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Peprah P, Agyemang-Duah W, Gyamfi N, Asare BYA, Boateng D, Appiah JO, Adu C. Cigarette smoking during breastfeeding in Papua New Guinea: Prevalence and demographic and socio-economic predictors. PLoS One 2022; 17:e0278373. [PMID: 36454927 PMCID: PMC9714934 DOI: 10.1371/journal.pone.0278373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cigarette smoking during breastfeeding is reported to contribute to significant changes in the composition of breast milk not only by reducing its protective features but also affecting infants' response to breastfeeding and breast milk. However, studies on the prevalence of cigarette smoking and associated factors during breastfeeding are limited in Papua New Guinea (PNG). This study estimates the prevalence of cigarette smoking and its association with demographic and economic factors among breastfeeding women in PNG. METHODS We used weighted survey data from the 2016-2018 PNG Demographic and Health Survey (PNGDHS). A weighted sample of 3,822 women who were breastfeeding during the survey were included in the study. The outcome variable in the present study is current cigarette smoking. A multiple logistic regression analysis was used to estimate the association between current cigarette smoking status and socio-demographic and economic variables of breastfeeding women. The regression analysis results were reported using adjusted odds ratios (aOR) with their respective 95% confidence intervals (CIs). RESULTS From the weighted sample, the prevalence of cigarette smoking among breastfeeding women was 21.9%; of which 60.8% smoked daily. The mean number of cigarettes smoked in the last 24 hours preceding the survey was 6.05(SD = 5.99). Multiple logistic regression analysis revealed that breastfeeding women who were from the Momase (aOR: 2.337, CI: 1.786-3.058, p<0.001) and Highlands (AOR: 1.589, CI: 1.213-2.082, p = 0.001), had no religious affiliation (aOR: 3.665, CI: 1.235-10.877, p = 0.019), and households with daughters as household heads (aOR: 1.901, CI: 1.231-2.935, p = 0.004) and being in more than one union (aOR: 2.374, CI: 1.805-3.123, p<0.001) were significantly more likely to smoke cigarette compared to women from southern region, those affiliated to Anglican church, those with husband as household heads, and being in one union respectively. CONCLUSION Cigarette smoking among breastfeeding women in PNG is relatively high, and region of residence, religion, relationship to household head, and the number of unions remain independent predictors. Interventions should target the individual socio-economic and cultural contexts within which breastfeeding occurs.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | | | - Naomi Gyamfi
- Faculty of Medicine and Health, School of Health, University of New England, Armidale NSW, Australia
| | - Bernard Yeboah-Asiamah Asare
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Kent Street, Perth, Australia
- Institute of Applied of Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Dickson Boateng
- Department of Geography, Mary Immaculate College, University of Limerick, Limerick, Ireland
| | | | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- College of Public Health, Medical and Veterniary Sciences, James Cook University, Townsville, Queensland, Australia
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Najafipour H, Mahdavi A, Kordestani Z, Zamaninasab Z, Shadkam Farokhi M, Shamsadini A, Azizi E. The Prevalence and 5-Year Incidence Rate of Cigarette Smoking and Water-Pipe Tobacco Smoking and Their Associated Factors among 15 to 80 Years Old Urban Population in Southeast Iran: Results from KERCADR Study. ADDICTION & HEALTH 2022; 14:205-213. [PMID: 36544984 PMCID: PMC9743829 DOI: 10.34172/ahj.2022.1273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/14/2021] [Indexed: 11/29/2022]
Abstract
Background Cigarette and tobacco smoking are closely associated with chronic cardiovascular disease and lung cancer. We aimed to assess the prevalence and 5-year incidence rate (IR) of these two risk factors for cardiovascular diseases in Kerman, southeastern of Iran. Methods 10015 individuals aged 15-80 were recruited to the study between 2014 and 2018 (Kerman coronary artery disease (CAD) risk factors study, KERCADRS) of which 2820 had also participated in the first phase (5 years earlier). We took fasting blood samples and collected demographic information and data on cigarette and water-pipe tobacco smoking (WPTS) through interviews. Findings The overall prevalence of cigarette smoking increased from 8.1% in phase1 to 8.8% in phase 2. During the same period, the prevalence of WPTS increased from 10% to 14%, especially in the age groups of 15-45 years. The prevalence of opium dependance was higher among cigarette smokers compared to WPT users. The overall 5-year IR of cigarette and WPTS was 3.6 and 4.65 per 1000 person-years respectively. The highest IRs of cigarette smoking and WPTS were reported in the age group of 15-39 years, and IR of WPTS was higher among women. Obesity, diabetes, and hypertension associated with a reduced IRs of cigarette and WPTS. Conclusion Over the past five years, the prevalence of cigarette smoking has increased slightly, but WPTS has increased more rapidly, especially among women. The highest prevalence of cigarette and WPT smoking was in the age groups of 15-39 years. Smoking is shifting from cigarette smoking to WPTS. Age- and gender-oriented interventions would help correct the unhealthy life style in the community and prevent further smoking-related morbidities and mortalities.
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Affiliation(s)
- Hamid Najafipour
- Physiology Research Center, Institute of Neuropharmacology, and Department of Physiology and Pharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Amin Mahdavi
- Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences and Department of Cardiology, Kerman University of Medical Sciences, Kerman, Iran,Corresponding Author: Amin Mahdavi, MD, Cardiovascular Research Center and Department of Cardiology, Afzalipour Medical Faculty, Shafa Hospital, Shafa Street, Kerman, Iran. Tel: +983412264071, Fax: +983412264097, Emails: ,
| | - Zeinab Kordestani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Zamaninasab
- Department of Biostatistics, Faculty of Health, and Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Atefeh Shamsadini
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Elnaz Azizi
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Kiviniemi MT, Orom H, Hay JL, Waters EA. Limitations in American adults' awareness of and beliefs about alcohol as a risk factor for cancer. Prev Med Rep 2021; 23:101433. [PMID: 34189021 PMCID: PMC8220226 DOI: 10.1016/j.pmedr.2021.101433] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022] Open
Abstract
Alcohol is a carcinogen. Recommendations to reduce alcohol use to lower cancer risk are increasingly common. However, neither the beliefs of US adults about alcohol consumption and cancer risk, nor factors influencing those beliefs, are well understood. We used data from the 2019 Health Information National Trends Survey (analysis N = 4,470) to examine beliefs about whether drinking too much alcohol increases cancer risk. We compared those beliefs to beliefs for three other health problems, and examined whether believing alcohol is a cancer risk factor was related to demographics, risk perceptions, other beliefs about the nature of cancer, and alcohol consumption behavior. Only 33% of US adults reported believing that alcohol is a cancer risk factor; 27% stated that it was not, and the highest proportion (40%) reported they did not know. Misbeliefs and lack of knowledge about alcohol and health outcomes were higher for cancer than other outcomes. Higher age, education, seeking health information, risk perceptions, and pessimistic beliefs about cancer predicted both lack of knowledge and misbeliefs about alcohol use and cancer. However, misbeliefs and lack of knowledge were not limited to those who reported alcohol consumption. Demographic and psychosocial factors are associated with problematic beliefs about alcohol's role as a risk factor for cancer. Because perceived risk for health problems is a driver of behavior change, cancer prevention and control efforts to reduce alcohol consumption must attend to and address both the misperceptions about and lack of knowledge of alcohol's role in increasing risk for cancer.
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Affiliation(s)
- Marc T. Kiviniemi
- Department of Health, Behavior, and Society University of Kentucky, Lexington, KY, USA
| | - Heather Orom
- Department of Community Health & Health Behavior University at Buffalo, SUNY Buffalo, NY, USA
| | - Jennifer L. Hay
- Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Institute, New York, NY, USA
| | - Erika A. Waters
- Department of Surger, Washington University at Saint Louis School of Medicine, St. Louis, MO, USA
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Williams CD, Taylor T, Stanton C, Makambi K, Hicks J, Adams-Campbell LL. A Feasibility Study of Smoking Cessation Utilizing an Exercise Intervention among Black Women: 'Quit and Fit'. J Natl Med Assoc 2021; 113:243-251. [PMID: 33518358 PMCID: PMC10105489 DOI: 10.1016/j.jnma.2020.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 11/13/2020] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Women who engage in higher levels of exercise while trying to quit smoking have been shown to be less likely to relapse and to sustain their smoking abstinence longer. This study sought to examine the benefits of exercise for improving smoking cessation among Black women. METHODS We evaluated the feasibility of a 12-week smoking and exercise intervention, Quit and Fit, tailored for Black women. All participants (intervention and control) received 12 weeks of smoking cessation counseling via telephone and 9 weeks of nicotine lozenges. Participants who were randomly assigned to the intervention condition were also assigned to a 12-week exercise group. RESULTS Thirty-eight women were enrolled and 27 completed a 12-week follow-up assessment. Women from the intervention group were more likely to complete the 12-week follow-up assessment compared to participants in the control group (80% vs. 61%). Overall, 7 of the 38 participants (18%) were abstinent at 12 weeks (biochemically verified by expired carbon monoxide). Among the 25 women who completed the 12-week follow-up, abstinence was reported in 33% of the intervention group and 20% of the control group. Using an intent-to-treat approach, 25% of women in the intervention group were abstinent at 12 weeks (n = 5), compared to 11.1% for the control group (n = 2). These differences were not statistically significant. CONCLUSIONS The overall retention rate was 71% (27/38) at 12 weeks with higher among the intervention group (16/20; 80%) compared to the control group (11/18; 61%). The study demonstrates that it is feasible to retain African-American women in a short-term study of smoking cessation and exercise.
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Affiliation(s)
| | | | | | - Kepher Makambi
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Jennifer Hicks
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
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Narcisse MR, Dobbs P, Long CR, Purvis RS, Kimminau KS, McElfish PA. Electronic cigarette use and psychological distress in the Native Hawaiian and Pacific Islander adults compared with other racial/ethnic groups: Data from the National Health Interview Survey, 2014. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:225-236. [PMID: 31535719 PMCID: PMC9284937 DOI: 10.1002/jcop.22248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/22/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
Document the prevalence of electronic cigarette (E-cigarette) use among the native Hawaiian and other Pacific Islander (NHPI) adults compared with other racial/ethnic groups, and examine associations between psychological distress and E-cigarette use. 2014 National Health Interview Survey (NHIS) and 2014 NHPI-NHIS were combined for comparisons. Data were analyzed using descriptive statistics, Rao-Scott χ2 test, and multivariable logistic regression. E-cigarette use among NHPI (5.6%) was significantly higher than among Blacks (2.1%), Hispanics (2.2%), and Asians (1.7%; p < .001). NHPI with Kessler 6 (K6) score of 11-24 had greater odds of using E-cigarettes (odds ratio [OR]: 3.90; 95% confidence intervals [CI]: 1.81-8.42) as compared to those with a K6 score of 0. Associations between having a K6 score of 11-24 and using E-cigarettes were also found for Whites (OR: 3.49; CI: 2.44-4.99), Asians (OR: 5.29; CI: 1.29-21.70), and Hispanics (OR: 6.14; CI: 2.72-13.83). E-cigarette use was higher among NHPI relative to other racial/ethnic groups. NHPI with K6 score of 11-24 had greater odds of using E-cigarettes as compared to those with a K6 score of 0. Policies and strategies to reduce E-cigarette use among NHPI should give careful consideration to the associations between E-cigarette use and psychological distress in the NHPI population.
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Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Page Dobbs
- College of Arts and Sciences, Department of Health and Exercise Science, The University of Oklahoma, 1401 Asp Ave., Room 118 Norman, OK 73019
| | - Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Rachel S. Purvis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
| | - Kim S. Kimminau
- Department of Family Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 North College Avenue, Fayetteville, AR 72703
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Ra JS, Cho YH. Psychosocial Factors Associated With Smoking Intention in Korean Male Middle School Students. J Sch Nurs 2016; 33:355-363. [PMID: 27702913 DOI: 10.1177/1059840516671782] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined psychosocial factors influencing smoking intention in Korean male middle school students. We used a descriptive cross-sectional design, based on the biopsychosocial model, to analyze data from 309 male adolescents aged 14–16 years in middle school. Of the psychological factors examined, stress and risk-taking tendency were significantly associated with smoking intention. Of the social factors examined, social normative beliefs, close friends’ and siblings’ smoking, and low socioeconomic status were significant factors in smoking intention. The explanatory power of these variables in the predictive model was 23.1%. In conclusion, the unique psychological and social characteristics of adolescents should be reflected in interventions for smoking prevention.
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Affiliation(s)
- Jin Suk Ra
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Yoon Hee Cho
- College of Nursing, Dankook University, Cheonan, South Korea
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Sartor CE, Grant JD, Duncan AE, McCutcheon VV, Nelson EC, Calvert WJ, Madden PA, Heath AC, Bucholz KK. Childhood sexual abuse and two stages of cigarette smoking in African-American and European-American young women. Addict Behav 2016; 60:131-6. [PMID: 27131220 DOI: 10.1016/j.addbeh.2016.03.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 03/29/2016] [Accepted: 03/31/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of the current study was to determine whether the higher rates of childhood sexual abuse (CSA) but lower rates of cigarette smoking in African-American vs. European-American women can be explained in part by a lower magnitude of association between CSA and smoking in African-American women. METHODS Data were drawn from a same-sex female twin study of substance use (n=3521; 14.3% African-American). Cox proportional hazards regression analyses using CSA to predict smoking initiation and progression to regular smoking were conducted separately by race/ethnicity. Co-twin status on the smoking outcome was used to adjust for familial influences on smoking (which may overlap with family-level influences on CSA exposure). RESULTS After adjusting for co-twin status, CSA was associated with smoking initiation in European Americans (hazard ratio (HR)=1.43, 95% confidence intervals (CI): 1.26-1.62) and with smoking initiation ≤16 in African Americans (HR=1.70, CI: 1.26-2.29). CSA was associated with regular smoking onset ≤15 in European Americans (HR=1.63, CI: 1.21-2.18), with no change in HR after adjusting for co-twin status. In the African-American subsample, the HR for CSA was reduced to non-significance after adjusting for co-twin status (from HR=3.30, CI: 1.23-8.89 to HR=1.16, CI: 0.71-1.92 for regular smoking ≤15). CONCLUSIONS CSA is associated with moderate elevation in risk for initiating smoking among African-American and European-American women. By contrast, CSA is associated with elevated risk for (adolescent onset) regular smoking only in European-American women. Furthermore, there is significant overlap between risk conferred by CSA and familial influences on regular smoking in African-American but not European-American women.
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Keith RJ, Al Rifai M, Carruba C, De Jarnett N, McEvoy JW, Bhatnagar A, Blaha MJ, Defilippis AP. Tobacco Use, Insulin Resistance, and Risk of Type 2 Diabetes: Results from the Multi-Ethnic Study of Atherosclerosis. PLoS One 2016; 11:e0157592. [PMID: 27322410 PMCID: PMC4913922 DOI: 10.1371/journal.pone.0157592] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 06/01/2016] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Tobacco use is associated with insulin resistance and incident diabetes. Given the racial/ethnic differences in smoking patterns and incident type 2 diabetes our objective was to evaluate the association between tobacco use and insulin resistance (IR) as well as incident type 2 diabetes mellitus in a contemporary multiethnic cohort. METHODS AND RESULTS We studied 5,931 Multi- Ethnic Study of Atherosclerosis (MESA) participants who at baseline were free of type 2 diabetes (fasting glucose ≥7.0 mmol/l (126 mg/dl) and/or use of insulin or oral hypoglycemic medications) categorized by self-reported tobacco status and reclassified by urinary cotinine (available in 58% of participants) as never, current or former tobacco users. The association between tobacco use, IR (fasting plasma glucose, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR)) and incident diabetes over 10 years was evaluated using multivariable linear regression and Cox proportional hazards models, respectively. Mean age of the participants was 62 (±10) years, 46% were male, 41% Caucasian, 12% Chinese, 26% African American and 21% Hispanic/Latino. IR biomarkers did not significantly differ between current, former, and never cigarette users (P >0.10) but showed limited unadjusted differences for users of cigar, pipe and smokeless tobacco (All P <0.05). Fully adjusted models showed no association between dose or intensity of tobacco exposure and any index of IR. When stratified into participants that quit smoking vs. those who continued smoking during the 10-year study there was no difference in serum glucose levels or frequency of diabetes. In fully adjusted models, there was no significant difference in diabetes risk between former or current cigarette smokers compared to never smokers [HR (95% CI) 1.02 (0.77,1.37) and 0.81 (0.52,1.26) respectively]. CONCLUSION In a contemporary multi-ethnic cohort, there was no independent association between tobacco use and IR or incident type 2 diabetes. The role smoking plays in causing diabetes may be more complicated than originally thought and warrants more in-depth large contemporary multi-ethnic studies.
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Affiliation(s)
- Rachel J. Keith
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
| | - Mahmoud Al Rifai
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
- Ciccarone Center for the Prevention of Heart Disease, John Hopkins Medical, Baltimore, Maryland, United States of America
| | - Christopher Carruba
- Department of Medicine, University of Colorado, Aurora, Colorado, United States of America
| | - Natasha De Jarnett
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
| | - John W. McEvoy
- Ciccarone Center for the Prevention of Heart Disease, John Hopkins Medical, Baltimore, Maryland, United States of America
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
| | - Michael J. Blaha
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
- Ciccarone Center for the Prevention of Heart Disease, John Hopkins Medical, Baltimore, Maryland, United States of America
| | - Andrew P. Defilippis
- Diabetes and Obesity Center, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- Division of Cardiology, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, United States of America
- American Heart Association—Tobacco Regulatory and Addiction Center, Louisville, Kentucky, United States of America
- Ciccarone Center for the Prevention of Heart Disease, John Hopkins Medical, Baltimore, Maryland, United States of America
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Sartor CE, Grant JD, Agrawal A, Sadler B, Madden PAF, Heath AC, Bucholz KK. Genetic and environmental contributions to initiation of cigarette smoking in young African-American and European-American women. Drug Alcohol Depend 2015; 157:54-9. [PMID: 26482091 PMCID: PMC4663123 DOI: 10.1016/j.drugalcdep.2015.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Distinctions in the relative contributions of genetic and environmental factors to initiation of cigarette smoking may explain, in part, the differences between African Americans and European Americans in the prevalence of smoking. The current investigation is the first to compare heritable and environmental influences on smoking initiation between African-American and European-American women. METHODS Data were drawn from Missouri Adolescent Female Twin Study participants and female Missouri Family Study participants (n=4498; 21% African-American, the remainder European-American). Mean ages at first and last assessments were 17.0 (SD=3.5) and 24.0 (SD=3.2), respectively. Twin-sibling modeling was conducted to estimate the proportion of variance in smoking initiation (i.e., ever trying a cigarette) attributable to additive genetic, shared environmental, special twin environmental, and unique environmental factors. RESULTS Additive genetic influences accounted for approximately half of the variance in smoking initiation in both African-American and European-American women. In the African-American subsample, the remaining variance was attributable primarily to unique environmental factors (46%; 95% CI: 28-71%). In the European-American subsample, only 12% (95% CI: 8-16%) of the variance was attributable to unique environmental factors, with the remainder accounted for by shared environmental (13%; 95% CI: 0-41%) and special twin environmental (24%; 95% CI: 0-52%) factors. CONCLUSIONS The estimated heritability of smoking initiation is substantial and nearly identical for African-American and European-American women, but the type of environmental factors that contribute to risk differ by race/ethnicity. Whereas the primary environmental influences on European-American women's smoking initiation are at the family level, those that impact African-American women's smoking initiation are primarily individual-specific.
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Affiliation(s)
- Carolyn E. Sartor
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Julia D. Grant
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Pamela A. F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew C. Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Koszowski B, Rosenberry ZR, Kanu A, Viray LC, Potts JL, Pickworth WB. Nicotine and carbon monoxide exposure from inhalation of cigarillo smoke. Pharmacol Biochem Behav 2015; 139:7-14. [PMID: 26459155 DOI: 10.1016/j.pbb.2015.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/24/2015] [Accepted: 10/08/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND There has been an increase in the use of cigarillos in the US. People who smoke cigarillos typically also regularly smoke cigarettes (dual users). METHODS We compared puffing topography, biomarkers of acute exposure [exhaled carbon monoxide (COex) and plasma nicotine] and physiologic effects from usual brand cigarette and Black & Mild cigarillo smoking in dual users (N=23) in two laboratory sessions. RESULTS Participants (21 men) smoked an average of 17.5cigarettes/day. Cigarillo consumption varied widely from as few as 1/week to daily. Participants were highly nicotine dependent (average FTND score: 6.3). There were statistically significant differences in smoking behavior between cigarette and cigarillo smoking in time to smoke, number of puffs, and total puff volume (all P<0.001). Average puff duration, interpuff interval average puff volume, and puff velocity did not differ between cigarettes and cigarillos. Nicotine boost was similar after both cigarettes and cigarillos. COex boost was significantly greater after cigarillo smoking compared to cigarette smoking (P<0.001). CONCLUSIONS The smoking pattern and exposure profile indicate that dual users inhale cigarillo smoke just as they inhale cigarette smoke thereby exposing themselves to considerable amounts of nicotine and other components of tobacco smoke. COex exposure results imply that cigarillo smoking may be associated with higher exposure to smoke-delivered volatile components of mainstream cigarillo smoke including carcinogens when compared to cigarettes. IMPACT The findings that cigarillos and cigarettes are smoked similarly in dual users are relevant to health and regulatory considerations on cigar products.
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Affiliation(s)
- Bartosz Koszowski
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States.
| | - Zachary R Rosenberry
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Alieu Kanu
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Lauren C Viray
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Jennifer L Potts
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
| | - Wallace B Pickworth
- Battelle Memorial Institute, Battelle Public Health Center for Tobacco Research, Baltimore, MD, United States
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Pulvers K, Romero DR, Blanco L, Sakuma KLK, Ahluwalia JS, Trinidad DR. Light and intermittent smoking among California Black, Hispanic/Latino, and non-Hispanic White men and women. Nicotine Tob Res 2015; 17:755-9. [PMID: 25335947 DOI: 10.1093/ntr/ntu221] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 10/08/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The prevalence of light and intermittent smoking (LITS) is increasing as the prevalence of heavier smoking continues to fall. The purpose of this study was to examine changes in LITS over time among Blacks, Hispanic/Latinos (Latinos) and non-Hispanic Whites (Whites). METHODS Data from the California Tobacco Surveys from 1990, 1992, and 1996 (Time 1 [T1]) were combined and compared to combined data from 1999, 2002, 2005, and 2008 (Time 2 [T2]). T1 participants (N = 50,424) included Blacks (n = 3,029), Latinos (n = 7,910), and Whites (n = 39,485). T2 participants (N = 53,005) included Blacks (n = 5,460), Latinos (n = 14,273), and Whites (n = 33,246). RESULTS LITS increased by a factor of 12.9% to a rate of 79.6% (76.0-83.2) among Latinos, by 19.4% to a rate of 74.4% (70.9-77.9) among Blacks, and by 51.7% to a rate of 48.9% (47.5-50.3) among Whites. In unadjusted analyses at T1, females were more likely to be LITS than males across ethnic groups. At T2, this sex difference was maintained among Whites, but not Blacks and Latinos. Females were significantly more likely to be LITS than males when controlling for demographic variables. CONCLUSIONS The present study found that LITS rates increased over time for male and female Black, Latino and White adults. There is a need for increased tobacco control attention to LITS across all ethnic groups, but with additional focus on Blacks, Latinos, and women who have the highest rates of LITS.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA;
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, San Marcos, CA
| | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Kari-Lyn K Sakuma
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Jasjit S Ahluwalia
- Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
| | - Dennis R Trinidad
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
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Andrews JO, Mueller M, Newman SD, Magwood G, Ahluwalia JS, White K, Tingen MS. The association of individual and neighborhood social cohesion, stressors, and crime on smoking status among African-American women in southeastern US subsidized housing neighborhoods. J Urban Health 2014; 91:1158-74. [PMID: 25316192 PMCID: PMC4242849 DOI: 10.1007/s11524-014-9911-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to examine the associations between individual and neighborhood social contextual factors and smoking prevalence among African-American women in subsidized neighborhoods. We randomly sampled 663 adult women in 17 subsidized neighborhoods in two Southeastern US states. The smoking prevalence among participants was 37.6%, with an estimated neighborhood household prevalence ranging from 30 to 68%. Smokers were more likely to be older, have lower incomes, have lower BMI, and live with other smokers. Women with high social cohesion were less likely to smoke, although living in neighborhoods with higher social cohesion was not associated with smoking prevalence. Women with higher social cohesion were more likely to be older and had lived in the neighborhood longer. Women with high stress (related to violence and disorder) and who lived in neighborhoods with higher stress were more likely to smoke. Younger women were more likely to have higher stress than older women. There were no statistically significant associations with objective neighborhood crime data in any model. This is the first study to examine both individual and neighborhood social contextual correlates among African-American women in subsidized neighborhoods. This study extends findings about smoking behaviors and neighborhood social contexts in this high-risk, urban population. Future research is needed to explore age and residential stability differences and perceptions of social cohesion, neighborhood disorder, and perceived violence in subsidized housing. Further research is also warranted on African-American women, subsidized housing, smoking, social context, health disparities' effective strategies to address these individual and contextual factors to better inform future ecological-based multilevel prevention, and cessation intervention strategies.
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Smith MV, Ramsay C, Mazure CM. Understanding disparities in subpopulations of women who smoke. CURRENT ADDICTION REPORTS 2014; 1:69-74. [PMID: 24533257 PMCID: PMC3922222 DOI: 10.1007/s40429-013-0002-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Tobacco use is the leading known cause of preventable death and disease among women. In this paper we use fundamental concepts and definitions from the general health-disparities literature to examine smoking behavior among subpopulations of women. We focus on three factors associated with disparities in smoking behavior among subgroups of women-race and/or ethnicity, educational status, and acculturation. We suggest that research on smoking behavior among subpopulations of women is beginning to reveal not only different smoking behavior but disparities among women in different subpopulations. We conclude that subpopulation-based understanding of gender differences and disparities in smoking is critical to improvement of research design, intervention objectives, and public health policy on smoking in women.
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Affiliation(s)
- Megan V. Smith
- Yale University School of Medicine, Department of Psychiatry, 142 Temple Street, Suite #301, New Haven, CT 06511, USA
- Yale University School of Medicine, Child Study Center, 135 College Street, Suite #220, New Haven, CT 06510, USA
- Yale School of Public Health, Department of Epidemiology, Social & Behavioral Sciences, 135 College Street, Suite #220, New Haven, CT 06510, USA
| | - Christina Ramsay
- Yale University, Department of Psychology, 135 College Street, Suite #220, New Haven, CT 06510, USA
| | - Carolyn M. Mazure
- Yale University School of Medicine, Department of Psychiatry, 142 Temple Street, Suite #301, New Haven, CT 06511, USA
- Yale University School of Medicine, Child Study Center, 135 College Street, Suite #220, New Haven, CT 06510, USA
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Bethea TN, Rosenberg L, Charlot M, O'Connor GT, Adams-Campbell LL, Palmer JR. Obesity in relation to lung cancer incidence in African American women. Cancer Causes Control 2013; 24:1695-703. [PMID: 23744044 DOI: 10.1007/s10552-013-0245-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 05/29/2013] [Indexed: 01/01/2023]
Abstract
PURPOSE Although a number of studies have found an inverse association between body mass index (BMI) and risk of lung cancer, there is little information on this relation in African Americans, who experience a higher incidence of lung cancer. METHODS We assessed the relation of BMI to incidence of lung cancer in the Black Women's Health Study, an ongoing prospective follow-up of 59,000 women in the USA. Cox proportional hazard models were used to estimate hazard ratios for various levels of BMI relative to BMI 18.5-24.9 kg/m2 ("normal weight") with adjustment for age, education, pack-years of smoking, and other covariates. Two other anthropometric measures, waist circumference (WC) and waist/hip ratio (WHR), were also assessed. A total of 323 primary lung cancer cases were identified from 1995 to 2011. RESULTS The hazard ratio (HR) for BMI ≥ 30 relative to BMI 18.5-24.9 was 0.69 (95% CI 0.51-0.92). As expected, cigarette smoking was strongly associated with increased risk of lung cancer. In analyses stratified by smoking status, the HR for BMI ≥ 30 relative to BMI 18.5-24.9 was 0.62 (0.38-1.00) among current smokers, 0.90 (0.56-1.42) among former smokers, and 0.83 (0.41-1.70) among never smokers (p for interaction = 0.28). Control for pack-years of smoking or age started smoking had little effect on the hazard ratios. WC and WHR were not materially associated with lung cancer risk. CONCLUSION Our results indicate that high BMI is associated with a lower risk of lung cancer in African American women, particularly among current smokers.
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Affiliation(s)
- Traci N Bethea
- Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA, 02215, USA,
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15
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Smoking During Pregnancy Rates Trends in a High Smoking Prevalence State, 1990–2009. South Med J 2012; 105:636-44. [DOI: 10.1097/smj.0b013e318273de96] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Jessup MA, Dibble SL, Cooper BA. Smoking and behavioral health of women. J Womens Health (Larchmt) 2012; 21:783-91. [PMID: 22512870 DOI: 10.1089/jwh.2011.2886] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Using data from a study of reliability and validity of a screening tool for co-occurring substance abuse and mental health problems, our objective was to compare behavioral health issues of female smokers and nonsmokers and explore correlates of smoking. METHODS Using a convenience sample (n=1021), we recruited participants to complete an online survey conducted in substance abuse treatment, primary care, mental health services, senior, and public settings. The survey included demographic questions, smoking status, the co-occurring disorders screening tool, the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) and the Postraumatic Stress Disorder Checklist (PCL)-Civilian. RESULTS One third of participants self-identified as smokers, and African American, American Indian, and bisexual women reported the highest rates of smoking. Seventy-two percent of women reported at least one mental health problem in the past year; 29% had a past year substance abuse problem, and 26% reported a past year co-occurring disorder of both. Smokers had significantly higher rates of posttraumatic stress disorder (PTSD), past year depression and anxiety, suicidality, past year substance abuse, and co-occurring disorders. Smokers also had significantly higher rates of lifetime intimate partner violence (IPV) and childhood abuse. CONCLUSIONS Smoking in women was associated with significantly higher rates of mental health and substance abuse problems. Substance abuse, being in a treatment setting, IPV, African American and mixed ethnicity, Medicaid insurance status, reduced income, and no home ownership were identified as predictors of smoking. Screening and evaluation of smoking status, mental health, substance use disorders, and the presence and impact of violence are essential for women's health.
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Affiliation(s)
- Martha A Jessup
- The Institute for Health & Aging, Department of Social & Behavioral Sciences, School of Nursing, University of California, San Francisco, San Francisco, CA 94143-0646, USA.
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Palmer RC, McKinney S. Health care provider tobacco cessation counseling among current African American tobacco users. J Natl Med Assoc 2011; 103:660-7. [PMID: 22046843 DOI: 10.1016/s0027-9684(15)30405-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Tobacco use is the leading cause of preventable mortality and morbidity in the United States. Patients advised to quit use of tobacco products by their health care providers are more likely to quit, yet it has been documented that patients are not receiving this advice. The aim of this study was to investigate whether or not current African American tobacco users were receiving provider-initiated advice to quit. A cross-sectional survey identified 245 self-reported African American tobacco users residing in Maryland. Study variables collected included sociodemographics, access to care, smoking status, and assessed if tobacco cessation counseling was ever provided. Among those surveyed, only 42% reported ever being counseled to quit tobacco use and, of those who had a recent clinical encounter (within the past year), only 20% reported being counseled. Multivariate logistic regression identified that having a regular source of health care, living in an urban setting, and being female increased chances of being advised to quit tobacco use. Overall, findings indicate that African Americans are not being screened or receiving cessation counseling as recommended by leading health agencies. Health care provider training to promote better integration of tobacco screening and tobacco cessation counseling during the patient encounter is needed.
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Affiliation(s)
- Richard C Palmer
- Robert Stempel College of Public Health and Social Work, 11200 SW 8th St, Miami, FL 33199, USA.
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Holahan CK, Holahan CJ, Powers DA, Hayes RB, Marti CN, Ockene JK. Depressive symptoms and smoking in middle-aged and older women. Nicotine Tob Res 2011; 13:722-31. [PMID: 21504881 DOI: 10.1093/ntr/ntr066] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Smoking research and intervention efforts have neglected older women. Depressive symptoms, which are common in middle-aged and older women, are related to the maintenance of adult smoking. METHODS This study investigated the relation of a composite measure of current depressive symptoms, derived from a short form of the Center for Epidemiological Studies Depression Scale, and history of depressive symptoms, derived from two items from the Diagnostic Interview Schedule, to smoking outcomes in the Women's Health Initiative Observational Study (N = 90,627). Participants were postmenopausal with an average age of 63.6 years at baseline. Participants were recruited from urban, suburban, and rural areas surrounding 40 clinical centers in the United States. Analyses controlled for age, educational level, and ethnicity. RESULTS In multinomial logistic regression analyses, depressive symptoms were related cross-sectionally to current light (odds ratio [OR] = 1.19, 95% CI = 1.14-1.23) and heavier (OR = 1.28, 95% CI = 1.23-1.32) smoking at baseline compared with nonsmokers. In prospective multiple logistic regression analyses, baseline depressive symptoms were negatively predictive of smoking cessation at a 1-year follow-up (OR = .85, 95% CI = 0.77-0.93) and at participants' final assessments in the study (OR = .92, 95% CI = 0.85-0.98). Light smokers had more than 2 times higher odds of smoking cessation than did heavier smokers. CONCLUSIONS The present findings demonstrate a consistent link between depressive symptoms and negative smoking-related behaviors among middle-aged and older women at both light and heavier smoking levels.
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Affiliation(s)
- Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, 1 University Station, Austin, TX 78712, USA.
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