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Wang N, Dove MS, Tong EK. Serious psychological distress and higher associations with tobacco and cannabis use among college students in the United States. Prev Med 2024; 185:108041. [PMID: 38866211 DOI: 10.1016/j.ypmed.2024.108041] [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: 02/12/2024] [Revised: 05/10/2024] [Accepted: 06/10/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To examine associations between serious psychological distress (SPD) and tobacco and cannabis use among college students in the United States. METHODS This cross-sectional study included 257,626 college students from the 2019-2022 National College Health Assessment survey. SPD was defined as having symptoms in the past month. Current tobacco (i.e., cigarettes, e-cigarettes) and cannabis use was defined as past month use. Multiple product use was categorized for single, dual, or triple products. Adjusted logistic regression models were used to examine associations between SPD, tobacco, cannabis, and multiple product use. RESULTS SPD increased over time (18.4% to 23.8%) among students and nearly 30% of tobacco or cannabis users reported SPD. Cigarette, e-cigarette, or cannabis use was associated with about a 50-60% increased likelihood of reporting SPD than non-current use of each product, with the highest associations in Fall 2020. Triple product users had double the likelihood of reporting SPD, followed by dual users at 70% and single users at 47%, relative to non-current users. Daily users also had nearly twice the likelihood of reporting SPD, followed by non-daily users at 13-35%, relative to non-current users. CONCLUSIONS College students have an increasing burden of SPD which is significantly associated with tobacco and cannabis use. There is a dose-response relationship between the number of tobacco and cannabis products used, as well as the frequency of use, and SPD among U.S. college students. Colleges addressing student mental health should prioritize the implementation of screening and treatment support for tobacco, cannabis, and multiple product use.
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Affiliation(s)
- Nan Wang
- Department of Public Health Sciences, University of California Davis, Davis, USA
| | - Melanie S Dove
- Department of Public Health Sciences, University of California Davis, Davis, USA; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, USA
| | - Elisa K Tong
- Department of Internal Medicine, University of California Davis, 4150 V Street Suite 2400, Sacramento, CA 95817, USA; Tobacco Cessation Policy Research Center, University of California Davis Comprehensive Cancer Center, Sacramento, USA.
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2
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Hong Q, Liao Y, Zhang N. Implicit Theories of Smoking and Intention to Quit: A Serial Mediation Model. Nicotine Tob Res 2024; 26:621-628. [PMID: 37878750 DOI: 10.1093/ntr/ntad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/06/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION There is growing evidence that implicit theories of smoking (ITS)-whether smokers perceive smoking behavior as malleable or fixed-are significant predictors of quitting intentions. AIMS AND METHODS This cross-sectional study aims to investigate the underlying mechanisms of implicit theories on smoking in predicting smokers' intentions to quit. We conducted multiple linear regression with quitting intentions as the dependent variable, ITS as the independent variable, and sociodemographic variables, quitting attempts in the past year, and receiving quitting advice in the past 12 months as the covariates. The mediating role of consideration of future consequences (CFC) and self-efficacy in the relationship between implicit theories of smoking and quitting intentions was evaluated by mediation analyses. RESULTS A total of 510 smokers were included in the final analyses. Smokers holding a higher incremental theory of smoking reported a higher likelihood of considering future consequences (β = 0.289, p < .001) and a weaker possibility of considering immediate results (β = -0.317, p < .001), which, in turn, enhanced their quitting self-efficacy and then led to stronger intentions to quit smoking (β = 0.261, p < .001). CONCLUSIONS The current study enriched our understanding of the underlying mechanisms that connect smokers' ITS and their likelihood of smoking cessation such that higher incremental theories of smoking predict stronger intention to quit smoking, and the effect was serially mediated by smokers' likelihood of considering future consequences of their behavior and their perceived self-efficacy for smoking cessation. IMPLICATIONS This study indicated the mediating role of CFC and self-efficacy for smoking cessation on the relationship between the ITS and quitting intentions. These two psychological factors and the pathways may be important points for understanding the model of implicit theories for smoking and improving the effectiveness of implicit theories-based intervention on smoking cessation.
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Affiliation(s)
- Qiumian Hong
- Department of Social Medicine, School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
| | - Ning Zhang
- Department of Social Medicine, School of Public Health and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, P. R. China
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3
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Greenfield E, Alves MDS, Rodrigues F, Nogueira JO, da Silva L, de Jesus HP, Cavalcanti DR, Carvalho BFDC, Almeida JD, Mendes MA, Oliveira Alves MG. Preliminary Findings on the Salivary Metabolome of Hookah and Cigarette Smokers. ACS OMEGA 2023; 8:36845-36855. [PMID: 37841134 PMCID: PMC10569005 DOI: 10.1021/acsomega.3c03683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/10/2023] [Indexed: 10/17/2023]
Abstract
The aim of the study was to evaluate the salivary metabolomic profile of patients who habitually smoke hookah and cigarettes. The groups consisted of 33 regular and exclusive hookah smokers, 26 regular and exclusive cigarette smokers, and 30 nonsmokers. Unstimulated whole saliva was collected for the measurement of salivary metabolites by gas chromatography coupled with tandem mass spectrometry (GC-MS/MS). The MetaboAnalyst software was used for statistical analysis and evaluation of biomarkers. 11 smoking salivary biomarkers were identified using the area under receiving-operator curver criterion and threshold of 0.9. Xylitol and octadecanol were higher in cigarette smokers compared to controls; arabitol and maltose were higher in controls compared to cigarette smokers; octadecanol and tyramine were higher in hookah smokers compared to controls; phenylalanine was higher in controls compared to hookah smokers; and fructose, isocitric acid, glucuronic acid, tryptamine, maltose, tyramine, and 3-hydroxyisolvaleric acid were higher in hookah smokers compared to cigarettes smokers. Conclusions: The evaluation of the salivary metabolome of hookah smokers, showing separation between the groups, especially between the control versus hookah groups and cigarette versus hookah groups, and it seems to demonstrate that the use of hookah tobacco is more damaging to health.
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Affiliation(s)
- Ellen Greenfield
- Technology
Research Center (NPT), Universidade de Mogi
das Cruzes, Mogi das
Cruzes 08780-911, Brazil
| | - Mariana de Sá Alves
- Department
of Biosciences and Oral Diagnosis, Institute
of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo 01049-010, Brazil
| | - Fernanda Rodrigues
- Technology
Research Center (NPT), Universidade de Mogi
das Cruzes, Mogi das
Cruzes 08780-911, Brazil
| | | | | | | | | | - Bruna Fernandes do Carmo Carvalho
- Department
of Biosciences and Oral Diagnosis, Institute
of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo 01049-010, Brazil
| | - Janete Dias Almeida
- Department
of Biosciences and Oral Diagnosis, Institute
of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo 01049-010, Brazil
| | - Maria Anita Mendes
- Dempster
MS Lab, Department of Chemical Engineering, Polytechnic School, University of Sao Paulo, Sao Paulo 05508-900, Brazil
| | - Mônica Ghislaine Oliveira Alves
- Technology
Research Center (NPT), Universidade de Mogi
das Cruzes, Mogi das
Cruzes 08780-911, Brazil
- Department
of Biosciences and Oral Diagnosis, Institute
of Science and Technology, São Paulo State University (UNESP), São José dos Campos, São Paulo 01049-010, Brazil
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Mauduy M, Mauny N, Mange J. Tobacco Dependence Among French University Students: A Cluster Analytic Approach to Identifying Distinct Psychological Profiles of Smokers. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221107560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigates the combination of several psychological factors related to tobacco smoking to identify smokers’ psychological profiles among French university students. A cluster analysis was performed on smoking motives, psychosocial variables, and the smoker identity ( N = 909). Five profiles were identified and then compared regarding tobacco dependence and motivations to quit. “Normative” and “sociohedonist smokers” are characterized by two distinct social factors (normative influences and social motives) and moderate dependence. “Dependent identified smokers” have higher levels of dependence motives, smoker identity and tobacco dependence associated with low motivations to quit. “Inconsistent smokers” have weak smoker identity and weak smoking motives, a strong perceived control over resisting smoking, low dependence and motivations to quit. “Coping smokers” have strong sedative and addictive motives and exhibit moderate dependence and motivations to quit. This research encourages prevention programs to consider the diversity of student smokers with strategies adapted to their psychological profiles.
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Affiliation(s)
- Maxime Mauduy
- Psychology, LPCN, University of Caen Normandy, Caen, France
| | - Nicolas Mauny
- Psychology, LPCN, University of Caen Normandy, Caen, France
| | - Jessica Mange
- Psychology, LPCN, University of Caen Normandy, Caen, France
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5
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Poole R, Carver H, Anagnostou D, Edwards A, Moore G, Smith P, Wood F, Brain K. Tobacco use, smoking identities and pathways into and out of smoking among young adults: a meta-ethnography. Subst Abuse Treat Prev Policy 2022; 17:24. [PMID: 35346260 PMCID: PMC8960094 DOI: 10.1186/s13011-022-00451-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This meta-ethnography investigates how young adults describe their tobacco use, smoking identities and pathways into and out of regular smoking, to inform future smoking prevention and harm reduction interventions. METHODS Eight databases were systematically searched using keywords and indexed terms. Studies were included if they presented qualitative data from young adults aged 16-25 reporting smoking histories and/or smoking identities from countries culturally similar to the UK. A systematic and rigorous meta-ethnographic approach was employed, consistent with Noblit and Hare's methodology. RESULTS Thirty papers were included. Reasons stated for taking up smoking and becoming a smoker included alleviating stress, transforming one's identity, and coping with the transition to further education, employment or leaving home. Many used smoking to aid acceptance within new peer groups, particularly when alcohol was present. Smoking was also perceived as an act of resistance and a coping mechanism for those with marginalised identities. Barriers to quitting smoking included young adults' minimisation or denial of the health risks of smoking and not identifying with "being a smoker". CONCLUSIONS This meta-ethnography may provide a blueprint to inform the development of health and wellbeing interventions designed specifically for young adults. Smoking cessation interventions should be co-designed with young adults based on their perceived needs, resonant with their desire to quit in the future at key milestones. Harm reduction interventions should address the social aspect of addiction, without reinforcing stigma, particularly for those with marginalised identities.
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Affiliation(s)
- Ria Poole
- European Centre for Environment and Human Health, University of Exeter Medical School, Royal Cornwall Hospital, Knowledge Spa, Cornwall, TR1 3DH, Truro, UK.
| | - Hannah Carver
- Salvation Army Centre for Addiction Services and Research, Faculty of Social Sciences, University of Stirling, FK9 4LA, Stirling, UK
| | - Despina Anagnostou
- Division of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo Ward, 606-8507, Kyoto, Japan
| | - Adrian Edwards
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Graham Moore
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, 1-3 Museum Place, CF10 3BD, Cardiff, UK
| | - Pamela Smith
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Fiona Wood
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
| | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionydd, Heath Park, CF14 4YS, Cardiff, UK
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Chen H, Fan Y, Li X, Gao L, Li W. The Relationship Between Smoker Identity and Smoking Cessation Among Young Smokers: The Role of Smoking Rationalization Beliefs and Cultural Value of Guanxi. Front Psychiatry 2022; 13:812982. [PMID: 35558421 PMCID: PMC9086586 DOI: 10.3389/fpsyt.2022.812982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Although the relationship between smoker identity and smoking cessation behavior has been confirmed, the role of smoking-related beliefs and cultural values in this relationship for young smokers is little known. The present study aimed to examine whether the relationship between smoker identity and smoking cessation behavior would be mediated by smoking rationalization beliefs and/or intention to quit smoking and whether the effect of smoker identity on smoking cessation behavior was moderated by cultural value of guanxi. A total of 708 young smokers participated in the study and completed questionnaires that measured smoker identity, smoking rationalization beliefs, intention to quit smoking, smoking cessation behavior and cultural value of guanxi. The results showed: (1) the relationship between smoker identity and smoking cessation behavior was negative and significant. (2) The mediating effect of intention to quit smoking and the serial mediating effect of "smoking rationalization beliefs → intention to quit smoking" on the relationship between smoker identity and smoking cessation behavior was significant. (3) Both the serial mediating effect of "smoking rationalization beliefs → intention to quit smoking" and the direct effect of smoker identity on smoking cessation behavior were moderated by cultural value of guanxi. The current findings increased understanding of psychosocial mechanisms underlying the hindering effect of smoker identity on smoking cessation and suggested the role of smoking rationalization beliefs and cultural value of guanxi should be considered in smoking cessation interventions for young smokers.
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Affiliation(s)
- Haide Chen
- College of Education and Human Development, Zhejiang Normal University, Jinhua, China
| | - Yumeng Fan
- College of Education and Human Development, Zhejiang Normal University, Jinhua, China
| | - Xinwei Li
- College of Education and Human Development, Zhejiang Normal University, Jinhua, China
| | - Lingfeng Gao
- College of Education and Human Development, Zhejiang Normal University, Jinhua, China
| | - Weijian Li
- College of Education and Human Development, Zhejiang Normal University, Jinhua, China
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7
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Phan L, Mays D, Tercyak KP, Johnson AC, Rehberg K, Lipkus IM. Initial development of the Hookah Smoker Scale: Assessing young adults' mental schemas about hookah "smokers". Transl Behav Med 2021; 11:206-215. [PMID: 31722424 DOI: 10.1093/tbm/ibz155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many young adult hookah tobacco users do not consider themselves hookah "smokers," but data on this topic are limited. There are no existing measures of young adults' mental schemas of hookah "smokers." We examined the factor structure and reliability of the Hookah Smoker Scale and examined associations with perceived harm and addictiveness and attitudes toward hookah. Two hundred and forty-six young adult (ages 18-30) hookah smokers participated in a cross-sectional online study. Participants completed items assessing schemas characterizing hookah smokers and valid measures of perceived harm and addictiveness of hookah smoking, risk appraisals, and attitudes toward hookah. Exploratory factor analysis using principal axis factoring with oblique rotation extracted a 12-item scale with three dimensions (Regular Use, Social-Enabled Use, and Self-Enabled Use). The scale explained 69.7% of the variance (eigenvalue = 9.2). Cronbach's α for the scale was .89, with Cronbach's α ≥ .80 for four-item subscales. Higher subscale scores indicate stronger beliefs that the dimension characterizes a hookah smoker. Higher Regular Use scores (score variance = 46.9%; eigenvalue = 5.6) were associated with greater perceived harm and addictiveness (β = 0.21, p = .01), greater risk appraisals (β = 0.20, p = .02), and more negative attitudes toward hookah (β = -0.18, p = .03). The Hookah Smoker Scale is a promising measure that can be used to identify targets for preventing and reducing young adults' hookah tobacco use. Findings also suggest young adults associate health risks of hookah with daily smoking, but not with intermittent social smoking patterns.
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Affiliation(s)
- Lilianna Phan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Darren Mays
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Kenneth P Tercyak
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
| | - Andrea C Johnson
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.,Department of Prevention and Community Health, Milken Institute School of Public Health, Washington, DC, USA
| | - Kathryn Rehberg
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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Gazibara T, Milic M, Parlic M, Stevanovic J, Mitic N, Maric G, Tepavcevic DK, Pekmezovic T. What differs former, light and heavy smokers? Evidence from a post-conflict setting. Afr Health Sci 2021; 21:112-122. [PMID: 34394288 PMCID: PMC8356624 DOI: 10.4314/ahs.v21i1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence suggests that people who live in regions affected by the armed conflict are more likely to smoke. OBJECTIVE The purpose of this study was to assess factors associated with smoking status in a sample of students in the northern Kosovo province. MATERIALS AND METHODS A total of 514 students enrolled in University in Kosovska Mitrovica, Kosovo, were recruited between April to June 2015 at Student Public Health Center during mandatory health checks. Participants filled in socio-demographic and behavioral questionnaire and Beck Depression Inventory (BDI). Based on responses about smoking, students were categorized in non-smokers, former smokers, light smokers (1-13 cigarettes/day) and heavy smokers (> 13 cigarettes/day). RESULTS Of 514 students, 116 (22.6%) classified themselves as smokers. Higher education level of fathers (Odds ratio [OR]=2.89, 95% confidence interval [CI] 1.30-6.44, p=0.009), not living with smokers (OR=0.42, 95%CI 0.15-0.97, p=0.017) and longer exposure to second hand smoke (OR=1.07, 95%CI 1.01-1.13, p=0.036) was associated with former smoking. Studying medical and natural sciences (OR=2.07, 95%CI 1.05-4.18, p=0.040), consuming alcohol (OR=2.98, 95%CI 1.19-10.03, p=0.020), living with smokers (OR=2.88, 95%CI 1.49-5.56, p=0.002), longer exposure to second hand smoke (OR=1.06, 95%CI 1.01-1.11, p=0.019) and having a more intense depressive symptoms (OR=1.08, 95%CI 1.03-1.13, p=0.002) was associated with light smoking. Being male (OR=0.22, 95%CI 0.07-0.41, p=0.001), older (OR=1.47, 95%CI 1.21-1.78, p=0.001), living with smokers (OR=3.78, 95%CI 1.69-8.07, p=0.001), longer daily exposure to second-hand smoke (OR=1.10, 95%CI 1.04-1.16, p=0.001), and having more severe depressive symptoms (OR=1.12, 95%CI 1.07-1.18, p=0.001) were associated with heavy smoking. CONCLUSION Smoking prevention and cessation programs should include the entire community, because exposure to environmental second hand smoke may facilitate initiation and more intense smoking. Screening of student smokers for depression should be prioritized in the process of rebuilding the framework for primary and secondary prevention in the post-conflict period.
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Affiliation(s)
- Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marija Milic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Milan Parlic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Jasmina Stevanovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Nebojsa Mitic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Gorica Maric
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Williamson TJ, Riley KE, Carter-Harris L, Ostroff JS. Changing the Language of How We Measure and Report Smoking Status: Implications for Reducing Stigma, Restoring Dignity, and Improving the Precision of Scientific Communication. Nicotine Tob Res 2020; 22:2280-2282. [PMID: 32756966 DOI: 10.1093/ntr/ntaa141] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/28/2020] [Indexed: 11/14/2022]
Affiliation(s)
- Timothy J Williamson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kristen E Riley
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ
| | - Lisa Carter-Harris
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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Robert PO, Grard A, Mélard N, Mlinarić M, Rimpelä A, Richter M, Kunst AE, Lorant V. The effect of school smoke-free policies on smoking stigmatization: A European comparison study among adolescents. PLoS One 2020; 15:e0235772. [PMID: 32663217 PMCID: PMC7360046 DOI: 10.1371/journal.pone.0235772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/22/2020] [Indexed: 11/18/2022] Open
Abstract
The increasing denormalization of smoking by tobacco control policies and a normative smoke-free climate may shift power towards adolescent non-smokers. It is unclear, however, how common stigmatization of smokers is among adolescents or how stigmatization relates to the denormalization of smoking in their school and social environment. This paper aims to measure (1) whether stigmatization among European adolescents varies according to smoking status and socioeconomic position (SES), and (2) whether stigmatization is greater in school environments in which smoking is denormalized (i.e. those with low smoking rates and strong school tobacco policies). Data on 12,991 adolescents were collected in 55 schools in seven European countries (SILNE R-survey, 2016/17). We applied Stuber’s adapted scale of perceived stereotyping and discrimination towards smokers to smoking status and five variables indicating a power shift towards non-smokers: the school’s tobacco control policy (STP) score, the percentage of adolescents in the school who smoke, parents’ level of education, students’ academic performance, and the percentage of their friends who smoke. Multilevel regressions were applied to the global score for perceived stigmatization. Discrimination against smokers and stereotyping of smokers were frequently reported. Smokers reported less ‘perceived stigmatization of smoking’ than non-smokers (Beta = -0.146, p < 0.001). High-SES students reported stereotyping and discrimination more frequently than lower-SES students. The perception of stigmatization was lower among students whose academic performance was poor (Beta = -0.070, p < 0.001) and among those who had friends who smoked (Beta = -0.141, p < 0.001). Stigmatization was lower in schools with greater exposure to smoking and was not associated with the school’s STP score. Perceived stigmatization of smoking is common among European adolescents. Smokers themselves, however, perceive stigmatization less often than non-smokers. Strong school tobacco policies do not increase stigmatization, but a social environment that is permissive of smoking decreases perceived stigmatization.
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Affiliation(s)
- Pierre-Olivier Robert
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
- * E-mail:
| | - Adeline Grard
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Nora Mélard
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Martin Mlinarić
- Institute of Medical Sociology (IMS), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Arja Rimpelä
- Faculty of Social Sciences (SOC), Unit of Health Sciences, Tampere University, Tampere, Finland
- Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, Tampere, Finland
| | - Matthias Richter
- Institute of Medical Sociology (IMS), Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anton E. Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Vincent Lorant
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
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11
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Torres OV, Estep JC, Gwin M, Villalta I. Gender Differences in Negative Mood, Emotional Intelligence and Tobacco Use among Young Adults. Subst Use Misuse 2020; 55:1881-1891. [PMID: 32532170 DOI: 10.1080/10826084.2020.1775649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Tobacco use is recognized as a form of addiction and remains a significant health concern. Despite this well accepted problem, the various components associated with tobacco use across gender remain relatively unknown. Objectives: The purpose of this study was to investigate the relationship between tobacco use and negative moods (anxiety, depression, stress) between men and women. The relationship between emotional intelligence (EI) and attitudes about smoking was also investigated. Methods: A questionnaire was used to determine sociodemographic characteristics, negative moods, EI, smoking behavior, and tobacco-related attitudes (N = 350). Results: Amongst individuals who used tobacco products, women reported greater disturbances in stress and anxiety compared to men. In addition, both men and women who used tobacco products reported higher depression scores compared to nonsmokers, however, no gender differences were observed. Hierarchical regression analyses revealed that higher EI scores explained negative attitudes about smoking in relation to health concerns. Lastly, women reported stronger attitudes for the restriction of cigarette sales and marketing of tobacco products. Conclusion: These findings support the literature by showing that mood dysregulation is an important factor associated with tobacco use among women. Additionally, we report that specific aspects of EI are psychological constructs closely linked with attitudes about smoking. Future studies elucidating the various components of tobacco use across gender might lead to more effective treatments for smoking.
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Affiliation(s)
- Oscar V Torres
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Justin C Estep
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Mary Gwin
- Department of Social Sciences, San Diego Mesa College, San Diego, California, USA
| | - Ian Villalta
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
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Correlates of smoker identity among intermittent and light daily young adult smokers: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Addict Behav 2019; 98:106034. [PMID: 31301643 DOI: 10.1016/j.addbeh.2019.106034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/17/2019] [Accepted: 06/23/2019] [Indexed: 12/30/2022]
Abstract
Identifying as a 'smoker' has been associated with many cigarette smoking-related behaviors, including less frequent and intense cigarette use. Additional smoking behaviors (e.g., use of cannabis or cigars) also may contribute to self-identification as a 'smoker'. This study compared correlates of identifying as a 'smoker' and measurement strategies for non-daily cigarette consumption among young-adult intermittent and light daily smokers. Using data from Wave 1 of the PATH Study, different measurements of past 30-day non-daily cigarette use were evaluated. Weighted logistic regression models were used to compare associations with self-identification as a smoker among 18-24 year-old intermittent and light daily smokers (n = 1531). Use of other smoked products (combustible tobacco, cannabis) and other documented correlates of smoker identity were evaluated. As frequency of monthly smoking increased, self-identification as a smoker increased (1-5 days = 24%, 6-19 days = 48%, 20-29 days = 78%, light daily smokers = 93%, daily smokers using >5 cigarettes per day = 99%). Self-reported smoking status 12 months ago significantly contributed to current identification as a smoker. Smoking cigars daily or using cannabis in the past 30 days were each positively associated with smoker identity. Different measurement approaches to non-daily cigarette use offer different advantages in terms of interpretability and granularity of information. Compared to daily smokers, non-daily smokers exhibit significant variability in identifying as a smoker, and systematic correlates of smoker identification are apparent. These findings may serve to enhance understanding of non-daily smokers and potential targets for intervention among this growing subpopulation of tobacco users.
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Ren L, Cui LB, Chen C, Dong X, Wu Z, Wang Y, Yang Q. The implicit beliefs and implicit behavioral tendencies towards smoking-related cues among Chinese male smokers and non-smokers. BMC Public Health 2019; 19:1000. [PMID: 31345189 PMCID: PMC6659297 DOI: 10.1186/s12889-019-7319-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The dual-process theory is central to several models of addiction, implying the importance of automatic processes in the maintenance and development of addiction. Implicit beliefs are traces of previous experience which relate to the representation in cognition. Implicit behavioral tendencies are traces of previous experience which relate to the representation in behavioral tendencies. In this study, we aim to provide behavioral evidence for implicit beliefs and implicit behavioral tendencies towards smoking-related cues among Chinese male smokers and non-smokers. We also examine the relationships among implicit beliefs, implicit behavioral tendencies and smoking behaviors of smokers. METHODS In order to achieve these goals, we used an implicit association test (IAT) to measure implicit beliefs and implicit behavioral tendencies simultaneously. Thirty-nine smokers and twenty-five non-smokers were tested, using smoking-related words and images, as well as neutral words and images as stimuli. RESULTS Our analysis shows significant differences in smokers' and non-smokers' implicit beliefs and behavioral tendencies (t62 = 3.494, p < 0.001; t62 = 5.034, p < 0.001). In the group of smokers, implicit beliefs and implicit behavioral tendencies were positively correlated with each other (r = 0.460, p < 0.01). In addition, smokers' scores for implicit behavioral tendencies are negatively correlated with the number of cigarettes smoked per day (r = - 0.51, p < 0.001). CONCLUSIONS This study suggests that implicit beliefs and behavioral tendencies toward smoking-related cues vary significantly between Chinese male smokers and non-smokers. In addition, there is a positive correlation between implicit beliefs and behavioral tendencies within smokers. It also shows for the first time that the implicit behavioral tendencies are related to smoking behaviors. Our results may be considered as references for smoking cessation interventions focused on changes at the implicit level, and they provide a new perspective for measuring different dimensions of implicit attitudes by an IAT. This finding might promote the development of the network theory of implicit attitudes.
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Affiliation(s)
- Lei Ren
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Long-Biao Cui
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Chen Chen
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Xiaojun Dong
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Zhongying Wu
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Yidi Wang
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China
| | - Qun Yang
- Department of Clinical Psychology, Fourth Military Medical University, No. 169 West Changle Road, Xi'an, 710032, China.
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Stanley SJ, Pitts MJ. "I'm Scared of the Disappointment": Young Adult Smokers' Relational Identity Gaps and Management Strategies as Sites of Communication Intervention. HEALTH COMMUNICATION 2019; 34:904-911. [PMID: 29469651 DOI: 10.1080/10410236.2018.1440507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
While cigarette smoking is decreasing among young adults, rates of nicotine consumption through other devices, most notably electronic cigarettes, are on the rise. Framed by communication theory of identity, this study examines young adult smokers' experiences with relational others in regard to their smoking. Focus group discussions and individual interviews convened with 20 young adult cigarette and electronic cigarette smokers revealed identity gaps implicating the relational layer of identity, including personal-relational, enacted-relational, and personal-enacted-relational identity gaps. Participants used communicative and behavioral strategies to manage relational discrepancies. The documented identity gaps and management strategies present opportunities for targeted smoking cessation interventions that amplify dissonance created through identity gaps as a motivational tactic.
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Berg CJ, Haardörfer R, Payne JB, Getachew B, Vu M, Guttentag A, Kirchner TR. Ecological momentary assessment of various tobacco product use among young adults. Addict Behav 2019; 92:38-46. [PMID: 30579116 DOI: 10.1016/j.addbeh.2018.12.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Young adults are at high risk for using traditional and novel tobacco products. However, little is known about daily/weekly use patterns or psychosocial triggers for using various tobacco products. METHODS This ecological momentary assessment (EMA) study examined timing, tobacco cravings, affect, social context, and other substance use (alcohol, marijuana) in relation to use of cigarettes, electronic nicotine delivery systems (ENDS), and any tobacco product (i.e., cigarettes, ENDS, cigars, hookah), respectively. We also examined interactions between these predictors, sex, and race/ethnicity. From a longitudinal study of 3418 18-25 year-olds from seven Georgia colleges/universities, we recruited 72 reporting current tobacco use to participate in the 21-day EMA study; 43 participated, of which 31 completed ≥66% assessments and were analyzed. Cravings, affect, social context, and substance use were assessed daily across four four-hour windows. RESULTS Of the 31 participants, average age was 21.10 years (SD = 1.95), 45.2% were female, and 71.0% non-Hispanic White; 71.0% used cigarettes, 58.1% ENDS, 38.7% cigars, and 25.8% hookah (25.6% used one product, 46.5% two, 27.9% ≥ three). Predictors of cigarette use included higher anxiety, greater odds of marijuana and alcohol use, and higher boredom levels among women. Predictors of ENDS use included being non-White and greater odds of marijuana use, as well as higher tobacco cravings among women and higher boredom among men. Predictors of any tobacco product use included being non-White, higher boredom levels, and greater odds of marijuana and alcohol use. CONCLUSIONS Distinct interventions may be needed to address use of differing tobacco products among young adults.
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Affiliation(s)
- 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; Winship Cancer Institute, Emory University, 1365 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - 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
| | - Jackelyn B Payne
- Winship Cancer Institute, Emory University, 1365 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Milkie Vu
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Alexandra Guttentag
- College of Global Public Health, New York University, 715 Broadway, 12th Floor New York, NY 10003, United States
| | - Thomas R Kirchner
- College of Global Public Health, New York University, 715 Broadway, 12th Floor New York, NY 10003, United States
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Lee Y, Lee KS. Factors Related to Smoking Status Among Young Adults: An Analysis of Younger and Older Young Adults in Korea. J Prev Med Public Health 2019; 52:92-100. [PMID: 30971075 PMCID: PMC6459759 DOI: 10.3961/jpmph.18.201] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/14/2019] [Indexed: 01/20/2023] Open
Abstract
Objectives Young adulthood represents a critical developmental period during which the use of tobacco may begin or cease. Furthermore, differences in smoking behaviors between younger (aged 18-24 years) and older (aged 25-34 years) young adults may exist. This study aimed to characterize patterns related to current smoking in younger and older young adults. Methods This study used data acquired from the Sixth Korea National Health and Nutrition Examination Survey conducted from 2013 to 2014. A total of 2069 subjects were categorized as younger (712 subjects) and older (1357 subjects) young adults. The chi-square test was used to assess the relationships between smoking status and socio-demographic, health-related, and smoking-related factors. Multivariable logistic regression models were constructed to assess the factors affecting current smoking in these age groups. Results The current smoking prevalence was 18.3% among the younger young adults and 26.0% among the older young adults. Sex, education level, occupation, perceived health status, alcohol consumption, and electronic cigarette use were related to current smoking in both age groups. Secondhand smoke exposure at home and stress levels showed significant relationships with smoking in younger and older young adults, respectively. Conclusions Strong correlations were found between the observed variables and smoking behaviors among young adults. Determining the factors affecting smoking and designing interventions based on these factors are essential for smoking cessation in young adults.
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Affiliation(s)
- Yeji Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
| | - Kang-Sook Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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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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The Role of the Subjective Importance of Smoking (SIMS) in Cessation and Abstinence. J Smok Cessat 2019; 14:1-11. [PMID: 33791042 DOI: 10.1017/jsc.2018.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction Each year about two thirds of U.S. smokers make a quit attempt. Yet, less than 5% remain abstinent three months post-quit date. One factor that may affect abstinence is negative feelings about the self-associated with being a smoker (disequilibrium), particularly if smoking is important to the sense of self and one is trying to quit. Aims We evaluated a multivariate structural equation model proposing that smoking's subjective importance to a smoker would influence carbon monoxide verified smoking abstinence at 24 weeks (post-quit date). Further, we assessed whether the relation would be moderated by the smoker's experience of disequilibrium. Methods Participants were 440 regular smokers taking part in a clinical trial assessing the effectiveness of different durations of nicotine replacement therapy use. Participants completed the subjective importance of smoking survey at baseline and were assessed for carbon monoxide verified seven-day point prevalence abstinence at 24 weeks. Results Using exploratory structural equation modelling, the subjective importance of smoking was associated with point prevalence abstinence at 24 weeks, but only for smokers with high disequilibrium. Conclusions The results of this study suggest that experiencing negative feelings about being a smoker could motivate smokers to remain abstinent, despite the importance of smoking to the smoker's sense of self.
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19
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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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20
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Wellman RJ, O'Loughlin EK, Dugas EN, Montreuil A, Dutczak H, O'Loughlin J. Reasons for quitting smoking in young adult cigarette smokers. Addict Behav 2018; 77:28-33. [PMID: 28946012 DOI: 10.1016/j.addbeh.2017.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 08/24/2017] [Accepted: 09/17/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although most young adult smokers want to quit smoking, few can do so successfully. Increased understanding of reasons to quit in this age group could help tailor interventions, but few studies document reasons to quit in young adults or examine reasons to quit by smoker characteristics. METHODS In 2011-12, 311 current smokers (age 22-28, M=24.1; 48.9% male, 51.1% female; 50.4% daily smokers) from the Nicotine Dependence in Teens Study completed the Adolescent Reasons for Quitting scale. We assessed differences in the importance of 15 reasons to quit by sex, education, smoking frequency, quit attempt in the past year, perceived difficulty in quitting, and motivation to quit. We also examined differences between participants who discounted the importance of long-term health risks and those who acknowledged such risks. RESULTS Concerns about getting sick or still smoking when older were considered very important by >70% of participants. Median scores were higher among daily smokers, those who had tried to quit or who expressed difficulty quitting, and those with strong motivation to quit. Discounters (14.5% of participants) were primarily nondaily, low-consumption smokers. Their Fagerström Test for Nicotine Dependence scores did not differ from non-discounters', and 11% (vs. 35.7% of non-discounters) were ICD-10 tobacco dependent. CONCLUSIONS Novel smoking cessation interventions are needed to help young adult smokers quit by capitalizing on their health concerns. Discounters may need educational intervention to better understand the impact of even "light" smoking on their health before or in conjunction with quit interventions.
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Affiliation(s)
- Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States
| | - Erin K O'Loughlin
- INDI Department, Concordia University, Montréal, Quebec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
| | - Erika N Dugas
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
| | - Annie Montreuil
- Institut National de Santé Publique du Quebec, Montréal, Quebec, Canada
| | - Hartley Dutczak
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
| | - Jennifer O'Loughlin
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada; Institut National de Santé Publique du Quebec, Montréal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada.
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21
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Burns A, Webb M, Stynes G, O'Brien T, Rohde D, Strawbridge J, Clancy L, Doyle F. Implementation of a Quit Smoking Programme in Community Adult Mental Health Services-A Qualitative Study. Front Psychiatry 2018; 9:670. [PMID: 30622485 PMCID: PMC6308392 DOI: 10.3389/fpsyt.2018.00670] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/20/2018] [Indexed: 01/01/2023] Open
Abstract
Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants' motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy.
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Affiliation(s)
- Annette Burns
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Greg Stynes
- EVE, Health Service Executive, Dublin, Ireland
| | - Tom O'Brien
- EVE, Health Service Executive, Dublin, Ireland
| | - Daniela Rohde
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Luke Clancy
- TobaccoFree Research Institute, Dublin Institute of Technology, Dublin, Ireland
| | - Frank Doyle
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
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Liber AC, Warner KE. Has Underreporting of Cigarette Consumption Changed Over Time? Estimates Derived From US National Health Surveillance Systems Between 1965 and 2015. Am J Epidemiol 2018; 187:113-119. [PMID: 28595348 DOI: 10.1093/aje/kwx196] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/02/2017] [Indexed: 11/12/2022] Open
Abstract
According to survey data, the prevalence of Americans' self-reported cigarette smoking is dropping steadily. However, the accuracy of national surveys has been questioned because of declining response rates and the increasing stigmatization of smoking. We used data from 2 repeated, cross-sectional, nationally representative health surveys (National Survey on Drug Use and Health (NSDUH), 1979-2014; and National Health Interview Survey (NHIS), 1965-2015) to determine whether self-reported cigarette consumption has changed over time as a proportion of federally taxed cigarette sales. From each survey, we calculated national equivalents of annual cigarette consumption. From 1979 to 1997, the amount of cigarettes that NSDUH and NHIS respondents reported corresponded to an average of 59.5% (standard deviation (SD), 2.3%) and 65.6% (SD, 3.2%), respectively, of taxed cigarette sales. After 1997, respondents' reported smoking data corresponded to the equivalent of an average of 64.2% (SD, 5.9%) and 63.3% (SD, 2.5%), respectively, of taxed cigarette sales. NHIS figures remained steady throughout the latter period, with a decline during 2013-2015 from 65.9% to 61.1%. NSDUH figures increased steadily, exceeding those of the NHIS after 2002. Given the consistent underreporting of cigarette consumption over time, these surveys are likely not less accurate than they were previously. The recent decrease in NHIS accuracy, however, gives pause about the magnitude of the reported decline in smoking prevalence in 2014 and 2015. Improvement in the accuracy of NSDUH data is encouraging.
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Affiliation(s)
- Alex C Liber
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
- Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Kenneth E Warner
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan
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Villanti AC, Johnson AL, Rath JM. Beyond education and income: Identifying novel socioeconomic correlates of cigarette use in U.S. young adults. Prev Med 2017; 104. [PMID: 28647547 PMCID: PMC5857885 DOI: 10.1016/j.ypmed.2017.06.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young adulthood is defined by transitions in family life, living situations, educational settings, and employment. As a result, education and income may not be appropriate measures of socioeconomic status (SES) in young people. Using a national sample of young adults aged 18-34 (n=3364; collected February 2016), we explored novel socioeconomic correlates of ever cigarette use, past 30-day cigarette use, and daily cigarette use, weighted to account for non-response. Measures of SES assessed current education, household income, employment status, and subjective financial situation (SFS) and childhood SES (maternal and paternal education, SFS during childhood, parental divorce before age 18). Parental smoking during childhood was examined in sensitivity analyses. The highest prevalence of ever cigarette use was in young adults whose parents divorced before age 18 (57% vs. 47% overall). In general, current education, subjective financial status, and parental education were inversely correlated with past 30-day and daily cigarette use in bivariate analyses. In multivariable Poisson regression models controlling for age, gender, race/ethnicity, and other SES measures, lower education and poorer SFS were most strongly correlated with ever and past 30-day cigarette use. Lower maternal education emerged as the strongest correlate of daily smoking, conferring a twofold higher prevalence of daily smoking compared to maternal education of a Bachelor's degree or greater. Current household income was not a strong predictor of any cigarette use outcome. Novel measures like SFS may improve estimates of socioeconomic disadvantage during this developmental stage.
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Affiliation(s)
- Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, Fourth Floor, Washington, DC 20001, USA; Department of Psychiatry, University of Vermont College of Medicine, 1 South Prospect Street, MS 482, Burlington, VT 05401, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Amanda L Johnson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, 900 G Street NW, Fourth Floor, Washington, DC 20001, USA
| | - Jessica M Rath
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Evaluation Science and Research, Truth Initiative, 900 G Street NW, Fourth Floor, Washington, DC 20001, USA
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Fryer CS, Seaman EL, Clark RS, Plano Clark VL. Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies. PLoS One 2017; 12:e0183471. [PMID: 28841689 PMCID: PMC5571971 DOI: 10.1371/journal.pone.0183471] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/07/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology. METHODS Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research. RESULTS We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs. CONCLUSIONS The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.
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Affiliation(s)
- Craig S. Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, United States of America
- Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Elizabeth L. Seaman
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, Maryland, United States of America
| | - Rachael S. Clark
- Educational Studies, School of Education, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Vicki L. Plano Clark
- Educational Studies, School of Education, University of Cincinnati, Cincinnati, Ohio, United States of America
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Berg MB, Lin L, White M, Alfonso-Barry J. Attitudinal and behavioral differences between cigarette users who do and do not identify as "smokers". JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:372-379. [PMID: 28362159 DOI: 10.1080/07448481.2017.1312417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/10/2017] [Accepted: 02/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). PARTICIPANTS Students from 2 colleges in Massachusetts (N = 538; April 2016). METHODS Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. RESULTS NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. CONCLUSIONS College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.
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Affiliation(s)
- Michael B Berg
- a Department of Psychology , Wheaton College , Norton , Massachusetts , USA
| | - Linda Lin
- b Department of Psychology , Emmanuel College , Boston , Massachusetts
| | - Madeleine White
- a Department of Psychology , Wheaton College , Norton , Massachusetts , USA
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Zaborskis A, Volkyte A, Narbutaite J, Virtanen JI. Smoking and attitudes towards its cessation among native and international dental students in Lithuania. BMC Oral Health 2017; 17:106. [PMID: 28693469 PMCID: PMC5504839 DOI: 10.1186/s12903-017-0397-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 06/30/2017] [Indexed: 12/01/2022] Open
Abstract
Background Dental professionals are uniquely positioned to discourage smoking among their patients. However, little is known about the role of cultural background and attitudes towards smoking in the education of these professionals. Our study aimed to compare native Lithuanian and international dental students’ smoking habits, knowledge about the harmfulness of smoking and attitudes towards smoking cessation. Methods We conducted a cross-sectional survey of smoking and its cessation among dental students at the Lithuanian University of Health Sciences (Kaunas, Lithuania) in 2012. All Lithuanian and international dental students in each year of dental school were invited to participate in the survey during a compulsory practical class or seminar. Altogether 606 students participated in the survey with a response rate of 84.2%. Explanatory factorial analysis (EFA), multivariate Discriminant Analysis (DA) and Binary Logistic Regression (BLR) served for the statistical analyses. Results The percentages of occasional/current regular smokers were 41.1% and 55.7% (p = 0.068) among Lithuanian and international male students, and 22.7% and 22.9% (p = 0.776) among Lithuanian and international female students, respectively. The international dental students had a deeper knowledge of the harmfulness/addictiveness of smoking and held more positive attitudes towards smoking cessation among their patients than did the native Lithuanian dental students. Conclusions The findings of the study underscored the need to properly incorporate tobacco cessation training into the curriculum of dental education. However, consideration of the cultural background of dental students in building up their capacity and competence for intervening against smoking is essential.
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Affiliation(s)
- Apolinaras Zaborskis
- Institute of Health Research, Faculty of Public Health, Lithuanian University of Health Sciences, Tilzes 18, LT-47181, Kaunas, Lithuania
| | - Aiste Volkyte
- Faculty of Odontology, Lithuanian University of Health Sciences, Luksos-Daumanto 6, LT-50106, Kaunas, Lithuania
| | - Julija Narbutaite
- Faculty of Odontology, Lithuanian University of Health Sciences, Luksos-Daumanto 6, LT-50106, Kaunas, Lithuania. .,Lithuanian University of Health Sciences Hospital, Kaunas, Lithuania.
| | - Jorma I Virtanen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
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Exploring Support for 100% College Tobacco-Free Policies and Tobacco-Free Campuses Among College Tobacco Users. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 22:29-39. [PMID: 25859902 DOI: 10.1097/phh.0000000000000262] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tobacco-free campus policy is identified as an effective means to address tobacco use on college campuses; however, the prevalence of tobacco-free policies (TFPs) in the United States remains low. This study explores college tobacco users' support for a university's TFP and tobacco-free campuses (TFCs) in general. METHODS A standardized and structured questionnaire was administered to 790 college tobacco users recruited in a university located in a tobacco-growing region of the United States, during April-May 2011, to collect information on support for TFPs and TFCs and sociodemographic-political characteristics. Descriptive and multivariable logistic regression analyses were conducted to identify key factors associated with support for TFPs and TFCs. RESULTS Approximately 2 of 5 tobacco users favored TFPs and TFCs. Multivariable logistic regression models showed that demographic factors were mostly not significantly associated with attitudes of the college tobacco users. Instead, while knowledge about harmful effects of exposure to secondhand tobacco smoke significantly increased support for both TFPs and TFCs, parental and peer smoking and exposure to tobacco industry promotions significantly decreased the likelihoods of support compared with respective referent groups. CONCLUSION Study findings suggest that campus advocacy and education campaigns for campus tobacco policies to pay attention to tobacco use behavior of familial relations, tobacco industry activities, and other political determinants of tobacco users' attitudes. Thus, this study should inform national initiatives to promote TFPs nationwide such as the Tobacco-Free College Campus Initiative.
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Risso DS, Kozlitina J, Sainz E, Gutierrez J, Wooding S, Getachew B, Luiselli D, Berg CJ, Drayna D. Genetic Variation in the TAS2R38 Bitter Taste Receptor and Smoking Behaviors. PLoS One 2016; 11:e0164157. [PMID: 27711175 PMCID: PMC5053502 DOI: 10.1371/journal.pone.0164157] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 09/20/2016] [Indexed: 12/02/2022] Open
Abstract
Common TAS2R38 taste receptor gene variants specify the ability to taste phenylthiocarbamide (PTC), 6-n-propylthiouracil (PROP) and structurally related compounds. Tobacco smoke contains a complex mixture of chemical substances of varying structure and functionality, some of which activate different taste receptors. Accordingly, it has been suggested that non-taster individuals may be more likely to smoke because of their inability to taste bitter compounds present in tobacco smoke, but results to date have been conflicting. We studied three cohorts: 237 European-Americans from the state of Georgia, 1,353 European-Americans and 2,363 African-Americans from the Dallas Heart Study (DHS), and 4,973 African-Americans from the Dallas Biobank. Tobacco use data was collected and TAS2R38 polymorphisms were genotyped for all participants, and PTC taste sensitivity was assessed in the Georgia population. In the Georgia group, PTC tasters were less common among those who smoke: 71.5% of smokers were PTC tasters while 82.5% of non-smokers were PTC tasters (P = 0.03). The frequency of the TAS2R38 PAV taster haplotype showed a trend toward being lower in smokers (38.4%) than in non-smokers (43.1%), although this was not statistically significant (P = 0.31). In the DHS European-Americans, the taster haplotype was less common in smokers (37.0% vs. 44.0% in non-smokers, P = 0.003), and conversely the frequency of the non-taster haplotype was more common in smokers (58.7% vs. 51.5% in non-smokers, P = 0.002). No difference in the frequency of these haplotypes was observed in African Americans in either the Dallas Heart Study or the Dallas Biobank. We conclude that TAS2R38 haplotypes are associated with smoking status in European-Americans but not in African-American populations. PTC taster status may play a role in protecting individuals from cigarette smoking in specific populations.
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Affiliation(s)
- Davide S. Risso
- Laboratory of Communication Disorders, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, United States of America
- Laboratory of Molecular Anthropology and Centre for Genome Biology, Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Julia Kozlitina
- McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Eduardo Sainz
- Laboratory of Communication Disorders, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Joanne Gutierrez
- Laboratory of Communication Disorders, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Stephen Wooding
- Health Sciences Research Institute, University of California Merced, Merced, United States of America
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Emory University Woodruff Health Sciences Center, Atlanta, GA, United States of America
| | - Donata Luiselli
- Laboratory of Molecular Anthropology and Centre for Genome Biology, Department of Biological, Geological, and Environmental Sciences, University of Bologna, Bologna, Italy
| | - Carla J. Berg
- Department of Behavioral Sciences and Health Education, Emory University Woodruff Health Sciences Center, Atlanta, GA, United States of America
| | - Dennis Drayna
- Laboratory of Communication Disorders, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, United States of America
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Berg CJ, Haardörfer R, Lewis M, Getachew B, Lloyd SA, Thomas SF, Lanier A, Trepanier K, Johnston T, Grimsley L, Foster B, Benson S, Smith A, Barr DB, Windle M. DECOY: Documenting Experiences with Cigarettes and Other Tobacco in Young Adults. Am J Health Behav 2016; 40:310-21. [PMID: 27103410 PMCID: PMC4903022 DOI: 10.5993/ajhb.40.3.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We examined psychographic characteristics associated with tobacco use among Project DECOY participants. METHODS Project DECOY is a 2-year longitudinal mixed-methods study examining risk for tobacco use among 3418 young adults across 7 Georgia colleges/universities. Baseline measures included sociodemographics, tobacco use, and psychographics using the Values, Attitudes, and Lifestyle Scale. Bivariate and multivariable analyses were conducted to identify correlates of tobacco use. RESULTS Past 30-day use prevalence was: 13.3% cigarettes; 11.3% little cigars/cigarillos (LCCs); 3.6% smokeless tobacco; 10.9% e-cigarettes; and 12.2% hookah. Controlling for sociodemographics, correlates of cigarette use included greater novelty seeking (p < .001) and intellectual curiosity (p = .010) and less interest in tangible creation (p = .002) and social conservatism (p < .001). Correlates of LCC use included greater novelty seeking (p < .001) and greater fashion orientation (p = .007). Correlates of smokeless tobacco use included greater novelty seeking (p = .006) and less intellectual curiosity (p < .001). Correlates of e-cigarette use included greater novelty seeking (p < .001) and less social conservatism (p = .002). Correlates of hookah use included greater novelty seeking (p < .001), fashion orientation (p = .044), and self-focused thinking (p = .002), and less social conservatism (p < .001). CONCLUSIONS Psychographic characteristics distinguish users of different tobacco products.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael Lewis
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Betelihem Getachew
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Steven A Lloyd
- Department of Psychological Science, University of North Georgia, Dahlonega, GA, USA
| | - Sarah Fretti Thomas
- Department of Exercise Physiology, Valdosta State University, Valdosta, GA, USA
| | - Angela Lanier
- Department of Kinesiology, Berry College, Mount Berry, GA, USA
| | | | - Teresa Johnston
- Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, USA
| | - Linda Grimsley
- Department of Nursing, Albany State University, Albany, GA, USA
| | - Bruce Foster
- Campus Life, Central Georgia Technical College, Warner Robins, GA, USA
| | | | - Alicia Smith
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Atlanta, GA, USA
| | - Dana Boyd Barr
- Department of Environmental Health, Emory University School of Public Health, Atlanta, GA, USA
| | - Michael Windle
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Guillory J, Lisha N, Lee YO, Ling PM. Phantom smoking among young adult bar patrons. Tob Control 2016; 26:153-157. [PMID: 27048205 DOI: 10.1136/tobaccocontrol-2015-052821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/14/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore the prevalence and sociodemographic makeup of smokers who do not self-identify as smokers (ie, phantom smokers) compared with self-identifying smokers in a sample of bar-going young adults aged 18-30 years to more accurately assess young adult prevalence of smoking and inform cessation message targeting. METHODS Cross-sectional surveys of smokers (n=3089) were conducted in randomly selected bars/nightclubs in seven US cities. Logistic regression models assessed associations between phantom smoking (past 30-day smoking and denial of being a smoker), tobacco and alcohol use behaviours (eg, social smoking, nicotine dependence, smoking while drinking, past 30-day alcohol use) and demographics. RESULTS Compared with smokers, phantom smokers were more likely to be college graduates (OR=1.43, 95% CI 1.03 to 1.98) and to identify themselves as social smokers (OR=1.60, 95% CI 1.27 to 2.12). Phantom smokers had lower odds of smoking while drinking (OR=0.28, 95% CI 0.25 to 0.32), being nicotine dependent (OR=0.36, 95% CI 0.22 to 0.76) and having quit for at least 1 day in the last year (OR=0.46, 95% CI 0.36 to 0.69) compared with smokers. CONCLUSIONS This research extends phantom smoking literature on college students to provide a broader picture of phantom smoking among young adults in high-risk contexts and of varying levels of educational attainment. Phantom smokers may be particularly sensitive to social pressures against smoking, suggesting the importance of identifying smoking as a behaviour (rather than identity) in cessation messaging to ensure that phantom smokers are reached.
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Affiliation(s)
- Jamie Guillory
- RTI International, Research Triangle Park, North Carolina, USA
| | - Nadra Lisha
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Youn Ok Lee
- RTI International, Research Triangle Park, North Carolina, USA
| | - Pamela M Ling
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
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Villanti AC, Bover Manderski MT, Gundersen DA, Steinberg MB, Delnevo CD. Reasons to quit and barriers to quitting smoking in US young adults. Fam Pract 2016; 33:133-9. [PMID: 26733658 PMCID: PMC5006105 DOI: 10.1093/fampra/cmv103] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Young adulthood provides an enormous opportunity to alter trajectories of smoking behaviour for a large public health impact. OBJECTIVE The purpose of this study was to examine correlates of perceived barriers to quitting smoking and reasons to quit in a sample of young adult current and former smokers. METHODS This study used data from the 2011 National Young Adult Health Survey, a random-digit-dial cellphone survey. Participants were US young adult current smokers aged 18-34 (n = 699) and young adults who were either current smokers who had made a quit attempt in the past-year (n = 402) or former smokers (n = 289). Correlates of barriers to quitting smoking and reasons for quitting smoking were assessed using bivariate and multivariable analyses. RESULTS More than half of current smokers identified 'loss of a way to handle stress' (59%) and 'cravings or withdrawal' (52%) as barriers to quitting. Female gender, daily smoking and intention to quit remained significantly associated with endorsing 'loss of a way to handle stress' as a barrier to quitting in multivariable analyses. The two most popular reasons for quitting smoking were physical fitness (64%) and the cost of tobacco (64%). CONCLUSION These findings highlight barriers to cessation and the reasons that young smokers give for quitting. This information may be helpful to physicians as they counsel their young adult patients to quit smoking.
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Affiliation(s)
- Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Daniel A Gundersen
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and
| | - Michael B Steinberg
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Cristine D Delnevo
- Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ and
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Okoli CT, Kodet J. A systematic review of secondhand tobacco smoke exposure and smoking behaviors: Smoking status, susceptibility, initiation, dependence, and cessation. Addict Behav 2015; 47:22-32. [PMID: 25863004 DOI: 10.1016/j.addbeh.2015.03.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/17/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To examine the association between secondhand tobacco smoke exposure (SHSe) and smoking behaviors (smoking status, susceptibility, initiation, dependence, and cessation). METHODS Terms and keywords relevant to smoking behaviors and secondhand tobacco smoke exposure were used in a search of the PubMed database. Searches were limited to English language peer-reviewed studies up till December 2013. Included papers: a) had clearly defined measures of SHSe and b) had clearly defined measures of outcome variables of interest. A total of 119 studies were initially retrieved and reviewed. After further review of references from the retrieved studies, 35 studies were finally selected that met all eligibility criteria. RESULTS The reviewed studies consisted of thirty-five (89.7%) studies with differing measures of SHSe (including questionnaire and biological measures) and varying definitions of main outcome variables of interest between studies. The majority of the studies (77%) were cross-sectional in nature. The majority of studies found that SHSe was associated with greater likelihood of being a smoker, increased susceptibility and initiation of smoking, greater nicotine dependence among nonsmokers, and poorer smoking cessation. CONCLUSIONS The review found positive associations between SHSe and smoking status, susceptibility, initiation and nicotine dependence and a negative association with smoking cessation. In light of design limitations, future prospective and clinical studies are needed to better understand the mechanisms whereby SHSe influences smoking behaviors.
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Virtanen JI, Filppula M, Maldupa I, Patja K. Smoking and attitudes towards it and its cessation among dental students in Latvia. Acta Odontol Scand 2015; 73:421-6. [PMID: 25415367 DOI: 10.3109/00016357.2014.976261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevalence of smoking is higher in Latvia than in most EU countries. This study aimed to determine the level of knowledge of dental students in Latvia about the effects of smoking on oral health and their attitudes toward smoking and its cessation. METHODS A cross-sectional survey among all the dental students in Latvia was conducted in 2011. Students at the Riga Stradins University were asked to participate in this anonymous, voluntary survey. The questionnaire included items concerned with the students' own smoking habits, their knowledge of smoking as an addiction and its health effects and their attitudes towards its prevention and cessation in a dental setting. The response rate was 87% (173/200). The Chi-square test and logistic regression were used for the statistical analyses. RESULTS About one quarter of the students (24%) were daily or occasional smokers and almost half of the male students (46%) had smoked at least 100-times in their lifetime. The students revealed a lack of knowledge about the addictive nature of smoking, in that about half of the students did not consider smoking physically or socially addictive. About one fifth (21.4%) didn't consider environmental tobacco smoke (ETS) harmful to one's health. Although the students' awareness of smoking improved during their studies, the most significant factor related to their knowledge was their own smoking history (OR=2.7; p=0.021). CONCLUSIONS Smoking was frequent among undergraduate dental students and they lacked knowledge of its addictiveness. More emphasis ought to be placed on education with regard to smoking and on cessation services.
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Affiliation(s)
- Jorma I Virtanen
- Department of Community Dentistry, Institute of Dentistry, University of Oulu , Oulu , Finland
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Gathuru IM, Tarter RE, Klein-Fedyshin M. Review of hookah tobacco smoking among college students: policy implications and research recommendations. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2015; 41:272-80. [PMID: 26057153 DOI: 10.3109/00952990.2015.1043738] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND About 30% of college students have smoked hookah tobacco. Although most students perceive this product to be innocuous and non-addictive, hookah tobacco increases the risk for disease and nicotine dependence. Currently, the US Food and Drug Administration (FDA) does not regulate the manufacture, distribution, or sale of hookah tobacco. OBJECTIVE Empirical literature pertaining to hookah tobacco smoking is reviewed with a focus on the implications for regulatory policy. METHODS PubMed, PsycINFO, and Scopus databases were searched to locate articles published in English. The literature search combined several key words including "hookahs", "college", "advertising", "health effects", and "health policy". RESULTS Smoking hookah tobacco may play a role in the initiation of smoking among tobacco-naïve college students and may portend persistent smoking among those who have smoked cigarettes. College students are typically nondaily, social smokers. They do not perceive that their heightened risk for tobacco diseases and nicotine dependence relates to their smoking behavior. However, few public health messages target college-age adults to counter media messages that endorse hookah tobacco smoking. CONCLUSION Given that the FDA is not authorized to ban specific tobacco products, policy actions should focus on the development of effective risk communication strategies that target college-age adults and on limiting the accessibility of hookah tobacco products to these adults. Accordingly, a research agenda that would inform these policy actions is proposed.
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Tombor I, Shahab L, Herbec A, Neale J, Michie S, West R. Smoker identity and its potential role in young adults' smoking behavior: A meta-ethnography. Health Psychol 2015; 34:992-1003. [PMID: 25622078 PMCID: PMC4577249 DOI: 10.1037/hea0000191] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. METHODS A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16-34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. RESULTS Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals' defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. CONCLUSIONS Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker's identity can play an important role in smoking cessation. (PsycINFO Database Record
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Affiliation(s)
- Ildiko Tombor
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Lion Shahab
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Aleksandra Herbec
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Joanne Neale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London
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Abstract
BACKGROUND This research was motivated by findings that college students who smoke cigarettes often self-categorize as nonsmokers, that is, they reject the social identity of "smoker." OBJECTIVES The goal of the present study was to shed light on college students' smoker identities beyond the smoker/nonsmoker dichotomy. METHODS Focus groups were conducted to investigate how college students categorize their own smoking patterns and to identify what behaviors and attitudes are associated with these different categories of smoker identities. Forty-one students from a western university participated in this study in November 2011. RESULTS The focus group results indicated that there were five distinct smoker identities on campus. Light and regular smokers were the daily smoker identities present, while stress, social, and drunk smokers were the occasional smoker identities. Moreover, each of these smoker identities was defined by a unique pattern of smoking behavior, attitudes, and motives. CONCLUSIONS/IMPORTANCE These findings support the notion that there are different types of smokers, both daily and occasional, in the college population. We suggest that researchers, healthcare providers, and prevention/intervention programs may all benefit from distinguishing between these different types of smokers.
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Affiliation(s)
- Juliana D Rosa
- a Department of Psychology , Colorado State University , Fort Collins , Colorado , USA
| | - Patricia Aloise-Young
- a Department of Psychology , Colorado State University , Fort Collins , Colorado , USA
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Berg CJ, Romero DR, Pulvers K. Perceived harm of tobacco products and individual schemas of a smoker in relation to change in tobacco product use over one year among young adults. Subst Use Misuse 2015; 50:90-8. [PMID: 25338288 PMCID: PMC4299871 DOI: 10.3109/10826084.2014.958858] [Citation(s) in RCA: 18] [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] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Given increases in nondaily smoking and alternative tobacco use among young adults, we examined the nature of change of various tobacco product use among college students over a year and predictors of use at one-year follow-up. METHODS An online survey was administered to students at six Southeast colleges and universities (N = 4,840; response rate = 20.1%) in Fall 2010, with attempts to follow up in Fall 2011 with a random subsample of 2,000 participants (N = 718; response rate = 35.9%). Data were analyzed from 698 participants with complete data regarding tobacco, marijuana, and alcohol use over a one-year period, perceived harm of tobacco use, and schemas of a "smoker" (as per the Classifying a Smoker Scale). RESULTS Baseline predictors of current smoking at follow-up included being White (p = .001), frequency of smoking (p < .001), alternative tobacco use (p < .001), and perceived harm of smoking (p = .02); marginally significant predictors included marijuana use (p = .06) and lower scores on the Classifying a Smoker Scale (p = .07). Baseline predictors of current smoking at follow-up among baseline nondaily smokers included more frequent smoking (p = .008); lower Classifying a Smoker Scale score was a marginally significant predictor (p = .06). Baseline predictors of alternative tobacco use at follow-up included being male (p = .007), frequency of smoking (p = .04), alternative tobacco use (p < .001), and frequency of alcohol use (p = .003); marginally significant predictors included marijuana use (p = .07) and lower perceived harm of smokeless tobacco (p = .06) and cigar products (p = .08). CONCLUSIONS Tobacco control campaigns and interventions might target schemas of a smoker and perceived risks of using various tobacco products, even at low levels.
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Affiliation(s)
- Carla J. Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, Georgia, USA
| | - Devan R. Romero
- Department of Kinesiology, California State University San Marcos, Twin Oaks Valley Rd, San Marcos, California, USA
| | - Kim Pulvers
- Department of Psychology, California State University San Marcos, Twin Oaks Valley Rd, San Marcos, California, USA
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Berg CJ, Stratton E, Sokol M, Santamaria A, Bryant L, Rodriguez R. Novel incentives and messaging in an online college smoking intervention. Am J Health Behav 2014; 38:668-80. [PMID: 24933136 DOI: 10.5993/ajhb.38.5.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine the feasibility, acceptability, and potential effectiveness of an online intervention targeting college smokers. The incentives involved discounted or free goods and services from businesses proximal to each campus. METHODS A randomized controlled trial was conducted with 122 current smokers recruited from 2 Southeastern US universities. The intervention involved health behavior monitoring, targeted messaging, and incentives for healthy goods and services versus the American Cancer Society's Guide to Quitting Smoking online. RESULTS The intervention achieved greater adherence and utilization (p's < .001). Overall, 55.6% learned about a local business through this program. At end-of-treatment, intervention participants less frequently attempted to quit (p = .02) but smoked fewer cigarettes/day (p = .05). Both groups demonstrated significant end-of-treatment cessation rates. CONCLUSIONS This intervention demonstrated feasibility and acceptability.
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Affiliation(s)
- Carla J Berg
- Emory University Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, USA.
| | - Erin Stratton
- Emory University Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA, USA
| | | | | | - Lawrence Bryant
- Georgia State University, Department of Respiratory Therapy, USA
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Carroll MV, Chang J, Sidani JE, Barnett TE, Soule E, Balbach E, Primack BA. Reigniting tobacco ritual: waterpipe tobacco smoking establishment culture in the United States. Nicotine Tob Res 2014; 16:1549-58. [PMID: 24972889 DOI: 10.1093/ntr/ntu101] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Waterpipe tobacco smoking (WTS) is an increasingly prevalent form of tobacco use in the United States. Its appeal may stem from its social, ritualistic, and aesthetic nature. Our aim in this study was to understand WTS as a social ritual with the goal of informing prevention efforts. METHODS We conducted a covert observational study consisting of 38 observation sessions in 11 WTS establishments in 3 U.S. cities. Data collection was based on an established conceptual framework describing ritualistic elements of tobacco use. Iterative codebook development and qualitative thematic synthesis were used to analyze data. RESULTS Atmospheres ranged from quiet coffee shop to boisterous bar party environments. While some children and older adults were present, the majority of clientele were young adults. Men and women were evenly represented. However, there were 19 occurrences of a male smoking by himself, but no women smoked alone. The vast majority (94%) of the clientele were actively smoking waterpipes. All 83 observed groups manifested at least 1 of the ritual elements of our conceptual framework, while 41 of the 83 observed groups (49%) demonstrated all 4 ritual elements. CONCLUSIONS Despite its heterogeneity, WTS is often characterized by 1 or more established elements of a tobacco-related social ritual. It may be valuable for clinical and public health interventions to acknowledge and address the ritualistic elements and social function of WTS.
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Affiliation(s)
- Mary V Carroll
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Judy Chang
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E Sidani
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Tracey E Barnett
- Department of Behavioral Science and Community Health, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Eric Soule
- Department of Behavioral Science and Community Health, University of Florida College of Public Health and Health Professions, Gainesville, FL
| | - Edith Balbach
- Community Health Program, School of Arts and Sciences, Tufts University, Medford, MA
| | - Brian A Primack
- Program for Research on Media and Health, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Berg CJ. Reasons for Nondaily Smoking among Young Adults: Scale Development and Validation. J Smok Cessat 2014; 9:17-25. [PMID: 25258646 PMCID: PMC4172326 DOI: 10.1017/jsc.2013.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Given the increased rates of nondaily smoking and the lack of validated measures to assess factors related to nondaily smoking, we aimed to develop a measure of reasons for nondaily smoking among young adults. Specifically, we developed a scale assessing reasons or triggers for nondaily smoking and examined its reliability, factor structure, and concurrent validity. METHODS We administered an online survey to 2,000 students at six colleges in the Southeastern US, and 718 (35.9%) returned a completed survey. The current analyses focused on the 95 participants who reported nondaily smoking (i.e., smoking between 1 and 29 days of the past 30 days). In addition to the items created for scale development, measures included socio-demographics, other measures of motivation and confidence/self-efficacy, past smoking/quitting history, readiness to quit, and other psychosocial factors related to smoking. RESULTS The 19-item Reasons for Nondaily Smoking Scale (RNS) demonstrated an average score of 45.36 (SD = 15.55) and internal consistency (Cronbach's alpha of 0.79). Factor analysis of the items extracted four factors which accounted for 57.4% of score variance: Social influences; Enhancing buzzes and positive affect; Negative affect regulation; and Lack of concern of addiction. Concurrent and discriminant validity were documented. CONCLUSIONS Developing validated measures designed to assess factors associated with nondaily smoking will enhance our ability to address this growing public health concern. The development and validation of the RNS for young adults may be critical in informing our intervention strategies and potentially for effecting or predicting cessation among young adult nondaily smokers.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, USA
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Hoeppner BB, Bidwell LC, Colby SM, Barnett NP. Smoking patterns and their relationship to drinking among first-year college students. Nicotine Tob Res 2014; 16:743-52. [PMID: 24415586 PMCID: PMC4015088 DOI: 10.1093/ntr/ntt205] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 11/16/2013] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Unlike older smokers, young adult smokers frequently engage in light and intermittent smoking. It remains unclear how stable such smoking patterns are over time, as substantial variability exists between these smokers. This study identified subgroups of college student smokers based on the trajectory of their smoking frequency during the first year of college, thereby examining stability versus instability over time. We then tested if the interplay between drinking and smoking differed in the identified groups to determine the relative role drinking may play in intermittent versus more regular smoking. METHODS Incoming college students at 3 institutions completed online biweekly surveys of their daily substance use throughout the first year of college. Students who reported smoking at least 1 cigarette during this year (n = 266) were included in analyses (70% female, 74% White). RESULTS Group-based trajectory modeling identified 5 groups of smokers, 3 of which maintained their smoking frequency throughout the year (77%), and 2 groups of infrequent smokers showed significant trends (11% increasing, 12% decreasing). Notably, nondaily smoking was maintained at different specific frequencies (e.g., 1 vs. 3 days per week). Identified groups differed in the relationship between drinking and smoking, where cooccurrence was particularly strong among infrequent smokers, and trends in smoking quantity differed between groups. CONCLUSIONS While there was a diversity of smoking patterns in the sample, patterns of intermittent smoking remain relatively stable for a majority of students throughout the year. Intervention messages targeting drinking and smoking should be tailored on the basis of smoking frequency.
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Affiliation(s)
- Bettina B. Hoeppner
- Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Suzanne M. Colby
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Nancy P. Barnett
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
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Leas EC, Zablocki RW, Edland SD, Al-Delaimy WK. Smokers who report smoking but do not consider themselves smokers: a phenomenon in need of further attention. Tob Control 2014; 24:400-3. [PMID: 24500273 DOI: 10.1136/tobaccocontrol-2013-051400] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/07/2014] [Indexed: 11/04/2022]
Abstract
BACKGROUND Heightened stigma surrounding the action of smoking may decrease the likelihood that individuals who engage in smoking identify with the label 'smoker'. Non-identifying smokers (NIS) may undermine accurate smoking prevalence estimates and can be overlooked by tobacco control efforts. OBJECTIVE We sought to characterise NIS in a cross-sectional study using a sample representative of the population of adults (>18 years) in California who reported smoking at least 100 cigarettes in their lifetime, smoking at least some days and at least once in the last 30 days (n=1698). Individuals were considered NIS if they met the above criteria and answered 'no' when asked if they 'considered themselves a smoker'. RESULTS We estimate that 395 928 (SD=54 126) NIS were living in California in 2011 (a prevalence of 12.3% of all smokers in California). The odds of being NIS were higher among non-daily smokers who were previously daily smokers (adjusted OR (AOR)=7.63, 95% CI 2.67 to 21.8) or were never previously daily smokers (AOR=7.14, CI 2.78 to 18.3) compared with daily smokers. The odds of being an NIS were also higher among those who did not believe they were addicted to cigarettes (AOR=3.84, CI 1.68 to 9.22), were older than 65 years (vs less than 45 years) (AOR=3.35, CI 1.16 to 9.75) or were from ethnic minorities including Black and Asian (vs non-Hispanic white) (AOR=3.16, CI 1.19 to 8.49). CONCLUSIONS Smoking surveillance should restructure selection criteria to more accurately account for NIS in areas with high stigma toward smokers. Targeted interventions may be needed for NIS including educating healthcare providers to enquire more deeply into smoking habits.
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Affiliation(s)
- Eric C Leas
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Rong W Zablocki
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Steven D Edland
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
| | - Wael K Al-Delaimy
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California, USA
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Kvaavik E, von Soest T, Pedersen W. Nondaily smoking: a population-based, longitudinal study of stability and predictors. BMC Public Health 2014; 14:123. [PMID: 24498864 PMCID: PMC3923098 DOI: 10.1186/1471-2458-14-123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 02/04/2014] [Indexed: 11/17/2022] Open
Abstract
Background Nondaily smoking appears to have remained stable in Western countries in recent years, alongside a steep decline in daily smoking. Nondaily smoking increases the risk of several diseases and premature mortality, but our knowledge about nondaily smoking is limited. The present study was designed to examine the stability of nondaily smoking during young adulthood, and to identify adolescent factors predictive of nondaily smoking compared with nonsmoking and non-nicotine-dependent and nicotine-dependent daily smoking. Methods A population-based sample (n = 942) of Norwegians was followed up by surveys for 13 years, from adolescence to young adulthood. Information about smoking patterns, nicotine dependence, school achievement, parents’ and peers’ smoking, and parental monitoring was collected. Data on parental and participants’ education were obtained from a national register. Results Of all nondaily smokers at age 21 years, 26% were still nondaily smokers at 27 years, while 17% had become daily smokers and 57% had quit. Bivariate analyses revealed that young adult nondaily smokers did not differ from nonsmokers on any of the included variables, while a number of differences in parental, peers’ and individual characteristics were observed between nondaily smokers and the two categories of smokers in young adulthood. Longitudinal analyses revealed that unorganized leisure time activities and peers’ smoking differentiated nondaily smoking from nonsmoking. Higher educational achievement and less parental binge drinking predicted nondaily smoking and differentiated it from both categories of daily smoking. Conclusions The degree of nondaily smoking-stability from 21 to 27 years of age was modest, and most nondaily smokers quit smoking in the course of young adulthood. Young adult nondaily smokers were quite similar to nonsmokers, but differed substantially from both nicotine-dependent and nondependent daily smokers. The study suggests that nondaily smoking—at least in the absence of traditional risk factors for smoking—is usually a transitory behavior, with most people returning to nonsmoking.
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Affiliation(s)
- Elisabeth Kvaavik
- Norwegian Institute for Alcohol and Drug Research, P,O, Box 565, Sentrum N-0105, Oslo, Norway.
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Abstract
BACKGROUND In recent decades, daily smoking has become less common, while occasional smoking has stayed at the same level. The purpose of the study is to describe occasional smokers on the basis of their smoking behaviour and socio-demographic characteristics. MATERIAL AND METHOD Data from Statistics Norway's quarterly surveys of tobacco use in 2010 and 2011 were used. Information on smoking habits, smoking-related behaviour and the respondents' attitudes to their own smoking was collected in telephone interviews. RESULTS Of the 8,700 men and women aged 16-74 (response rate 57%) who were included, altogether 1,583 were daily smokers and 907 occasional smokers. The occasional smokers were younger, more frequently lived in large cities and had a higher level of education and income than the daily smokers. Twenty-nine of 174 (17%) occasional smokers used snus on a daily basis, compared to 10 of 394 (3%) of the daily smokers. The occasional smokers had great confidence in their ability to quit: 95% responded that they would be smoke-free in five years, compared to 55% of the daily smokers (n = 2,158). Fifty-five (35%) of the occasional smokers lit up several times weekly (16 cigarettes per week on average), while the remaining (65%) smoked only once per week as a maximum (five cigarettes per week on average). Those who smoked several times each week had attitudes to their own smoking and usage pattern for tobacco that were similar to those of the daily smokers. Nearly half of the occasional smokers defined themselves as non-smokers. INTERPRETATION Norwegian occasional smokers are a heterogeneous group in terms of their smoking pattern and frequency, and many define themselves as non-smokers.
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Tracy JJ, Lombardo TW, Bentley JP. A smoker identity measure for experimental, intermittent, and daily college student smokers. Am J Health Promot 2013; 27:55-62. [PMID: 22950927 DOI: 10.4278/ajhp.110401-quan-146] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To provide initial tests of internal consistency reliability and both structural and concurrent validity of a smoker identity (SI) scale for college student populations. DESIGN Cross-sectional design. SETTING Midsouth university. PARTICIPANTS Undergraduates in a random sample of university classes completed surveys (92.3% response rate). METHOD SI items derived from a literature review and clinical expertise, lifetime and current tobacco use, cigarette purchasing patterns, and quitting variables. ANALYSIS Current (some days or every day) cigarette users (n = 362) were divided into daily, intermittent, and experimental smoker groups. After principal components analysis was conducted on the SI items, analysis of variance (ANOVA) was used to assess SI differentiation of smoker groups, and correlational analysis or ANOVA was used to assess SI relationships with smoking and quitting variables. RESULTS Eight SI items produced a high-internal-consistency, single-factor structure (α = .93) and clearly differentiated the three smoker groups. Higher SI scores indicated greater smoking rate, smoking within 30 minutes of awakening, larger purchased quantities, and both greater interest and lower confidence in quitting. CONCLUSIONS The scale demonstrated good reliability and validity. Other SI measures exist, but this is the first scale to establish utility with experimental and intermittent smokers-substantial groups among college students. The extent to which cigarette users identify as smokers may provide useful information beyond behavioral measures, especially among college students.
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Affiliation(s)
- Josie J Tracy
- Portland VA Medical Center, 3710 SW US Veterans Hospital Road, PO Box 1035, V3SATP, Portland, OR 97207, USA.
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Nondaily Smoking Cessation Motivation for Young Adults: Scale Development and Validation. J Smok Cessat 2013. [DOI: 10.1017/jsc.2013.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Nondaily smoking is a growing public health concern, particularly among young adults. Given the lack of existing measures for assessing factors associated with this smoking pattern, the present study aims to develop a measure of motivation to quit among young adult nondaily smokers. Specifically, we developed a scale assessing motivation for nondaily smoking cessation, and examined its reliability, factor structure, and concurrent validity.Methods: We administered an online survey to 2,000 students at six colleges in the Southeastern US, and 718 (35.9%) returned a completed survey. The current analyses focused on the 95 participants who reported nondaily smoking (i.e., smoking between 1 and 29 days of the past 30 days). In addition to the items created for scale development, measures included sociodemographics, other measures of motivation and confidence/self-efficacy, past smoking/quitting history, readiness to quit, and perceived harm.Results: The 13-item Nondaily Smoking Cessation Motivation Questionnaire (NSCM) had an average score of 56.95 (SD = 24.33) and high internal consistency (Cronbach's alpha of 0.94). Factor analysis using principal components extraction with varimax rotation extracted three factors accounting for 76.8% of the variance: Controlled motivation, Autonomous motivation, and Amotivation. Concurrent and discriminant validity were documented.Conclusions: This study provided information about the development and validation of the Nondaily Smoking Cessation Motivation Questionnaire for young adult nondaily smokers. Given the lack of validated measures to assess factors associated with nondaily smoking, this assessment may be critical in informing our intervention strategies and potentially for predicting cessation among nondaily smokers in the young adult population.
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Pokhrel P, Little MA, Herzog TA. Current Methods in Health Behavior Research Among U.S. Community College Students: A Review of the Literature. Eval Health Prof 2013; 37:178-202. [PMID: 24227658 DOI: 10.1177/0163278713512125] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The majority of health behavior research involving college students in the United States has focused on 4-year college students. Two-year or community college students have been less studied, although a significant proportion of U.S. undergraduates, primarily those from disadvantaged socioeconomic and/or racial/ethnic background, are enrolled in community colleges. Thus, there is a need to enhance health behavior and health promotion research among community college students. This study systematically reviewed 42 published, peer-reviewed health behavior studies conducted among U.S. community college students in order to determine the current state of research in the area with regard to behaviors studied, research designs used, recruitment and data collection strategies practiced, rates of student participation, and characteristics of the participants represented. Findings identified the methodological limitations of current research and suggested optimal recruitment and data collection methods suitable for various research needs. Findings are discussed in the context of enhancing health behavior research among U.S. community college students.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Melissa A Little
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Thaddeus A Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, Honolulu, HI, 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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Hussain R, Guppy M, Robertson S, Temple E. Physical and mental health perspectives of first year undergraduate rural university students. BMC Public Health 2013; 13:848. [PMID: 24034822 PMCID: PMC3847612 DOI: 10.1186/1471-2458-13-848] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 09/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND University students are often perceived to have a privileged position in society and considered immune to ill-health and disability. There is growing evidence that a sizeable proportion experience poor physical health, and that the prevalence of psychological disorders is higher in university students than their community peers. This study examined the physical and mental health issues for first year Australian rural university students and their perception of access to available health and support services. METHODS Cross-sectional study design using an online survey form based on the Adolescent Screening Questionnaire modeled on the internationally recognised HEADSS survey tool. The target audience was all first-year undergraduate students enrolled in an on-campus degree program. The response rate was 41% comprising 355 students (244 females, 111 males). Data was analysed using standard statistical techniques including descriptive and inferential statistics; and thematic analysis of the open-ended responses. RESULTS The mean age of the respondents was 20.2 years (SD 4.8). The majority of the students lived in on-campus residential college style accommodation, and a third combined part-time paid work with full-time study. Most students reported being in good physical health. However, on average two health conditions were reported over the past six months, with the most common being fatigue (56%), frequent headaches (26%) and allergies (24%). Mental health problems included anxiety (25%), coping difficulties (19.7%) and diagnosed depression (8%). Most respondents reported adequate access to medical doctors and support services for themselves (82%) and friends (78%). However the qualitative comments highlighted concerns about stigma, privacy and anonymity in seeking counselling. CONCLUSIONS The present study adds to the limited literature of physical and mental health issues as well as barriers to service utilization by rural university students. It provides useful baseline data for the development of customised support programs at rural campuses. Future research using a longitudinal research design and multi-site studies are recommended to facilitate a deeper understanding of health issues affecting rural university students.
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Affiliation(s)
- Rafat Hussain
- School of Rural Medicine, University of New England, Armidale, NSW 2351, Australia.
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Udo T, Mun EY, Buckman JF, Vaschillo EG, Vaschillo B, Bates ME. Potential side effects of unhealthy lifestyle choices and health risks on basal and reactive heart rate variability in college drinkers. J Stud Alcohol Drugs 2013; 74:787-96. [PMID: 23948539 PMCID: PMC3749321 DOI: 10.15288/jsad.2013.74.787] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 02/08/2013] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Emerging adults often begin making independent lifestyle choices during college, yet the association of these choices with fundamental indicators of health and adaptability is unclear. The present study examined the relationship between health risks and neurocardiac function in college drinkers. METHOD Heart rate variability (HRV) was assessed at baseline and in reaction to a paced breathing challenge in 212 college drinkers (53.8% women). Basal HRV served as a general indicator of health. Reactive HRV (during paced breathing) was used as a marker of an individual's adaptability to challenge. The relationship of HRV to alcohol use, cigarette use, exercise, sleep, and body mass index (BMI) was assessed. RESULTS Greater alcohol use and less exercise were associated with lower basal HRV. BMI was unrelated to basal HRV but was negatively associated with reactive HRV during the breathing challenge. CONCLUSIONS High levels of alcohol use and lack of exercise are negative correlates of cardiovascular and general health, even in apparently healthy college drinkers. The negative relationship between BMI and reactive HRV suggests that overweight individuals have reduced ability to psychophysiologically adapt to challenges; understanding the temporal course of this relationship is needed. This study highlights the importance of examining HRV at baseline and in response to a challenge to capture the active neurocardiac processes that contribute to health and adaptive responding. The suppressive effects of health risks on HRV are modifiable; thus, HRV may be useful in evaluating the health benefits of lifestyle change and in promoting change behaviors in college drinkers.
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Affiliation(s)
- Tomoko Udo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Eun-Young Mun
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Jennifer F. Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Evgeny G. Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Bronya Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Marsha E. Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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