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Mantey DS, Case KR, Omega-Njemnobi O, Springer AE, Kelder SH. Use frequency and symptoms of nicotine dependence among adolescent E-cigarette users: Comparison of JUUL and Non-JUUL users. Drug Alcohol Depend 2021; 228:109078. [PMID: 34614433 PMCID: PMC8595823 DOI: 10.1016/j.drugalcdep.2021.109078] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Nicotine exposure among adolescent e-cigarette users remains a public health concern. JUUL, a popular e-cigarette brand among youth, is particularly alarming given the high nicotine delivery (59 mg/mL). This study compares e-cigarette use frequency and symptoms of nicotine dependence among adolescent JUUL and non-JUUL users. METHODS We analyzed data from the 2020 National Youth Tobacco Survey. Participants were n = 1713 U.S. middle and high school students who reported past 30-day e-cigarette use. We compared adolescent e-cigarette users who reported JUUL use to those who did not. Outcomes were: (1) symptoms of nicotine dependence (i.e. nicotine cravings; use within 30 min of waking); (2) past 30-day e-cigarette use frequency, categorized as 1-5 days, 6-19 days, and 20-30 days. Covariates were sex, race/ethnicity, other tobacco product use, primary e-cigarette device type (i.e., disposable; pod; mod/tank). RESULTS Overall, 49.5% of adolescent e-cigarette users reported using JUUL in the past 30 days, 40.1% reported symptoms of nicotine dependence, and 36.2% reported using an e-cigarette on 20-30 days. JUUL users were 1.77 (95% CI: 1.36-2.31) times as likely to report symptoms of nicotine dependence and 1.43 (95% CI: 1.02-2.01) time as likely to report using e-cigarettes on 20-30 days, compared to 1-5 days, relative to non-JUUL users, controlling for covariates. CONCLUSION JUUL use was associated with greater odds of nicotine dependence and more frequent e-cigarette use among adolescents. Greater prevention and regulatory efforts should be made to prevent adolescent use of high dose nicotine devices such as JUUL.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Kathleen R Case
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1050, San Antonio, TX 78229, United States.
| | - Onyinye Omega-Njemnobi
- Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Austin, TX, United States.
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
| | - Steven H Kelder
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States.
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Mantey DS, Chido-Amajuoyi OG, Omega-Njemnobi O, Montgomery L. Cigarette smoking frequency, quantity, dependence, and quit intentions during adolescence: Comparison of menthol and non-menthol smokers (National Youth Tobacco Survey 2017-2020). Addict Behav 2021; 121:106986. [PMID: 34087763 PMCID: PMC8244158 DOI: 10.1016/j.addbeh.2021.106986] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/15/2021] [Accepted: 05/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Use of menthol cigarettes is linked to sustained cigarette smoking adults. However, the relationship between menthol and smoking profile has not been thoroughly explored in adolescent cigarette smokers. This study examines the relationship between use of menthol cigarette and smoking frequency (i.e., days per month), quantity (i.e., cigarettes per day), quit intentions, and nicotine dependence (i.e., craving tobacco; use within 30 min of waking). METHODS We pooled four years (2017-2020) of cross-sectional data from the National Youth Tobacco Survey. Participants were 2699 adolescent, past 30-day cigarette smokers. Multinomial logistic regression models examined the relationship between menthol and cigarette smoking frequency and quantity. Logistic regressions examined the relationship between menthol and intentions to quit smoking and nicotine dependence. Models controlled for socio-demographics and other tobacco use. RESULTS Menthol cigarette smokers had greater risk of smoking 20-30 days per month relative to 1-5 days per month (RRR: 1.90; 95% CI: 1.41 - 2.54) and greater risk of smoking 11+ cigarettes per day relative to 1 or less cigarettes per day (RRR: 1.35; 95% CI: 1.01 - 1.80), adjusting for covariates. Menthol cigarette smokers had lower odds of intentions to quit smoking (Adj OR: 0.70; 95% CI: 0.58 - 0.84) but great odds of craving tobacco (OR: 1.47; 95% CI: 1.20 - 1.81) and using tobacco within 30 minutes of waking (OR: 1.63; 95% CI: 1.29 - 2.05), adjusting for covariates CONCLUSION: Findings suggest the relationship between menthol and cigarette smoking profile (i.e., frequency, quantity, quit intentions) is different for youth than that of adults. This study adds adolescent-specific evidence to existing research that suggests menthol reinforces sustained cigarette smoking among youth.
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Affiliation(s)
- Dale S Mantey
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, United States.
| | - Onyema Greg Chido-Amajuoyi
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, United States
| | - Onyinye Omega-Njemnobi
- Department of Health Promotion and Behavioral Science, University of Texas School of Public Health, United States
| | - LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, United States
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Hoeppner BB, Hoeppner SS, Carlon HA, Abry A, Darville A, Rohsenow DJ. Preparing for the Quit Day: Comparing Beliefs of Nondaily Versus Daily Young Adult Smokers as They Prepare for a Quit Attempt. Nicotine Tob Res 2021; 23:1038-1046. [PMID: 32882037 DOI: 10.1093/ntr/ntaa166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 09/01/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Most smoking cessation approaches are modeled on heavy daily smoking. With increasing prevalence of nondaily smoking, it may be necessary to modify these approaches for nondaily smokers. AIMS To provide information about beliefs and attitudes relevant to smoking cessation for nondaily smokers. METHODS Secondary analysis of two prospective studies on young adult smokers (18-24 years of age) provided brief advice to quit smoking. Measures include baseline levels of constructs relevant to smoking cessation counseling and perceived benefits of and barriers to smoking cessation. RESULTS Participants (n = 40 nondaily, 122 daily smokers) were predominantly White (70% and 84%, respectively), gender-balanced (50% and 43% female), full-time college students (89% and 95%). At baseline, nondaily smokers reported lower levels of nicotine dependence (p < .001; nondaily: Fagerström Test for Nicotine Dependence (FTND) = 0.8 ± 1.5, daily: FTND = 3.1 ± 1.9), lower urge to smoke (p < .001), greater self-efficacy when facing external smoking stimuli (p = .03), expecting to experience fewer positive effects (reduced negative affect, p = <.001, stimulation, p = .02), and valuing the importance of smoking effects less (ps < .01) than daily smokers. During counseling, nondaily smokers generated both fewer benefits of cessation (Wald X2(df = 1) = 4.91, p = .027) and fewer barriers (Wald X2(df = 1) = 5.99, p =.014) than daily smokers. Withdrawal was not listed by nondaily smokers as a barrier (p < .01). CONCLUSIONS Constructs relevant to smoking cessation for daily smokers were less salient to young nondaily smokers, compared with moderately addicted young daily smokers, as indicated by responses to standardized scales and by the generation of fewer benefits and barriers in counseling. Interventions may need to find novel ways to engage nondaily smokers, particularly young adult, in smoking cessation efforts. IMPLICATIONS This study is unique in eliciting benefits and barriers from nondaily smokers as they are about to make a quit attempt. This is a critically important point in time, as this is the point in time in which an action plan is formed and can be informed and enhanced by smoking cessation support. Our study further allowed direct comparison to daily smokers undergoing the same procedures, which allowed the identification of unique factors that may impact nondaily smokers in their quit attempt, which may guide intervention efforts. Use of a mixed method design further strengthen the rigor of this study.
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Affiliation(s)
- Bettina B Hoeppner
- Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Susanne S Hoeppner
- Department of Psychiatry, Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, MA
| | - Hannah A Carlon
- Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Alexandra Abry
- Department of Psychiatry, Recovery Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Damaris J Rohsenow
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
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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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Wang Y, Sung HY, Yao T, Lightwood J, Max W. Infrequent and Frequent Nondaily Smokers and Daily Smokers: Their Characteristics and Other Tobacco Use Patterns. Nicotine Tob Res 2019; 20:741-748. [PMID: 28186549 DOI: 10.1093/ntr/ntx038] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 02/01/2017] [Indexed: 11/13/2022]
Abstract
Introduction The proportion of smokers who do not smoke daily has increased over time, but nondaily smokers are a heterogeneous group. We compare characteristics and other tobacco product use of infrequent nondaily, frequent nondaily, and daily US adult smokers. Methods We analyzed data from the 1998, 2000, 2005, and 2010 National Health Interview Surveys. Current smokers were categorized as daily, infrequent nondaily (smoked 1-12 days in the past 30 days), and frequent nondaily (smoked 13-29 days in the past 30 days) smokers. Multinomial logistic regression analysis was used to analyze the correlates of infrequent nondaily, frequent nondaily, and daily smoking. Results Among current smokers, 8.3% were infrequent nondaily, 8.1% were frequent nondaily, and 83.6% were daily smokers. The prevalence of infrequent versus daily smoking increased over time, with a smaller increase among non-Hispanic Blacks than non-Hispanic Whites. The adjusted odds of both infrequent and frequent smoking versus daily smoking differed by age, race/ethnicity, education, poverty status, marital status, region, quit attempts in the past 12 months, and binge drinking. Snuff users (vs. non-snuff users) were 2.4 times as likely to be infrequent than daily smokers. There were also differences in race/ethnicity, education, marital status, region, quit attempts, and snuff use between infrequent versus frequent smokers. Conclusion Infrequent smokers differ from both frequent and daily smokers in socio-demographics, quit attempts, and snuff use. The heterogeneity of nondaily smokers should be considered in developing targeted tobacco control and smoking cessation programs. Implications Infrequent and frequent nondaily smokers were found to differ from daily smokers in age, race/ethnicity, education, poverty status, marital status, region, and quit attempts and they were different from each other in race/ethnicity, education, marital status, region, and quit attempts. Binge drinkers were more likely to be infrequent smokers and frequent smokers versus daily smokers. Current snuff users were found to have increased odds of infrequent smoking versus daily smoking and versus frequent smoking. These results highlight the importance of acknowledging the differences among nondaily smokers in smoking frequency in developing targeted tobacco control and smoking cessation programs.
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Affiliation(s)
- Yingning Wang
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Hai-Yen Sung
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - James Lightwood
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
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Hoeppner BB, Hoeppner SS, Schick MR, Milligan CM, Helmuth E, Bergman BG, Abroms LC, Kelly JF. Using the text-messaging program SmokefreeTXT to support smoking cessation for nondaily smokers. Subst Use Misuse 2019; 54:1260-1271. [PMID: 30999794 DOI: 10.1080/10826084.2018.1552300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Smoking cessation interventions for nondaily smokers are needed. The current study explores the fit of the text-messaging intervention SmokefreeTXT for nondaily smokers. METHODS Adult nondaily smokers (N = 32; mean age = 35 ± 12, 64% female, 53% non-Hispanic White) were enrolled in SmokefreeTXT. SmokefreeTXT usage data were recorded passively, theorized mechanisms of change were assessed at baseline and 2, 6, and 12 weeks after the chosen quit day, and EMA protocols captured real-time cigarette reports at baseline, and during the first two weeks after the quit day. RESULTS Most participants completed the SmokefreeTXT program and responded to system-initiated inquiries, but just-in-time interaction with the program was limited. In retrospective recall at treatment end, content of the text-messages was rated as "neutral" to "helpful." Within-person change was observed in theorized mechanisms, with less craving (p < 0.01), increased abstinence self-efficacy (external: p < 0.01; internal: p < 0.01), and poorer perceptions of pros of smoking (psychoactive benefits: p < 0.01, pleasure p < 0.01; and pros: p < 0.01) reported after SmokefreeTXT initiation compared to baseline. Exploratory analyses of real-time reports of smoking (225 cigarette reports in N = 17 who relapsed) indicated that cigarettes smoked in the first two weeks after quitting were more likely to occur to reduce craving (OR = 2.21[1.21-3.72]), and less likely to occur to socialize (OR = 0.06[0.01-0.24]), between 19:00 and 23:00 (OR = 0.34[0.17-0.66]), and on Saturdays (OR = 0.59[0.35-0.99]) than prior to quitting. CONCLUSIONS While well accepted by nondaily smokers, SmokefreeTXT could potentially be improved by targeting cons of smoking, enhancing engagement with the just-in-time component of SmokefreeTXT, and tweaking the timing of text-messages.
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Affiliation(s)
- Bettina B Hoeppner
- a Recovery Research Institute, Massachusetts General Hospital , Harvard Medical School , Boston , Massachusetts, USA.,b Department of Psychiatry , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts, USA
| | - Susanne S Hoeppner
- b Department of Psychiatry , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts, USA.,c Massachusetts General Hospital , Center for Anxiety and Traumatic Stress Disorders , Boston , Massachusetts, USA
| | - Melissa R Schick
- a Recovery Research Institute, Massachusetts General Hospital , Harvard Medical School , Boston , Massachusetts, USA
| | - Connor M Milligan
- a Recovery Research Institute, Massachusetts General Hospital , Harvard Medical School , Boston , Massachusetts, USA
| | - Eric Helmuth
- d Boston University School of Public Health , Boston , Massachusetts, USA
| | - Brandon G Bergman
- a Recovery Research Institute, Massachusetts General Hospital , Harvard Medical School , Boston , Massachusetts, USA
| | - Lorien C Abroms
- e Department of Prevention and Community Health, Milken Institute School of Public Health , George Washington University , Washington , DC , USA
| | - John F Kelly
- a Recovery Research Institute, Massachusetts General Hospital , Harvard Medical School , Boston , Massachusetts, USA.,b Department of Psychiatry , Massachusetts General Hospital, Harvard Medical School , Boston , Massachusetts, USA
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Swayampakala K, Thrasher JF, Hardin JW, Titus AR, Liu J, Fong GT, Fleischer NL. Factors associated with changing cigarette consumption patterns among low-intensity smokers: Longitudinal findings across four waves (2008-2012) of ITC Mexico Survey. Addict Behav Rep 2018; 8:154-163. [PMID: 30364679 PMCID: PMC6197769 DOI: 10.1016/j.abrep.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background Light and intermittent smoking has become increasingly prevalent as smokers shift to lower consumption in response to tobacco control policies. We examined changes in cigarette consumption patterns over a four-year period and determined which factors were associated with smoking transitions. Methods We used data from a cohort of smokers from the 2008–2012 ITC Mexico Survey administrations to investigate transitions from non-daily (ND; n = 669), daily light (DL; ≤5 cigarettes per day (cpd); n = 643), and daily heavy (DH; >5 cpd; n = 761) smoking patterns. To identify which factors (i.e., sociodemographic measures, perceived addiction, quit behavior, social norms) were associated with smoking transitions, we stratified on smoking status at time t (ND, DL, DH) and used multinomial (ND, DL) and binomial (DH) logistic regression to examine transitions (quitting/reducing or increasing versus same level for ND and DL, quitting/reducing versus same level for DH). Results ND smokers were more likely to quit at follow-up than DL or DH smokers. DH smokers who reduced their consumption to ND were more likely to quit eventually compared to those who continued as DH. Smokers who perceived themselves as addicted had lower odds of quitting/reducing smoking consumption at follow-up compared to smokers who did not, regardless of smoking status at the prior survey. Quit attempts and quit intentions were also associated with quitting/reducing consumption. Conclusions Reducing consumption may eventually lead to cessation, even for heavier smokers. The findings that perceived addiction and quit behavior were important predictors of changing consumption for all groups may offer insights into potential interventions. Smoking transitions were evaluated in a cohort of Mexican smokers. The cohort consisted mostly of understudied light and intermittent smokers (LITS). Reductions in smoking intensity were found to facilitate smoking cessation. Greater perceived addiction inhibited cessation for smokers at all levels of intensity. LITS patterns warrant attention as number of low-intensity smokers worldwide grows.
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Affiliation(s)
- Kamala Swayampakala
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Andrea R. Titus
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Nancy L. Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Corresponding author at: Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Smiling Instead of Smoking: Development of a Positive Psychology Smoking Cessation Smartphone App for Non-daily Smokers. Int J Behav Med 2018; 24:683-693. [PMID: 28197846 DOI: 10.1007/s12529-017-9640-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The usefulness of mobile technology in supporting smoking cessation has been demonstrated, but little is known about how smartphone apps could best be leveraged. The purpose of this paper is to describe the program of research that led to the creation of a smoking cessation app for non-daily smokers, so as to stimulate further ideas to create "smart" smartphone apps to support health behavior change. METHOD Literature reviews to evaluate the appropriateness of the proposed app, content analyses of existing apps, and smoking cessation sessions with non-daily smokers (n = 38) to inform the design of the app. RESULTS The literature reviews showed that (1) smoking cessation apps are sought after by smokers, (2) positive affect plays an important role in smoking cessation, (3) short, self-administered exercises consistently bring about enduring positive affect enhancements, and (4) low treatment-seeking rates of non-daily smokers despite high motivation to quit indicate a need for novel smoking cessation support. Directed content analyses of existing apps indicated that tailoring, two-way interactions, and proactive features are under-utilized in existing apps, despite the popularity of such features. Conventional content analyses of audio-recorded session tapes suggested that difficulty in quitting was generally linked to specific, readily identifiable occasions, and that social support was considered important but not consistently sought out. CONCLUSION The "Smiling Instead of Smoking" (SIS) app is an Android app that is designed to act as a behavioral, in-the-pocket coach to enhance quitting success in non-daily smokers. It provides proactive, tailored behavioral coaching, interactive tools (e.g., enlisting social support), daily positive psychology exercises, and smoking self-monitoring.
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Mohamadian F, Baghri M, Delpisheh A, Veisani Y. Interventional study plan to investigate the training effects on physical and psychological outcomes awareness of smoking in teenagers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:99. [PMID: 29296600 PMCID: PMC5747224 DOI: 10.4103/jehp.jehp_160_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Studies have found that nearly 90% of the first use of tobacco takes place before high school graduation (teenagers) and training discussion due to prevention can be useful, therefore, here, we aimed to determine the effects of training on awareness of cigarette outcomes (physical and psychological) in male teenagers. MATERIALS AND METHODS We conducted an interventional study using Solomon's four-group plan, which used a two-stage cluster sampling in four groups (two experimental groups and two control groups). The three sessions of at least 2 h of education intervention including visual displaying using photo, film, and short scientific texts were held for the interventional group. After 1 month, all four groups took posttest, and research groups were followed up after 8 months of intervention. All data were analyzed using one-way analysis of variance and covariance in SPSS. RESULTS According to the results, the mean of posttest scores had increased rather than pretest scores, and generally, a significant difference was observed (P ≤ 0.001). These results were significant in the aspect of both physical and psychological outcomes awareness. The difference between the mean of scores in follow-up period and posttest was not statistically significant, and it shows training retention after 8 months (P < 0.666). CONCLUSIONS It can be concluded that through the training, it is possible to increase the awareness of teenagers about physical and psychological outcomes of cigarette smoking that this can have an important role in smoking prevention.
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Affiliation(s)
- Fathola Mohamadian
- Department of Psychology, Ilam University of Medical Sciences, Ilam, Iran
| | - Maryam Baghri
- Department of Physiology Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Delpisheh
- Department of Clinical Epidemiology, Ilam University of Medical Sciences, Ilam, Iran
| | - Yousef Veisani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
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Wang Y, Sung HY, Yao T, Lightwood J, Max W. Factors associated with short-term transitions of non-daily smokers: socio-demographic characteristics and other tobacco product use. Addiction 2017; 112:864-872. [PMID: 27886652 PMCID: PMC5382088 DOI: 10.1111/add.13700] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/29/2016] [Accepted: 11/21/2016] [Indexed: 12/01/2022]
Abstract
AIMS To examine the transitions in smoking status among non-daily smokers who transitioned to daily or former smokers or remained as non-daily smokers during a 12-month period. We analyzed factors associated with these transitions, including the use of cigars and smokeless tobacco (SLT). DESIGN Secondary data analyses using pooled data from the 2003, 2006/07 and 2010/11 Tobacco Use Supplements to the Current Population Survey (TUS-CPS). SETTING United States. PARTICIPANTS Self-respondents aged 18+ who have smoked for more than 5 years and were non-daily smokers 12 months before the interview (n = 13 673, or 14.5% of current smokers). MEASUREMENTS Multinomial logistic regression model to determine the correlates of non-daily to daily, stable non-daily and non-daily to former smoking transitions among non-daily smokers at baseline. The model controlled for socio-demographic factors and the use of cigars and SLT. FINDINGS Of the adults in our sample, 2.6% were non-daily smokers at baseline. Among these, 69.7% remained non-daily smokers (stable non-daily smokers), 18.4% became daily smokers (non-daily to daily smokers) and 11.9% quit smoking (non-daily to former smokers) after 12 months. The non-daily to daily versus stable non-daily smoking transition was less likely among those who were aged 65+ (P = 0.018), male (P < 0.001), Hispanic (P < 0.001), with an income of $25 000-49 999 or ≥$75 000 and current users of SLT (P = 0.003), but more likely among those without a college degree compared with the appropriate reference group. The non-daily to former versus stable non-daily smoking transition was less likely among those aged 25+, male (P = 0.013), non-Hispanic Asian (P = 0.032), without a college degree, widowed/divorced/separated (P = 0.013) or never married (P = 0.011) and current users of cigars (P = 0.003) compared with the appropriate reference group. CONCLUSIONS While more than two-thirds of non-daily smokers in the United States remain as such after 12 months, others become daily smokers or quit. The likelihood of remaining stable non-daily smokers and of transition from non-daily to daily and non-daily to former smokers is associated with socio-demographic factors and current use of cigars and smokeless tobacco.
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Affiliation(s)
- Yingning Wang
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - Hai-Yen Sung
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - Tingting Yao
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
| | - James Lightwood
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA
| | - Wendy Max
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, CA
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11
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Lindström M. Commentary on Wang et al. (2017): Differing patterns of short-term transitions of nondaily smokers for different indicators of socioeconomic status (SES). Addiction 2017; 112:873-874. [PMID: 28378330 DOI: 10.1111/add.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, S-205 02, Malmö, Sweden
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12
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Reyes-Guzman CM, Pfeiffer RM, Lubin J, Freedman ND, Cleary SD, Levine PH, Caporaso NE. Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys. Cancer Epidemiol Biomarkers Prev 2017; 26:228-239. [PMID: 27760782 PMCID: PMC5296280 DOI: 10.1158/1055-9965.epi-16-0028] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Light and/or intermittent smokers have been the fastest growing segment of cigarette smokers in the United States over the past two decades. Defining their behavioral characteristics is a critical public health priority. METHODS Our sample included 78,229 U.S. adults from three pooled contemporary population-based surveys: the 2012 NHIS, 2012 NSDUH, and 2011-2012 NHANES. We classified current smokers into four categories (light and intermittent [LITS], light-daily, heavier-intermittent, and heavier-daily) and assessed smoking behaviors, illicit drug use, and mental health indicators using weighted analyses. RESULTS Analyses associated smoking categories with nicotine dependence, age of smoking initiation, race/ethnicity, and other demographic and behavioral factors. Compared with heavier-daily smokers, smokers who were LITS were most likely to have mild or no nicotine dependence (weighted odds ratio [OR], 16.92; 95% confidence interval [CI], 13.10-21.85), to start smoking cigarettes regularly after age 21 (OR, 3.42; 95% CI, 2.84-4.12), and to be Hispanic (OR, 5.38; 95% CI, 4.38-6.61). Additional significant results were found for other categories of smokers. CONCLUSIONS Based on pooled data from three large national surveys, light and/or intermittent smokers differed in smoking, drug use, and mental health behaviors from heavier-daily, former, and never smokers. Notable differences by level of smoking frequency and intensity were observed for nicotine dependence, age of smoking initiation, and race/ethnicity. IMPACT Our results may help focus preventive measures and policies for the growing number of light and/or intermittent smokers in the United States because smoking patterns vary by behavioral and socioeconomic factors. Cancer Epidemiol Biomarkers Prev; 26(2); 228-39. ©2016 AACR.
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Affiliation(s)
- Carolyn M Reyes-Guzman
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland.
- Department of Epidemiology and Biostatistics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Jay Lubin
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
| | - Sean D Cleary
- Department of Epidemiology and Biostatistics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia
| | - Paul H Levine
- Department of Epidemiology, University of Nebraska Medical Center, College of Public Health, Nebraska Medical Center, Omaha, Nebraska
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, NCI, Rockville, Maryland
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Tan AKG, Yen ST. Cigarette consumption by individuals in Malaysia: a zero-inflated ordered probability approach. J Public Health (Oxf) 2017. [DOI: 10.1007/s10389-016-0754-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Albertsen K, Hannerz H, Borg V, Burr H. Work environment and smoking cessation over a five-year period. Scand J Public Health 2016; 32:164-71. [PMID: 15204176 DOI: 10.1080/14034940310017779] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: The authors set out to estimate effects of occupational factors on smoking cessation among Danish employees. Methods: Data from 3,606 observations of smokers gathered from the Danish National Work Environment Cohort Study in 1990, 1995, and 2000 were analysed by logistic regression. The model comprised background variables, smoking variables, and measures of psychosocial and other aspects of the work environment. Results: Statistically significant odds ratios (OR) for cessation were found for medium versus no exposure to noise (OR 0.71, 95% CI 0.54 - 0.93), for high versus low physical workload (OR 0.49, 95% CI 0.47 - 0.73), for high versus low psychological demands (OR 1.42, 95% CI 1.12 - 1.80), and for medium versus low levels of responsibility at work (OR 1.31, 95% CI 1.03 - 1.65). Conclusion: The probability of smoking cessation differs between people with different exposures to certain work environmental factors.
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Affiliation(s)
- Karen Albertsen
- Department of Psychology and Sociology, National Institute of Occupational Health, Copenhagen, Denmark.
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15
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Saddleson ML, Kozlowski LT, Giovino GA, Homish GG, Mahoney MC, Goniewicz ML. Assessing 30-day quantity-frequency of U.S. adolescent cigarette smoking as a predictor of adult smoking 14 years later. Drug Alcohol Depend 2016; 162:92-8. [PMID: 26987520 PMCID: PMC6119624 DOI: 10.1016/j.drugalcdep.2016.02.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/01/2016] [Accepted: 02/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND To improve measures of monthly tobacco cigarette smoking among non-daily smokers, predictive of future non-daily monthly and daily smoking. METHODS Data from United States National Longitudinal Study of Adolescent to Adult Health, tracking adolescents, ages 12-21, over 14 years were analyzed. At baseline, 6501 adolescents were assessed; 5114 individuals provided data at waves 1 and 4. Baseline past 30-day non-daily smokers were classified using quantity-frequency measures: cigarettes smoked/day by number of days smoked in the past 30 days. RESULTS Three categories of past 30-day non-daily smokers emerged using cigarettes/month (low:1-5, moderate: 6-60, high: 61+) and predicted past 30-day smoking at follow-up (low: 44.5%, moderate: 60.0%, high: 77.0%, versus 74.2% daily smokers; rτ=-0.2319, p<0.001). Two categories of non-smokers plus low, moderate and high categories of non-daily smokers made up a five-category non-daily smoking index (NDSI). High NDSI (61+ cigs/mo.) and daily smokers were equally likely to be smoking 14 years later (High NDSI OR=0.97, 95% CI=0.53-1.80 [daily as reference]). Low (1-5 cigs/mo.) and moderate (6-60 cigs/mo.) NDSI were distinctly different from high NDSI, but similar to one another (OR=0.21, 95% CI=0.15-0.29 and OR=0.22, 95% CI=0.14-0.34, respectively) when estimating future monthly smoking. Among those smoking at both waves, wave 1 non-daily smokers, overall, were less likely than wave 1 daily smokers to be smoking daily 14 years later. CONCLUSIONS Non-daily smokers smoking over three packs/month were as likely as daily smokers to be smoking 14-years later. Lower levels of non-daily smoking (at ages 12-21) predicted lower likelihood of future monthly smoking. In terms of surveillance and cessation interventions, high NDSI smokers might be treated similar to daily smokers.
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Affiliation(s)
- M L Saddleson
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, Buffalo, NY, USA.
| | - L T Kozlowski
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, Buffalo, NY, USA
| | - G A Giovino
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, Buffalo, NY, USA
| | - G G Homish
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, Buffalo, NY, USA
| | - M C Mahoney
- University at Buffalo, State University of New York, School of Public Health and Health Professions, Department of Community Health and Health Behavior, Buffalo, NY, USA; Roswell Park Cancer Institute, Department of Medicine and Department of Health Behavior, Buffalo, NY, USA
| | - M L Goniewicz
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, NY, USA
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Jiang N, Gonzalez M, Ling PM, Glantz SA. Relationship of Smokefree Laws and Alcohol Use with Light and Intermittent Smoking and Quit Attempts among US Adults and Alcohol Users. PLoS One 2015; 10:e0137023. [PMID: 26445314 PMCID: PMC4596828 DOI: 10.1371/journal.pone.0137023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 08/13/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction Light and intermittent smoking (LITS) has become increasingly common. Alcohol drinkers are more likely to smoke. We examined the association of smokefree law and bar law coverage and alcohol use with current smoking, LITS, and smoking quit attempts among US adults and alcohol drinkers. Methods Cross-sectional analyses among a population-based sample of US adults (n = 27,731) using restricted data from 2009 National Health Interview Survey and 2009 American Nonsmokers' Rights Foundation United States Tobacco Control Database. Multivariate logistic regression models examined the relationship of smokefree law coverage and drinking frequency (1) with current smoking among all adults; (2) with 4 LITS patterns among current smokers; and (3) with smoking quit attempts among 6 smoking subgroups. Same multivariate analyses were conducted but substituted smokefree bar law coverage for smokefree law coverage to investigate the association between smokefree bar laws and the outcomes. Finally we ran the above analyses among alcohol drinkers (n = 16,961) to examine the relationship of smokefree law (and bar law) coverage and binge drinking with the outcomes. All models controlled for demographics and average cigarette price per pack. The interactions of smokefree law (and bar law) coverage and drinking status was examined. Results Stronger smokefree law (and bar law) coverage was associated with lower odds of current smoking among all adults and among drinkers, and had the same effect across all drinking and binge drinking subgroups. Increased drinking frequency and binge drinking were related to higher odds of current smoking. Smokefree law (and bar law) coverage and drinking status were not associated with any LITS measures or smoking quit attempts. Conclusions Stronger smokefree laws and bar laws are associated with lower smoking rates across all drinking subgroups, which provides further support for these policies. More strict tobacco control measures might help reduce cigarette consumption and increase quit attempts.
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Affiliation(s)
- Nan Jiang
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, United States of America; School of Public Health, The University of Hong Kong, Hong Kong, China
| | - MariaElena Gonzalez
- School of Social Sciences, Humanities & Arts, University of California Merced, Merced, California, United States of America
| | - Pamela M Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, United States of America
| | - Stanton A Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, United States of America
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Scheuermann TS, Mburu WE, Mathur C, Ahluwalia JS. Correlates of Converted and Native Nondaily Smoking. Nicotine Tob Res 2015; 17:1112-9. [PMID: 25542913 PMCID: PMC4627482 DOI: 10.1093/ntr/ntu272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 11/24/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Nondaily smokers represent a growing proportion of current smokers in the United States. However, little is known about which characteristics are important in distinguishing between nondaily smokers who are former daily smokers (converted nondaily) and nondaily smokers who never smoked daily (native nondaily). This study contrasts converted and native nondaily smokers on demographic, psychosocial, tobacco-related characteristics and quit intentions and behaviors in a tri-ethnic sample (Blacks, Whites, and Latinos) of smokers. METHODS Smokers were recruited for a web-based survey using an online panel survey company. Participants were 1,201 nondaily smokers (904 converted nondaily smokers and 297 native nondaily smokers). A multivariable logistic regression was conducted to assess the associations between demographic, smoking-related, and psychosocial variables with converted versus native nondaily smoking. RESULTS Logistic regression indicated that number of years smoking, years as a nondaily smoker, number of days smoked in a month, smoking dependence, identity as a smoker, and number of smoking cessation methods used were correlates of being converted nondaily smokers versus native nondaily smokers. CONCLUSIONS Clinicians and researchers should consider characteristic variations in nondaily smokers when designing and implementing intervention efforts targeting this smoking population.
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Affiliation(s)
- Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS;
| | - Waruiru E Mburu
- Department of Medicine and Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
| | - Charu Mathur
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jasjit S Ahluwalia
- Department of Medicine and Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN
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Cigarettes and alcohol: The influence of nicotine on operant alcohol self-administration and the mesolimbic dopamine system. Biochem Pharmacol 2015; 97:550-557. [PMID: 26253689 DOI: 10.1016/j.bcp.2015.07.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/30/2015] [Indexed: 12/11/2022]
Abstract
Studies in human populations consistently demonstrate an interaction between nicotine and ethanol use, each drug influencing the use of the other. Here we present data and review evidence from animal studies that nicotine influences operant self-administration of ethanol. The operant reinforcement paradigm has proven to be a behaviorally relevant and quantitative model for studying ethanol-seeking behavior. Exposure to nicotine can modify the reinforcing properties of ethanol during different phases of ethanol self-administration, including acquisition, maintenance, and reinstatement. Our data suggest that non-daily intermittent nicotine exposure can trigger a long-lasting increase in ethanol self-administration. The biological basis for interactions between nicotine and ethanol is not well understood but may involve the stress hormone systems and adaptations in the mesolimbic dopamine system. Future studies that combine operant self-administration with techniques for monitoring or manipulating in vivo neurophysiology may provide new insights into the neuronal mechanisms that link nicotine and alcohol use.
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Racially classified social group differences in cigarette smoking, nicotine dependence, and readiness to quit. J Addict Nurs 2014; 24:71-81. [PMID: 24621484 DOI: 10.1097/jan.0b013e31829293b0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose was to determine racially classified social group differences in smoking, nicotine dependence, and readiness to quit between African American and Caucasian smokers. The cross-sectional study included 53 African American and 839 Caucasian smokers participating in a larger population-based cessation intervention study. Data were analyzed from the interview conducted before the intervention; half of the participants were in the treatment group, recruited from those who had joined a cessation contest, whereas control group participants were recruited using random-digit dialing and were not in the contest. African Americans began smoking later, smoked fewer cigarettes daily, reported lower nicotine dependence, and had greater readiness to quit smoking than Caucasians. Of those who had ever used an evidence-based method, African American smokers were more likely to only use evidence-based quit methods, whereas Caucasian smokers were more likely to mix evidence-based with "cold turkey." Controlling for demographics and treatment group, racially classified social group was a predictor of readiness to quit smoking. Later, age of initiation, positive partner support, and using evidence-based quit methods also predicted greater readiness to quit.
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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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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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Reitzel LR, Buchanan TS, Nguyen N, Ahluwalia JS. Associations of subjective social status with nondaily and daily smoking. Am J Health Behav 2014; 38:245-53. [PMID: 24629553 DOI: 10.5993/ajhb.38.2.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To explore associations between subjective social status (SSS) and smoking level among 2274 adult current smokers. METHODS Associations were investigated using a covariate-adjusted proportional odds cumulative logit model. Moderation (via race/ethnicity or sex) and mediation (via depressive symptoms, social/emotional support, or life satisfaction) were explored in additional models. RESULTS Higher SSS was associated with greater likelihood of nondaily versus light daily or moderate/ heavy daily smoking (p = .017). Life satisfaction partially mediated the association of SSS and smoking level (p = .003). CONCLUSIONS Higher SSS was associated with greater likelihood of nondaily relative to light daily or moderate to heavy smoking, potentially via greater life satisfaction. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Educational Psychology, College of Education, University of Houston, Houston, Department of Health Disparities Research at The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Taneisha S Buchanan
- Center for Health Equity and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nga Nguyen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN, 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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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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Berg CJ, Wen H, Cummings JR, Ahluwalia JS, Druss BG. Depression and substance abuse and dependency in relation to current smoking status and frequency of smoking among nondaily and daily smokers. Am J Addict 2013; 22:581-9. [PMID: 24131166 PMCID: PMC3801476 DOI: 10.1111/j.1521-0391.2013.12041.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 08/20/2012] [Accepted: 10/23/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Daily smoking rates are decreasing while intermittent or nondaily smoking rates are increasing. Little is known about the association of depression, alcohol abuse and dependence, and illicit drug abuse and dependence with different patterns of smoking, particularly nondaily smoking. Thus, we examined these relationships among current smokers versus nonsmokers and among those who smoke daily versus less frequently. METHODS We conducted a secondary analysis of 37,897 adults who participated in the 2008 National Survey on Drug Use and Health. We developed logistic regression models examining predictors of (i) current smoking and (ii) number of days smoking per month (1-10 days, 11-29 days, and ≥30 days) among current smokers, focusing on past-year major depression, alcohol abuse and dependence, and illicit drug abuse and dependence. RESULTS Compared to nonsmokers, current smokers more frequently reported a major depressive episode (p < .001), alcohol dependence (p < .001) and abuse (p < .001), and illicit drug dependence (p < .001) and abuse (p < .001), controlling for sociodemographics. Among current smokers, greater smoking frequency was associated with illicit drug dependence (p = .004), but lower likelihood of alcohol dependence (p = .01), alcohol abuse (p = .01), and illicit drug abuse (p = .01). CONCLUSIONS Although depression and substance use were associated with greater likelihood of smoking, most measures were inversely associated with frequency of smoking. Thus, it is important to examine underlying mechanisms contributing to these counterintuitive findings in order to inform intervention approaches. SCIENTIFIC SIGNIFICANCE With increased rates of nondaily smoking, developing a greater understanding about the mental health correlates related to this pattern of smoking is critical.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia
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Jiang N, Ling PM. Impact of alcohol use and bar attendance on smoking and quit attempts among young adult bar patrons. Am J Public Health 2013; 103:e53-61. [PMID: 23488485 DOI: 10.2105/ajph.2012.301014] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined cigarette smoking and quit attempts in the context of alcohol use and bar attendance among young adult bar patrons with different smoking patterns. Methods. We used randomized time location sampling to collect data among adult bar patrons aged 21 to 26 years in San Diego, California (n = 1235; response rate = 73%). We used multinomial and multivariate logistic regression models to analyze the association between smoking and quit attempts and both drinking and binge drinking among occasional, regular, very light, and heavier smokers, controlling for age, gender, race/ethnicity, and education. RESULTS Young adult bar patrons reported high rates of smoking and co-use of cigarettes and alcohol. Binge drinking predicted smoking status, especially occasional and very light smoking. All types of smokers reported alcohol use, and bar attendance made it harder to quit. Alcohol use was negatively associated with quit attempts for very light smokers, but positively associated with quitting among heavier smokers. CONCLUSIONS Smoking and co-use of cigarettes and alcohol are common among young adult bar patrons, but there are important differences by smoking patterns. Tobacco interventions for young adults should prioritize bars and address alcohol use.
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Affiliation(s)
- Nan Jiang
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143, USA
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Schane RE, Prochaska JJ, Glantz SA. Counseling nondaily smokers about secondhand smoke as a cessation message: a pilot randomized trial. Nicotine Tob Res 2013; 15:334-42. [PMID: 22592447 PMCID: PMC3545714 DOI: 10.1093/ntr/nts126] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 04/04/2012] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Nondaily smoking represents a substantial and growing fraction of smokers, many of whom do not consider themselves smokers or at risk of tobacco-related diseases and, so, may be less responsive to counseling content contained in traditional cessation interventions. This study compares the effects brief counseling interventions (<20 min) focused on the harm smoking does to themselves (harm to self, HTS) versus the harm their secondhand smoke (SHS) does to others (harm to others, HTO) among nondaily smokers. METHODS Randomized trial of 52 nondaily smokers (smoked in the past week, but not daily) recruited between September 2009 and June 2010; 40 completed the study. We measured changes in motivation and smoking status at 3 months postintervention. RESULTS There was a difference in quitting between the two groups, with 9.5% (2 out of 21) for HTS and 36.8% (7 out of 19) for HTO subjects reporting not smoking any cigarettes in the prior week (p = .06 by Fisher exact test and .035 by likelihood-ratio chi-square). Motivation and self-efficacy increased from baseline to 3-month follow-up, but not differentially by intervention group. CONCLUSIONS Consistent with findings from research conducted by the tobacco industry as early as the 1970s that concluded that social smokers feel immune from the personal health effects of tobacco but are concerned about the consequences of their SHS on others, educating nondaily smokers about the dangers of SHS to others appears to be a more powerful cessation message than traditional smoking cessation counseling that emphasizes the harmful consequences to the smoker.
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Affiliation(s)
- Rebecca E. Schane
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Medicine, University of California San Francisco, CA
- San Francisco Free Clinic, San Francisco, CA
| | - Judith J. Prochaska
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Psychiatry, University of California San Francisco, CA
| | - Stanton A. Glantz
- Center for Tobacco Control Research and Education, University of California San Francisco, CA
- Department of Medicine, University of California San Francisco, CA
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Shiffman S, Dunbar MS, Scholl SM, Tindle HA. Smoking motives of daily and non-daily smokers: a profile analysis. Drug Alcohol Depend 2012; 126:362-8. [PMID: 22784601 PMCID: PMC3970262 DOI: 10.1016/j.drugalcdep.2012.05.037] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 05/30/2012] [Accepted: 05/31/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-daily or intermittent smoking is becoming common, but little is known about smoking patterns of intermittent smokers (ITS). This study assesses differences in the profile of smoking motives of non-daily, ITS and daily smokers (DS). METHODS Participants were 218 DS and 252 ITS (152 converted ITS [CITS], who previously smoked daily, and 80 native ITS [NITS] who did not), not currently quitting, recruited by advertisement. ITS were defined as smoking 4-27 days per month; DS as smoking daily, 5-30 cigarettes per day. Participants completed the Wisconsin Inventory of Smoking Dependence Motives (WISDM), yielding scores for 13 different motives. The within-profile standard deviation expressed profile scatter (differentiation among motives), and profile shape was assessed on scores standardized for within-profile mean and standard deviation. RESULTS There was no difference between ITS and DS on profile scatter. ITS and DS differed in the shape of the standardized score profile, with DS scoring higher on Tolerance, Craving, Automaticity, Loss of Control and Behavioral Choice motives, and ITS scoring higher on Cue Exposure, Weight Control, and Positive Reinforcement motives. CITS did not differ from NITS in profile scatter or profile shape. CONCLUSION ITS differ from DS in the relative importance of motives, with ITS emphasizing motives associated with acute, situational smoking, and DS emphasizing dependence-related motives. Among ITS, history of daily smoking did not influence the profile of motives.
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Affiliation(s)
- Saul Shiffman
- Smoking Research Group, Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA.
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Berg CJ, Schauer GL, Ahluwalia JS, Benowitz NL. Correlates of NNAL levels among nondaily and daily smokers in the college student population. ACTA ACUST UNITED AC 2012; 2012. [PMID: 24298447 DOI: 10.2147/cbf.s34642] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Recent simultaneous increases in nondaily smoking and decreases in daily smoking make the identification of nondaily smokers through biomarker measures as well as the relationship of biomarker levels to smoking behaviors important topics. However, little is known about biochemical identification and carcinogen exposure of nondaily smokers. One tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), has a long half-life, making it a useful marker for long-term and intermittent tobacco exposure. Thus, we examined correlates of urine NNAL levels among nondaily and daily smokers. METHODS In 2011, we obtained urine samples from 64 current cigarette smokers (37 nondaily; 27 daily) in the Southeastern US and assessed participants' sociodemographics, smoking-related information, and other tobacco use. Our sample included 14 participants concurrently using other combustible tobacco products and eight concurrently using smokeless tobacco. RESULTS Of six participants smoking for only one day in the past 30, four had detectable NNAL levels; thus, two nondaily smokers were excluded from the remainder of the analyses. In multivariate analysis, average cigarettes per day on smoking days (B = 23.00, 95% Confidence Interval [CI] 13.81, 32.20, P < 0.001) and number of days of smokeless tobacco use (B = 17.11, CI 13.53, 20.70, P < 0.001) were associated with NNAL levels among nondaily smokers (R2 = 0.234). Multivariate analysis indicated that average cigarettes per day (B = 15.83, CI 2.89, 28.76, P = 0.02) was the only significant correlate of NNAL levels among daily smokers. We used receiver operating characteristic (ROC) analyses to identify a potential urinary NNAL (normalized for creatinine) cutoff point of 81.6 pg/mL/g creatinine (88.9% sensitivity, 80.0% specificity) to discriminate nondaily from daily smokers. Excluding polytobacco-product users from these analyses provided similar results. CONCLUSION Different correlates of NNAL levels exist among nondaily and daily cigarette smokers. Urine NNAL demonstrates the potential to be used to discriminate nondaily from daily smokers among young adults.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA
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Shiffman S, Tindle H, Li X, Scholl S, Dunbar M, Mitchell-Miland C. Characteristics and smoking patterns of intermittent smokers. Exp Clin Psychopharmacol 2012; 20:264-77. [PMID: 22390208 PMCID: PMC3718278 DOI: 10.1037/a0027546] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Current models of smoking and dependence assume a need to smoke at regular intervals to maintain nicotine levels, yet about 25% of adult smokers do not smoke daily. This subset of intermittent smokers (ITS) has gone largely unexamined. In this study, we describe the demographics, smoking history, and smoking behavior of ITS (n = 282; 50.2% male) in comparison to daily smokers (DS; n = 233; 60.7% male). Within ITS, we also compare "converted" ITS (CITS), who had previously smoked daily, with "native" ITS (NITS). On average, ITS were 34.66 years of age, and had smoked 42,850 cigarettes in the course of an average of 18 years of smoking. They smoked an average of 4.38 days per week, consuming 4.39 cigarettes a day on smoking days, and demonstrated considerable day-to-day variability in cigarette consumption. Almost half of ITS had Fagerstrom Test of Nicotine Dependence scores of 0, indicating no dependence. Compared to DS, ITS were more likely to cite alcohol drinking, socializing, and being with other smokers as common contexts for smoking, and they also more often cited being angry or stressed. Data suggested that ITS' behavior was not explained by use of other nicotine products nor by economic constraints on smoking, nor by differences in psychological adjustment. Within ITS, CITS were heavier, more frequent, and more dependent smokers. In many respects, CITS were intermediate between NITS and DS. ITS show distinct patterns of smoking behavior that are not well explained by current models of nicotine dependence.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Exploring the next frontier for tobacco control: Nondaily smoking among New York City adults. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2012; 2012:145861. [PMID: 22685481 PMCID: PMC3363994 DOI: 10.1155/2012/145861] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 02/10/2012] [Accepted: 02/28/2012] [Indexed: 11/24/2022]
Abstract
Objective. Among current smokers, the proportion of Nondaily smokers is increasing. A better understanding of the characteristics and smoking behaviors of Nondaily smokers is needed. Methods. We analyzed data from the New York City (NYC) Community Health Survey to explore Nondaily smoking among NYC adults. Univariate analyses assessed changes in Nondaily smoking over time (2002–2010) and identified unique characteristics of Nondaily smokers; multivariable logistic regression analysis identified correlates of Nondaily smoking in 2010. Results. The proportion of smokers who engage in Nondaily smoking significantly increased between 2002 and 2010, from 31% to 36% (P = 0.05). A larger proportion of Nondaily smokers in 2010 were low income and made tax-avoidant cigarette purchases compared to 2002. Smoking behaviors significantly associated with Nondaily smoking in 2010 included smoking more than one hour after waking (AOR = 8.8, 95% CI (5.38–14.27)); buying “loosies” (AOR = 3.5, 95% CI (1.72–7.08)); attempting to quit (AOR = 2.3, 95% CI (1.36–3.96)). Conclusion. Nondaily smokers have changed over time and have characteristics distinct from daily smokers. Tobacco control efforts should be targeted towards “ready to quit” Nondaily smokers.
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Shiffman S, Ferguson SG, Dunbar MS, Scholl SM. Tobacco dependence among intermittent smokers. Nicotine Tob Res 2012; 14:1372-81. [PMID: 22529224 DOI: 10.1093/ntr/nts097] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Intermittent smokers (ITS) are an increasingly prevalent segment of smokers, yet it is unknown whether or how dependence severity may vary across ITS. METHODS Participants were 217 ITS (70 never daily ITS [NITS], 138 converted ITS [CITS], and 9 unknown), who smoked 4-27 days per month, and 197 daily smokers (DS), recruited for a study on smoking patterns. Participants completed questionnaires on dependence (time to first cigarette after waking, Fagerström Test of Nicotine Dependence [FTND], Nicotine Dependence Syndrome Scale [NDSS], Wisconsin Inventory of Smoking Dependence Motives [WISDM], and Hooked on Nicotine Checklist [HONC]) and recorded each cigarette in real time over 3 weeks using Ecological Momentary Assessment. Logistic regression assessed differences in dependence between groups (DS vs. ITS; CITS vs. NITS), and least squares regression examined associations between dependence and smoking behavior (mean, maximum cigarettes per day; proportion of days smoked; longest period of abstinence) within ITS. RESULTS As expected, DS were significantly more dependent than ITS: FTND, NDSS, and WISDM discriminated between ITS and DS with greater than 90% accuracy. Similarly, among ITS, NITS demonstrated lower dependence than CITS. Within ITS, dependence measures also correlated with observed smoking rate and duration of abstinence. CONCLUSIONS The study confirmed that DS are more dependent than ITS and that CITS are more dependent than NITS. Importantly, ITS exhibit features of dependence, and there is meaningful variation in dependence within ITS, suggesting that some aspects of dependence may appear with very infrequent smoking. Future work should examine implications for ITS' potential progression to daily smoking and cessation outcome.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, 130 N. Bellefield Avenue, Suite 510, Pittsburgh, PA 15213, USA.
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Berg CJ, Ling PM, Hayes RB, Berg E, Nollen N, Nehl E, Choi WS, Ahluwalia JS. Smoking frequency among current college student smokers: distinguishing characteristics and factors related to readiness to quit smoking. HEALTH EDUCATION RESEARCH 2012; 27:141-50. [PMID: 22156071 PMCID: PMC3605919 DOI: 10.1093/her/cyr106] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 11/07/2011] [Indexed: 05/22/2023]
Abstract
Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1-5 days, 10.5% (n = 281) smoked 6-29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (β = 0.63, 95% CI 0.57-0.69) and more frequent other tobacco use (β = 0.04, 95% CI 0.02-0.05), drinking (β = 0.04, 95% CI 0.02-0.07) and binge drinking (β = 0.09, 95% CI 0.06-0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road NE, Fifth Floor, Atlanta, GA 30322, USA.
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Berg CJ, Sutfin EL, Mendel J, Ahluwalia JS. Use of and interest in smoking cessation strategies among daily and nondaily college student smokers. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:194-202. [PMID: 22420696 PMCID: PMC4521395 DOI: 10.1080/07448481.2011.586388] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To examine use of and interest in cessation strategies among nondaily and daily college student smokers. PARTICIPANTS 800 undergraduate student smokers aged 18 to 25. METHODS The authors examined nondaily versus daily smoking in relation to use of and interest in cessation strategies using an online survey. RESULTS Nondaily (65.8%) versus daily smokers (34.3%) were more likely to have made a quit attempt (p = .01) but less likely to have used any assistance (p < .001). Nondaily smokers were less interested in pharmacotherapy and traditional behavioral interventions; however, there was no difference in interest in technology-based interventions among nondaily versus daily smokers. Controlling for covariates, there were no significant differences in interest in traditional or technology-based behavioral interventions. Higher motivation, lower confidence, and depressive symptomatology were related to interest in each intervention. Smoking for social reasons was related to interest in technology-based interventions. CONCLUSIONS Different intervention strategies may be appropriate for nondaily and daily smokers.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA 30322, USA.
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Harrison ELR, McKee SA. Non-daily smoking predicts hazardous drinking and alcohol use disorders in young adults in a longitudinal U.S. sample. Drug Alcohol Depend 2011; 118:78-82. [PMID: 21441000 PMCID: PMC3134579 DOI: 10.1016/j.drugalcdep.2011.02.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 02/25/2011] [Accepted: 02/26/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND It is known that daily smoking is associated with the development of alcohol use disorders. However, non-daily smoking is prevalent in young adults and is associated with increased rates of problematic alcohol use in cross-sectional data. It is unknown whether non-daily smoking is predictive of hazardous drinking and alcohol use disorders using longitudinal data. The primary aim of the present investigation was to explore the temporal relationship between non-daily smoking and drinking in young adults, and secondarily, whether college status modified this relationship. METHODS Using Waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), we examined the predictive relationship of smoking status at Wave 1 and change in college status between Waves on alcohol drinking, hazardous drinking, and alcohol abuse and dependence disorders at Wave 2. The sample was restricted to individuals aged 18-25 years at Wave 1. FINDINGS Daily and non-daily smokers at Wave 1, compared to nonsmokers, were at a greater risk for hazardous drinking and alcohol use disorders at Wave 2, after controlling for Wave 1 drinking. College status did not modify smoking and drinking interactions. CONCLUSIONS The findings indicate non-daily smoking is predictive of increased, problematic alcohol use among young adults longitudinally and they support increasing evidence that non-daily smokers represent an important population. Future research should be conducted to continue developing targeted interventions. Early treatments for smoking behavior might have a beneficial effect on reducing the development of problematic patterns of alcohol use and alcohol use disorders.
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Affiliation(s)
- Emily L R Harrison
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA
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Berg CJ, Buchanan T, Ahluwalia JS. Cardiovascular Disease Risk Among Light and Nondaily Smokers. CURRENT CARDIOVASCULAR RISK REPORTS 2011. [DOI: 10.1007/s12170-011-0196-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Campbell ML, Bozec LJ, McGrath D, Barrett SP. Alcohol and tobacco co-use in nondaily smokers: an inevitable phenomenon? Drug Alcohol Rev 2011; 31:447-50. [PMID: 21615810 DOI: 10.1111/j.1465-3362.2011.00328.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Alcohol use has consistently been associated with smoking among nondaily smokers. However, this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long-term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non-smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol-tobacco co-administration patterns. DESIGN AND METHODS 183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face-to-face interviews during which they provided details about their lifetime and past-week tobacco and alcohol administration patterns. RESULTS EOS were more likely to report having used alcohol at the time of their first-ever cigarette relative to the other subgroups (P ≤ 0.001), but there were no differences in past-week co-administration patterns between the subgroups. Overall, less than one-third of all smoking sessions occurred when drinking, but these accounted for more than half of all cigarettes consumed during the previous week. Moreover, while only 42% of drinking sessions involved tobacco co-administration, when drinking and smoking did co-occur, significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01). DISCUSSION AND CONCLUSIONS Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co-administration is associated with mutual dose escalation.
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Berg CJ, Lessard L, Parelkar PP, Thrasher J, Kegler MC, Escoffery C, Goldade K, Ahluwalia JS. College student reactions to smoking bans in public, on campus and at home. HEALTH EDUCATION RESEARCH 2011; 26:106-18. [PMID: 21123843 PMCID: PMC6433431 DOI: 10.1093/her/cyq076] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 10/18/2010] [Indexed: 05/11/2023]
Abstract
We examined college student reactions to a statewide public smoke-free policy, campus policies and private restrictions through an online survey among 2260 students at a 2-year college and a university and 12 focus groups among smokers. Among survey participants, 34.6% smoked in the past month (35.0% daily, 65.0% non-daily). Correlates of receptivity to public policies included attending the university, not living with smokers and non-smoker status (versus daily and non-daily smoking). Correlates of receptivity to outdoor campus policies included being a university student, unmarried, without children, from homes where parents banned indoor smoking and a non-smoker. Correlates of having home restrictions included not living with smokers, no children, parents banning indoor smoking and non-smoker status. Correlates of having car restrictions included attending the university, not living with smokers, having children, parents banning indoor smoking and non-smoker status. Qualitative findings indicated support for smoke-free policies in public (albeit greater support for those in restaurants versus bars) and on campus. Participants reported concern about smokers' and bar/restaurant owners' rights, while acknowledging several benefits. Overall, 2-year college students and smokers (non-daily and daily) were less supportive of smoke-free policies.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences.ealth Education, Emory University Rollins School of Public Health, 1518 Clifton Road NE, 5th Floor, Atlanta, GA 30322, USA.
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Petits fumeurs et fumeurs intermittents. Rev Mal Respir 2010; 27:1150-63. [DOI: 10.1016/j.rmr.2010.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Accepted: 05/31/2010] [Indexed: 11/20/2022]
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Edwards SA, Bondy SJ, Kowgier M, McDonald PW, Cohen JE. Are occasional smokers a heterogeneous group? An exploratory study. Nicotine Tob Res 2010; 12:1195-202. [PMID: 20978108 DOI: 10.1093/ntr/ntq168] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Occasional smokers represent an important segment of all smokers and have been described to be a heterogeneous group in terms of past experience and likelihood of maintaining nondaily smoking behavior. METHODS In the prospective Ontario Tobacco Survey, 408 occasional smokers were followed for a year. Characteristics of subgroups of occasional smokers, as suggested by previous literature, were studied for personal and smoking behavior group differences. Agglomerative hierarchical clustering was also used to empirically identify subgroups of occasional smokers using average linkage. Smoking status at 1-year follow-up was examined overall and by the identified subgroups to determine if any were useful predictors of persistent status as nondaily smoking and likelihood of smoking cessation. RESULTS Significant differences were seen among the subgroups of occasional smokers suggested in previous studies including the number of quit attempts, setting a firm quit date, and whether or not participants cared others knew they smoked in descriptive analyses. Exploratory cluster analysis suggested 4 clusters of occasional smokers based on differences in age, perceived addiction, and history of daily smoking. Subgroups based on participants' history of smoking, self-reported addiction level, and empirically identified cluster subgroups resulted in significant differences of smoking status at 1-year follow-up. CONCLUSIONS This study suggests that occasional smokers may be a heterogeneous group with different subgroups characterized by age, accumulated smoking experience and smoking pattern, as well as factors associated with the likelihood of quitting altogether, over time, and perceived addiction.
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Jackson KM, Colby SM, Sher KJ. Daily patterns of conjoint smoking and drinking in college student smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2010; 24:424-35. [PMID: 20853927 PMCID: PMC2946201 DOI: 10.1037/a0019793] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epidemiological data indicate a robust association between smoking and alcohol use. However, a critical question that is less resolved is the extent to which the smoking event takes place during the time of alcohol consumption. The present study used data from an 8-week prospective web-based study of college student smokers to examine daily associations between smoking and alcohol use, using measures of both likelihood and level of use. Findings indicated that consumption of alcohol and smoking covaried on a daily basis per person. In addition, consistent with the idea of smoking as a social activity for college students, light smokers were more likely than heavier smokers to smoke while drinking and to smoke more cigarettes while drinking. Smoking behavior among light smokers may be influenced by external social contextual cues, in contrast to heavier smokers who may be more affected by internal cues. Implications of findings for prevention work suggest the importance of targeting social situations in which smoking and drinking co-occur.
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Affiliation(s)
- Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI 02912, USA.
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McKee SA, Harrison ELR, Shi J. Alcohol expectancy increases positive responses to cigarettes in young, escalating smokers. Psychopharmacology (Berl) 2010; 210:355-64. [PMID: 20352411 PMCID: PMC2874601 DOI: 10.1007/s00213-010-1831-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Accepted: 03/09/2010] [Indexed: 12/15/2022]
Abstract
RATIONALE A large proportion of smokers consolidate their smoking patterns during young adulthood, and it is possible that the high rates of drinking found in this age group may facilitate the transition from nondaily to daily cigarette use. OBJECTIVE The primary aim of this study was to examine how alcohol alters the subjective effects of smoking in heavy-drinking young adults (age 21-25) who are still at an experimental stage of smoking but show recent increases in their smoking behavior. METHODS Using a within-subject design, we examined whether alcohol or the expectation of receiving alcohol increased either subjective responses to smoking or the amount smoked. Subjects participated in three sessions, in which they received alcohol (0.08 g/dL targeted blood alcohol level), a taste-masked placebo presented as alcohol, or a mixer beverage not presented as alcohol. Measures included positive and negative subjective reactivity (e.g., satisfaction, nausea, craving relief, and enjoyment of airway sensations) associated with smoking a single cigarette and subsequent ad lib smoking behavior. RESULTS Both conditions in which the subjects expected to receive alcohol increased positive effects of smoking (satisfaction, calm, and taste), compared to the mixer beverage. Alcohol, compared to the placebo and mixer beverages, decreased negative effects (nausea) associated with smoking a cigarette and increased subsequent smoking. CONCLUSIONS This initial study has implications for understanding how alcohol and the expectation of alcohol improves the experience of smoking in nondaily smokers who are still at an experimental stage of smoking.
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Light and intermittent cigarette smokers: a review (1989-2009). Psychopharmacology (Berl) 2009; 207:343-63. [PMID: 19830407 DOI: 10.1007/s00213-009-1675-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 09/10/2009] [Indexed: 10/20/2022]
Abstract
RATIONALE Growing proportions of smokers in the USA do not smoke everyday and can be referred to as light and intermittent smokers (LITS). Despite a current prevalence of LITS in the USA estimated at 25-33% of all smokers, a systematic review of the literature on this group of smokers has yet to be written. OBJECTIVES The aim of this paper is to review and evaluate research on LITS and to identify, describe and discuss commonalities and differences between LITS and daily smokers. METHODS The primary databases used to search for publications were Pub Med (National Library of Medicine) and SCOPUS (Elsevier). RESULTS LITS inhale smoke and have post-smoking blood nicotine concentrations that are broadly equivalent to those found in daily smokers. However, LITS differ from daily smokers with regard to cigarette consumption and frequency of cigarette use, sociodemographic and socioeconomic characteristics, motives, personality traits, dependence, withdrawal and craving, response to smoking-related cues, quitting perception, past-smoking status, and initiation. CONCLUSIONS In contrast to daily smokers, LITS show few or no signs of dependence as currently defined by DSM-IV criteria, appear to exercise more self-control, seem to be less impulsive, and their smoking experience is primarily associated with positive rather than negative reinforcement. Conclusions drawn from the reviewed literature highlight the multivariate factors that must be taken into account when defining LITS and emphasize the importance of further research on this increasing fraction of smokers. The potential implications of increased LITS prevalence on smoking-related disease risks remain to be thoroughly investigated.
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Schane RE, Glantz SA, Ling PM. Nondaily and social smoking: an increasingly prevalent pattern. ACTA ACUST UNITED AC 2009; 169:1742-4. [PMID: 19858429 DOI: 10.1001/archinternmed.2009.315] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rebecca E Schane
- Department of Medicine and Cardiovascular Research Institute, Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA 94143-1390, USA
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Hukkinen M, Kaprio J, Broms U, Koskenvuo M, Korhonen T. Characteristics and consistency of light smoking: long-term follow-up among Finnish adults. Nicotine Tob Res 2009; 11:797-805. [PMID: 19423697 DOI: 10.1093/ntr/ntp065] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The main body of smoking behavior research has targeted primarily moderate and heavy smoking. This study aimed to define characteristics of daily light smoking and to examine the consistency of this smoking pattern. METHODS We examined light smoking among the Finnish adult population using longitudinal data from the Older Finnish Twin Cohort, collected in 1975, 1981, and 1990. We defined light smoking as fewer than 5 cigarettes/day and heavy smoking as 20 or more cigarettes per day. We examined the characteristics of light smokers in comparison to heavy smokers, studied which baseline features predicted change in the light smoking pattern, and described how this pattern changed over time. RESULTS Among 9,940 current smokers in 1975, we identified 772 (7.8%) light smokers and 2,668 (26.9%) heavy smokers. Cross-sectionally, light smoking was characterized by female sex; younger age; higher education; lower consumption of alcohol, coffee, and other tobacco products; being single and physically active; and older age at smoking onset. Light smokers reported strong inhalation of cigarette smoke less often than did other smokers. Longitudinally, higher education, binge drinking, and moving in with a partner predicted changes in light smoking. The majority of the baseline light smokers were former, moderate, or heavy smokers at follow-ups, whereas only about 6% reported consistent light smoking throughout the 15-year study period. DISCUSSION In long-term follow-up, consistent light smokers represent a relatively small fraction of smokers. This dynamic pattern of light smoking complicates inferences from studies of health consequences, suggesting that light smoking should not be evaluated based on a single assessment.
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Affiliation(s)
- Maria Hukkinen
- Department of Public Health, University of Helsinki, and the National Institute for Health and Welfare, Helsinki FIN-00014, Finland
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Ackerson LK, Viswanath K. Communication inequalities, social determinants, and intermittent smoking in the 2003 Health Information National Trends Survey. Prev Chronic Dis 2009; 6:A40. [PMID: 19288983 PMCID: PMC2687846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Intermittent smokers account for a large proportion of all smokers, and this trend is increasing. Social and communication inequalities may account for disparities in intermittent smoking status. METHODS Data for this study came from 2,641 ever-smokers from a 2003 nationally representative cross-sectional survey. Independent variables of interest included race/ethnicity, sex, household income, education, health media attention, and cancer-related beliefs. The outcome of interest was smoking status categorized as daily smoker, intermittent smoker, or former smoker. Analyses used 2 sets of multivariable logistic regressions to investigate the associations of covariates with intermittent smokers compared with former smokers and with daily smokers. RESULTS People with high education and high income, Spanish-speaking Hispanics, and women were the most likely to be intermittent rather than daily smokers. Women and Spanish-speaking Hispanics were the most likely to be intermittent rather than former smokers. Attention to health media sources increased the likelihood that a person would be an intermittent smoker instead of a former or daily smoker. Believing that damage from smoking is avoidable and irreversible was associated with lower odds of being an intermittent smoker rather than a former smoker but did not differentiate intermittent smoking from daily smoking. CONCLUSION The results indicate that tailoring smoking-cessation campaigns toward intermittent smokers from specific demographic groups by using health media may improve the effect of these campaigns and reduce social health disparities.
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Affiliation(s)
- Leland K. Ackerson
- Department of Community Health and Sustainability, University of Massachusetts Lowell. At the time of this research, Dr Ackerson was affiliated with the Dana-Farber Cancer Institute, Boston, Massachusetts
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Levy DE, Biener L, Rigotti NA. The natural history of light smokers: a population-based cohort study. Nicotine Tob Res 2009; 11:156-63. [PMID: 19264862 DOI: 10.1093/ntr/ntp011] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Among cigarette smokers, lower levels of consumption, defined as smoking fewer cigarettes per day (CPD) or not smoking daily, are becoming more common. The relationship between cigarette consumption and smoking frequency (daily or nondaily) is not well characterized, and the natural history of light smoking (defined here as smoking < or =10 CPD) is poorly understood. METHODS We assessed changes in CPD and smoking frequency over time among light smokers (< or =10 CPD) and very light smokers (< or =5 CPD), using a population-based longitudinal survey of 3,083 adult smokers in Massachusetts who were interviewed three times over a 4-year follow-up period (in 2000-2001, 2002-2003, and 2005-2006). We used logistic regression to identify factors associated with light smokers' progression to heavier smoking or smoking reduction/quitting. RESULTS Seventy percent of very light smokers were nondaily smokers. Very light nondaily smokers differed from very light daily smokers by younger age, higher socioeconomic status, a social smoking pattern, later smoking initiation, less evidence of nicotine addiction, and more recent and planned cessation efforts. Very light nondaily smokers and smokers consuming 6-10 CPD were more likely to remain in the same smoking category and were less likely to increase consumption than were very light daily smokers. Factors independently associated with increasing consumption among very light smokers were smoking daily, nicotine dependence, White ethnicity, social smoking, and having more friends who smoked; among smokers consuming 6-10 CPD, male gender and lack of quitting self-efficacy were associated with increasing consumption. CONCLUSION Our findings indicate that most light smoking is not a gateway to heavier smoking.
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Affiliation(s)
- Douglas E Levy
- Tobacco Research and Treatment Center, MGH Institute for Health Policy, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114, USA.
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Fagan P, Brook JS, Rubenstone E, Zhang C, Brook DW. Longitudinal precursors of young adult light smoking among African Americans and Puerto Ricans. Nicotine Tob Res 2009; 11:139-47. [PMID: 19251769 DOI: 10.1093/ntr/ntp009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Studies have consistently documented the importance of examining light smoking among African American and Latino adolescent and adult smokers. Little is known, however, about the psychosocial antecedents of adolescent and young adult light smoking in these racial/ethnic minority groups. METHODS This study examined the longitudinal interrelationships and pathways leading to light smoking among African Americans (n = 288) and Puerto Ricans (n = 262). Specifically, we assessed parental factors, perceived discrimination, peer smoking, personality factors, and light smoking in late adolescence as precursors to light smoking among African American and Puerto Rican young adults. RESULTS The results of structural equation modeling showed that a history of greater parental smoking, less parental educational attainment, and more perceived discrimination were each mediated by peer smoking and the youth's maladaptive personality and behavior in late adolescence. The youth's maladaptive personality and behavioral characteristics and light smoking in late adolescence, in turn, predicted light smoking in young adulthood. There were no significant racial/ethnic or gender differences in the pathways to light smoking. DISCUSSION Findings highlight the longitudinal pathways to light smoking among African Americans and Puerto Ricans. The results suggest that effective prevention and cessation programs must address peer and parental social influences, perceived discrimination, and especially, emotional and behavioral problems in late adolescence to reduce light smoking among late adolescents and young adults in these racial/ethnic groups.
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Affiliation(s)
- Pebbles Fagan
- Behavioral Research Program, Division of Cancer Control and Populations Sciences, National Cancer Institute/NIH, 6130 Executive Boulevard, Bethesda, MD 20892-7337, USA.
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Boulos DNK, Loffredo CA, El Setouhy M, Abdel-Aziz F, Israel E, Mohamed MK. Nondaily, light daily, and moderate-to-heavy cigarette smokers in a rural area of Egypt: a population-based survey. Nicotine Tob Res 2009; 11:134-8. [PMID: 19246629 DOI: 10.1093/ntr/ntp016] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Understanding tobacco use among nondaily and light daily cigarette smokers is needed because they are dissimilar from other smokers and may require specific prevention efforts. METHOD We compared three groups of adult male smokers in rural Egypt: light daily and nondaily smokers versus moderate-to-heavy daily smokers. Data were obtained from a household survey in 2003 in six randomly selected villages in the Nile Delta region of Egypt. There were 7,657 adult participants, of whom 48.6% were male and 51.4% were female. Among them, 1,401 males (37.6%) and 5 females (0.1%) were self-identified as current cigarette smokers; further analysis focused on males. We restricted data analysis to those who reported a stable pattern of 3+ years of smoking. There were 42 nondaily smokers. Daily smokers were subdivided into two groups: light daily smokers (who smoked no more than 10 cigarettes/day; n = 223) and moderate-to-heavy daily smokers (who smoked at least 11 cigarettes/day; n = 769). RESULTS We found statistically significant differences between these groups on nearly every measure: nondaily smokers tended to be younger and unmarried, but they also had higher levels of education and professional occupations compared with the other smokers. Nondaily and the light daily smokers were more likely than moderate-to-heavy smokers to be planning to quit and to have self-efficacy for quitting, and they were less likely to be smoking in the presence of their wife and children at home. DISCUSSION Further understanding of nondaily and light daily smokers may aid in tailoring specific interventions.
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Affiliation(s)
- Dina N K Boulos
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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