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Jackson SE, Brown J, Shahab L, Cox S. Trends in non-daily cigarette smoking in England, 2006-2024. BMC Med 2024; 22:426. [PMID: 39444038 DOI: 10.1186/s12916-024-03635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 09/13/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Cigarette smoking is incredibly harmful, even for people who do not smoke every day. This study aimed to estimate trends in non-daily smoking in England between 2006 and 2024, how these differed across population subgroups, and to explore changes in the profile of non-daily smokers in terms of their sociodemographic and smoking characteristics and vaping and alcohol consumption. METHODS Data were collected monthly between November 2006 and April 2024 as part of a nationally representative, repeat cross-sectional survey of adults (≥ 18 years; n = 353,711). We used logistic regression to estimate associations between survey wave and non-daily smoking and used descriptive statistics to characterise the profile of non-daily smokers across 3-year periods. RESULTS The proportion who smoked non-daily was relatively stable between November 2006 and November 2013, at an average of 10.5% [10.1-10.9%] of cigarette smokers, then increased to 27.2% [26.0-28.4%] of cigarette smokers (4.0% [3.7-4.2%] of adults) by April 2024. This increase was particularly pronounced among younger adults (e.g. reaching 52.8%, 20.4%, and 14.4% of 18-, 45-, and 65-year-old cigarette smokers by April 2024) and those who vape (reaching 34.2% among vapers vs. 23.1% among non-vapers). Over time, there were reductions in non-daily smokers' mean weekly cigarette consumption (from 34.3 in 2006-2009 to 21.1 in 2021-2024), urges to smoke (e.g. the proportion reporting no urges increased from 29.2 to 38.0%), and motivation to stop smoking (e.g. the proportion highly motivated to quit within the next 3 months decreased from 30.8 to 21.0%). CONCLUSIONS An increasing proportion of adults in England who smoke cigarettes do not smoke every day, particularly younger adults. Although non-daily smokers report smoking fewer cigarettes and weaker urges to smoke than they used to, which may make it easier for them to stop smoking, they appear to be decreasingly motivated to quit.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Consortium, Edinburgh, UK.
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, Edinburgh, UK
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Choi SH, Templin T, Marrocco A. Development of an online discrete choice experiment to elicit preferences for tobacco treatment among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37437187 DOI: 10.1080/07448481.2023.2227715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/24/2023] [Accepted: 06/11/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE To develop an online discrete choice experiment (DCE) to elicit preferences for the format and content of tobacco treatment and determine the feasibility of the survey in face-to-face online interviews among college students. PARTICIPANTS A convenience sample of 28 college students. METHODS A pilot online DCE survey with sixteen choice sets was developed. The feasibility was assessed by: 1) ease of reading the survey descriptions, 2) ease of completing the DCE survey, and 3) appropriateness of the number of choice sets. Think-aloud data were analyzed to understand decision-making processes. RESULTS All participants completed the DCE survey and reported that it was very easy to read and complete and that the number of sixteen choice sets was appropriate. Such results support the feasibility of our online DCE survey. Five decision-making strategies were identified. CONCLUSIONS An online DCE survey administered during online interviews may replace in-person interviews for college students.
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Affiliation(s)
- Seung Hee Choi
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Thomas Templin
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Anna Marrocco
- College of Nursing, Wayne State University, Detroit, Michigan, USA
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Mavragani A, Siegel KR, Dickerman SR, Todi AA, Kahler CW, Park ER, Hoeppner SS. Testing the Outcomes of a Smoking Cessation Smartphone App for Nondaily Smokers: Protocol for a Proof-of-concept Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e40867. [PMID: 36787172 PMCID: PMC9975937 DOI: 10.2196/40867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Nondaily smoking is a widespread, increasingly prevalent pattern of smoking, particularly in ethnic minority and vulnerable populations. To date, no effective treatment approach for this type of smokers has been identified. OBJECTIVE This study aims to use a randomized controlled trial to evaluate proof-of-concept markers of the Smiling instead of Smoking (SiS) app, a smoking cessation smartphone app designed specifically for nondaily smokers. This app was developed iteratively and is now in its third version. Previous studies have demonstrated acceptability and feasibility when participants were onboarded in person (study 1) and remotely (study 2) and showed within-person changes in line with hypothesized mechanisms of change. This is the first randomized test of this app. METHODS In total, 225 adult nondaily smokers will be asked to undertake a quit attempt while using smoking cessation support materials for a period of 7 weeks. Participants will be randomized to use the SiS smartphone app, the National Cancer Institute smartphone app QuitGuide, or the National Cancer Institute smoking cessation brochure "Clearing the Air." Participants will take part in a 15-minute scripted onboarding phone call during which study staff will introduce participants to their support materials. Survey links will be sent 2, 6, 12, and 24 weeks after the participants' initially chosen quit date. The primary outcome is self-efficacy to remain abstinent from smoking at treatment end, measured using the Smoking Self-Efficacy Questionnaire. Secondary outcomes cover several domains relevant to treatment development and implementation: treatment acceptability (eg, satisfaction with smoking cessation support, measured using the Client Satisfaction Questionnaire, and app usability, measured using the System Usability Scale); treatment feasibility (eg, measured using the number of days participants used the SiS or QuitGuide app during the prescribed treatment period); and, in an exploratory way, treatment efficacy assessed using self-reported 30-day point prevalence abstinence. RESULTS Recruitment began in January 2021 and ended June 2022. The final 24-week follow-up was completed in January 2023. This trial is funded by the American Cancer Society. CONCLUSIONS This study is designed to test whether the prescribed use of the SiS app results in greater self-efficacy to abstain from smoking in nondaily smokers than commonly recommended alternative treatments and whether the SiS app treatment is acceptable and feasible. Positive results will mean that the SiS app warrants testing in a large-scale randomized controlled trial to test its effectiveness in supporting smoking cessation in nondaily smokers. The design of this study also provides insights into issues pertinent to smoking cessation smartphone app treatment development and implementation by measuring, in a randomized design, markers of treatment satisfaction, engagement with the technology and content of the treatment, and adherence to the treatment plan. TRIAL REGISTRATION ClinicalTrials.gov NCT04672239; https://clinicaltrials.gov/ct2/show/NCT04672239. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40867.
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Affiliation(s)
| | - Kaitlyn R Siegel
- Recovery Research Institute, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah R Dickerman
- Biobehavioral Laboratory, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Akshiti A Todi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Elyse R Park
- Mongan Institute, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Susanne S Hoeppner
- OCD & Related Disorders Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Meacham MC, Liang OS, Zhao M, Yang CC, Thrul J, Ramo DE. Connectedness Based on Shared Engagement Predicts Remote Biochemically Verified Quit Status Within Smoking Cessation Treatment Groups on Facebook. Nicotine Tob Res 2021; 23:71-76. [PMID: 31593592 DOI: 10.1093/ntr/ntz193] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 10/03/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Engagement with online content and online social network integration are associated with smoking behavior change, but less is known about social dynamics of shared engagement between participants in group-based social media interventions. METHODS Participants were 251 young adult smokers aged 18 to 25 assigned to one of 29 secret Facebook groups tailored to their readiness to quit smoking ("pre-contemplation," "contemplation," and "preparation"). Groups varied in size and were randomly assigned to receive monetary incentives for engagement. All groups received daily posts for 90 days and were assessed for remote biochemically verified smoking abstinence at the end of the intervention. Across 29 groups, we examined associations between group features (group size, incentive condition, readiness to quit) with how connected members were within the group based on shared engagement with the same content (measured by density). At the individual level, we examined associations between 7-day biochemically verified smoking abstinence and how connected an individual was within the group (measured by degree centrality). RESULTS After adjusting for comment volume, being in a contemplation group (vs. pre-contemplation group) was associated with a decrease in comment-based density. Individual degree centrality was significantly associated with biochemically verified smoking abstinence for both comments and likes. CONCLUSIONS Future group-based social media interventions for smoking cessation may want to focus on promoting connected engagement between participants, rather than simply quantity of engagement. IMPLICATIONS Participants in a smoking cessation intervention delivered through Facebook groups were more likely to have biochemically verified smoking abstinence if they were more connected to the rest of the group via shared engagement. Promoting shared engagement between participants may be more likely to promote behavior change than volume of engagement alone.
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Affiliation(s)
- Meredith C Meacham
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA
| | - Ou Stella Liang
- College of Computing and Informatics, Drexel University, Philadelphia, PA
| | - Mengnan Zhao
- College of Computing and Informatics, Drexel University, Philadelphia, PA
| | - Christopher C Yang
- College of Computing and Informatics, Drexel University, Philadelphia, PA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA.,Hopelab, San Francisco, CA
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Camenga DR, Bernstein SL, Dziura J, Fiellin L, Krishnan-Sarin S. Feasibility of text messaging to augment brief advice and nicotine replacement therapy for smoking cessation in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:1-8. [PMID: 31373882 PMCID: PMC6995438 DOI: 10.1080/07448481.2019.1643730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 05/29/2019] [Accepted: 07/08/2019] [Indexed: 06/05/2023]
Abstract
To test the feasibility of a university health center-delivered smoking cessation intervention that adds a 6-week course of text messaging to brief advice and nicotine patch therapy. Participants: Young adult cigarette smokers (n = 40) from 2 universities from January 2015 to May 2016. Methods: Randomized controlled trial comparing brief advice, nicotine patch therapy and: (1) a 6-week text messaging intervention (n = 20); or (2) no text messaging (n = 20). Primary outcomes included enrollment, retention and satisfaction. Results: Forty participants enrolled (38% of those screened). Retention rates were 98% and 92.5% at 6 and 12 weeks. Of those who completed the text intervention (n = 16), 64.3% felt the texts were "helpful", however they reported desire for tailoring and concern that texts triggered smoking. Biochemically confirmed abstinence rates did not significantly differ between text and control arms. Conclusions: These feasibility data suggest that text messaging may need to be modified to better engage and motivate college-age smokers.
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Affiliation(s)
- Deepa R Camenga
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Steven L Bernstein
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - James Dziura
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Lynn Fiellin
- Department of Internal Medicine & Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Driver EM, Gushgari A, Chen J, Halden RU. Alcohol, nicotine, and caffeine consumption on a public U.S. university campus determined by wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 727:138492. [PMID: 32334214 DOI: 10.1016/j.scitotenv.2020.138492] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 05/12/2023]
Abstract
Alcohol, nicotine, and caffeine use in at-risk populations is a public health concern that claims over 550,000 lives annually. Self-reported surveys from college students often reveal overconsumption of these substances. Unfortunately, the costs of these surveys are high, and consequently, the results from few studies are often extrapolated across the entire target population. Here we employed wastewater-based epidemiology (WBE) to directly measure the levels of these three psychotropic substances and their metabolites in sewage from a large public Southwestern U.S. university campus during the 2017-2018 academic year. Results showed per person alcohol consumption was 11.3 ± 7.5 g d-1 person-1 or 0.8 ± 0.5 drinks d-1 person-1, similar to averages of nationwide estimates from self-reporting of this subpopulation aged 18-25 years (10.1 ± 0.8 g d-1 person-1 or 0.7 ± 0.06 drinks d-1 person-1). Caffeine and nicotine consumption determined by WBE were significantly lower (p < 0.05) than nationwide estimates from self-reporting (caffeine: 114 ± 49 vs. 178 ± 19 mg d-1 person-1; nicotine: 627 ± 219 vs. 927 ± 243 μg d-1 person-1). Strong positive correlations were found for consumption of alcohol and nicotine (Spearman rs: 0.71; p < 0.01), and nicotine and caffeine (0.59, p < 0.01), but not alcohol and caffeine (0.17). Alcohol and nicotine consumption were significantly higher on weekends compared to weekdays (p < 0.01), while caffeine consumption was higher during the week (p < 0.05). This first U.S. WBE study on alcohol, nicotine, and caffeine use among U.S. college students demonstrated the feasibility and practicality of longitudinally tracking the behavior of an entire campus population of 60,000 students directly, repeatedly, and more inexpensively (US$0.58/person) compared to conventional questionnaires (US$127/person).
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Affiliation(s)
- Erin M Driver
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute & School of Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85287-8101, USA
| | - Adam Gushgari
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute & School of Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85287-8101, USA
| | - Jing Chen
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute & School of Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85287-8101, USA
| | - Rolf U Halden
- Biodesign Center for Environmental Health Engineering, The Biodesign Institute & School of Sustainable Engineering and the Built Environment, Arizona State University, 1001 S. McAllister Ave, Tempe, AZ 85287-8101, USA.
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7
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Ickes MJ, Butler K, Wiggins AT, Kercsmar S, Kay Rayens M, Hahn EJ. Truth® ads, receptivity, and motivation to use or quit tobacco among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:366-373. [PMID: 30645188 DOI: 10.1080/07448481.2018.1549559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/02/2018] [Accepted: 11/11/2018] [Indexed: 06/09/2023]
Abstract
Objective: Examine receptivity and motivation to use/quit tobacco among college students after viewing Truth ads. Participants: Random sample of 10,000 college students invited to complete online survey February 2016 (8.5% response rate). Methods: Quasi-experimental. Participants (N = 854) watched four ads and answered survey items for each ad. Results: Students rated ad receptivity and decreased motivation to use tobacco higher for the Catmageddon ad than the others. Regardless of ad, men and current cigarette smokers reported lower receptivity. Younger age was associated with lower motivation to use tobacco for all ads. Tobacco users reported greater motivation to quit with the Catmageddon ad. Conclusions: College students were receptive to the Truth ads, and many indicated lower motivation to use tobacco. Men, older college students, and current cigarette smokers were less receptive to the ads, reinforcing the need to develop tailored campaigns to reach these subgroups.
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Affiliation(s)
- Melinda J Ickes
- College of Education & BREATHE, University of Kentucky, Lexington, KY, USA
| | - Karen Butler
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Amanda T Wiggins
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Sarah Kercsmar
- Health Sciences, University of Kentucky, Lexington, KY, USA
| | - Mary Kay Rayens
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
| | - Ellen J Hahn
- BREATHE, College of Nursing, University of Kentucky, Lexington, KY, USA
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Ramo DE, Meacham M, Thrul J, Belohlavek A, Sarkar U, Humfleet G. Exploring Identities and Preferences for Intervention Among LGBTQ+ Young Adult Smokers Through Online Focus Groups. J Adolesc Health 2019; 64:390-397. [PMID: 30509769 DOI: 10.1016/j.jadohealth.2018.09.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/11/2018] [Accepted: 09/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE LGBTQ+ young adults are disproportionately affected by tobacco use and associated health conditions. A culturally tailored intervention may improve smoking cessation with this priority population. We conducted focus groups to inform development of a social media intervention to help LGBTQ+ young adults quit smoking. METHODS We conducted two focus groups with LGBTQ+ young adults (N = 27) throughout the United States in a Facebook secret group online setting. An online survey characterized tobacco and other substance use. Questions posed to focus group participants addressed patterns and contexts of smoking, LGBTQ+ identity, and barriers and facilitators to participating in a culturally tailored smoking cessation intervention on social media. Focus group transcripts were coded and analyzed using directed content analysis. RESULTS Overall, young adults had mixed feelings about linking the identities of LGBTQ+ and smoking, and reflected differences in online and "real life" identities. Participants were generally receptive to a social media smoking cessation intervention with concerns about privacy in sharing their smoking status and LGBTQ+ identities with their online social networks. Gender nonconforming individuals had some unique concerns about Facebook policies. CONCLUSIONS This study highlights important considerations in tailoring a social media intervention for LGBTQ+ young adults. We identified experiences of LGBTQ+ young adults that would support tailoring to a diverse community, and suggestions for how to make smoking cessation programs more appealing to this priority population.
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Affiliation(s)
- Danielle E Ramo
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California.
| | - Meredith Meacham
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Alina Belohlavek
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California
| | - Urmimala Sarkar
- Department of General Internal Medicine, Center for Vulnerable Populations, University of California, San Francisco, California
| | - Gary Humfleet
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California
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Andrews ME, Sabado M, Choi K. Prevalence and characteristics of young adult smokers in the U.S. in the precontemplation stage of smoking cessation. Addict Behav 2018; 84:167-170. [PMID: 29689471 DOI: 10.1016/j.addbeh.2018.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/05/2018] [Accepted: 04/08/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The precontemplation stage of smoking cessation refers to having no intention to quit smoking in the next six months. We aimed to estimate the prevalence of and characteristics associated with the precontemplation stage of smoking cessation among U.S. young adult smokers to inform the development of targeted interventions. METHODS We analyzed data in 2017 from the 2013-2014 National Adult Tobacco Survey. Young adult (18-29 years old) daily and non-daily smokers were included (n = 1809). We applied weighted multiple logistic regression models to examine the associations between demographics, tobacco use behaviors, exposure to pro- and anti-tobacco messages, and the precontemplation stage of smoking cessation. RESULTS 59.0% of U.S. young adult smokers are in the precontemplation stage of smoking cessation. Unemployment was positively associated with being in the precontemplation stage of smoking cessation (AOR = 1.42 95% CI = 1.05, 1.91). Smoking every day (vs. some days), more cigarettes smoked per day, using roll-your-own cigarettes (vs. manufactured cigarettes only), currently smoking cigars, and signing up for promotional offers were positively associated with being in the precontemplation stage of smoking cessation (p < 0.05). Non-Hispanic Black was negatively associated with precontemplation stage (AOR = 0.40, 95% CI = 0.27, 0.59). Not smoking after viewing a health warning on a cigarette pack was negatively associated with the precontemplation stage of smoking cessation (AOR = 0.36, 95% CI = 0.25, 0.51). CONCLUSIONS Many U.S. young adult smokers classify as being in the precontemplation stage of smoking cessation. Interventions to motivate these smokers to quit smoking with considerations of their specific characteristics (e.g., being unemployed) are warranted.
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Pulvers K, Ridenour C, Woodcock A, Savin MJ, Holguin G, Hamill S, Romero DR. Marijuana use among adolescent multiple tobacco product users and unique risks of dual tobacco and marijuana use. Drug Alcohol Depend 2018; 189:80-89. [PMID: 29890454 PMCID: PMC6062467 DOI: 10.1016/j.drugalcdep.2018.04.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescence is a peak time for uptake of both tobacco and marijuana (dual use). This study aimed to identify clusters of lifetime tobacco and marijuana use patterns and associated risk factors, and to determine whether dual tobacco and marijuana use is uniquely associated with greater risk than use of either tobacco or marijuana alone. METHOD High school students participated in a survey during Fall 2014 (N = 976; 68% Hispanic; 57% parental education < high school). Items from national youth surveys were used to measure lifetime and current use of tobacco products, marijuana, alcohol, drug use, and other risk behaviors, and literature-based surveys were used to measure psychological constructs. RESULTS Latent Class Analysis identified three clusters of lifetime tobacco use patterns (no tobacco, one or two products, and more than two products), each with a correspondingly distinct profile of risk behaviors; risk escalated with use of more tobacco products. Multinomial modeling characterized personal, environmental, and behavioral correlates of dual lifetime tobacco and marijuana use, including lower parental monitoring, lower grades, higher guilt, higher lifetime alcohol and drug use, and more substance use by friends, in reference to single lifetime use of either tobacco or marijuana. CONCLUSION Broader use of tobacco (i.e., more products) was associated with numerous risk factors. Dual lifetime use of tobacco and marijuana was associated with numerous risks compared to single use of either tobacco or marijuana. Longitudinal work is needed to understand temporal relationships between risk variables to determine optimal timing for interventions to reduce harmful behaviors.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States.
| | - Cliff Ridenour
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Anna Woodcock
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Micah J Savin
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Gabriel Holguin
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Sharon Hamill
- Department of Psychology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
| | - Devan R Romero
- Department of Kinesiology, California State University San Marcos, 333 S Twin Oaks Valley Rd., San Marcos, CA 92096, United States
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Butler KM, Ickes MJ, Rayens MK, Wiggins AT, Ashford K, Hahn EJ. Intention to quit smoking and polytobacco use among college student smokers. Prev Med Rep 2018; 10:72-75. [PMID: 29560301 PMCID: PMC5856666 DOI: 10.1016/j.pmedr.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 02/09/2018] [Accepted: 02/11/2018] [Indexed: 11/28/2022] Open
Abstract
Little is known about polytobacco use in college students. One nationally representative survey indicated 51.3% of tobacco-using college students used more than one product, which may increase risk of tobacco-related disease and premature death. The purpose of this study was to examine the association of intention to quit smoking (ITQS) cigarettes with polytobacco use status, controlling for frequency of tobacco product use and cigarette smoking intensity as measured by cigarettes per day (CPD). Data are from a larger quasi-experimental study conducted at a large state university in the Southeastern United States. Analysis is based on the combined sample of current smokers from two randomly selected cohorts surveyed two months apart. Polytobacco users (n = 52) were as likely as cigarette-only users (n = 81) to intend to quit smoking. Compared to students who used tobacco products 1–9 days per month, students using 10–29 days per month or daily reported higher ITQS. Higher intensity smokers (>10 CPD) were 71% less likely to indicate ITQS, compared to lower intensity smokers (≤10 CPD) (p = .025). College student polytobacco users were as likely as those using only cigarettes to intend to quit smoking. Interventions are needed to target college student polytobacco users as well as cigarette smokers as both groups may intend to quit. Smokers using 10 or fewer CPD and those who use tobacco products daily or 10–29 days per month may be more motivated to quit than college students who smoke with more intensity but who use tobacco products less frequently. 44.4% of the sample reported using at least one form of tobacco in addition to cigarettes. Polytobacco users were as likely as cigarette-only users to intend to quit smoking (ITQS). Significant ITQS predictors were sex, academic status, use frequency, cigarettes per day (CPD). Higher intensity smokers (>10 CPD) were 71% less likely than lower intensity (≤10 CPD) to ITQS. Students using tobacco 10–29 days/month or daily (vs. 1–9 days/month) reported greater ITQS.
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Affiliation(s)
- Karen M Butler
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Melinda J Ickes
- University of Kentucky Department of Kinesiology and Health Promotion, College of Education, 111 Seaton, Lexington, KY 40506-0219, United States
| | - Mary Kay Rayens
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Amanda T Wiggins
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Kristin Ashford
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Ellen J Hahn
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
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Peña-Purcell NC, Rahn RN, Atkinson TD. Assessing College Students’ Perceptions About Cigarette Smoking: Implications for Prevention. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1428701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Reddy MM, Kanungo S, Naik BN, Kar SS. Willingness to quit tobacco smoking and its correlates among Indian smokers - Findings from Global Adult Tobacco Survey India, 2009-2010. J Family Med Prim Care 2018; 7:1353-1360. [PMID: 30613524 PMCID: PMC6293941 DOI: 10.4103/jfmpc.jfmpc_169_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: In the stages of change model for smoking cessation, “willingness to quit” forms the starting point. Objective: To determine the prevalence and correlates of willingness to quit among smokers in India from Global Adult Tobacco Survey (GATS), 2009–2010. Methods: Secondary data analysis of GATS, 2009–10, was done to find the correlates of willingness to quit among smokers. All the sociodemographic variables, smoking-related factors such as frequency, previous attempt to quit, and also effect of antitobacco messages delivered to various media were tested for association using multivariable analysis. Results: Of 9627 current smokers analyzed, 50.9% [95% confidence interval (CI): 49.9–51.9] were willing to quit smoking. Multivariable analysis showed that younger age groups [prevalence ratio (PR): 1.31, 95% CI: 1.05–1.65], individuals who have their first smoke after 60 min of wakeup (PR: 1.19, 95% CI: 1.05–1.36), those living in a house with smoking restriction (PR: 1.29, 95% CI: 1.17–1.42), those who received advice to quit from doctor, those who attempted to quit in the past 12 months (PR: 1.28, 95% CI: 1.03–1.60), having knowledge about illness caused due to smoking, and those who have noticed antismoking messages in billboards/hoardings were willing to quit smoking compared to their counterparts (PR: 1.13, 95% CI: 1.04–1.23). Conclusion: Enforcing social restrictions like smoking restriction at house and also brief advice by doctors to quit smoking during any contact with the tobacco user could improve quit rate especially in young tobacco users and those who have attempted to quit before.
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Affiliation(s)
- Mahendra M Reddy
- Department of Community Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, India
| | - Srikanta Kanungo
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Bijaya Nanda Naik
- Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Weinberger AH, Gbedemah M, Wall MM, Hasin DS, Zvolensky MJ, Chaiton M, Goodwin RD. Depression Among Non-Daily Smokers Compared to Daily Smokers and Never-Smokers in the United States: An Emerging Problem. Nicotine Tob Res 2017; 19:1062-1072. [PMID: 28339571 PMCID: PMC5896441 DOI: 10.1093/ntr/ntx009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/06/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Depression is strongly associated with daily smoking. Yet, little is known about the association between depression and non-daily smoking. The aim of this study was to investigate the prevalence of past-year depression and changes in past-year depression over time among non-daily smokers, compared to daily smokers and never-smokers, overall and stratified by age, gender, income, nicotine dependence, and cigarettes per day. METHODS Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons aged 12 and over (total study population N = 496 805). The prevalence of past-year depression was examined annually among non-daily smokers, daily smokers, and never-smokers from 2005 to 2013 using linear trend analyses. RESULTS Past-year depression was common among 10.10% of non-daily smokers, common among 10.78% of daily smokers, and 5.51% of never-smokers in 2013. The prevalence of depression increased from 2005 to 2013 among non-daily smokers (9.06% vs. 10.10%; p = .034) while there was no significant change in depression over time among daily smokers. Increases in depression among non-daily smokers occurred for both men and women and appear most pronounced youth, those smoking fewer cigarettes, and those without nicotine dependence. CONCLUSIONS The prevalence of depression among non-daily smokers was equivalent to daily smokers and nearly twice that among nonsmokers. Depression appears to be increasing over time in non-daily smokers especially among youth, those who smoke less, and those without nicotine dependence. More work on the mental health of non-daily smokers is needed as this is an increasing and understudied group. IMPLICATIONS This is the first study to investigate changes in the prevalence of depression among non-daily smokers compared to daily smokers and never-smokers over the past decade in a nationally representative sample of the United States. The results suggest an increase in depression among non-daily smokers over time that did not similarly occur for daily smokers. Further, there were several subgroups of non-daily smokers among whom depression has increased more rapidly. This study suggests the need for more information about the relationship between depression and non-daily smoking including the impact of depression on quit attempts and outcomes.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Misato Gbedemah
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY
| | - Melanie M Wall
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- New York State Psychiatric Institute, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY
- New York State Psychiatric Institute, New York, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Chaiton
- Ontario Tobacco Research Unit, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), Queens, NY
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Cabriales JA, Suro Maldonado B, Cooper TV. Smoking transitions in a sample of Hispanic daily light and intermittent smokers. Addict Behav 2016; 62:42-6. [PMID: 27310033 DOI: 10.1016/j.addbeh.2016.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/17/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022]
Abstract
Few studies have documented the differences between daily light (DLS; ≤10 cigarettes per day) and intermittent (ITS; nondaily) smokers. The primary aim of this study was to assess the potential transitions (i.e., increased/stayed at same level) between baseline and a 3month follow-up of Hispanic DLS and ITS who were randomly assigned to a control group of a brief cessation intervention. Additionally, potential nicotine addiction differences between groups of smokers (e.g., ITS who became DLS vs. those who did not change) were assessed. Participants were 190 Hispanic DLS/ITS (who represent a subsample from a larger dataset, n=370) with complete data (53.7% female; Mage=38.6years, SD=15.1; range=18-74years) randomized to the control arm of a brief cessation intervention. Participants completed sociodemographics, tobacco use history, and the Fagerström Test for Nicotine Dependence (FTND; Heatherton, Kozlowski, Frecker and Fagerström, 1991). The majority of participants remained DLS (41.1%) or ITS (21.6%). ANCOVA findings indicated significant group differences regarding FTND scores (F [5114]=6.93, p<0.001). Those who remained DLS had significantly higher FTND scores than those who remained ITS and those who converted from ITS to DLS. Within these DLS/ITS who were randomized to a control group, smoking transitions primarily remained stable over time, particularly among DLS (who demonstrated higher nicotine dependence), suggesting the need for low level cessation interventions to continue and include a focus on dependence symptoms.
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Haardörfer R, Berg CJ, Lewis M, Payne J, Pillai D, McDonald B, Windle M. Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis. Addict Behav 2016; 59:58-64. [PMID: 27074202 DOI: 10.1016/j.addbeh.2016.03.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 02/11/2016] [Accepted: 03/29/2016] [Indexed: 11/19/2022]
Abstract
Limited research has examined polysubstance use profiles among young adults focusing on the various tobacco products currently available. We examined use patterns of various tobacco products, marijuana, and alcohol using data from the baseline survey of a multiwave longitudinal study of 3418 students aged 18-25 recruited from seven U.S. college campuses. We assessed sociodemographics, individual-level factors (depression; perceptions of harm and addictiveness,), and sociocontextual factors (parental/friend use). We conducted a latent class analysis and multivariable logistic regression to examine correlates of class membership (Abstainers were referent group). Results indicated five classes: Abstainers (26.1% per past 4-month use), Alcohol only users (38.9%), Heavy polytobacco users (7.3%), Light polytobacco users (17.3%), and little cigar and cigarillo (LCC)/hookah/marijuana co-users (10.4%). The most stable was LCC/hookah/marijuana co-users (77.3% classified as such in past 30-day and 4-month timeframes), followed by Heavy polytobacco users (53.2% classified consistently). Relative to Abstainers, Heavy polytobacco users were less likely to be Black and have no friends using alcohol and perceived harm of tobacco and marijuana use lower. Light polytobacco users were older, more likely to have parents using tobacco, and less likely to have friends using tobacco. LCC/hookah/marijuana co-users were older and more likely to have parents using tobacco. Alcohol only users perceived tobacco and marijuana use to be less socially acceptable, were more likely to have parents using alcohol and friends using marijuana, but less likely to have friends using tobacco. These findings may inform substance use prevention and recovery programs by better characterizing polysubstance use patterns.
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Affiliation(s)
- Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Michael Lewis
- Department of Marketing, Goizueta Business School, Emory University, 1300 Clifton Road, Atlanta, GA 30322, United States
| | - Jackelyn Payne
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Drishti Pillai
- Deparment of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Bennett McDonald
- Deparment of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
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Li X, Holahan CK, Holahan CJ. Sociodemographic and Psychological Characteristics of Very Light Smoking Among Women in Emerging Adulthood, National Survey of Drug Use and Health, 2011. Prev Chronic Dis 2015; 12:E111. [PMID: 26182146 PMCID: PMC4509100 DOI: 10.5888/pcd12.140547] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Although smoking prevalence and average cigarette consumption have declined, very light smoking (5 or fewer cigarettes per day) has increased. Very light smoking is common among young adult women. This study examines the differences between the sociodemographic and psychosocial factors associated with women in emerging adulthood who are very light smokers and similar women who are at other smoking levels. Methods The sample consisted of 9,789 women aged 18 to 25 years who took part in the 2011 National Survey on Drug Use and Health in the United States. Variables were sociodemographic factors, psychological adjustment, substance misuse, smoking attitudes, daily smoking, age at smoking initiation, and nicotine dependence. Analyses used were χ2 and multinomial logistic regression. Results Almost a fifth of participants and about three-fifths of smokers were very light smokers (no more than 5 cigarettes per day). Very light smokers were relatively more likely than other smokers to be young (aged 18 to 20), to be from a minority group, and to have some college education. They also were less likely to be married. The characteristics of very light smokers (poor psychological adjustment and tendency to misuse other substances) were similar to the characteristics of other smokers. However, very light smokers were more likely than other smokers to recognize high risks in smoking, less likely to report nicotine dependence, and more likely to be nondaily smokers. Conclusion Prevention programs targeting women in emerging adulthood need to recognize the prevalence of very light smoking in this population. Although comorbid psychological disorders and substance use present challenges, very light smokers’ perception of higher smoking risks and lower nicotine dependence compared with that of other smokers provide intervention opportunities.
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Affiliation(s)
- Xiaoyin Li
- University of Texas at Austin, Austin, Texas
| | - Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, 2109 San Jacinto Blvd, D3700, Austin, TX 78712.
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Berg CJ, Ajay VS, Ali MK, Kondal D, Khan HM, Shivashankar R, Pradeepa R, Mohan D, Fatmi Z, Kadir MM, Tandon N, Mohan V, Narayan KMV, Prabhakaran D. A cross-sectional study of the prevalence and correlates of tobacco use in Chennai, Delhi, and Karachi: data from the CARRS study. BMC Public Health 2015; 15:483. [PMID: 25958327 PMCID: PMC4432508 DOI: 10.1186/s12889-015-1817-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 05/04/2015] [Indexed: 11/29/2022] Open
Abstract
Background Tobacco burdens in India and Pakistan require continued efforts to quantify tobacco use and its impacts. We examined the prevalence and sociodemographic and health-related correlates of tobacco use in Delhi, Chennai (India), and Karachi (Pakistan). Methods Analysis of representative surveys of 11,260 participants (selected through multistage cluster random sampling; stratified by gender and age) in 2011 measured socio-demographics, tobacco use history, comorbid health conditions, and salivary cotinine. We used bivariate and multivariate regression analyses to examine factors associated with tobacco use. Results Overall, 51.8 % were females, and 61.6 % were below the age of 45 years. Lifetime (ever) tobacco use prevalence (standardized for world population) was 45.0 %, 41.3 %, and 42.5 % among males, and 7.6 %, 8.5 %, and 19.7 % among females in Chennai, Delhi, and Karachi, respectively. Past 6 month tobacco use prevalence (standardized for world population) was 38.6 %, 36.1 %, and 39.1 % among males, and 7.3 %, 7.1 %, and 18.6 % among females in Chennai, Delhi, and Karachi, respectively. In multivariable regression analyses, residing in Delhi or Karachi versus Chennai; older age; lower education; earning less income; lower BMI; were each associated with tobacco use in both sexes. In addition, semi-skilled occupation versus not working and alcohol use were associated with tobacco use in males, and having newly diagnosed dyslipidemia was associated with lower odds of tobacco use among females. Mean salivary cotinine levels were higher among tobacco users versus nonusers (235.4; CI: 187.0-283.8 vs. 29.7; CI: 4.2, 55.2, respectively). Conclusion High prevalence of tobacco use in the South Asian region, particularly among men, highlights the urgency to address this serious public health problem. Our analyses suggest targeted prevention and cessation interventions focused on lower socioeconomic groups may be particularly important. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1817-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, 1518 Clifton Rd NE, 30322, Atlanta, Georgia, USA.
| | - Vamadevan S Ajay
- Public Health Foundation of India, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India. .,Centre for Chronic Disease Control, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India.
| | - Mohammed K Ali
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Rd NE, 30322, Atlanta, Georgia, USA.
| | - Dimple Kondal
- Public Health Foundation of India, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India. .,Centre for Chronic Disease Control, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India.
| | - Hassan M Khan
- Aga Khan University, Stadium Road, P.O. Box 3500, 74800, Karachi, Pakistan.
| | - Roopa Shivashankar
- Public Health Foundation of India, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India. .,Centre for Chronic Disease Control, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India.
| | - Rajendra Pradeepa
- Madras Diabetes Research Foundation, No 4, Conran Smith Road, Gopalapuram, 600 086, Chennai, India.
| | - Deepa Mohan
- Madras Diabetes Research Foundation, No 4, Conran Smith Road, Gopalapuram, 600 086, Chennai, India.
| | - Zafar Fatmi
- Aga Khan University, Stadium Road, P.O. Box 3500, 74800, Karachi, Pakistan.
| | - Muhammad M Kadir
- Aga Khan University, Stadium Road, P.O. Box 3500, 74800, Karachi, Pakistan.
| | - Nikhil Tandon
- Department of Endocrinology & Metabolism, All India Institute of Medical Sciences (AIIMS), Ansari, New, Nagar, 110029, Delhi, India.
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, No 4, Conran Smith Road, Gopalapuram, 600 086, Chennai, India.
| | - K M Venkat Narayan
- Hubert Department of Global Health, Emory University Rollins School of Public Health, 1518 Clifton Rd NE, 30322, Atlanta, Georgia, USA.
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India. .,Centre for Chronic Disease Control, Plot No 47, Sector 44, 122002, Gurgaon, Haryana, India.
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Guillory J, Johns M, Farley SM, Ling PM. Loose Cigarette Purchasing and Nondaily Smoking Among Young Adult Bar Patrons in New York City. Am J Public Health 2015; 105:e140-7. [PMID: 25880951 DOI: 10.2105/ajph.2014.302518] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined loose cigarette (loosie) purchasing behavior among young adult (aged 18-26 years) smokers at bars in New York City and factors associated with purchase and use. METHODS Between June and December 2013, we conducted cross-sectional surveys (n = 1916) in randomly selected bars and nightclubs. Using multivariable logistic regression models, we examined associations of loose cigarette purchasing and use with smoking frequency, price, social norms, cessation behaviors, and demographics. RESULTS Forty-five percent (n = 621) of nondaily smokers and 57% (n = 133) of daily smokers had ever purchased a loosie; 15% of nondaily smokers and 4% of daily smokers reported that their last cigarette was a loosie. Nondaily smokers who never smoked daily were more likely than were daily smokers to have last smoked a loosie (odds ratio = 7.27; 95% confidence interval = 2.35, 22.48). Quitting behaviors and perceived approval of smoking were associated with ever purchasing and recently smoking loosies. CONCLUSIONS Loosie purchase and use is common among young adults, especially nondaily smokers. Smoking patterns and attitudes should be considered to reduce loose cigarette purchasing among young adults in New York City.
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Affiliation(s)
- Jamie Guillory
- At the time of the analysis and writing, Jamie Guillory was with the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco. Michael Johns and Shannon M. Farley are with the New York City Department of Health and Mental Hygiene, New York, NY. Pamela M. Ling is with the Division of General Internal Medicine, Department of Medicine, and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Michael Johns
- At the time of the analysis and writing, Jamie Guillory was with the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco. Michael Johns and Shannon M. Farley are with the New York City Department of Health and Mental Hygiene, New York, NY. Pamela M. Ling is with the Division of General Internal Medicine, Department of Medicine, and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Shannon M Farley
- At the time of the analysis and writing, Jamie Guillory was with the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco. Michael Johns and Shannon M. Farley are with the New York City Department of Health and Mental Hygiene, New York, NY. Pamela M. Ling is with the Division of General Internal Medicine, Department of Medicine, and the Center for Tobacco Control Research and Education, University of California, San Francisco
| | - Pamela M Ling
- At the time of the analysis and writing, Jamie Guillory was with the Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco. Michael Johns and Shannon M. Farley are with the New York City Department of Health and Mental Hygiene, New York, NY. Pamela M. Ling is with the Division of General Internal Medicine, Department of Medicine, and the Center for Tobacco Control Research and Education, University of California, San Francisco
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Berg CJ, Stratton E, Schauer GL, Lewis M, Wang Y, Windle M, Kegler M. Perceived harm, addictiveness, and social acceptability of tobacco products and marijuana among young adults: marijuana, hookah, and electronic cigarettes win. Subst Use Misuse 2015; 50:79-89. [PMID: 25268294 PMCID: PMC4302728 DOI: 10.3109/10826084.2014.958857] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There has been an increase in non-daily smoking, alternative tobacco product and marijuana use among young adults in recent years. OBJECTIVES This study examined perceptions of health risks, addictiveness, and social acceptability of cigarettes, cigar products, smokeless tobacco, hookah, electronic cigarettes, and marijuana among young adults and correlates of such perceptions. METHODS In Spring 2013, 10,000 students at two universities in the Southeastern United States were recruited to complete an online survey (2,002 respondents), assessing personal, parental, and peer use of each product; and perceptions of health risks, addictiveness, and social acceptability of each of these products. RESULTS Marijuana was the most commonly used product in the past month (19.2%), with hookah being the second most commonly used (16.4%). The least commonly used were smokeless tobacco products (2.6%) and electronic cigarettes (4.5%). There were high rates of concurrent product use, particularly among electronic cigarette users. The most positively perceived was marijuana, with hookah and electronic cigarettes being second. While tobacco use and related social factors, related positively, influenced perceptions of marijuana, marijuana use and related social factors were not associated with perceptions of any tobacco product. Conclusions/Importance: Marketing efforts to promote electronic cigarettes and hookah to be safe and socially acceptable seem to be effective, while policy changes seem to be altering perceptions of marijuana and related social norms. Research is needed to document the health risks and addictive nature of emerging tobacco products and marijuana and evaluate efforts to communicate such risks to youth.
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Affiliation(s)
- Carla J. Berg
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Erin Stratton
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Gillian L. Schauer
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Michael Lewis
- Department of Marketing, Emory University Goizueta Business School, Atlanta, Georgia, USA
| | - Yanwen Wang
- Department of Marketing, Emory University Goizueta Business School, Atlanta, Georgia, USA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Michelle Kegler
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
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McNamara RS, Song EY, Reboussin BA, Spangler J, Pockey JR, Kimes C, Foley KL, Sutfin EL. Motivational interviewing intervention with college student tobacco users: providers' beliefs and behaviors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2015; 63:286-290. [PMID: 25580630 PMCID: PMC4428958 DOI: 10.1080/07448481.2014.1003376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study assessed college student health providers' use of Motivational Interviewing (MI) with tobacco users, as well as their beliefs about the use of brief interventions to help college student tobacco users quit. MI is recommended by the United States Public Health Service to increase tobacco users' willingness to quit. PARTICIPANTS Participants included 83 clinicians from health clinics at 7 different universities in North Carolina. METHODS Paper-and-pencil baseline survey from a cluster randomized trial of college student health clinicians. RESULTS Twenty-two percent of respondents reported always or usually using MI during the past month for tobacco-using patients not ready to make a quit attempt. Student health providers also reported information with regards to their beliefs about tobacco cessation treatment, barriers to intervening with patients, and confidence in motivating students to consider quitting. CONCLUSIONS Results highlight the need to encourage clinicians' use of motivationally focused interventions with student tobacco users. [Table: see text].
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Affiliation(s)
- Robert S. McNamara
- Counseling Center, Wake Forest University, Winston-Salem, North Carolina
- Counseling Center, University of North Carolina Wilmington, Wilmington, North Carolina (current)
| | - Eun-Young Song
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Beth A. Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - John Spangler
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Caroline Kimes
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Kristie L. Foley
- Medical Humanities Program, Davidson College, Davidson, North Carolina
| | - Erin L. Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Lee HS, Catley D, Harris KJ. Improving understanding of the quitting process: psychological predictors of quit attempts versus smoking cessation maintenance among college students. Subst Use Misuse 2014; 49:1332-9. [PMID: 24758706 PMCID: PMC4086835 DOI: 10.3109/10826084.2014.901386] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined motivation, positive and negative outcome expectations of quitting, and self-efficacy as predictors of quit attempts and cessation maintenance in a smoking cessation intervention for college students (N = 303). Psychological measures assessed at baseline were used to predict smoking behavior outcomes. Analysis of variance (ANOVA) and logistic regression analysis revealed that motivation and self-efficacy were strong, differential predictors of quit attempts and cessation maintenance, respectively. This study extends the previous findings regarding psychological predictors of quitting processes to college students, and suggests the need for interventions tailored according to phases of quitting processes.
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Affiliation(s)
- Hyoung S Lee
- 1Interdisciplinary Arts and Sciences, University of Washington Tacoma , Tacoma, Washington , USA
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Pulvers K, Scheuermann TS, Emami AS, Basora B, Luo X, Khariwala SS, Ahluwalia JS. Reasons for smoking among tri-ethnic daily and nondaily smokers. Nicotine Tob Res 2014; 16:1567-76. [PMID: 25011469 DOI: 10.1093/ntr/ntu108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nondaily smokers experience adverse effects from tobacco use, yet they have been understudied compared to daily smokers. Understanding how reasons for smoking (RS) differ by smoking level, gender, and race/ethnicity could inform tailored interventions. METHODS A cross-sectional survey was administered through an online panel survey service to 2,376 current smokers who were at least 25 years of age. The sample was stratified to obtain equal numbers of 3 racial/ethnic groups (African American [AA], Latino, and White) across smoking level (native nondaily, converted nondaily, daily light, and daily moderate/heavy). RESULTS A 7-factor structure of a 20-item Modified Reasons for Smoking Scale (MRSS) was confirmed (each subscale alpha > 0.80). Each factor of the MRSS varied by smoking level, with nondaily smokers endorsing all RS less frequently than daily smokers (p < .0001). The 4 smoker subgroups incrementally differed from one another (p < .05) with several exceptions between converted nondaily and daily light smokers. Males reported stronger RS on 5 out of 7 reasons (p < .05). Females had higher scores on tension reduction/relaxation (p < .0001). Latinos reported stronger RS than Whites and AAs on all reasons (p < .05) except for tension reduction/relaxation (p > .05). AAs and Whites were comparable on all RS (p > .05). CONCLUSIONS The present study highlights considerable variability across smoking level, gender, and race/ethnicity in strength of RS. Addressing subgroup differences in RS may contribute to more sensitive and effective prevention and treatment efforts.
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Affiliation(s)
- Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, CA;
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Ashley S Emami
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Brittany Basora
- Department of Psychology, California State University San Marcos, San Marcos, CA
| | - Xianghua Luo
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, Minneapolis, MN
| | - Jasjit S Ahluwalia
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Minnesota Department of Medicine and Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
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A cross-sectional study examining youth smoking rates and correlates in Tbilisi, Georgia. BIOMED RESEARCH INTERNATIONAL 2014; 2014:476438. [PMID: 24738059 PMCID: PMC3971510 DOI: 10.1155/2014/476438] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/06/2014] [Indexed: 11/24/2022]
Abstract
Georgia has high smoking rates; however, little is known about the prevalence and correlates of youth smoking. We conducted a secondary data analysis of a 2010 cross-sectional survey of 1,879 secondary and postsecondary school students aged 15 to 24 years in Tbilisi, Georgia, examining substance use, perceived risk, and recreational activities in relation to lifetime and current (past 30 days) smoking. Lifetime and current smoking prevalence was 46.1% and 22.6%, respectively. In secondary schools, lifetime smoking correlates included being male, consuming alcohol, lifetime marijuana use, and lower perceived risk (P's ≤ .001). Correlates of current smoking among lifetime smokers included being male, consuming alcohol, lifetime marijuana use, lower perceived risk, less frequently exercise, and more often going out (P's < .05). In postsecondary schools, lifetime smoking correlates included being male, consuming alcohol, lifetime marijuana use, lower perceived risk, more often going out, and recreational internet use (P's < .0). Correlates of current smoking among lifetime smokers included being male (P's = .04), consuming alcohol, marijuana use, lower perceived risk, and more often going out (P's < .05). Tobacco control interventions might target these correlates to reduce smoking prevalence in Georgian youth.
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Enofe N, Berg CJ, Nehl EJ. Alternative tobacco use among college students: who is at highest risk? Am J Health Behav 2014; 38:180-9. [PMID: 24629547 DOI: 10.5993/ajhb.38.2.3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examines smoking status, substance use, sociodemographics, and psychosocial characteristics in relation to alternative tobacco use among college students. METHODS Current tobacco use (cigarettes, cigar-like products, hookah, chew, snus) and correlates (sociodemographics, sensation-seeking, attitudes toward tobacco and smokers, social factors) were assessed among students aged 18-25 at 6 Southeastern US colleges using an online survey. RESULTS Those who were younger, male, black, cigarette and marijuana users, and demonstrating at-risk psychosocial factors were at increased risk of alternative tobacco product use (p < .001). Among current smokers, never daily nondaily smokers were 3 times as likely as former daily non-daily smokers and daily smokers to use alternative tobacco products (p < .001). CONCLUSIONS Important risk factors for alternative tobacco use included important sociodemographic and psychosocial characteristics.
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Affiliation(s)
- Nosayaba Enofe
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA.
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
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McClure LA, Arheart KL, Lee DJ, Sly DF, Dietz NA. Young adult former ever smokers: the role of type of smoker, quit attempts, quit aids, attitudes/beliefs, and demographics. Prev Med 2013; 57:690-5. [PMID: 24021991 PMCID: PMC3855223 DOI: 10.1016/j.ypmed.2013.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 08/16/2013] [Accepted: 08/31/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Young adults who smoke are often nondaily users who either quit or transition into dependent smokers. Further, this age group often has been considered an extension of the adult population. This study aims to examine young adult former ever smokers to understand factors associated with their stopping smoking. METHOD Telephone interviews were conducted in 2010 with 4401 young adults in Florida. We examined the association between former ever smokers and sociodemographics, smoking behavior, quit attempts, quit aids, and attitudes/beliefs about smoking. RESULTS Thirty-seven percent of young adults were former smokers, 20% were current smokers, and 43% were never smokers. Former smokers were more likely to be female, situational smokers (compared to occasional or established), more likely to have stopped smoking without acknowledging making a quit attempt, less likely to have used a quit aid, and less likely to display pro-tobacco attitudes/beliefs. CONCLUSION Young adult former and current smokers have unique patterns of smoking and stopping smoking. Young adults may require novel intervention techniques to promote prevention and cessation based on these unique smoking patterns. Future research is needed to understand motivations to quit smoking among young adults.
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Affiliation(s)
- Laura A. McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14 Street, 15 Floor C202, Miami, Florida 33136, USA
| | - Kristopher L. Arheart
- Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1120 NW 14 St, 10 Floor, Miami, FL 33136, USA
| | - David J. Lee
- Sylvester Comprehensive Cancer Center, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room 911, Miami, Florida 33136, USA
| | - David F. Sly
- College of Social Sciences, Florida State University, 543 Old Cove Rd N, Jasper, GA 30143, USA
| | - Noella A. Dietz
- Department of Epidemiology and Public Health, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14 Street, 15 Floor C202, Miami, Florida 33136, USA
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