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Gorini G, Carreras G, Cortini B, Verdi S, Petronio MG, Sestini P, Chellini E. Smoke-Free Homes and Youth Smoking Behavior in Italy: Findings From the SIDRIAT Longitudinal Study. Nicotine Tob Res 2016; 18:2075-2082. [PMID: 27287390 DOI: 10.1093/ntr/ntw149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 05/25/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Few studies have explored whether smoke-free homes (SFH) can promote reductions of smoking onset in children, particularly in households with smoking parents. The aim of this study was to determine whether youths living in SFH were less likely to progress to smoking. METHODS We conducted a longitudinal, 11-year, two-wave study on 778 children aged 6-7 years and 985 adolescents aged 13-14 in 2002. At baseline, youths were asked whether or not adults smoked at home (SFH); at follow-up, in 2012-2014, whether a household smoking ban (HSB) had been implemented during the course of the study. Logistic regression was used to investigate SFH effects on youth smoking behaviors. RESULTS Sixty-nine percent of children and 54% of adolescents reported SFH at baseline; 80% of children and 71% of adolescents reported HSB at follow-up. Youths living in non-SFH at baseline were twice as likely to become established smokers at follow-up compared with those living in SFH (children + adolescents: odds ratio [OR] = 1.99; 95% confidence interval [CI] = 1.39-2.94; adolescents: OR = 2.15; 95% CI = 1.36-3.42; children: OR = 1.69; 95% CI = 0.80-3.56), either for youths living with nonsmoking parents at baseline and follow-up (OR for both children and adolescents = 3.06; 95% CI = 1.70-5.51) or for youths with ≥1 smoking parent at baseline and follow-up (OR = 2.12, 95% CI = 1.01-4.46). The effect was greater in youths living in the worst situation (non-SFH at baseline + non-HSB at follow-up) compared with those in the best situation (SFH at baseline + HSB at follow-up; children: OR = 3.20; 95% CI = 1.10-9.35; adolescents: OR = 5.41; 95% CI = 2.66-10.97). CONCLUSIONS Household smoke-free policies had a significant impact in protecting youths from becoming established smokers. IMPLICATIONS The results of the SIDRIAT longitudinal study showed that youths living in homes where people smoked at baseline were twice as likely to become established smokers 11 years later at follow-up, compared with youths living in SFH. The lower number of established smokers among youths living in SFH at baseline was recorded not only in households with nonsmoking parents but also in those with smoking parents. Implementing a home smoking ban is recommended in all households. Living in homes with no ban may be a risk factor for smoking initiation, which is independent of having smoking parents.
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Affiliation(s)
- Giuseppe Gorini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy;
| | - Giulia Carreras
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | - Barbara Cortini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | - Simona Verdi
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
| | | | - Piersante Sestini
- Section of Phthisiology and Diseases of Respiratory Tract, Siena University, Siena, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Cancer Research & Prevention Institute (ISPO), Florence, Italy
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Gregoire B, Azagba S, Asbridge M. Smoke-free homes, smoking susceptibility and familial smoking among never-smoking high school students: a cross-sectional analysis. CMAJ Open 2016; 4:E298-303. [PMID: 27398377 PMCID: PMC4933637 DOI: 10.9778/cmajo.20160010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Research has shown that living in a smoke-free home has a positive effect on adolescents' perceived acceptance of smoking. However, the relationship between smoke-free homes and adolescent smoking behaviours remains unclear. The aim of this study was to examine the association between smoke-free homes and smoking susceptibility among high school students, and to determine whether these associations persist when analyses are stratified by familial smoking status. METHODS We conducted a random cross-sectional survey (2012/2013 Youth Smoking Survey) of primary, junior and high school students in Canada (n = 47 203). Multivariable logistic regression analyses were used to examine the associations between smoke-free homes and susceptibility to smoking among never-smoking high school students, with and without stratification by familial smoking. RESULTS Analyses showed that adolescents living in a smoke-free home had reduced odds of being susceptible to smoking (odds ratio [OR] 0.582, 95% confidence interval [CI] 0.428-0.791) compared with their peers living in households where smoking was permitted. When adolescents had other family members who were smokers, having a smoke-free home was not significantly associated with reduced smoking susceptibility (OR 0.878, 95% CI 0.721-1.071). INTERPRETATION Our results suggest that smoke-free homes may influence future smoking initiation. Optimal success in preventing youth smoking uptake necessitates having a coherent antismoking message between the home smoking environment and familial smoking behaviour.
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Affiliation(s)
- Bruce Gregoire
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Sunday Azagba
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
| | - Mark Asbridge
- Department of Community Health and Epidemiology (Gregoire, Asbridge), Dalhousie University, Halifax, NS; Propel Centre for Population Health Impact (Azagba), School of Public Health and Health Systems, University of Waterloo, Waterloo, Ont
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Luh DL, Chen HH, Yen AMF, Wang TT, Chiu SYH, Fann CY, Chen SLS. Effect of self-reported home smoking restriction on smoking initiation among adolescents in Taiwan: a prospective cohort study. BMJ Open 2015; 5:e007025. [PMID: 26116613 PMCID: PMC4486945 DOI: 10.1136/bmjopen-2014-007025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aims of this study were to investigate the influence of home smoking restriction (HSR) and the modified effect of parental smoking on smoking initiation among adolescents. DESIGN Prospective Cohort Study. SETTING Junior high school in Keelung City, Taiwan. PARTICIPANTS This study collected and evaluated primary data from the Adolescent Smoking and Other Health-Related Behaviour Survey conducted in Keelung City, which aimed to investigate smoking and health-related behaviours in junior high school students (2008-2009). Data on students free of smoking in 2008 and following them until 2009 (n=901) to ascertain whether they had started smoking were analysed with logistic regression mode to examine the proposed postulates. MAIN OUTCOME MEASURE The outcome variable was smoking initiation, which was defined as smoking status (yes/no) in the 2009 follow-up questionnaire. The main independent variable was HSR obtained from an adolescent self-reported questionnaire. Information on parental smoking was measured by adolescents self-reporting the smoking behaviour of their father and mother. RESULTS The rate of HSR was 29.79% among 7th grade adolescents. The effect of HSR on smoking initiation in adolescents was statistically significantly modified by paternal smoking (p=0.04) but not by maternal smoking (p=0.54). The effect of HSR on smoking initiation was small for fathers with the habit of smoking (OR=0.89, 95% CI (0.42 to 1.88)), but the corresponding effect size was 3.2-fold (OR=2.84, 95% CI 1.19 to 6.81) for fathers without the habit of smoking. CONCLUSIONS Paternal smoking behaviour may play an interactive role with HSR in preventing smoking initiation among Taiwanese adolescents.
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Affiliation(s)
- Dih-Ling Luh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsiu-Hsi Chen
- Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ting-Ting Wang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department and Graduate Institute of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Yuan Fann
- Department of Health Industry Management, School of Healthcare Management, Kainan University, Taoyuan, Taiwan
| | - Sam Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Hock LK, Ghazali SM, Cheong KC, Kuay LK, Li LH, Ying CY, Huey TC, Yee LW, Ying OS, Yen YL, Abdullah N, Wymen S, Ibrahim N. Correlates of Susceptibility to Smoking among Secondary School Students in Kota Tinggi District, Johor, Malaysia. Asian Pac J Cancer Prev 2013; 14:6971-8. [DOI: 10.7314/apjcp.2013.14.11.6971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ossip DJ, Chang Y, Nabi-Burza E, Drehmer J, Finch S, Hipple B, Rigotti NA, Klein JD, Winickoff JP. Strict smoke-free home policies among smoking parents in pediatric settings. Acad Pediatr 2013; 13:517-23. [PMID: 24238677 PMCID: PMC4046861 DOI: 10.1016/j.acap.2013.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 05/27/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine strict smoke-free home policies among smoking parents assessed in pediatric offices. METHODS We analyzed baseline parental survey data from 10 control practices in a national trial of pediatric office-based tobacco control interventions (Clinical Effort Against Secondhand Smoke Exposure, CEASE). We used logistic regression models with generalized estimating equations to examine factors associated with strict smoke-free home policies. RESULTS Subjects were 952 parents who were current smokers. Just over half (54.3%) reported strict smoke-free home policies. Few reported being asked (19.9%) or advised (17.1%) regarding policies by pediatricians. Factors associated with higher odds of policies were child 5 years or younger (adjusted odds ratio [aOR] 2.43, 95% confidence interval [CI] 1.53, 3.86), nonblack race/ethnicity (aORs 2.17-2.60, 95% CIs 1.25-5.00), non-Medicaid (HMO/private (aOR 1.84, 95% CI 1.31, 2.58); self-pay/other aOR 1.76, 95% CI 1.12, 2.78); well-child versus sick child visit (aOR 1.61, 95% CI 1.11, 2.34), fewer than 10 cigarettes per day (aOR 1.80, 95% CI 1.31, 2.47), no other home smokers (aOR 1.68, 95% CI 1.26, 2.25), only father smoking (aOR 1.73, 95% CI 1.06, 2.83), and strict smoke-free car policy (aOR 3.51, 95% CI 2.19, 5.64). CONCLUSIONS Nearly half of smoking parents did not have strict smoke-free home policies. Parents were less likely to report policies if they were heavier smokers, black, living with other smokers, or attending a sick child visit; if they did not have a young child or smoke-free car policy; if they had a child on Medicaid; and if anyone other than only the father smoked. Few pediatricians addressed or recommended strict smoke-free home policies in an office visit. The pediatric office encounter represents a currently missed opportunity to intervene regarding smoke-free homes, particularly for high-risk groups.
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Affiliation(s)
- Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY.
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Tyc VL, Puleo E, Emmons K, de Moor JS, Ford JS. Smoking Restrictions Among Households of Childhood and Young Adult Cancer Survivors: Implications for Tobacco Control Efforts. J Adolesc Young Adult Oncol 2013; 2:17-24. [PMID: 23610739 DOI: 10.1089/jayao.2012.0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study assessed the prevalence of smoking restrictions among households of survivors of childhood and young adult cancer who smoke. It also examined the relationship between home smoking restrictions and motivation to quit smoking, as well as other smoking, psychosocial, and environmental factors. METHODS Participants included 374 smokers who were childhood or young adult cancer survivors (between the ages of 18 and 55 years) recruited from five cancer centers to participate in a randomized smoking cessation trial. Survivors completed baseline measures about the smoking restrictions in their households, their smoking behavior, and related psychological and environmental factors, which are the focus of the current manuscript. RESULTS Almost 54% of survivors reported that smoking was prohibited in their households. Living with a nonsmoking partner, having a strict smoking policy at work, and not being nicotine dependent all increased the likelihood of having a total home smoking ban. Participants who were older, smoked more cigarettes per day over the prior week, and received prior chemotherapy were less likely to reside in households that adopted total bans. CONCLUSION Findings suggest that socio-environmental factors and current smoking behaviors are associated with complete smoking restrictions in the homes of survivors. These factors should be considered when communicating with survivors about the importance of establishing strict smoking policies in their private residences.
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Affiliation(s)
- Vida L Tyc
- St. Jude Children's Research Hospital , Memphis, Tennessee
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Pahl K, Brook JS, Koppel J, Lee JY. Unexpected benefits: pathways from smoking restrictions in the home to psychological well-being and distress among urban Black and Puerto Rican Americans. Nicotine Tob Res 2011; 13:706-13. [PMID: 21498429 PMCID: PMC3150690 DOI: 10.1093/ntr/ntr062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 03/10/2011] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study examined the pathways from smoking policies in the home (no ban, partial ban, and total ban on smoking) to psychological well-being (e.g., self-esteem) and psychological symptoms (e.g., depressive symptoms) as mediated by a healthy lifestyle (engaging in exercise, eating healthful foods, and sleeping enough) and cigarette smoking among a sample of urban Black and Puerto Rican Americans. METHODS Questionnaire data were collected from 816 participants (mean age = 32 years). Structural equation modeling (SEM) was employed to examine the pathways of restrictions on smoking in the home to a healthy lifestyle, cigarette smoking, psychological well-being, and psychological distress. RESULTS The SEM showed mediational pathways linking higher levels of restrictions on smoking in the home with a healthy lifestyle, which in turn was related negatively to psychological distress and positively to psychological well-being. Higher levels of restrictions on smoking in the home were also related inversely to cigarette smoking, which was related positively to psychological distress and negatively to psychological well-being. CONCLUSIONS Findings show that higher levels of restrictions on smoking in the home are associated with a healthier lifestyle and less cigarette smoking, which in turn are associated with better psychological functioning. Greater restrictions on smoking in the home may thus support positive lifestyle choices, including exercise and nutrition, as well as psychological functioning.
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Affiliation(s)
- Kerstin Pahl
- Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, New York, NY 10016, USA.
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King K, Martynenko M, Bergman MH, Liu YH, Winickoff JP, Weitzman M. Family composition and children's exposure to adult smokers in their homes. Pediatrics 2009; 123:e559-64. [PMID: 19336347 PMCID: PMC4049446 DOI: 10.1542/peds.2008-2317] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Smoking behavior is strongly influenced by the social environment. More information is needed about how the composition of households with children is associated with adult smoking behavior so that more effective interventions to reduce children's secondhand smoke exposure can be devised and implemented. METHODS Using data from the Medical Expenditure Panel Survey 2000-2004, we conducted cross-sectional analyses to assess how adult smoking behavior is associated with household characteristics, including the number of adults and smokers present, the relationship of the child to the head of household, and relationships between adult members of the household. RESULTS More than one third (34.4%) of children lived with > or =1 adult smoker. Almost half (49.4%) of poor children lived with a smoker, and they were more likely to live with multiple smokers compared with those who lived at >400% of the federal poverty level (21.2% vs 7.8%). Approximately 5 million children lived in households headed by an adult other than their parent, and they were significantly more likely to live with smokers: 53.4% of children who lived in their grandparents' homes and 46.2% of children in homes of other adults lived with at least 1 adult smoker, compared with 33.3% who lived in their parents' home. A total of 59.4% of all children who lived with a smoker had a smoking mother, and 56.7% of those children lived with > or =2 smokers, whereas only 17.0% of children whose mother did not smoke had smoking adults in the home. CONCLUSIONS These findings demonstrate the significant influence of household composition on children's likelihood to live in homes with adult smokers.
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Affiliation(s)
| | | | | | - Ying-Hua Liu
- New York University Department of Pediatrics,The American Academy of Pediatrics Julius B. Richard Center of Excellence,New York University Institute for Community Health and Research
| | - Jonathan P. Winickoff
- The American Academy of Pediatrics Julius B. Richard Center of Excellence,MGH Center for Child and Adolescent Health Policy
| | - Michael Weitzman
- New York University Department of Pediatrics,The American Academy of Pediatrics Julius B. Richard Center of Excellence,New York University Institute for Community Health and Research
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Albers AB, Biener L, Siegel M, Cheng DM, Rigotti NA. Impact of parental home smoking policies on policy choices of independently living young adults. Tob Control 2009; 18:245-8. [PMID: 19168475 DOI: 10.1136/tc.2008.025478] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether adolescents living in parental homes where smoking is banned are more likely to move into smoke-free living quarters when they leave home. METHODS We analysed data on 693 youths from a 4-year, three-wave prospective study of a representative sample of Massachusetts adolescents (aged 12-17). All youths resided in independent living quarters at follow-up. The primary outcome was presence of a smoking ban in the living quarters at follow-up. The primary predictor was presence of a household smoking ban in the parental home, assessed 2 years before the outcome. Generalised linear mixed effects models examined the effect of a parental household smoking ban on the odds of moving into smoke-free living quarters at follow-up overall and stratified by smoking status at follow-up. RESULTS Youths leaving home had much higher odds of moving to smoke-free living quarters if their parental household had had a smoking ban (odds ratio (OR) = 12.70, 95% CI, 6.19 to 26.04). Other independent predictors included moving into a school or college residence (OR = 3.88, 95% CI 1.87 to 8.05), and not living with smokers at follow-up (OR = 3.91, 95% CI 1.93 to 7.92). CONCLUSIONS A household smoking ban in the parental home appears to lead youths to prefer smoke-free living quarters once they leave home.
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Affiliation(s)
- A B Albers
- Social and Behavioral Sciences Department, Boston University School of Public Health, Boston, Massachusetts, USA.
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Klein EG, Forster JL, Erickson DJ, Lytle LA, Schillo B. The relationship between local clean indoor air policies and smoking behaviours in Minnesota youth. Tob Control 2008; 18:132-7. [PMID: 19103639 DOI: 10.1136/tc.2007.024307] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND While clean indoor air (CIA) policies are intended to reduce exposure to second-hand smoke in the workplace, restrictions in public workplaces have the potential to discourage youth smoking. There is growing evidence from cross-sectional and ecological studies, but limited evidence from longitudinal studies that this is so. OBJECTIVE To evaluate the association between local CIA policies and smoking behaviours among Minnesota youth over time. DESIGN, SETTING AND SUBJECTS A cohort of 4233 Minnesota youths, ages 11 to 16 at baseline, was interviewed via telephone for 6 years (2000-2006). Individual, family and community level variables were collected from participants every 6 months. A generalised estimating equation (GEE) logistic regression was used to assess the relationship between CIA policies and past-month smoking in youth over time. The analysis was controlled for potential confounders at individual and community levels. RESULTS There was not significant association between CIA policies and youth smoking behaviours in the multivariate analyses. At the individual level, parental smoking significantly increased the odds of smoking nearly 40% and close friend smoking increased the odds of past-month smoking by nearly 100% for each close friend. Banning smoking in the home was significantly associated with a 12% reduction in the odds of past-month smoking. CONCLUSION After accounting for other community and individual level factors known to be associated with youth smoking, there was no significant association between CIA policies and past-month smoking for youth over time.
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Affiliation(s)
- E G Klein
- Health Behavior Health Promotion Division, Ohio State University College of Public Health, 456 Cunz Hall, 1841 Neil Avenue, Columbus, OH 43210, USA.
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Albers AB, Biener L, Siegel M, Cheng DM, Rigotti N. Household smoking bans and adolescent antismoking attitudes and smoking initiation: findings from a longitudinal study of a Massachusetts youth cohort. Am J Public Health 2008; 98:1886-93. [PMID: 18703438 DOI: 10.2105/ajph.2007.129320] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to determine whether adolescents living in households in which smoking was banned were more likely to develop antismoking attitudes and less likely to progress to smoking compared with those living in households in which smoking was not banned. METHODS We completed a longitudinal 4-year, 3-wave study of a representative sample of 3834 Massachusetts youths aged 12 to 17 years at baseline; 2791 (72.8%) were reinterviewed after 2 years, and 2217 (57.8%) were reinterviewed after 4 years. We used a 3-level hierarchical linear model to analyze the effect of a household ban on antismoking attitudes and smoking behaviors. RESULTS The absence of a household smoking ban increased the odds that youths perceived a high prevalence of adult smoking, among both youths living with a smoker (odds ratio [OR] = 1.56; 95% confidence interval [CI] = 1.15, 2.13) and those living with nonsmokers (OR = 1.75; 95% CI = 1.29, 2.37). Among youths who lived with nonsmokers, those with no home ban were more likely to transition from nonsmoking to early experimentation (OR = 1.89; 95% CI = 1.30, 2.74) than were those with a ban. CONCLUSIONS Home smoking bans may promote antismoking attitudes among youths and reduce progression to smoking experimentation among youths who live with nonsmokers.
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Affiliation(s)
- Alison B Albers
- Social and Behavioral Sciences Department, Boston University School of Public Health, 801 Massachusetts Ave, Crosstown Center 4th Floor, Boston, MA 02118, USA.
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Hanson K, Zylla E, Allen S, Li ZZ, Hatsukami DK. Cigarette reduction: an intervention for adolescent smokers. Drug Alcohol Depend 2008; 95:164-8. [PMID: 18242008 PMCID: PMC2441529 DOI: 10.1016/j.drugalcdep.2007.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 12/04/2007] [Accepted: 12/04/2007] [Indexed: 10/22/2022]
Abstract
This observational study examined whether adolescents who were not interested in quitting could reduce cigarette smoking and if cigarette reduction led to a corresponding and significant reduction in biomarkers of exposure. The study design was a randomized, open-label trial of nicotine patch and nicotine gum with an added placebo control. Participants (n=103) attended 4 treatment visits over 4 weeks and follow-up visits at 3- and 6-months. Participants were told to reduce their smoking by 25% of baseline smoking during the 1st week and by 50% of baseline smoking during the subsequent 3 weeks. Of consented participants, 91.3% (n=94/103) completed the study until the end-of-treatment, 85.1% (n=80/94) completed the 3-month follow-up visit and 71.3% (n=67/94) completed the 6-month follow-up visit. Participants had a very high prevalence of co-morbidity. With regard to the percentage of participants who achieved a 50% reduction of baseline smoking, there were no significant differences among treatment groups (p=.89). At the end-of-treatment, 49.4% of participants (n=41) had reduced smoking by at least 50%. Additionally, there was no significant group, visit or interaction effect of a biomarker measure for carcinogen exposure (p>.05). The results suggest that reduction may be a potential aid to engage adolescents who are unable or unwilling to quit, but should not be an end goal. The effect of treatment methods on outcome measures did not differ significantly.
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Affiliation(s)
- Karen Hanson
- University of Minnesota, Tobacco Use Research Center, Minneapolis, MN 55414 USA
| | - Emily Zylla
- University of Minnesota, Tobacco Use Research Center, Minneapolis, MN 55414 USA
| | - Sharon Allen
- University of Minnesota, Tobacco Use Research Center, Minneapolis, MN 55414 USA
| | - Zhong-ze Li
- University of Minnesota, Cancer Center, Minneapolis, MN 55455 USA
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