1
|
Erng MN, Reid N, Moritz KM, van Driel M. Prenatal alcohol exposure risk perception dimensions and influencing factors: A systematic review and conceptual model. Aust N Z J Public Health 2023; 47:100047. [PMID: 37075515 DOI: 10.1016/j.anzjph.2023.100047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/26/2023] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE This paper aims to explore the available literature to understand how risks regarding prenatal alcohol exposure are perceived. METHODS A systematic review (PROSPERO; CRD 42020212887) was undertaken. PubMed, Embase, PsycINFO, and CINAHL were searched for relevant quantitative and qualitative studies. A thematic analysis of the studies was performed. RESULTS Fifteen articles-nine quantitative and six qualitative studies met the inclusion criteria. Three dimensions of risk perceptions were identified-perceived susceptibility, perceived severity, and affective risk perception. Three influencing factors of these dimensions were also identified: information (i.e., consistency, confirmation bias, strength of the evidence, and perceived relevance), sociocultural (i.e., social inclusivity, cultural context, and risk interpretation), and individual (i.e., risks versus benefits, controllability, and experience). These dimensions and influencing factors were brought together to create the proposed novel Pregnancy Alcohol Risk Perception (PARP) conceptual model. CONCLUSIONS The novel PARP conceptual model developed from the current literature provides a framework to guide understanding of risk perceptions, which includes a wide range of potential influencing factors. IMPLICATIONS FOR PUBLIC HEALTH The novel PARP conceptual model provides the groundwork for further refinement with stakeholders, which could in turn be used to inform the design of interventions and health promotional materials to support harm reduction approaches and prevention of prenatal alcohol exposure.
Collapse
Affiliation(s)
- May N Erng
- The University of Queensland, Child Health Research Centre, South Brisbane, 4101, Australia.
| | - Natasha Reid
- The University of Queensland, Child Health Research Centre, South Brisbane, 4101, Australia
| | - Karen M Moritz
- The University of Queensland, School of Biomedical Sciences, St Lucia, 4067, Australia
| | - Mieke van Driel
- Primary Care Clinical Unit, The University of Queensland, Herston, 4006, Australia
| |
Collapse
|
2
|
Khurana A, Loan CM, Romer D. Predicting cigarette use initiation and dependence in adolescence using an affect-driven exploration model. Front Psychol 2022; 13:887021. [PMID: 36132193 PMCID: PMC9484548 DOI: 10.3389/fpsyg.2022.887021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/20/2022] [Indexed: 12/02/2022] Open
Abstract
Adolescent decisions, especially in novel contexts, are often guided by affective evaluations (i.e., feelings associated with a stimulus) rather than knowledge of the risks and probabilities of different outcomes. In this study, we used the affect-driven exploration (ADE) model to illustrate how affective evaluations can play a critical role in driving early use of cigarettes, as well as the adaptive function of the resulting experiential learning in informing future affect and cigarette use. We analyzed five waves of data collected from a large, diverse community sample of adolescents who were followed from early to late adolescence (N = 386; 50.9% female; Baseline age = 11.41 ± 0.88 years) during years 2004-2010 to model trajectories of positive affect and risk perceptions (associated with cigarette use) and examined the associations of these trajectories with their self-reported cigarette use and dependence symptoms. Consistent with the ADE model, early initiators reported higher levels of positive affect at baseline, which we argue may have led them to try cigarettes. Notably, most early initiators reported a decline in positive affect over time, suggesting an experience-based shift in affective evaluations associated with cigarette use. Risk perceptions associated with cigarette use did not emerge as a significant predictor of cigarette use or subsequent dependence. Therefore, for deterring adolescent cigarette use, efforts to influence affect (through graphic warning labels and other media) may be more effective than directly influencing risk perceptions. Despite the affective basis for initiating cigarette use, few adolescents engaged in early use (N = 20) or developed symptoms of dependence (N = 25). Majority of those who engaged in early cigarette use showed a decline in positive affect, with corresponding increase in risk perceptions over time. Some early users may indeed continue to engage in cigarette use, but this is likely driven by the addictive properties of the drug. Overall these findings challenge the popular stereotype of impulsive and emotionally reactive behaviors during adolescence, and suggest a more nuanced interpretation of adolescent risk behavior.
Collapse
Affiliation(s)
- Atika Khurana
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Christopher M. Loan
- Department of Educational Methodology, Policy and Leadership, College of Education, University of Oregon, Eugene, OR, United States
| | - Dan Romer
- Annenberg Public Policy Center, Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
3
|
Asharani PV, Lau JH, Ai Ling Seet V, Devi F, Wang P, Roystonn K, Lee YY, Cetty L, Teh WL, Verma S, Mok YM, Chong SA, Subramaniam M. Smoking-Related Health Beliefs in a Sample of Psychiatric Patients: Factors Associated with the Health Beliefs and Validation of the Health Belief Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041571. [PMID: 33562257 PMCID: PMC7916053 DOI: 10.3390/ijerph18041571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
This study examined the (a) health beliefs and emotions (perception of risk, benefits, severity, and worry) about smoking among current and former smokers, (b) their awareness of health warnings, (c) factors associated with smoking-related health beliefs, and (d) the factor structure of the health belief questionnaire. Participants (n = 184) were recruited from a tertiary psychiatric care hospital. Current smokers showed a significantly higher risk perception and lower perceived benefits compared to former smokers. Younger age (<40 years), nicotine dependence (ND), a history of smoking-related diseases (SRD), and intention to quit were significantly associated with a higher risk perception in current smokers. Younger age, a history of SRDs, and motivation to quit were positively associated with health beliefs, while the latter two were associated with worry. Motivation and younger age were associated with a better perception of benefits and severity. Information on the cigarette packets was the major source of awareness for the sample, and 69% reported that existing campaigns were not effective in discouraging their smoking. Personalized risk communication and educational initiatives must focus on improving the knowledge of risk, benefits, and increase motivation to promote health cognition and thus smoking cessation.
Collapse
Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
- Correspondence: ; Tel.: +65-63892961
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Vanessa Ai Ling Seet
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore 539747, Singapore;
- Office of Education, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| |
Collapse
|
4
|
Shani M, Kraft L, Müller M, Boehnke K. The potential benefits of camps for children and adolescents with celiac disease on social support, illness acceptance, and health-related quality of life. J Health Psychol 2020; 27:1635-1645. [PMID: 33198516 DOI: 10.1177/1359105320968142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Among N = 165 14-22-year-old bearers of celiac disease (CD), the German-based study examined if participation in camps for children with CD is related to higher CD-related quality of life (CD-QoL); N = 48 of the study participants attended at least one camp. Camp participation was found to be related to higher CD-QoL, an effect mediated by having more friends with CD and by perceiving higher social support. Camp participation was also associated with higher illness acceptance and lower anxiety. Results show the potential benefits of recreational activities in CD treatment, to be further examined in experimental research.
Collapse
Affiliation(s)
- Maor Shani
- Jacobs University Bremen, Germany.,Osnabrück University, Germany
| | | | | | - Klaus Boehnke
- Jacobs University Bremen, Germany.,National Research University Higher School of Economics, Russia
| |
Collapse
|
5
|
Maffioli EM, Mohanan M, Saran I, O'Meara WP. Does improving appropriate use of malaria medicines change population beliefs in testing and treatment? Evidence from a randomized controlled trial. Health Policy Plan 2020; 35:556-566. [PMID: 32129851 DOI: 10.1093/heapol/czaa010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2020] [Indexed: 01/08/2023] Open
Abstract
A major puzzle in malaria treatment remains the dual problem of underuse and overuse of malaria medications, which deplete scarce public resources used for subsidies and lead to drug resistance. One explanation is that health behaviour, especially in the context of incomplete information, could be driven by beliefs, pivotal to the success of health interventions. The objective of this study is to investigate how population beliefs change in response to an experimental intervention which was shown to improve access to rapid diagnostic testing (RDT) through community health workers (CHWs) and to increase appropriate use of anti-malaria medications. By collecting data on individuals' beliefs on malaria testing and treatment 12 and 18 months after the experimental intervention started, we find that the intervention increases the belief that a negative test result is correct, and the belief that the first-line anti-malaria drugs (artemisinin-based combination therapies or ACTs) are effective. Using mediation analysis, we also explore some possible mechanisms through which the changes happen. We find that the experience and knowledge about RDT and experience with CHWs explain 62.4% of the relationship between the intervention and the belief that a negative test result is correct. Similarly, the targeted use of ACTs and taking the correct dose-in addition to experience with RDT-explain 96.8% of the relationship between the intervention and the belief that the ACT taken is effective. As beliefs are important determinants of economic behaviour and might guide individuals' future decisions, understanding how they change after a health intervention has important implications for long-term changes in population behaviour.
Collapse
Affiliation(s)
- Elisa M Maffioli
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Manoj Mohanan
- Sanford School of Public Policy, Duke University, Durham, NC 27708, USA.,Department of Economics, Duke University, Durham, NC 27708, USA.,Duke Global Health Institute, Duke University, Durham, NC 27708, USA.,Duke Population Research Institute, Duke University, Durham, NC 27708, USA
| | - Indrani Saran
- Boston College School of Social Work, Boston, MA 02467, USA
| | - Wendy Prudhomme O'Meara
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC 27708, USA.,Moi University School of Public Health, College of Health Sciences, Eldoret, Kenya
| |
Collapse
|
6
|
Owusu D, Mamudu HM, Collins C, Robertson C, Wang L, Rafie B, Littleton MA. The Usage and Associated Factors of Alternative Tobacco Products among School-going Youth in Central Appalachia. J Health Care Poor Underserved 2019; 30:249-264. [PMID: 30827981 DOI: 10.1353/hpu.2019.0019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine alternative tobacco product (ATP) use and associated factors among middle school students in Appalachian Tennessee. METHOD Data (2015-2016; N=573) from school-based tobacco surveys in 11 middle schools in Appalachian Tennessee were analyzed. Multiple logistic regression model described factors associated with ATP use. RESULTS More than one-tenth (13.2%) of participants have ever used ATPs. Approximately 9%, 7%, 6%, and 2% of participants have ever used e-cigarettes, cigarettes, smokeless tobacco, and little cigars or cigarillos, respectively. The following were significantly associated with ever use of ATPs: believing tobacco users have more friends, owning tobacco-branded item(s), living with a tobacco user, having ever smoked cigarettes, and living in homes where smoking is allowed. CONCLUSION More than one in 10 of participants have ever used at least one ATP, and association with desirable objects and situations may promote ATP use. Interventions should seek to reduce these positive images and make all tobacco products unappealing.
Collapse
|
7
|
O'Brien EK, Persoskie A, Parascandola M, Hoffman AC. US Adult Interest in Less Harmful and Less Addictive Hypothetical Modified Risk Tobacco Products. Nicotine Tob Res 2019; 20:1317-1326. [PMID: 29059364 DOI: 10.1093/ntr/ntx227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/27/2017] [Indexed: 11/12/2022]
Abstract
Introduction Tobacco companies have a history of making health claims about their new products. Such claims are now regulated by the US Food and Drug Administration. We examined consumer interest in hypothetical modified risk tobacco products (MRTPs) among current, former, and never established smokers and examined whether interest was associated with beliefs about tobacco and cancer. Methods Data were analyzed from the US nationally representative 2015 Health Information National Trends Survey (HINTS-FDA 2015; N = 3738). Interest in hypothetical MRTPs was assessed by asking participants their likelihood of using tobacco products claiming to be less addictive and less harmful than other products. Results About half of current smokers and a tenth of both former and never smokers reported they were "somewhat" or "very" likely to try hypothetical MRTPs claiming to be less harmful or less addictive. Female smokers, former smokers with lower smoking harm perceptions, and never smokers who are young adults or without college education expressed more interest in these products. Interest in using these products was positively associated with believing that smoking status is a changeable individual characteristic and that it is possible for tobacco products to be made without some harmful chemicals. Conclusion We identified several subgroups of current, former, and never smokers who may be particularly affected by the marketing of MRTPs and therefore important to study to inform models of the potential population health impact of authorizing the marketing of MRTPs. Implications Findings about interest in hypothetical MRTPs can inform models of how the marketing of MRTPs could affect population health. Understanding which subgroups are particularly interested in MRTPs can help determine who might be important to study to inform these models. We identified several groups who may warrant specific attention: smokers who are female, former smokers who hold low harm perceptions of smoking, never smokers who are young adults or have a high school education or less, people who believe that smoking is a changeable individual characteristic, and people who believe that it is possible to make low chemical tobacco products.
Collapse
Affiliation(s)
- Erin Keely O'Brien
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Alexander Persoskie
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Mark Parascandola
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Allison C Hoffman
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| |
Collapse
|
8
|
Schuler MS, Dick AW, Stein BD. Sexual minority disparities in opioid misuse, perceived heroin risk and heroin access among a national sample of US adults. Drug Alcohol Depend 2019; 201:78-84. [PMID: 31200278 PMCID: PMC6612451 DOI: 10.1016/j.drugalcdep.2019.04.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Lesbian, gay and bisexual (LGB) adults have elevated use of many substances compared to heterosexual adults, yet LGB disparities in specific types of opioid misuse and perceived opioid risk have not been fully characterized. METHODS Data on 126,463 adults (including 8241 LGB adults) were from the 2015-2017 National Survey of Drug Use and Health. Logistic regression was used to estimate lesbian/gay (L/G) and bisexual disparities (relative to same-gender heterosexuals) for: lifetime prescription pain reliever misuse, heroin use and injection heroin use; past-year opioid misuse and opioid use disorder (OUD); and perceived risk of and access to heroin. RESULTS All LGB subgroups had elevated lifetime pain reliever misuse rates relative to same-gender heterosexuals. Lifetime heroin use was elevated among LGB women and bisexual men; bisexual women had 4 times the odds of injection heroin use. LGB women and gay men had 1.4-2.4 times the odds of past-year opioid misuse; bisexual women had 2.5 times the odds of OUD. LGB women reported both lower perceived risk of trying heroin and greater perceived heroin access. CONCLUSIONS Lifetime and past-year opioid misuse is elevated among LGB adults. Bisexual women are particularly at-risk, uniquely exhibiting disparities on high-risk injection use and OUD. Lower perceived risk of and greater access to heroin among LGB women may play a role in the onset or continuation of opioid misuse. Opioid misuse disparities among LGB adults are of substantial concern given the resultant elevated risk for fatal and non-fatal opioid overdose.
Collapse
Affiliation(s)
| | - Andrew W. Dick
- RAND Corporation, 20 Park Plaza #920, Boston, MA 02216, USA
| | - Bradley D. Stein
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA 15213, USA
| |
Collapse
|
9
|
Relative Risk Perceptions between Snus and Cigarettes in a Snus-Prevalent Society-An Observational Study over a 16 Year Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050879. [PMID: 30862006 PMCID: PMC6427464 DOI: 10.3390/ijerph16050879] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
Background: Most studies on perceived risks of smokeless tobacco products (SLT) have been conducted in the U.S., and the vast majority conclude that perceptions of the relative harmfulness of SLT versus cigarettes in the population are inconsistent with epidemiologically-based risk estimates, and typically conflated to that of cigarettes. We tested whether such inaccuracies also existed in Norway, where SLT-products are less toxic (Swedish snus) and SLT use is more prevalent than in the U.S. Methods: Over a 16 years period (2003⁻2018), 13,381 respondents (aged 16⁻79 years) answered questions about risk perceptions in Statistics Norway's nationally representative survey of tobacco behavior. We applied an indirect measure of comparative harm where risk beliefs for eight nicotine products were assessed independently of other products and then compared the answers. The wording of the question was: "We will now mention a variety of nicotine products and ask you how harmful you think daily use of these are. Use a scale from 1 to 7, where 1 is slightly harmful and 7 is very harmful". Mean scores with 95% confidence intervals were calculated. Results: The overall risk score for cigarettes was 6.48. The risk score for snus was 5.14⁻79.3% of the risk score of cigarettes. The relative risk scores for e-cigarettes (3.78) and NRT products (3.39) was 58.4% and 52.3% when compared to cigarettes. Perceptions of risk were stable over time. A strong association was observed between perceived risk of snus and having used snus in attempts to quit smoking. Conclusion: Perceptions of relative risk between snus and cigarettes is inconsistent with estimates from medical expert committees, which assess the overall health risk from use of Swedish snus to be minor when compared to the risk from smoking. Like the situation in the US, incorrect beliefs about SLT risks seem to be prevalent also in the snus-prevalent Norwegian setting. Accurate information on differential harms needs to be communicated. Future research should try to identify reasons why health authorities in the US and Scandinavia allow these well-documented misconceptions to persist.
Collapse
|
10
|
Wagner GA, Sanchez ZM, Fidalgo TM, Caetano SC, Carliner H, Martins SS. Sociodemographic factors associated with smoking risk perception in adolescents in São Paulo, Brazil. BRAZILIAN JOURNAL OF PSYCHIATRY 2019; 41:546-549. [PMID: 30758434 PMCID: PMC6899349 DOI: 10.1590/1516-4446-2018-0219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/23/2018] [Indexed: 11/25/2022]
Abstract
Objective: We examined the sociodemographic factors associated with smoking risk perceptions (SRP) in youth living in two very different neighborhoods in the city of São Paulo, Brazil: a middle-class central area (Vila Mariana) and a poor outer-city area (Capão Redondo). Methods: A cross-sectional survey was conducted with 180 public school-attending youth (all aged 12 years) and their parents. SRP was evaluated through self-reports. Weighted multinomial logistic regression was used to examine factors associated with SRP. Results: Smoking was considered a high-risk behavior by 70.9% of adolescents. There were significant differences in SRP associated with socioeconomic status (SES) and maternal smoking status. Having a non-smoking mother was positively associated with perceiving smoking as having low to moderate risk versus no risk (OR=3.91 [95%CI 1.27-12.02]). Attending school in Capão Redondo was associated with perceiving smoking as having high risk compared to no risk (OR=3.00 [95%CI 1.11-8.12]), and low SES was negatively associated with perceiving at least some risk in smoking versus perceiving no risk in this behavior. Conclusions: Youth whose mothers smoke appear to have lower SRP than those whose mothers do not smoke. Living in a poor outer-city area was associated with higher SRP.
Collapse
Affiliation(s)
- Gabriela A Wagner
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Zila M Sanchez
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Thiago M Fidalgo
- Departamento de Psiquiatria, Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brazil
| | - Sheila C Caetano
- Departamento de Psiquiatria, Escola Paulista de Medicina, UNIFESP, São Paulo, SP, Brazil
| | - Hannah Carliner
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
11
|
Owusu D, Mamudu HM, Robertson C, Wang L, Guy H, Collins C, Boghozian R, Littleton MA. Intention to Try Tobacco Among Middle School Students in a Predominantly Rural Environment of Central Appalachia. Subst Use Misuse 2019; 54:449-458. [PMID: 30618325 PMCID: PMC6615940 DOI: 10.1080/10826084.2018.1504080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Disparities in tobacco use exist across regions in the United States. The Central Appalachian region carries some of the very high rates of tobacco use prevalence but research on tobacco use initiation is sparse. OBJECTIVE To investigate the intention to try tobacco and its associated factors among nonsmoking youth. METHOD Data were obtained from school-based tobacco surveys (n = 539) conducted in 11 middle schools (6th-8th grades; aged 10-15 years) in Northeast Tennessee in 2015-2016. Nonsmoking participants without firm commitment to abstain from trying tobacco in the next year were considered to have an intention to try tobacco. The Full Information Maximum Likelihood estimation (FIML) method in Mplus was employed to conduct a multivariable logistic regression analysis to delineate correlates of intention to try tobacco. RESULTS Overall, 20.0% of participants had intention to try tobacco. Among participants with intention to try tobacco, 53.7% owned tobacco-branded item(s), 86.1% believed that tobacco users have more friends, and 88.9% lived with tobacco users. In the adjusted logistic model, ever use of tobacco products, home smoking rules, owning tobacco-branded item(s), living with tobacco users, believing that tobacco users have more friends, and perception of easy access to tobacco products were significantly associated with intention to try tobacco (p < .02). CONCLUSION This study suggests that individual, interpersonal, and community level factors influence intention to try tobacco in this environment where tobacco pre-emption laws impede development of local tobacco control policies and regulations. Thus, efforts should focus on tobacco use initiation preventive programs, including school-based tobacco control programs.
Collapse
Affiliation(s)
- Daniel Owusu
- Georgia State University Tobacco Center of Regulatory Science (GSU TCORS), Urban Life Building 850, 140 Decatur St, Atlanta, GA 30030, USA.
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, East Tennessee State University, P.O. Box 70264 Johnson City, TN, USA.
| | - Crystal Robertson
- Louisiana States University, School of Plant Environmental and Soil Sciences, Baton Rouge, LA.
| | - Liang Wang
- Department of Biostatistics and Epidemiology, East Tennessee State University, College of Public Health P.O. Box 70259, Johnson City, TN 37614.
| | - Holdon Guy
- Department of Health Services Management and Policy, East Tennessee State University, College of Public Health, P.O. Box 70264 Johnson City, TN, USA.
| | - Candice Collins
- Department of Biostatistics and Epidemiology, East Tennessee State University, College of Public Health P.O. Box 70259, Johnson City, TN 37614.
| | | | - Mary A Littleton
- Department of Community and Behavioral Health, East Tennessee State University, P.O. Box 70674, Johnson City, TN, USA.
| |
Collapse
|
12
|
Abstract
This paper provides new evidence on biased perceptions about the risks of smoking. It studies predictors of lung cancer risk perceptions. Lung cancer is one of the deadliest and most aggressive cancer types with 5-year survival rates of only up to 15%. A cross-sectional online survey in Berlin assessed lung cancer risk perceptions among smokers (n = 664), never smokers (n = 703), and former smokers (n = 501) in 2013. In addition to lung cancer risk perceptions, the survey measured many respondent characteristics, such as intention to quit smoking and a self-assessment of the likelihood of success in quitting. The findings show that 80% of all respondents overestimated lung cancer survival rates and suggest significant room for public health campaigns to educate smokers and nonsmokers about the deadliness of lung cancer. Multivariate linear regressions show that smokers who do not plan to quit estimate the 5-Year Lung Cancer Survival Rate to be 11% (p = 0.044) higher than other smokers. A reduction in risk perception biases may induce some smokers to alter their quitting intentions and others to successfully quit.
Collapse
|
13
|
Allinson JP, Hardy R, Donaldson GC, Shaheen SO, Kuh D, Wedzicha JA. Combined Impact of Smoking and Early-Life Exposures on Adult Lung Function Trajectories. Am J Respir Crit Care Med 2017; 196:1021-1030. [PMID: 28530117 DOI: 10.1164/rccm.201703-0506oc] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Both adverse early-life exposures and adult smoking can negatively influence adult lung function trajectory, but few studies consider how the impact of early-life exposures may be modified by subsequent smoking. METHODS The Medical Research Council National Survey of Health and Development is a nationally representative cohort, initially of 5,362 individuals, followed since enrollment at birth in March 1946. Using data collected prospectively across life and multilevel modeling, we investigated how the relationships between early-life exposures (infant lower respiratory infection, manual social class, home overcrowding, and pollution exposure) and FEV1 and FVC trajectories between ages 43 and 60-64 years were influenced by smoking behavior. MEASUREMENTS AND MAIN RESULTS Among 2,172 individuals, there were synergistic interactions of smoking with infant respiratory infection (P = 0.04) and early-life home overcrowding (P = 0.009), for FEV1 at 43 years. Within smoker-stratified models, there were FEV1 deficits among ever-smokers associated with infant lower respiratory infection (-108.2 ml; P = 0.001) and home overcrowding (-89.2 ml; P = 0.002), which were not evident among never-smokers (-15.9 ml; P = 0.69 and -13.7 ml; P = 0.70, respectively). FVC modeling, including 1,960 individuals, yielded similar results. FEV1 decline was greater in smokers (P < 0.001), but there was no effect of any early-life exposure on FEV1 decline. Neither smoking nor early-life exposures were associated with FVC decline. CONCLUSIONS Besides accelerating adult FEV1 decline, cigarette smoking also modifies how early-life exposures impact on both midlife FEV1 and FVC. These findings are consistent with smoking impairing pulmonary development during adolescence or early adulthood, thereby preventing catch-up from earlier acquired deficits.
Collapse
Affiliation(s)
- James P Allinson
- 1 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Rebecca Hardy
- 2 Medical Research Council Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom; and
| | - Gavin C Donaldson
- 1 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Seif O Shaheen
- 3 Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Diana Kuh
- 2 Medical Research Council Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom; and
| | - Jadwiga A Wedzicha
- 1 Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| |
Collapse
|
14
|
Kutlu-Koc V, Kalwij A. Individual Survival Expectations and Actual Mortality: Evidence from Dutch Survey and Administrative Data. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2017; 33:509-532. [PMID: 30976236 PMCID: PMC6241071 DOI: 10.1007/s10680-017-9411-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
Because of the important role that survival expectations play in individual decision making, we investigate the extent to which individual responses to survival probability questions are informative about actual mortality. In contrast to earlier studies, which relied on the Health and Retirement Study (HRS) of US individuals aged 50 and over, we combine household survey data on subjective survival probabilities with administrative data on actual mortality for Dutch respondents aged 25 and over. Our main finding is that in our sample, individual life expectancies (measured as subjective survival probabilities) do predict actual mortality even when we control for a large set of health indicators. Our results further suggest that, on average, women underestimate their remaining life duration, whereas men tend to predict their survival chances more realistically. Both sexes, however, tend to overestimate the age gradient in mortality risk and underestimate the health risks of smoking.
Collapse
Affiliation(s)
- Vesile Kutlu-Koc
- Munich Center for the Economics of Aging (MEA), Amalienstr. 33, Room. 360, 80799 Munich, Germany
| | - Adriaan Kalwij
- Utrecht University School of Economics, Kriekenpitplein 21-22, Room. 3.02, 3584 EC Utrecht, Netherlands
| |
Collapse
|
15
|
Votaw VR, Wittenauer J, Connery HS, Weiss RD, McHugh RK. Perceived risk of heroin use among nonmedical prescription opioid users. Addict Behav 2017; 65:218-223. [PMID: 27544695 DOI: 10.1016/j.addbeh.2016.08.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/18/2016] [Accepted: 08/13/2016] [Indexed: 01/09/2023]
Abstract
AIMS The prevalence of heroin use among nonmedical prescription opioid (NMPO) users has increased in recent years. Identifying characteristics associated with heroin use in this population can help inform efforts to prevent heroin initiation and maintenance. The aim of this study was to evaluate differences in perceived risk of heroin among NMPO users with and without histories of heroin use, and to examine temporal trends in perceived risk of heroin among this population. METHODS Data are from the 2002-2013 National Survey on Drug Use and Health, and included all past-year NMPO users (N=49,045). Participants reported perceived risk of trying heroin once or twice and regular heroin use. Responses were coded dichotomously (great risk vs. other risk) and logistic regression analyses were used to evaluate the association between lifetime heroin use and perceived risk of heroin, and to determine temporal changes in perceived risk. RESULTS Results indicated a significant association between lifetime heroin use and lower likelihood of reporting great risk of trying heroin (OR=0.38, 95% CI: 0.33, 0.44, p<0.001), and of regular use of heroin (OR=0.39, 95% CI: 0.32, 0.48, p<0.001). There was a significant, yet modest, trend toward decreasing perception of great risk from 2002 to 2013. CONCLUSIONS Findings from this analysis of nationally representative data indicate that NMPO users with a history of heroin use perceive heroin to be less risky than those without heroin use. Perception of risk has decreased from 2002 to 2013 in this population, consistent with increasing rates of heroin initiation.
Collapse
Affiliation(s)
- Victoria R Votaw
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.
| | - Justine Wittenauer
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Partners HealthCare, 800 Boylston Street, Boston, MA 02199, United States
| | - Hilary S Connery
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| | - Roger D Weiss
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| | - R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| |
Collapse
|
16
|
Cooper TV, Cabriales JA, Hernandez N, Law J. A baseline assessment of attitudes toward tobacco free campus policies in a U.S./México border university. Addict Behav 2016; 60:223-7. [PMID: 27174217 DOI: 10.1016/j.addbeh.2016.04.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/04/2016] [Accepted: 04/20/2016] [Indexed: 10/21/2022]
Abstract
In recent years there has been an increase in the number of smoke/tobacco free settings, including university campuses. Given the benefits associated with the implementation of smoke and tobacco free campus policies, it is important to study attitudes toward these due to their potential association with subsequent implementation issues. The present study assessed potential predictors of attitudes toward tobacco free campus (TFC) policies, tobacco use risk perception, and perceived problematic campus tobacco use at a university located on the U.S./México border. University faculty, staff, and students (N=3002; Mage=30.4; 60% female; 67.1% Hispanic) completed an online survey regarding tobacco use history, attitudes toward TFC policies, tobacco use risk perception, perception of problematic tobacco use on campus, and awareness of the current tobacco use campus policy. Male gender, non Hispanic white ethnicity, smoking behavior (history/current), and identifying the current tobacco use policy were associated with less positive attitudes toward TFC policies and lower tobacco use risk perception. Non Hispanic white ethnicity and current smoking were associated with a lower perception of problematic campus tobacco use. Attitudes toward TFC policies and perceptions were generally positive, yet educating about the risks associated with tobacco use and addressing misconceptions about the dangers of secondhand smoke to potentially promote TFC policies seem warranted.
Collapse
|
17
|
Gil-Lacruz AI, Gil-Lacruz M, Leeder S. Women and smoking—prices and health warning messages: evidence from Spain. Addict Behav 2015; 45:294-300. [PMID: 25770976 DOI: 10.1016/j.addbeh.2015.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 12/24/2014] [Accepted: 01/12/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE In Spain, fewer men are smoking every year yet the number of women smokers remains relatively high. This paper examines the impact of two anti-smoking policies (increased prices and obligatory pictorial health warning labels) on womens smoking decisions; generation cohorts are used to elucidate the determinants of those decisions. DATA SOURCE We have drawn 48,755 observations of women living in Spain from the Spanish National Health Surveys of 2001, 2003, 2006 and 2011. DATA SYNTHESIS Among the main results, we highlight that belonging to a particular generation modulates the manner in which individual characteristics and tobacco policies determine smoking decisions. For example, women's smoking was not considered as socially acceptable until the 1960s and therefore older women have lower smoking rates. However, for the younger female cohorts (generations X and Y) smoking was seen as an act of rebellion and modernity, so women belonging to these groups, irrespective of educational level, are more likely to smoke. CONCLUSIONS The price of cigarettes and pictorial health warning labels on cigarette packets also influence the smoking behaviour of Spanish women.
Collapse
|
18
|
Grevenstein D, Nagy E, Kroeninger-Jungaberle H. Development of risk perception and substance use of tobacco, alcohol and cannabis among adolescents and emerging adults: evidence of directional influences. Subst Use Misuse 2015; 50:376-86. [PMID: 25496046 DOI: 10.3109/10826084.2014.984847] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND While several studies have investigated the relationship between risk perception and substance use, surprisingly little is known about mutual influences between both variables over time. OBJECTIVES The present study aimed to explore two different hypotheses separately for tobacco, alcohol and cannabis: influences from risk perception on behavior (motivational hypothesis) and influences from behavior on risk perception (risk reappraisal hypothesis). METHODS A prospective and longitudinal cross-lagged panel design was used with substance use and risk perception measured five times over the course of 10 years. Participants were 318 German youths aged 14-15 at the beginning of the study. Risk perception and substance use frequency were measured using self-reports. RESULTS Structural equation modeling indicated significant influences of risk perception on substance use behavior for all substances, which supports the motivational hypothesis. Changes in risk perception predict changes in future substance use of tobacco, alcohol and cannabis. Specifically for cannabis, influences of substance use on risk perception can also be shown, thus, supporting the risk reappraisal hypothesis. CONCLUSIONS While there is support for the rationale behind adequate risk perception as a goal of preventive interventions, the possibility of risk reappraisal should not be neglected, especially regarding illicit substances.
Collapse
Affiliation(s)
- Dennis Grevenstein
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | | | | |
Collapse
|
19
|
Waters EA, Kincaid C, Kaufman AR, Stock ML, Peterson LM, Muscanell NL, Guadagno RE. Concerns about unintended negative consequences of informing the public about multifactorial risks may be premature for young adult smokers. Br J Health Psychol 2013; 19:720-36. [PMID: 24118369 DOI: 10.1111/bjhp.12069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 08/13/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Many health risks are associated with both genetic and behavioural factors. Concerns have been raised that learning about such multifactorial risks might have detrimental effects on health-related beliefs, cognitions, and affect. However, experimental evidence is sparse. OBJECTIVE To explore the effects of reading an online news article about the discovery of a genetic basis for nicotine addiction. METHODS Smokers (N = 333) were recruited from the psychology subject pools of two major universities. Participants were randomly assigned to read one of three news articles: one describing a genetic basis for nicotine addiction and lung cancer obtained from a national news source, one altered to indicate no genetic basis for nicotine addiction and lung cancer, or one unrelated attention control. Participants then completed an online questionnaire, which assessed smoking-related cognitions and affect, and beliefs about nicotine addiction, quitting smoking, and whether the harms of tobacco use are delayed. RESULTS There was no statistically significant influence of experimental condition on smoking-related cognitions/affect (ps > .05, η(2) < .002), beliefs about addiction and quitting (Wilks' λ = .98, p = .66, η(2) = .01), or delayed harm (ps > .05, η(2) < .002). CONCLUSION Reading an online news article about the presence or absence of a genetic basis for nicotine addiction was not found to change smoking-related cognitions/affect or beliefs among young adult smokers. Concerns about negative effects of multifactorial risk information on health beliefs may be premature. Nevertheless, to effectively translate basic genomics research into effective public health practice, further research should investigate these issues in different populations, via different communication modalities, and for different health outcomes. STATEMENT OF CONTRIBUTION What is already known on this subject? Information about the health implications of the interaction between genetics and behaviour is becoming prevalent. Learning about these interactions may reduce perceived risk and intentions to engage in health behaviours. What does this study add? Informing young adult smokers about the genetic basis for nicotine addiction does not affect health beliefs negatively. Responses are not moderated by endorsing the idea of genetic causation or current/experimenter smoking status.
Collapse
Affiliation(s)
- Erika A Waters
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA
| | | | | | | | | | | | | |
Collapse
|