The early health consequences of smoking: relationship with psychosocial factors among treatment-seeking Black smokers

Family Beliefs and Behaviors About Smoking and Young Children's Secondhand Smoke Exposure

INTRODUCTION

Home smoking bans (HSBs) reduce children's secondhand smoke exposure (SHSe), a contributor to health disparities. General psychosocial characteristics and SHSe beliefs and behaviors within the family may relate to HSB existence. This study's aim was to identify general psychosocial characteristics and SHSe beliefs associated with HSB presence and lower SHSe among children living with a smoker.

METHODS

Caregivers (n = 269) of Head Start preschool students (age 1-6 years) living with a smoker reported on HSBs, caregiver depressive symptoms and stress, family routines, SHSe beliefs, and household smoking characteristics. SHSe biomarkers included air nicotine in 2 areas of the home and child salivary cotinine.

RESULTS

One-quarter of families reported complete HSBs, and HSBs were more common among nonsmoking (37%) versus smoking caregivers (21%; p < .01). Perceived importance of HSBs differed between nonsmoking (9.7±1.0) versus smoking caregivers (9.1±2.0; p < .01). Smoking caregivers, more smokers in the home, and lower self-efficacy and intent to implement an HSB were consistently associated with lower likelihood of HSB existence and children's higher SHSe. Caregiver SHSe beliefs were more consistently associated with HSBs and SHSe than were general psychosocial factors.

CONCLUSIONS

Despite greater HSB likelihood and higher perceived importance of HSBs among nonsmoking versus smoking primary caregivers, SHSe reduction self-efficacy and intent are protective for Head Start students at high-risk for exposure. Pediatric healthcare providers and early education professionals may be able to support SHSe reduction efforts (e.g., smoking cessation, HSB implementation) and reduce children's SHSe with counseling strategies to address caregivers' HSB self-efficacy, intent, and related behaviors.

Familial Risk in Low-Income Children With Chronic Illness Exposed to Passive Smoke

BACKGROUND

This study highlights the family characteristics of a child living in a state of triple risk: chronically ill, exposed to passive smoke, and residing in a low-income household.

METHODS

Head Start families were divided into 4 groups based on passive smoke exposure and child chronic illness status. Analyses of covariance controlling for parent education, parent employment, marital status, and residence were conducted to identify group differences in the Family Map risk areas.

RESULTS

Families of chronically ill, passive smoke-exposed children demonstrated the highest levels of risks across a range of areas including: meeting basic needs, family conflict, parenting stress, and parental depression and anxiety.

CONCLUSIONS

Children living in poverty with a chronic illness who are exposed to smoke are likely to face many challenges in addition to their illness. Healthcare professionals can identify family risks and provide targeted educate and support to potentially reduce risk factors for children.

Health care provider tobacco cessation counseling among current African American tobacco users

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.

Depressive symptoms and smoking among young Turkish and Moroccan ethnic minority groups in The Netherlands: a cross-sectional study

BACKGROUND

Although evidence indicates a strong association between depressive symptoms and smoking among host and migrant adults, less is known about this relationship among young ethnic minority groups in Europe. This paper aims to assess the relationship between depressive symptoms and smoking among young Turkish and Moroccan migrants in the Netherlands.

METHODS

Multiple logistic regression analyses was used to analyze cross-sectional data from a sample of 364 Turkish and Moroccan migrants aged 15 to 24 years. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure the presence of clinically significant depressive symptoms. Smoking behavior was measured by a number of questions.

RESULTS

Of the respondents, 22% were smokers and 33% had depressive symptoms. The prevalence of depressive symptoms was significantly higher in smokers (42.9%) than in nonsmokers (29.5%). Respondents with depressive symptoms had increased odds of smoking even after adjusting for socioeconomic and cultural factors (OR = 2.68, 95% CI = 1.45-4.97).

CONCLUSIONS

Depressive symptoms were significantly associated with smoking behavior in young Turkish and Moroccan migrants. In addition to other acknowledged factors, depressive symptoms should also be considered in relation to the smoking behavior of this group. Intervention programs for smoking behavior should take depressive symptoms into account for young Turkish and Moroccan migrants.

Smoking behavior among low-income black adults: patterns and correlates of smoking trajectories

INTRODUCTION

Limited research has focused on identifying smoking patterns and correlates of cigarette use among low-income Blacks. Identifying smoking patterns and correlates of use would assist health providers to develop more culturally sensitive interventions.

METHODS

A semiparametric group-based trajectory modeling strategy was used to empirically identify patterns of cigarette use among 947 low-income Black adults (47% women) enrolled in a sexual risk reduction intervention at a sexually transmitted disease clinic. Patients' cigarette use was assessed 4 times over a 12-month period; correlates of cigarette use were examined.

RESULTS

Six smoking trajectories were empirically identified: none/rare smokers (n = 536), decreasing light smokers (n = 69), increasing light smokers (n = 51), low light smokers (n = 112), upper light smokers (n = 142), and moderate smokers (n = 33). Smoking trajectories were predicted by alcohol use, prior substance use treatment, marijuana use, and other illegal drug use, but the patterns varied by trajectory.

DISCUSSION

Results from this study show that Blacks' smoking patterns are associated with several risk factors. These findings suggest that development of prevention and cessation programs should be targeted to the specific needs of Blacks' smoking trajectories.