoking. After adjustment for risk from diet and cigarette smoke, only wood dust (OR = 2.36; 95% CI : 1.33- 4.19), and industrial heat (OR = 2.21; 95% CI : 1.12-4.33) remained clearly associated. Wood dust remained statistically significant after further adjustment for social class. No significant crude or adjusted association was found between NPC and formaldehyde (adjusted OR = 0.71; 95% CI : 0.34-1.43). CONCLUSIONS: This study supports previous findings that some occupational inhalants are risk factors for NPC. The statistical effect of wood dust remained substantial after adjustment for diet, cigarette smoke, and social class. Intense industrial heat emerged as a previously unreported risk factor, statistically significant even after adjustment for diet and cigarette smoke. No association was found between NPC and formaldehyde.