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Mojtabai R, Susukida R, Nejat K, Amin-Esmaeili M. Association of cigarette excise taxes and clean indoor air laws with change in smoking behavior in the United States: a Markov modeling analysis. J Public Health Policy 2024; 45:100-113. [PMID: 38155242 DOI: 10.1057/s41271-023-00458-x] [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] [Accepted: 11/20/2023] [Indexed: 12/30/2023]
Abstract
The rates of cigarette smoking in the United States have declined over the past few decades in parallel with increases in cigarette taxes and introduction of more stringent clean indoor air laws. Few longitudinal studies have examined association of taxes and clean indoor air policies with change in smoking nationally. This study examined the association of state and local cigarette taxes and clean indoor laws with change in smoking status of 18,499 adult participants of the longitudinal 2010-2011 Tobacco Use Supplement of the Current Population Survey over a period of 1 year. Every $1 increase in cigarette excise taxes was associated with 36% higher likelihood of stopping smoking among regular smokers. We found no association between clean indoor air laws and smoking cessation nor between taxes and clean indoor air laws with lower risk of smoking initiation. Cigarette taxes appear to be effective anti-smoking policies. Some state and local governments do not take full advantage of this effective policy measure.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA
| | | | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 North Broadway, Room 797, Baltimore, MD, 21205, USA.
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2
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Cheng Y, Dao C, Zhou H, Li B, Kember RL, Toikumo S, Zhao H, Gelernter J, Kranzler HR, Justice AC, Xu K. Multi-trait genome-wide association analyses leveraging alcohol use disorder findings identify novel loci for smoking behaviors in the Million Veteran Program. Transl Psychiatry 2023; 13:148. [PMID: 37147289 PMCID: PMC10162964 DOI: 10.1038/s41398-023-02409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 05/07/2023] Open
Abstract
Smoking behaviors and alcohol use disorder (AUD), both moderately heritable traits, commonly co-occur in the general population. Single-trait genome-wide association studies (GWAS) have identified multiple loci for smoking and AUD. However, GWASs that have aimed to identify loci contributing to co-occurring smoking and AUD have used small samples and thus have not been highly informative. Applying multi-trait analysis of GWASs (MTAG), we conducted a joint GWAS of smoking and AUD with data from the Million Veteran Program (N = 318,694). By leveraging GWAS summary statistics for AUD, MTAG identified 21 genome-wide significant (GWS) loci associated with smoking initiation and 17 loci associated with smoking cessation compared to 16 and 8 loci, respectively, identified by single-trait GWAS. The novel loci for smoking behaviors identified by MTAG included those previously associated with psychiatric or substance use traits. Colocalization analysis identified 10 loci shared by AUD and smoking status traits, all of which achieved GWS in MTAG, including variants on SIX3, NCAM1, and near DRD2. Functional annotation of the MTAG variants highlighted biologically important regions on ZBTB20, DRD2, PPP6C, and GCKR that contribute to smoking behaviors. In contrast, MTAG of smoking behaviors and alcohol consumption (AC) did not enhance discovery compared with single-trait GWAS for smoking behaviors. We conclude that using MTAG to augment the power of GWAS enables the identification of novel genetic variants for commonly co-occuring phenotypes, providing new insights into their pleiotropic effects on smoking behavior and AUD.
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Affiliation(s)
- Youshu Cheng
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Cecilia Dao
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Hang Zhou
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Boyang Li
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Rachel L Kember
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Sylvanus Toikumo
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Hongyu Zhao
- Yale School of Public Health, New Haven, CT, 06511, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Joel Gelernter
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Henry R Kranzler
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Amy C Justice
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Ke Xu
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
- Yale School of Medicine, New Haven, CT, 06511, USA.
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3
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Li X, Holahan CK, Loukas A, Holahan CJ, Pasch KE, Marti CN. Alternative Tobacco Use and Cigarette Smoking Transitions among College Students in Texas. Subst Use Misuse 2023; 58:389-396. [PMID: 36651240 PMCID: PMC9892304 DOI: 10.1080/10826084.2023.2165408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: High prevalence of very light cigarette smoking and use of alternative tobacco products (ATPs; i.e. electronic nicotine delivery systems [ENDS], cigars, and hookah) among young adult college students are causes for concern. The purpose of this study is to examine transitions in cigarette smoking (never vs. non-current vs. very light vs. heavier) among college students across 2.5 years and determine if the use of ATPs is related to these transitions. Methods: This study used six waves of data across 2.5 years from Project M-PACT. Participants who were 18-25 years of age at baseline were included in this study (n = 4,806). Cigarette smoking state was categorized as never smoking, non-current smoking [0 cigarettes smoked per day (cpd) in past month], very light smoking (< =5 cpd in past month), and heavier smoking (>5 in past month). Multi-state Markov models were used to examine temporal transitions in the four smoking states and examine the association of time-varying current ATP use with transitions in smoking states. Results: The probabilities of remaining in a smoking state decreased over time. The time-varying current ATP use was significantly related to increased odds of transitioning from never smoking to non-current smoking, from never smoking to very light smoking, and from non-current to very light smoking. Conclusions: Findings highlight the need to prevent ATP use among college students and in turn inhibit initiation and escalation of cigarette smoking.
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Affiliation(s)
- Xiaoyin Li
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Carole K Holahan
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Charles J Holahan
- Department of Psychology, The University of Texas at Austin, Austin, Texas, USA
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - C Nathan Marti
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
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4
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Kim MM, Curtin GM. Assessing the Evidence on the Differential Impact of Menthol versus Non-menthol Cigarette Use on Smoking Dependence in the US Population: A Systematic Review and Meta-analysis. Am J Health Behav 2022; 46:376-422. [PMID: 36109861 DOI: 10.5993/ajhb.46.4.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Menthol's effect on cigarette smoking behaviors is an intensely scrutinized US public health issue. This systematic review and meta-analysis examined the question: Does menthol cigarette use have a differential impact on smoking dependence compared with non-menthol cigarette use? Methods: We consulted 6 databases from inception to October 15, 2021. We included articles comparing menthol versus non-menthol cigarette smokers against predefined smoking dependence outcomes. Risk of bias was assessed using the AHRQ Evidence-Based Practice Center approach. We applied a random-effects model to pool adjusted odds ratios. Results: We synthesized 37 demographically adjusted studies. Meta-analytic results suggested non-menthol smokers were equally/more likely to report daily versus non-daily smoking; menthol use was associated with needing a cigarette within one hour; cigarettes per day was not associated with menthol use; menthol use was associated with a low (vs high) Heaviness of Smoking Index score; and results were either non-significant or associated menthol use with lower TTFC. Conclusions: Despite consistently good or fair quality adjusted studies across several measures, results were discordant depending on measures used and means of measurement. Overall, the evidence is insufficient to draw clear conclusions on a differential association between menthol (vs non-menthol) cigarette use and smoking dependence.
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Affiliation(s)
- Mimi M Kim
- Mimi M. Kim, Senior Director, Scientific & Regulatory Affairs, RAI Services Company, Winston-Salem NC, United States;,
| | - Geoffrey M Curtin
- Geoffrey M. Curtin, retired employee, RAI Services Company, Winston-Salem, NC, United States
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Hassett-Walker C. The Longitudinal Impact of Arrest, Criminal Conviction, and Incarceration on Smoking Classes. Tob Use Insights 2022; 15:1179173X221089710. [PMID: 35634273 PMCID: PMC9134438 DOI: 10.1177/1179173x221089710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background Previous research identifies three to six smoking classes over the life course. This study expands on earlier work about the impact of getting arrested in early adulthood on individuals' smoking classes, by including additional, more serious measures of justice system involvement (JSI), specifically criminal conviction and incarceration. Family processes were examined as secondary outcomes. Method Data from seventeen waves (1997-2015) of the National Longitudinal Survey of Youth were analyzed via group-based trajectory modeling (GBTM), multinomial logistic regression, and latent transition analyses (LTA). Smoking behavior through age 36 is examined. Marital status, parenthood, juvenile smoking, juvenile arrest, and prior crime victimization experiences were also included in the models. Results Seven smoking classes were revealed: two low- or non-smoking classes; two decreasing classes; and three "problem" smoking (e.g., increasing, or chronic) classes. All JSI types increased the likelihood of being in a smoking class rather than a non-smoking class. Arrest and conviction had larger odds ratios than the most severe form of JSI-incarceration-with respect to respondents' likelihood of being in an increasing or chronic smoking class. Juvenile smoking was the most robust predictor of smoking in adulthood. Conclusion Involvement with the justice system in all forms remains a negative health factor that increases smoking. While not typically a goal of criminal justice officials, attention should be paid to this unintended consequence of involvement with the justice system-increased smoking-given smoking's connection to serious illnesses such as cancer. As juvenile smoking is a strong risk factor for adult smoking, smoking prevention and cessation programs should start with youth; and be part of the offerings to individuals ensnared in the justice system at all levels.
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Kim MM, Curtin GM. Assessing the Evidence on the Differential Impact of Menthol versus Non-menthol Cigarette Use on Initiation and Progression to Regular Smoking: A Systematic Review and Meta-analysis. Am J Health Behav 2022; 46:143-163. [PMID: 35501962 DOI: 10.5993/ajhb.46.2.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Despite numerous assessments of the public health impact of menthol cigarettes, a rigorous synthesis related to menthol cigarettes and behavioral outcomes is lacking. This systematic review and meta-analysis examined the question: Does menthol cigarette use have a differential impact on initiation and progression to regular smoking compared to non-menthol cigarette use? Methods: We consulted 6 databases from their inception to October 15, 2021. We included articles comparing menthol versus non-menthol smokers among 4 predefined smoking initiation and progression outcomes. We assessed risk of bias was using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. We applied a random-effects model to pool adjusted odds ratios. Results: We qualitatively synthesized 16 adjusted studies across the outcomes. Results from one meta-analysis suggested no difference between menthol and non-menthol smokers in likelihood to report daily versus non-daily smoking. Conclusion: This systematic review and meta-analysis did not identify a consistent, statistically significant, or differential association between menthol use and progression to regular smoking. Varying definitions of outcome measures and lack of longitudinal evidence limited the confident conclusions that could be drawn from this evidence base.
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Affiliation(s)
- Mimi M. Kim
- Mimi M. Kim, Senior Director, Scientific & Regulatory Affairs, RAI Services Company, Winston-Salem NC United States; kimm1@rjrt. com
| | - Geoffrey M. Curtin
- Geoffrey M. Curtin, Retired employee of RAI Services company, Winston-Salem NC, Scientific & Regulatory Affairs, United States
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Kim MM, Curtin GM. Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation in the U.S. population: a systematic review and meta-analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:61. [PMID: 34380503 PMCID: PMC8359586 DOI: 10.1186/s13011-021-00397-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 12/12/2022]
Abstract
Background The potential impact of menthol versus non-menthol cigarette use on smoking behaviors is an intensely scrutinized topic in the public health arena. To date, several general literature reviews have been conducted, but findings and conclusions have been discordant. This systematic review followed PRISMA guidelines to examine the Key Question, “Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?” Methods Six databases—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Embase and PsycInfo—were queried from inception to June 12, 2020. Articles comparing menthol versus non-menthol cigarette smokers in terms of at least one predefined smoking cessation outcome were included. Risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. A random-effects model utilizing the DerSimonian and Laird method to pool adjusted odds ratio was applied. Variations among pooled studies were assessed using Cochran’s Q statistic, and heterogeneity was quantified using the inconsistency index (I2). Results Forty-three demographically adjusted studies (22 rated “good”, 20 rated “fair”, and one study rated “poor” individual study quality) comparing menthol and non-menthol smokers were qualitatively synthesized across the following measures (study count; strength of evidence): duration of abstinence (2; low); quit attempts (15; insufficient); rate of abstinence/quitting (29; moderate); change in smoking quantity/frequency (5; insufficient); and, return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for an association between menthol cigarette use and smoking cessation across outcomes. Meta-analyses found no difference between menthol and non-menthol cigarette use and either quit attempts or abstinence. Conclusions Given the lack of consistency or statistical significance in the findings—combined with a “low” overall strength of evidence grade, based on deficiencies of indirectness and inconsistency—no consistent or significant associations between menthol cigarette use and smoking cessation were identified. Recommendations for future studies include increased focus on providing longitudinal, adjusted data collected from standardized outcome measures of cessation to better inform long-term smoking cessation and menthol cigarette use. Such improvements should also be further considered in more methodologically rigorous systematic reviews characterized by objectivity, comprehensiveness, and transparency with the ultimate objective of better informing public health and policy decision making. Supplementary Information The online version contains supplementary material available at 10.1186/s13011-021-00397-4.
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Affiliation(s)
- Mimi M Kim
- Scientific & Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA.
| | - Geoffrey M Curtin
- Scientific & Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA
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8
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Klemperer EM, Hughes JR, Callas PW, West JC, Villanti AC. Tobacco and Nicotine Use Among US Adult "Never Smokers" in Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2021; 23:1199-1207. [PMID: 33433608 PMCID: PMC8186421 DOI: 10.1093/ntr/ntab009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION A common criterion for being labeled a "never smoker" is having smoked <100 lifetime cigarettes. This category is often used as an unexposed reference group to estimate the relative harm from cigarettes. We examined the amount of current and past cigarette and non-cigarette tobacco/nicotine use among adults who met this "never smoker" criterion. METHODS We analyzed cross-sectional data from 17 179 adult "never smokers" (ie, reported <100 lifetime cigarettes) in Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health (PATH) Study, a United States nationally representative sample. We used PATH-derived variables to describe "never smokers'" demographics as well as cigarette and non-cigarette tobacco/nicotine use. RESULTS Approximately half of "never smokers" were young adults (49.3%). Most were white (68.6%) with some college or more (64.4%). Most "never smokers" had tried any cigarette or non-cigarette tobacco/nicotine in their lifetime (66.7%), 8.5% smoked cigarettes in the past 30 days, and 5.3% were current experimental (ie, some days or every day) cigarette smokers. By definition, "never smokers" reported smoking <100 lifetime cigarettes. One fifth (22.8%) had a lifetime history of established regular non-cigarette tobacco/nicotine use and 8.6% were current established regular non-cigarette tobacco/nicotine users. In total, 9.4% of "never smokers" were current experimental or established regular users of combustible tobacco. CONCLUSIONS The 100-cigarette lifetime threshold includes substantial amounts of current and past tobacco use and thus does not represent lack of exposure to cigarette or non-cigarette tobacco. "Never smoker" reference groups may produce underestimates of the relative harms from cigarettes. IMPLICATIONS The <100 lifetime cigarettes criterion may not capture what many would consider true "never smokers." Relying on the current definition of "never smokers" as a reference group will include a substantial number of those currently and recently using combustible tobacco and thus produce data that may underestimate the relative harm from cigarettes. Prospective longitudinal research is needed to compare how the 100-cigarette lifetime threshold versus other definitions of regular cigarette smoking differ in predictive validity of clinically meaningful outcomes and health harms to determine the optimal criteria to define established cigarette smoking.
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Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - John R Hughes
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - Peter W Callas
- Department of Biostatistics, University of Vermont, Burlington, VT
| | - Julia C West
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
- Department of Psychological Science, University of Vermont, Burlington, VT
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Edwards KC, Kasza KA, Tang Z, Stanton CA, Sharma E, Halenar MJ, Taylor KA, Donaldson EA, Hull LC, Bansal-Travers M, Limpert J, Zandberg I, Gardner LD, Borek N, Kimmel HL, Compton WM, Hyland A. Correlates of tobacco product reuptake and relapse among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2021; 29:s216-s226. [PMID: 32321855 DOI: 10.1136/tobaccocontrol-2020-055660] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study examines sociodemographic and tobacco use correlates of reuptake and relapse to tobacco use across a variety of tobacco products (cigarettes, electronic nicotine delivery systems, cigars, hookah and smokeless tobacco) among the US population. DESIGN Data were drawn from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (ages 12-17) and adults (ages 18+). Reuptake (past 30-day use among previous tobacco users) and relapse (current use among former established users; adults only) were examined among previous users of at least one type of tobacco product at Wave 1 (W1) or Wave 2 (W2) (n=19 120 adults, n=3039 youth). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with reuptake/relapse at follow-up, over two 1-year periods (W1-W2 and W2-Wave 3). RESULTS Any tobacco product reuptake occurred in 7.8% of adult previous users and 30.3% of youth previous users. Correlates of any tobacco reuptake included being male, non-Hispanic black and bisexual in adults, but race and sexual orientation were not consistent findings in youth. Among recent former users, relapse rates were greater (32.9%). Shorter time since last use and greater levels of tobacco dependence showed the strongest association with any tobacco relapse. DISCUSSION Continued clinical and public health efforts to provide adults with tools to cope with tobacco dependence symptoms, especially within the first year or two after quitting, could help prevent relapse.
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Affiliation(s)
- Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States.,Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, United States
| | - Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Lynn C Hull
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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10
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Ni K, Wang B, Link AR, Sherman SE. Does Smoking Intensity Predict Cessation Rates? A Study of Light-Intermittent, Light-Daily, and Heavy Smokers Enrolled in Two Telephone-Based Counseling Interventions. Nicotine Tob Res 2020; 22:423-430. [PMID: 30535269 DOI: 10.1093/ntr/nty257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Though many interventions have been shown to be effective in helping smokers quit, outcomes may differ between light and heavy smokers. We identified differences in baseline characteristics and post-intervention cessation rates among smoker groups at two safety-net hospitals. METHODS We retrospectively analyzed cessation rates in 1604 patients randomized to either a quitline referral (1-2 telephone counseling sessions) or intensive counseling program (seven telephone sessions). Participants were stratified into light-intermittent (smoked on ≤24 of last 30 days), light-daily (smoked on >24/30 days, 1-9 cigarettes per day [CPD]), or heavy smokers (smoked on >24/30 days, ≥10 CPD). We compared baseline characteristics between smoker types using chi-squared tests, then identified predictors of 30-day abstinence using a multivariable model. RESULTS Compared with light-daily and light-intermittent smokers, heavy smokers were more likely to be white, male, concomitant e-cigarette users, to have high-risk alcohol use, to have used quitting aids previously, to have current or lifetime substance use (excluding cannabis), and have lower confidence in quitting. However, in multivariable analysis, smoker type was not significantly associated with cessation. The statistically significant predictors of cessation at 6 months were higher confidence in quitting and enrollment in the intensive counseling intervention. CONCLUSIONS Smoker type (light-intermittent, light-daily, or heavy) does not independently predict success in a cessation program. However, smoker type is strongly associated with patients' confidence in quitting, which may be one predictor of cessation. IMPLICATIONS This study of two safety-net hospitals emphasizes that the number of cigarettes smoked per day does not independently predict smoking cessation. Additionally, heavy smokers are at highest risk for the detrimental health effects of tobacco, yet have lower confidence and motivation to quit. Confidence in quitting may be one factor that affects cessation rates; however, further study is needed to identify which other attributes predict cessation. These findings suggest that smoker type may still be a useful proxy for predicting cessation and that interventions specifically designed for and validated in heavy smokers are needed to better aid these individuals.
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Affiliation(s)
- Katherine Ni
- Department of Medicine, New York University School of Medicine, New York, NY
| | - Binhuan Wang
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Alissa R Link
- Department of Population Health, New York University School of Medicine, New York, NY
| | - Scott E Sherman
- Department of Medicine, New York University School of Medicine, New York, NY.,Department of Population Health, New York University School of Medicine, New York, NY.,Department of Medicine, VA New York Harbor Healthcare System, New York, NY
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11
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Cardenas VM, Ali MM, Fischbach LA, Nembhard WN. Dual use of cigarettes and electronic nicotine delivery systems during pregnancy and the risk of small for gestational age neonates. Ann Epidemiol 2020; 52:86-92.e2. [PMID: 32805398 DOI: 10.1016/j.annepidem.2020.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of this study was to estimate the effect of cigarette smoking and electronic nicotine delivery systems (ENDS) use during pregnancy on small for gestational age (SGA). METHODS We used data from the 2016-2017 Arkansas Pregnancy Risk Assessment Monitoring System, estimated the risk ratio (RR) for SGA for maternal prenatal cigarette smoking-only use, cigarette smoking, and ENDS use (i.e., dual use), with no prenatal tobacco use as referent, accounting for the complex survey design. We also explored these effects for women who stopped smoking cigarettes during pregnancy among cigarette smokers and dual users. RESULTS Estimated adjusted RR for SGA for cigarette-only users was 1.7 (95% confidence interval [CI]: 1.1, 2.7), and 1.8 (95% CI: 1.0, 3.4) for dual users. These RR estimates increased after correcting for tobacco use misclassification. Women who were dual users (cigarette smokers and ENDS users) and continued using ENDS but stopped smoking cigarettes had an increased risk for SGA compared with nontobacco users, 3.2 (95% CI: 1.5, 6.6). CONCLUSIONS Our results in a population representative sample are consistent with the hypothesis that exposure to both maternal cigarette smoking and ENDS use increased the risk of SGA. Dual users still had an elevated risk of SGA after smoking cessation.
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Affiliation(s)
- Victor Manuel Cardenas
- Department of Epidemiology, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock.
| | - Mir Murtuza Ali
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock
| | - Lori Ann Fischbach
- Department of Epidemiology, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock
| | - Wendy Nicole Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock; Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Heath, University of Arkansas for Medical Sciences, Little Rock
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12
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Reddy KP, Bulteel AJB, Levy DE, Torola P, Hyle EP, Hou T, Osher B, Yu L, Shebl FM, Paltiel AD, Freedberg KA, Weinstein MC, Rigotti NA, Walensky RP. Novel microsimulation model of tobacco use behaviours and outcomes: calibration and validation in a US population. BMJ Open 2020; 10:e032579. [PMID: 32404384 PMCID: PMC7228509 DOI: 10.1136/bmjopen-2019-032579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Simulation models can project effects of tobacco use and cessation and inform tobacco control policies. Most existing tobacco models do not explicitly include relapse, a key component of the natural history of tobacco use. Our objective was to develop, calibrate and validate a novel individual-level microsimulation model that would explicitly include smoking relapse and project cigarette smoking behaviours and associated mortality risks. METHODS We developed the Simulation of Tobacco and Nicotine Outcomes and Policy (STOP) model, in which individuals transition monthly between tobacco use states (current/former/never) depending on rates of initiation, cessation and relapse. Simulated individuals face tobacco use-stratified mortality risks. For US women and men, we conducted cross-validation with a Cancer Intervention and Surveillance Modeling Network (CISNET) model. We then incorporated smoking relapse and calibrated cessation rates to reflect the difference between a transient quit attempt and sustained abstinence. We performed external validation with the National Health Interview Survey (NHIS) and the linked National Death Index. Comparisons were based on root-mean-square error (RMSE). RESULTS In cross-validation, STOP-generated projections of current/former/never smoking prevalence fit CISNET-projected data well (coefficient of variation (CV)-RMSE≤15%). After incorporating smoking relapse, multiplying the CISNET-reported cessation rates for women/men by 7.75/7.25, to reflect the ratio of quit attempts to sustained abstinence, resulted in the best approximation to CISNET-reported smoking prevalence (CV-RMSE 2%/3%). In external validation using these new multipliers, STOP-generated cumulative mortality curves for 20-year-old current smokers and never smokers each had CV-RMSE ≤1% compared with NHIS. In simulating those surveyed by NHIS in 1997, the STOP-projected prevalence of current/former/never smokers annually (1998-2009) was similar to that reported by NHIS (CV-RMSE 12%). CONCLUSIONS The STOP model, with relapse included, performed well when validated to US smoking prevalence and mortality. STOP provides a flexible framework for policy-relevant analysis of tobacco and nicotine product use.
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Affiliation(s)
- Krishna P Reddy
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander J B Bulteel
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Douglas E Levy
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Pamela Torola
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily P Hyle
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Taige Hou
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin Osher
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Liyang Yu
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Fatma M Shebl
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Kenneth A Freedberg
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Milton C Weinstein
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rochelle P Walensky
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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13
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Kasza KA, Edwards KC, Tang Z, Stanton CA, Sharma E, Halenar MJ, Taylor KA, Donaldson EA, Hull LC, Bansal-Travers M, Limpert J, Zandberg I, Gardner LD, Hammad HT, Borek N, Kimmel HL, Compton WM, Hyland A. Correlates of tobacco product cessation among youth and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s203-s215. [PMID: 32321854 PMCID: PMC7520817 DOI: 10.1136/tobaccocontrol-2019-055255] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report on demographic and tobacco use correlates of cessation behaviours across tobacco products (cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco) among the US population. DESIGN Data were drawn from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth (ages 12-17) and adults (ages 18+) . Past 30-day (P30D) tobacco users at Wave 1 (W1) or Wave 2 (W2) were included (n=1374 youth; n=14 389 adults). Generalised estimating equations were used to evaluate the association between demographic and tobacco use characteristics at baseline, with cessation behaviours at follow-up (discontinuing use, attempting to quit, quitting), over two 1-year periods (W1-W2, W2-Wave 3). RESULTS Among adult users of each type of tobacco product, frequency of use was negatively associated with discontinuing use. Among adult cigarette smokers, non-Hispanic white smokers, those with lower educational attainment and those with lower household income were less likely to discontinue cigarette use; ENDS use was positively associated with making quit attempts but was not associated with cigarette quitting among attempters; smokeless tobacco use was positively associated with quitting among attempters; tobacco dependence was negatively associated with quitting among attempters. Among youth cigarette smokers, tobacco dependence was negatively associated with making quit attempts. DISCUSSION Demographic correlates of tobacco cessation behaviours underscore tobacco use disparities in the USA. Use of ENDS and use of smokeless tobacco products are positively associated with some adult cigarette cessation behaviours.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Elisabeth A Donaldson
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lynn C Hull
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Izabella Zandberg
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Hoda T Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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14
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Hassett-Walker C, Shadden M. Examining Arrest and Cigarette Smoking in Emerging Adulthood. Tob Use Insights 2020; 13:1179173X20904350. [PMID: 32082049 PMCID: PMC7005980 DOI: 10.1177/1179173x20904350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 11/19/2022] Open
Abstract
Background: Despite prior studies, transitions in smoking patterns are not fully
understood. Getting arrested may alter an individual’s smoking pattern
through processes proscribed by the criminological labeling theory. This
study examined how arrest during emerging adulthood altered smoking behavior
during subsequent years and whether there were differential effects by
race/ethnicity and gender. Methods: We analyzed 15 waves of data from the National Longitudinal Survey of Youth
1997. Multinomial logistic regressions were performed using Stata software
version 14. Results: For both genders, arrested black men and women had the most distinct smoking
transitions (both increases and decreases) as compared with their
non-arrested counterparts. Among men, particularly black males, arrest in
early adulthood was associated with the men transitioning to both increased
and decreased smoking. Patterns in smoking transitions for women were less
clear, suggesting that women’s smoking may be influenced by factors not in
the models. Women had a low probability of starting to smoke or increasing
smoking if they were never arrested between 18 and 21 years of age. Conclusions: The results for transitioning into increased smoking offer some support for
labeling theory processes. Other findings suggest that arrest may lead to
some men reducing or quitting smoking. Early adulthood arrest may serve to
“shock the system” and contribute to males altering their prior smoking
behavior. Implications: Tobacco use over the life course, particularly across different racial and
ethnic groups, remains understudied. This study contributes to the
literature using a nationally representative sample to examine the effect of
getting arrested in emerging adulthood on cigarette use during subsequent
years. In conducting the study, investigators combined theories and
methodological approaches from 2 complementary disciplines: public health
and criminal justice. Because criminal justice policymakers tend to focus on
issues like ex-offender unemployment, public health officials can provide
guidance regarding the effect of justice system involvement on smoking,
particularly given the adverse health outcomes of using cigarettes.
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15
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Zyambo CM, Burkholder GA, Cropsey KL, Willig JH, Wilson CM, Gakumo CA, Westfall AO, Hendricks PS. Mental health disorders and alcohol use are associated with increased likelihood of smoking relapse among people living with HIV attending routine clinical care. BMC Public Health 2019; 19:1409. [PMID: 31664967 PMCID: PMC6819600 DOI: 10.1186/s12889-019-7705-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/30/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND People living with HIV (PLWH) have a high level of interest in quitting smoking, but only a small proportion have sustainable abstinence 6 months after cessation. Few investigations have focused on relapse to smoking among PLWH. In this investigation, we evaluated the prevalence of relapse after smoking cessation and the characteristics associated with smoking relapse using a retrospective, longitudinal cohort of PLWH during an eight-year observation. METHODS All patients aged ≥19 years that reported current smoking during the study period and then reported not smoking on a subsequent tobacco use questionnaire (quitters) were eligible for the study. In addition, patients required at least one subsequent follow-up visit after quitting where smoking status was again reported to allow for assessment of relapse. A Cox proportional hazard model was fit to evaluate factors associated with smoking relapse in PLWH attending routine clinical care. RESULTS Of the 473 patients who quit smoking in the study, 51% relapsed. In multivariable analysis, factors significantly associated with a higher likelihood of relapse were anxiety symptoms (HR = 1.55, 95% CI [1.11, 2.17]) and at-risk alcohol use (HR = 1.74, 95% CI [1.06, 2.85]), whereas antiretroviral therapy (ART) adherence (HR = 0.65, 95% CI [0.49, 0.99]) and longer time in care (HR = 0.94, 95% CI [0.91, 0.98]) were associated with a reduced likelihood of relapse after cessation. CONCLUSION Our study underscores the high prevalence of smoking relapse that exists among PLWH after they quit smoking. Successful engagement in mental health care may enhance efforts to reduce relapse in the underserved populations of PLWH.
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Affiliation(s)
- Cosmas M Zyambo
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, USA.
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
- Department; Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, USA.
- Department of Community and Family medicine, School of Public Health, University of Zambia, Lusaka, Zambia.
| | - Greer A Burkholder
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
| | - Karen L Cropsey
- Department of Psychiatry, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - James H Willig
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Craig M Wilson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
| | - C Ann Gakumo
- Department of Nursing, University of Massachusetts, Boston, MA, USA
| | - Andrew O Westfall
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, USA
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16
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Radaeli A, Nardin M, Azzolina D, Malerba M. Determinants of Smoking Status in a Sample of Outpatients Afferent to a Tertiary Referral Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214136. [PMID: 31717846 PMCID: PMC6862272 DOI: 10.3390/ijerph16214136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/25/2019] [Accepted: 10/26/2019] [Indexed: 11/16/2022]
Abstract
The identification of determinants of attempts to quit smoking and quitting smoking success is crucial for effective smoking prevention and/or cessation programs. Thus, here we have conducted a survey to determine the sociodemographic characteristics of tobacco use and the potential determinants of quitting smoking among a population of 140 subjects—101 smokers and 39 ex-smokers—referred to our clinic for respiratory diseases. Subject characteristics included demographic data, employment and education status, respiratory disease family history, smoking habits, life habits, diet, alcohol intake, and physical activity. In comparison with former smokers, active smokers were younger, lived with at least one smoking family member, and were more frequently exposed to passive smoke. They also displayed a higher coffee consumption, a higher frequency of in-between-meal snacks, and a lower chronic obstructive pulmonary disease (COPD) prevalence. In comparison with subjects who had never attempted to quit smoking, individuals who had attempted to quit smoking were younger, had a lower pack-year median, consumed a higher amount of coffee and alcohol, and conducted regular physical activity. Determinants of successful smoking cessation were older age, lower passive smoking exposure and daily coffee intake, and COPD diagnosis. Overall, our findings underscore the importance of health education in fostering successful smoking cessation in respiratory disease patients.
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Affiliation(s)
- Alessandro Radaeli
- ASST Spedali Civili di Brescia, Department of Emergency, University, 25123 Brescia, Italy;
| | - Matteo Nardin
- ASST Spedali Civili di Brescia, Department of Internal Medicine, 25123 Brescia, Italy;
| | - Danila Azzolina
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Mario Malerba
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
- Correspondence:
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17
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Parizadeh D, Moazzeni SS, Hasheminia M, Khaloo P, Mansournia MA, Azizi F, Momenan AA, Hadaegh F. Sex-specific initiation rates of tobacco smoking and its determinants among adults from a Middle Eastern population: a cohort study. Int J Public Health 2019; 64:1345-1354. [PMID: 31620810 DOI: 10.1007/s00038-019-01307-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 09/07/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To assess the initiation rate and determinants of tobacco smoking among adults. METHODS In the Tehran Lipid and Glucose Study, a population-based cohort from Iran, 6101 participants ≥ 18 years old who had never smoked tobacco at baseline (phase II: 2002-2006) were followed until phase VI (2015-2018). Sex-specific initiation rates per 1000 person-years for self-reported tobacco smoking and hazard ratios (HR) for its potential determinants (using Cox proportional hazards models) were calculated. RESULTS The age- and sex-adjusted smoking initiation rate was 13.77 [95% confidence interval (CI) 12.59-14.94] per 1000 person-years, of which 78% was attributed to water pipe use. Initiation rate was remarkably higher among men [19.1 (16.9-21.2)] than women [8.3 (7.4-9.2)] and declined in older age-groups. Among both genders, being married was protective [men: HR 0.67 (CI 95% 0.48-0.92); women: 0.58 (0.45-0.74)], while intermediate-level education (compared with high level) [men: 1.61 (1.14-2.26); women: 1.33 (0.95-1.84, p value = 0.092)] and passive smoking [men: 1.76 (1.36-2.28); women: 1.82 (1.42-2.33)] increased the risk. Educational intervention decreased the risk among women [0.74 (0.58-0.94)]. CONCLUSIONS The majority of adult smoking initiators started smoking with water pipe. The initiation rate was remarkably higher in men and younger age-groups. Passive smoking, being single and lower education were risk factors. Educational intervention was protective among women.
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Affiliation(s)
- Donna Parizadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Seyyed Saeed Moazzeni
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Mitra Hasheminia
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Pegah Khaloo
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.,Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Abbas Momenan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
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Abstract
INTRODUCTION Smoking tobacco is a risk factor for impaired wound healing, infection, delayed fracture healing, and prolonged hospital stay. Smoking cessation before surgery has shown a 40% relative risk reduction in total perioperative complications. The primary purpose of this study was to evaluate the effectiveness of preoperative smoking cessation on long-term smoking habits in patients undergoing elective lower extremity orthopaedic surgery. The secondary outcome is patient-reported effectiveness of the smoking cessation method. METHODS A retrospective cohort study was performed by identifying all patients who were smokers that were required to quit and subsequently had a normal nicotine/cotinine serum test before lower extremity orthopaedic surgery. Attempts were made to contact all patients and administer a survey inquiring about their demographics, medical history, smoking history, smoking cessation process, and the current smoking status. RESULTS Of 36 eligible patients, 23 completed the survey. Eleven patients identified as current nonsmokers (48%) at the time of survey follow-up (mean follow-up was 55 months with a range of 12 to 88 months). Of these 11, 82% said they were very likely to continue to refrain from smoking. Twelve patients identified as current smokers at the time of survey, and more than half of them stopped smoking for at least three months perioperatively. The most effective smoking cessation techniques reported were "cold turkey," "nonnicotine medication," and "transdermal nicotine patches." DISCUSSION Elective surgery offers a unique opportunity for smoking cessation. Of 23 patients required to quit smoking before surgery, 48% maintained smoking cessation for at least one year postoperatively. Of the 12 patients who relapsed, 55% stated that they did not resume smoking until at least 3 months postoperatively, suggesting that this particular period may be an important time for intensified smoking cessation counseling. LEVEL OF EVIDENCE Therapeutic level III.
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19
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Hilley C, Lindstrom Johnson S, Royce S, M'Cormack McGough F. Understanding factors related to nonsmoking intention among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:523-530. [PMID: 30285562 DOI: 10.1080/07448481.2018.1498345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 05/10/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
Objective: While cigarette smoking in the United States has declined, the age range of smoking initiation has risen to include young adults. This study investigated the relationship of Theory of Planned Behavior constructs (TPB; attitudes, subjective norms, and perceived behavioral control [PBC]) to nonsmoking intention among college students. Participants: Participants were 619 students at a Southeastern US university (69.8% female, 70.8% ≤ age 21, and 73.5% white). Methods: Students were recruited by email in March 2013 to participate in an online TPB-based questionnaire. Results: Future-oriented attitudes and PBC predicted higher nonsmoking intention; subjective norms did not. Moderator analyses indicated injunctive norms were more influential for occasional smokers and PBC was less influential. Conclusions: Findings suggest TPB is useful in predicting nonsmoking intention, but differentially for nonsmokers and occasional smokers. Future work should consider the health-related utility of future-oriented attitudes toward nonhealth domains and the differing beliefs of occasional smokers.
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Affiliation(s)
| | | | - Sherer Royce
- b Coastal Carolina University , Conway , South Carolina , USA
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20
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Weinberger AH, Seng EK, Shuter J. Racial/ethnic differences in perceived risks and benefits of quitting smoking in a sample of African American and Hispanic adults living with HIV/AIDS: A preliminary study. J Ethn Subst Abuse 2019; 20:171-186. [PMID: 31010385 DOI: 10.1080/15332640.2019.1598906] [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: 10/27/2022]
Abstract
Persons living with HIV/AIDS (PLWH) report very high prevalences of cigarette smoking, and there are racial/ethnic disparities in smoking consequences and quit outcomes. In this exploratory pilot study, we examined racial/ethnic differences in perceived risks and benefits of quitting cigarette smoking among 97 adult PLWH in the Bronx, New York (Hispanic, 53.6%; African American, 46.4%). Compared to African American PLWH, Hispanic PLWH reported greater endorsement of overall risks and benefits and risks of negative affect, difficulty concentrating, social ostracism, loss of enjoyment, and cravings. It may be useful to incorporate risks and benefits of quitting into smoking treatment for African American and Hispanic PLWH.
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Affiliation(s)
- Andrea H Weinberger
- Yeshiva University, Bronx, New York.,Albert Einstein College of Medicine, Bronx, New York
| | - Elizabeth K Seng
- Yeshiva University, Bronx, New York.,Albert Einstein College of Medicine, Bronx, New York
| | - Jonathan Shuter
- Yeshiva University, Bronx, New York.,Montefiore Medical Center, Bronx, New York
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21
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Thomas DP, Lyons L, Borland R. Predictors and reasons for starting and sustaining quit attempts in a national cohort of Aboriginal and Torres Strait Islander smokers. Drug Alcohol Rev 2019; 38:244-253. [DOI: 10.1111/dar.12917] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 01/11/2023]
Affiliation(s)
- David P. Thomas
- Tobacco Control Research, Menzies School of Health ResearchCharles Darwin University Darwin Australia
| | - Louise Lyons
- Public Health and ResearchVictorian Aboriginal Community Controlled Health Organisation Melbourne Australia
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22
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Esan H, Agress J, Seng EK, Shuter J, Weinberger AH. Characteristics associated with perceived interrelations of pain and smoking among people living with HIV. AIDS Care 2019; 31:1348-1352. [PMID: 30843727 DOI: 10.1080/09540121.2019.1587355] [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: 10/27/2022]
Abstract
Persons living with HIV/AIDS (PLWH) have very high prevalences of both cigaret smoking and pain, yet little is known about the relationship between smoking and pain for PLWH. The current study examines the perceived interrelations between pain and smoking and participant characteristics (i.e., demographics, heavier versus lighter smoking, current pain severity, depression, anxiety symptoms) in a sample of 101 current cigaret smoking adult PLWH in the Bronx, New York. Participants completed assessments of demographics, smoking behaviors, psychiatric symptoms, and pain severity. Interrelations of pain and smoking were measured using the 9-item Pain and Smoking Inventory (PSI) total score and three domain scores (pain as a motivator for smoking, smoking to cope with pain, and pain as a barrier for smoking cessation). Significant associations were found between greater current pain severity and greater endorsement of overall perceived interrelations between pain and smoking, pain as a motivator for smoking, and smoking to cope with pain. Greater anxiety symptoms were significantly associated with greater endorsement of overall perceived interrelations between pain and smoking, pain as a motivator for smoking, and smoking to cope with pain. Understanding the perceived relations between smoking and pain, as well as associated factors such as anxiety and pain severity, may help to guide interventions for PLWH who smoke in order to reduce the high prevalence of smoking and significant smoking-related health consequences.
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Affiliation(s)
- Hannah Esan
- Ferkauf Graduate School of Psychology, Yeshiva University , Bronx , NY , USA
| | - Josh Agress
- Rowan School of Osteopathic Medicine, Rowan University , Stratford , NJ , USA
| | - Elizabeth K Seng
- Ferkauf Graduate School of Psychology, Yeshiva University , Bronx , NY , USA.,The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine , Bronx , NY , USA.,Montefiore Headache Center, Montefiore Medical Center , Bronx , NY , USA
| | - Jonathan Shuter
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx , NY , USA.,AIDS Center and Division of Infectious Diseases, Montefiore Medical Center and the Albert Einstein College of Medicine , Bronx , NY , USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University , Bronx , NY , USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine , Bronx , NY , USA
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23
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Dobson KG, Gilbert-Ouimet M, Mustard CA, Smith PM. Association between dimensions of the psychosocial and physical work environment and latent smoking trajectories: a 16-year cohort study of the Canadian workforce. Occup Environ Med 2018; 75:814-821. [PMID: 30269102 DOI: 10.1136/oemed-2018-105138] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/15/2018] [Accepted: 08/30/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND This study aimed to determine the number of latent smoking trajectories among Canadians employed in the workforce over a 16-year period, and if latent trajectories in dimensions of the physical and psychosocial work environment were associated with specific smoking trajectories. METHODS We studied 5461 employed adults from the longitudinal Canadian National Population Health Survey. Daily cigarette consumption was measured biannually from 1994 to 2010. Work environment factors (skill discretion, decision authority, psychological demands, job insecurity, physical exertion and workplace social support) were measured in 1994 and then from 2000 to 2010 using an abbreviated form of the Job Content Questionnaire. Smoking and work environment trajectories were derived using group-based trajectory modelling. Associations between work environment trajectory classes and smoking trajectory classes were estimated using multinomial logistic regression. RESULTS Four latent smoking trajectories were seen: non-smokers; ceasing smokers (consuming ~14 cigarettes/day in 1994 and 0 in 2008-2010); smokers (consuming ~7 cigarettes/day between 1994 and 2010); and heavy smokers (consuming ~22 cigarettes/day in 1994 and ~14 in 2010). Lower skill discretion, high psychological demands, high physical exertion and low social support trajectories were associated with membership in the heavy smoking trajectory compared with the non-smoking trajectory. Low decision authority, high psychological demands and high physical exertion trajectories were associated with membership in the ceasing compared with the non-smoking trajectory. CONCLUSIONS Certain physical and psychosocial work environment trajectories were associated with heavy and ceasing smoking behaviours over a 16-year period. The role of the work environment should be further considered in smoking cessation programmes.
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Affiliation(s)
- Kathleen G Dobson
- Institute for Work & Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mahée Gilbert-Ouimet
- Institute for Work & Health, Toronto, Ontario, Canada.,Centre de Recherche du CHU de Québec, Quebec, Canada
| | - Cameron A Mustard
- Institute for Work & Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peter M Smith
- Institute for Work & Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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24
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Poghosyan H, Moen EL, Kim D, Manjourides J, Cooley ME. Social and Structural Determinants of Smoking Status and Quit Attempts Among Adults Living in 12 US States, 2015. Am J Health Promot 2018; 33:498-506. [PMID: 30071738 DOI: 10.1177/0890117118792827] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study examined the relationships among intermediary determinants, structural determinants, and adult smoking status and quit attempts. DESIGN Secondary data analysis of cross-sectional data. SETTING Data come from the 2015 Behavioral Risk Factor Surveillance System (BRFSS), Social Context module. A national, representative sample from 12 US states (Alabama, Arkansas, Delaware, District of Columbia, Georgia, Louisiana, Minnesota, Mississippi, Missouri, Rhode Island, Tennessee, and Utah). PARTICIPANTS A total of 64 053 noninstitutionalized US adults aged ≥18 years. MEASURES Smoking status and quit attempts were outcome variables. Individual-level structural determinants (age, sex, race/ethnicity, marital status, education, and employment status) and intermediary determinants (housing insecurity, food insecurity, health insurance, binge drinking, and general health mental health) from BRFSS. ANALYSIS Weighted multivariate, multinomial logistic regression. RESULTS Current smoking was greater among men, respondents aged between 35 to 64 and 55 to 64, adults who reported food insecurity, housing insecurity, frequent mental distress, binge drinking, and who were unemployed. Current smokers had higher odds of making quit attempts in the past 12 months if they were non-Hispanic Black, graduated college, and reported food and housing insecurity. CONCLUSION Multifaceted smoking cessation interventions that address food and housing needs also incorporate screening for potential comorbidities such as mental distress and/or hazardous alcohol use and may be needed to enhance smoking cessation rates among racially diverse adults.
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Affiliation(s)
- Hermine Poghosyan
- 1 Northeastern University, Bouve College of Health Sciences, Boston, MA, USA
| | - Erika L Moen
- 2 The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth Colleague, Lebanon, NH, USA
| | - Daniel Kim
- 3 Department of Health Sciences, Northeastern University, Bouve College of Health Sciences, Boston, MA, USA
| | - Justin Manjourides
- 3 Department of Health Sciences, Northeastern University, Bouve College of Health Sciences, Boston, MA, USA
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25
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Staerk L, Wang B, Preis SR, Larson MG, Lubitz SA, Ellinor PT, McManus DD, Ko D, Weng LC, Lunetta KL, Frost L, Benjamin EJ, Trinquart L. Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study. BMJ 2018; 361:k1453. [PMID: 29699974 PMCID: PMC5917175 DOI: 10.1136/bmj.k1453] [Citation(s) in RCA: 208] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the association between risk factor burdens-categorized as optimal, borderline, or elevated-and the lifetime risk of atrial fibrillation. DESIGN Community based cohort study. SETTING Longitudinal data from the Framingham Heart Study. PARTICIPANTS Individuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk factor) at index age. MAIN OUTCOME MEASURE Lifetime risk of atrial fibrillation at index age up to 95 years, accounting for the competing risk of death. RESULTS At index age 55 years, the study sample comprised 5338 participants (2531 (47.4%) men). In this group, 247 (4.6%) had an optimal risk profile, 1415 (26.5%) had a borderline risk profile, and 3676 (68.9%) an elevated risk profile. The prevalence of elevated risk factors increased gradually when the index ages rose. For index age of 55 years, the lifetime risk of atrial fibrillation was 37.0% (95% confidence interval 34.3% to 39.6%). The lifetime risk of atrial fibrillation was 23.4% (12.8% to 34.5%) with an optimal risk profile, 33.4% (27.9% to 38.9%) with a borderline risk profile, and 38.4% (35.5% to 41.4%) with an elevated risk profile. Overall, participants with at least one elevated risk factor were associated with at least 37.8% lifetime risk of atrial fibrillation. The gradient in lifetime risk across risk factor burden was similar at index ages 65 and 75 years. CONCLUSIONS Regardless of index ages at 55, 65, or 75 years, an optimal risk factor profile was associated with a lifetime risk of atrial fibrillation of about one in five; this risk rose to more than one in three a third in individuals with at least one elevated risk factor.
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Affiliation(s)
- Laila Staerk
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, USA
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark
| | - Biqi Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Sarah R Preis
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Martin G Larson
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Steven A Lubitz
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, USA
| | - Patrick T Ellinor
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, USA
| | - David D McManus
- Cardiology Division, Department of Medicine, University of Massachusetts Medical School, Worcester, USA
| | - Darae Ko
- Sections of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, USA
| | - Lu-Chen Weng
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, USA
| | - Kathryn L Lunetta
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Lars Frost
- Silkeborg Hospital, Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Emelia J Benjamin
- National Heart, Lung, and Blood Institute's and Boston University's Framingham Heart Study, Framingham, USA
- Sections of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Ludovic Trinquart
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
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26
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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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