A New Subspecies of Heliconius hermathena (Nymphalidae: Heliconiinae) from Southern Amazonia

The present paper describes Heliconius hermathena curua Freitas & Ramos ssp. nov. This subspecies exhibits a non-mimetic phenotype typical of H. hermathena, but is characterized by the merging of the yellow streak over the forewing cubitus with the red postmedian band in the dorsal forewing. The subspecies is known from two localities in the south of Altamira, Pará State, Brazil, where it inhabits an isolated patch of "campina" vegetation more than 600 km from the nearest known H. hermathena populations. Geographic isolation of the population is supported by molecular data; based on the mitochondrial gene COI, all individuals of H. hermathena curuassp. nov. form a monophyletic group and all haplotypes found in it are unique, suggesting that gene flow is not currently on-going. Given the fragile situation of Amazonian white sand forests and the proximity of the population to areas of intensive agriculture, this new subspecies and its habitat deserve attention.

Effect of a Mobile Phone Intervention on Quitting Smoking in a Young Adult Population of Smokers: Randomized Controlled Trial

Background

Digital mobile technology presents a promising medium for reaching young adults with smoking cessation interventions because they are the heaviest users of this technology.

Objective

The aim of this study was to determine the efficacy of an evidence-informed smartphone app for smoking cessation, Crush the Crave (CTC), on reducing smoking prevalence among young adult smokers in comparison with an evidence-informed self-help guide, On the Road to Quitting (OnRQ).

Methods

A parallel, double-blind, randomized controlled trial with 2 arms was conducted in Canada to evaluate CTC. In total, 1599 young adult smokers (aged 19 to 29 years) intending to quit smoking in the next 30 days were recruited online and randomized to receive CTC or the control condition OnRQ for a period of 6 months. The primary outcome measure was self-reported continuous abstinence at the 6-month follow-up.

Results

Overall follow-up rates were 57.41% (918/1599) and 60.48% (967/1599) at 3 and 6 months, respectively. Moreover, 45.34% (725/1599) of participants completed baseline, 3-, and 6-month follow-up. Intention-to-treat analysis (last observation carried forward) showed that continuous abstinence (N=1599) at 6 months was not significantly different at 7.8% (64/820) for CTC versus 9.2% (72/779) for OnRQ (odds ratio; OR 0.83, 95% CI 0.59-1.18). Similarly, 30-day point prevalence abstinence at 6 months was not significantly different at 14.4% (118/820) and 16.9% (132/779) for CTC and OnRQ, respectively (OR 0.82, 95% CI 0.63-1.08). However, these rates of abstinence were favorable compared with unassisted 30-day quit rates of 11.5% among young adults. Secondary measures of quit attempts and the number of cigarettes smoked per day at 6-month follow-up did not reveal any significant differences between groups. For those who completed the 6-month follow-up, 85.1% (359/422) of young adult smokers downloaded CTC as compared with 81.8% (346/423) of OnRQ, χ²_1(N=845)=1.6, P=.23. Furthermore, OnRQ participants reported significantly higher levels of overall satisfaction (mean 3.3 [SD 1.1] vs mean 2.6 [SD 1.3]; t₆₄₄=6.87, P<.001), perceived helpfulness (mean 5.8 [SD 2.4] vs mean 4.3 [SD 2.6], t₆₅₇=8.0, P<.001), and frequency of use (mean 3.6 [SD 1.2] vs mean 3.2 [SD 1.1], t₆₈₃=5.7, P<.001) compared with CTC participants.

Conclusions

CTC was feasible for delivering cessation support but was not superior to a self-help guide in helping motivated young adults to quit smoking. CTC will benefit from further formative research to address satisfaction and usage. As smartphone apps may not serve as useful alternatives to printed self-help guides, there is a need to conduct further research to understand how digital mobile technology smoking cessation interventions for smoking cessation can be improved.

Trial Registration

ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i)

An integrated pharmacokinetic/pharmacogenomic analysis of ABCB1 and SLCO1B1 polymorphisms on edoxaban exposure

Edoxaban and its low-abundance, active metabolite M4 are substrates of P-glycoprotein (P-gp; MDR1) and organic anion transporter protein 1B1 (OATP1B1), respectively, and pharmacological inhibitors of P-gp and OATP1B1 can affect edoxaban and M4 pharmacokinetics (PK). In this integrated pharmacogenomic analysis, genotype and concentration-time data from 458 healthy volunteers in 14 completed phase 1 studies were pooled to examine the impact on edoxaban PK parameters of allelic variants of ABCB1 (rs1045642: C3435T) and SLCO1B1 (rs4149056: T521C), which encode for P-gp and OATP1B1. Although some pharmacologic inhibitors of P-gp and OATP1B1 increase edoxaban exposure, neither the ABCB1 C3435T nor the SLCO1B1 T521C polymorphism affected edoxaban PK. A slight elevation in M4 exposure was observed among SLCO1B1 C-allele carriers; however, this elevation is unlikely to be clinically significant as plasma M4 concentrations comprise <10% of total edoxaban levels.

Health professional advice, use of medications and smoking cessation: A population-based prospective cohort study

INTRODUCTION

The mediating role of cessation medications in the association between health professional advice and quitting behaviors is unclear.

METHODS

Data were from the Ontario Tobacco Survey longitudinal study, collected between July 2005 and June 2011 in Ontario, Canada. The analytic sample included 3437 baseline smokers who were seen by health professionals during follow-up. Logistic regression with generalized estimating equations and mediation analysis techniques were used to examine the impact of advice and medications on quitting outcomes (making a quit attempt, short-term quitting 1-6months and long-term quitting>6months).

RESULTS

Those who received advice to quit smoking were more likely to use cessation medications than those who did not receive advice (21% vs. 13%, P<0.001). Receiving advice was associated with making a quit attempt (adjusted odds ratio (OR) 1.25, 95% confidence interval (CI) 1.10-1.41) and long-term quitting (adjusted OR 1.49, 95% CI 1.10-2.02), but not with short-term quitting. Use of cessation medications was associated with making a quit attempt (adjusted OR 11.83, 95% CI 9.93-14.08), short-term quitting (adjusted OR 3.69, 95% CI 2.90-4.68), and long-term quitting (adjusted OR 2.73, 95% CI 1.95-3.82). Using prescription medications was associated with a higher likelihood of quitting short-term (adjusted OR 2.43, 95% CI 2.59-3.74) and long-term (adjusted OR 2.27, 95% CI 1.23-4.17) than using NRT. Use of cessation medications was a significant mediator in the pathway from receiving advice to quitting.

CONCLUSION

Health professionals should advise smokers to quit and encourage them to use cessation medications, especially prescription medications when trying to quit.

Levels and trends in cigarette contraband in Canada

Background

There is overwhelming evidence that increases in tobacco taxes reduce tobacco use, save lives and increase government tax revenue. High taxes, however, create an incentive to devise ways to avoid or evade tobacco taxes through contraband tobacco. The associated consequences are significant and call for an accurate measurement of contraband's magnitude. However, its illegal nature makes the levels and trends in contraband intrinsically difficult to measure accurately.

Objective

To examine levels and trends in cigarette contraband in Canada.

Methods

We employed 2 approaches: first, we contrasted estimates of tax-paid cigarettes sales with consumption estimates based on survey data; second, we used data from several individual-level surveys that examined smokers' purchasing and use behaviours. We placed a particular emphasis on the provinces of Québec and Ontario because existing research suggests that cigarette contraband levels are far higher than in any other province.

Results

The estimates presented show a clear upward trend from the early 2000s in cigarette contraband in Québec and Ontario followed by, on the whole, a decreasing trend from about 2007 to 2009. None of the data presented provide support to the narrative that cigarette contraband has been increasing in recent years. Of note are Québec estimates which suggest relatively low levels of cigarette contraband since 2010, at levels no higher than in the early 2000s.

Conclusions

The data presented suggest that policies to tackle cigarette contraband introduced from the mid-2000s to late 2000s, at both federal and provincial levels, may have dampened the demand for contraband cigarettes.

Impact of Canadian tobacco packaging policy on use of a toll-free quit-smoking line: an interrupted time-series analysis

BACKGROUND

A policy for new pictorial health warning labels on tobacco packaging was introduced by Health Canada in 2012. The labels included, for the first time, a prominently displayed toll-free number for a quit-smoking line. We used data from the Ontario provincial quitline to investigate the call volume and number of new callers receiving treatment in the months before and after the new policy was introduced.

METHODS

We used an interrupted time-series analysis to examine trends in the overall call volume and number of new callers receiving treatment (≥ 1 telephone counselling session) through Ontario's quitline (Smokers' Helpline) between January 2010 and December 2013. We analyzed data using Box-Jenkins autoregressive integrated moving-average models; we adjusted the models for a major campaign promoting the quitline, a seasonality (January) effect and tobacco pricing.

RESULTS

We found a relative increase of 160% in the average monthly call volume during the 7 months after the introduction of the new labels (870 calls per month at baseline and 1391 additional calls per month on average after the policy change; standard error [SE] 108.94, p < 0.001), and a sustained increase of 43% in subsequent months. We observed a relative increase of 174% in the number of new callers receiving treatment (153 new callers per month at baseline and 267 additional new callers per month after the policy change; SE 40.03, p < 0.001) and a sustained increase of 80% in subsequent months. The effect was significant even after controlling for a major promotion campaign and the January effect.

INTERPRETATION

We found a significant increase in the monthly overall call volume and number of new callers receiving treatment per month after the introduction of the new tobacco health warning labels, with a sustained increase in overall calls and new callers beyond the first 7 months. Our findings add to the body of evidence on the benefit of including a toll-free quitline number on tobacco packaging.

Impact of Canadian tobacco packaging policy on quitline reach and reach equity

OBJECTIVE

To examine the impact of the new Canadian tobacco package warning labels with a quitline toll-free phone number for seven provincial quitlines, focusing on treatment reach and reach equity in selected vulnerable groups.

METHODS

A quasi-experimental design assessed changes in new incoming caller characteristics, treatment reach for selected vulnerable sub-populations and the extent to which this reach is equitable, before and after the introduction of the labels in June, 2012. Administrative call data on smokers were collected at intake. Pre- and post-label treatment reach and reach equity differences were analysed by comparing the natural logarithms of the reach and reach equity statistics.

RESULTS

During the six months following the introduction of the new warning labels, 86.4% of incoming new callers indicated seeing the quitline number on the labels. Treatment reach for the six-month period significantly improved compared to the same six-month period the year before from .042% to .114% (p<.0001) and reach equity significantly improved for young males (p<.0001) and those with high school education or less (p=.004).

CONCLUSIONS

The introduction of the new tobacco warning labels with a quitline toll-free number in Canada was associated with an increase in treatment reach. The toll-free number on tobacco warning labels aided in reducing tobacco related inequalities, such as improved reach equity for young males and those with high school or less education.

Effect of a Digital Social Media Campaign on Young Adult Smoking Cessation

INTRODUCTION

Social media (SM) may extend the reach and impact for smoking cessation among young adult smokers. To-date, little research targeting young adults has been done on the use of SM to promote quitting smoking. We assessed the effect of an innovative multicomponent web-based and SM approach known as Break-it-Off (BIO) on young adult smoking cessation.

METHODS

The study employed a quasi-experimental design with baseline and 3-month follow-up data from 19 to 29-year old smokers exposed to BIO (n = 102 at follow-up) and a comparison group of Smokers' Helpline (SHL) users (n = 136 at follow-up). Logistic regression analysis assessed differences between groups on self-reported 7-day and 30-day point prevalence cessation rates, adjusting for ethnicity, education level, and cigarette use (daily or occasional) at baseline.

RESULTS

The campaign reached 37 325 unique visitors with a total of 44 172 visits. BIO users had significantly higher 7-day and 30-day quit rates compared with users of SHL. At 3-month follow-up, BIO participants (32.4%) were more likely than SHL participants (14%) to have quit smoking for 30 days (odds ratio = 2.95, 95% CI = 1.56 to 5.57, P < .001) and BIO participants (91%) were more likely than SHL participants (79%) to have made a quit attempt (odds ratio = 2.69, 95% CI = 1.03 to 6.99, P = .04).

CONCLUSION

The reach of the campaign and findings on quitting success indicate that a digital/SM platform can complement the traditional SHL cessation service for young adult smokers seeking help to quit.

Spatial and temporal patterns of smoking prevalence in Ontario

BACKGROUND

Smoking prevalence varies over time and place due to various social, environmental and policy influences. However, its spatio-temporal patterns at small-area level are poorly understood. This paper attempts to describe spatio-temporal patterns of adult (age > 18) and youth (age 12-18) smoking prevalence at the municipality level in Ontario, Canada and identify potential socio-demographic, environmental, and policy factors that may affect the patterns.

METHODS

Multilevel temporal and spatio-temporal models were fitted to the Canadian Community Health Surveys (2000-2008) data. In total, approximately 160,000 respondents 12 years of age and over living in Ontario were used for this analysis.

RESULTS

The results indicate that during the time period 2003-2008, age-sex stratified smoking prevalence dropped for both the adult and youth populations in Ontario. The tendency is more obvious for youth than for adults. Smoking restriction at home is a leading factor associated with the decline of adult smoking prevalence, but does not play the same role for youth smoking. Despite the overall reduction, smoking prevalence varies considerably across the province and inequalities among municipalities have increased. Clusters of high and low smoking prevalence are both found within the study region.

CONCLUSION

The identified spatial and temporal variations help to indicate problems at the local level and suggest future research directions. Identifying these variations helps to strengthen surveillance and monitoring of smoking behaviours and the evaluation of policy and program development at the small-area level.

Effect of a mobile phone intervention on quitting smoking in a young adult population of smokers: randomized controlled trial study protocol

Background

Tobacco use remains the number one cause of preventable chronic disease and death in developed countries worldwide. In North America, smoking rates are highest among young adults. Despite that the majority of young adult smokers indicate wanting to quit, smoking rates among this age demographic have yet to decline. Helping young adults quit smoking continues to be a public health priority. Digital mobile technology presents a promising medium for reaching this population with smoking cessation interventions, especially because young adults are the heaviest users of this technology.

Objective

The primary aim of this trial is to determine the effectiveness of an evidence-informed mobile phone app for smoking cessation, Crush the Crave, on reducing smoking prevalence among young adult smokers.

Methods

A parallel randomized controlled trial (RCT) with two arms will be conducted in Canada to evaluate Crush the Crave. In total, 1354 young adult smokers (19 to 29 years old) will be randomized to receive the evidence-informed mobile phone app, Crush the Crave, or an evidence-based self-help guide known as “On the Road to Quitting” (control) for a period of 6 months. The primary outcome measure is a 30-day point prevalence of abstinence at the 6-month follow-up. Secondary outcomes include a 7-day point prevalence of abstinence, number of quit attempts, reduction in consumption of cigarettes, self-efficacy, satisfaction, app utilization metrics, and use of smoking cessation services. A cost-effectiveness analysis is included.

Results

This trial is currently open for recruitment. The anticipated completion date for the study is April 2016.

Conclusions

This randomized controlled trial will provide the evidence to move forward on decision making regarding the inclusion of technology-based mobile phone interventions as part of existing smoking cessation efforts made by health care providers. Evidence from the trial will also inform the development of future apps, provide a deeper understanding of the factors that drive change in smoking behavior using an app, and improve the design of cessation apps. This trial is among the first to assess the effect of a comprehensive and evidence-informed mHealth smoking cessation app on a large sample of young adult smokers. Strengths of the trial include the high-quality research design and in-depth assessment of the implementation of the intervention. If effective, the trial has the potential to demonstrate that including mHealth technology as a population-based intervention strategy can cost-effectively reach a greater proportion of the population and help young adult smokers to quit.

Trial Registration

ClinicalTrials.gov NCT01983150; http://clinicaltrials.gov/ct2/show/NCT01983150 (Archived by WebCite at http://www.webcitation.org/6VGyc0W0i).

We do not smoke but some of us are more susceptible than others: a multilevel analysis of a sample of Canadian youth in grades 9 to 12

BACKGROUND

Smoking susceptibility has been found to be a strong predictor of experimental smoking. This paper examined which student- and school-level factors differentiated susceptible never smokers from non-susceptible never smokers among a nationally representative sample of Canadian students in grades 9 to 12.

METHODS

Student-level data from the 2008-2009 Canadian Youth Smoking Survey were linked with school-level data from the 2006 Census, and one built environment characteristic (the density of tobacco retailers surrounding schools). These data were examined using multilevel logistic regression analyses.

RESULTS

The likelihood of a never smoker being susceptible to smoking significantly varied across schools (p=0.0002). Students in this study were more likely to be susceptible never smokers if they reported low self-esteem, held positive attitudes towards smoking, used alcohol or marijuana, had close friends who smoked, and came from homes without a total ban on smoking. The school location (rural versus urban), the socioeconomic status of the neighbourhood surrounding a school, and the density of tobacco retailers that were located within 1-km radius of each school were not associated with students' smoking susceptibility.

CONCLUSION

These findings underscore the continued need to develop school-based tobacco use prevention policies and/or programs that enhance students' self-esteem, address tobacco use misinformation and substance use, and include strategies targeting friends who smoke, and students who come from homes without a total ban on smoking.

Are experimental smokers different from their never-smoking classmates? A multilevel analysis of Canadian youth in grades 9 to 12

INTRODUCTION

Understanding the characteristics of experimental smoking among youth is critical for designing prevention programs. This study examined which student- and school-level factors differentiated experimental smokers from never smokers in a nationally representative sample of Canadian students in grades 9 to 12.

METHODS

School-level data from the 2006 Canadian Census and one built environment characteristic (tobacco retailer density) were linked with data from secondary school students from the 2008-2009 Canadian Youth Smoking Survey and examined using multilevel logistic regression analyses.

RESULTS

Experimental smoking rates varied across schools (p < .001). The location (adjusted odds ratio [AOR] = 0.66, 95% CI: 0.49-0.89) of the school (urban vs. rural) was associated with the odds of a student being an experimental smoker versus a never smoker when adjusting for student characteristics. Students were more likely to be experimental smokers if they were in a lower grade, reported low school connectedness, used alcohol or marijuana, believed that smoking can help people relax, received pocket money each week and had a family member or close friend who smoked cigarettes.

CONCLUSION

School-based tobacco prevention programs need to be grade-sensitive and comprehensive in scope; include strategies that can increase students' attachment to their school; and address multi-substance use, tobacco-related beliefs and the use of pocket money. These programs should also reach out to students who have smoking friends and family members. Schools located in rural settings may require additional resources.

The COMPASS study: a longitudinal hierarchical research platform for evaluating natural experiments related to changes in school-level programs, policies and built environment resources

Background

Few researchers have the data required to adequately understand how the school environment impacts youth health behaviour development over time.

Methods/Design

COMPASS is a prospective cohort study designed to annually collect hierarchical longitudinal data from a sample of 90 secondary schools and the 50,000+ grade 9 to 12 students attending those schools. COMPASS uses a rigorous quasi-experimental design to evaluate how changes in school programs, policies, and/or built environment (BE) characteristics are related to changes in multiple youth health behaviours and outcomes over time. These data will allow for the quasi-experimental evaluation of natural experiments that will occur within schools over the course of COMPASS, providing a means for generating “practice based evidence” in school-based prevention programming.

Discussion

COMPASS is the first study with the infrastructure to robustly evaluate the impact that changes in multiple school-level programs, policies, and BE characteristics within or surrounding a school might have on multiple youth health behaviours or outcomes over time. COMPASS will provide valuable new insight for planning, tailoring and targeting of school-based prevention initiatives where they are most likely to have impact.

The reach ratio--a new indicator for comparing quitline reach into smoking subgroups

INTRODUCTION

There is growing concern about population disparities in tobacco-related morbidity and mortality. This paper introduces the reach ratio as a complementary measure to reach for monitoring whether quitline interventions are reaching high risk groups of smokers proportionate to their prevalence in the population.

METHODS

Data on smokers were collected at intake by 7 Canadian provincial quitlines from 2007 to 2009 and grouped to identify 4 high risk subgroups: males, young adults, heavy smokers, and those with low education. Provincial data are from the Canadian Tobacco Use Monitoring Survey. Reach ratios (ReRas), defined as the proportion of quitline callers from a subgroup divided by the proportion of the smoking population in the subgroup, and 95% confidence intervals were calculated for the subgroups. A ReRa of 1.0 indicates proportionate representation.

RESULTS

ReRas for male smokers and young adults are consistently less than 1.0 across all provinces, indicating that a lower proportion of these high-risk smokers were receiving evidence-based smoking cessation treatment from quitlines. Those with high levels of tobacco addiction and less than high school education have ReRas greater than 1.0, indicating that a greater proportion of these smokers were receiving cessation treatments.

CONCLUSION

ReRas complement other measures of reach and provide a standardized estimate of the extent to which subgroups of interest are benefiting from available cessation interventions. This information can help quitline operators, funders, and policymakers determine the need for promotional strategies targeted to high risk subgroups, and allocate resources to meet program and policy objectives.

Are Aristolochic Acids Responsible for the Chemical Defence of Aposematic Larvae of Battus polydamas (L.) (Lepidoptera: Papilionidae)?

Aristolochic acids (AAs) are thought to be responsible for the chemical protection of the aposematic larvae Battus polydamas (L.) (Papilionidae: Troidini) against predators. These compounds are sequestered by larvae from their Aristolochia (Aristolochiaceae) host plants. Studying the role of the chemical protection of the second and fifth instars of B. polydamas against potential predators, we found that the consumption of larvae by the carpenter ant Camponotus crassus Mayr and young chicks Gallus gallus domesticus was dependent on larval developmental stage. Second instars were more preyed upon than fifth instars; however, the assassin bug Montina confusa Stål was not deterred by chemical defences of the fifth instar B. polydamas. Laboratory bioassays with carpenter ants and young chicks using palatable baits topically treated with a pure commercial mixture of AAs I and AAs II in concentrations up to 100 times those previously found in B. polydamas larvae showed no activity. Similar results were found in field bioassays, where palatable baits treated as above were exposed to the guild of predators that attack B. polydamas larvae and were also consumed irrespective of the commercial AA concentration used. These results suggest that the mixture of AAs I and AAs II have no defensive role against predators, at least against those investigated in the present work. Other compounds present in Aristolochia host plants such as O-glycosylated AAs; benzylisoquinoline alkaloids; and mono-, sesqui-, di-, and triterpenes, which can be sequestered by Troidini, could act as deterrents against predators.

Stereochemical inversion of pyrrolizidine alkaloids byMechanitis polymnia (Lepidoptera: Nymphalidae: Ithomiinae): Specificity and evolutionary significance

Pyrrolizidine alkaloids (PAs), acquired by adults or larvae of Danainae and Ithomiinae butterflies and Arctiidae moths from plants, protect these lepidopterans against predators and are biosynthetic precursors of male sex pheromones. The investigation of PAs in many species of wild-caught adults of Ithomiinae showed lycopsamine (1) [(7R)-OH, (2'S)-OH, (3'S)-OH] as the main alkaloid. In incorporation experiments, PA-free (freshly emerged) adults of the ithomiineMechanitis polymnia were fed seven PAs: lycopsamine and four of its known natural stereoisomers-indicine (2) [(7R)-OH, (2'R)-OH, (3'S)-OH], intermedine (3) [(7R)-OH, (2'S)-OH, (3'R)-OH], rinderine (4) [(7S)-OH, (2'S)-OH, (3'R)-OH], and echinatine (5) [(7S)-OH, (2'S)-OH, (3'S)-OH], and two PAs without the 7-OH: supinine (6) [(2'S)-OH, (3'R)-OH] and amabiline (7) [(2'S)-OH, (3'S)-OH]. Males epimerized PAs 3, 4, and 5 mainly to lycopsamine (1). Females fed these same three PAs changed a smaller proportion to lycopsamine; their lesser capacity to modify PAs corresponds to their normal acquisition of already transformed PAs from males during mating rather than through visits of adults to plant sources of PAs. The alkaloids1 and2, both 7R and 3'S, were incorporated without or with minimum change by males and females. Feeding experiments with6 and7 (males only) showed an inversion at the 3' center of6 and no change in7. The inversion from 7S to 7R (probably via oxyreduction) may be closely related to the evolution of acquisition of PAs by butterflies and moths. Two hypotheses are discussed: (1) The ancestral butterflies are probably adapted to tolerate, assimilate, and use (7R)-PAs (most common in plants; all widespread 1,2-unsaturated macrocyclic PA diesters show this configuration). The development of (7R)-PA receptors in the butterflies could lead to a specialization on this configuration in two ways: to help find PA plants and to utilize these components in sexual chemical communication. A later appearance of (7S)-PAs in plants could have selected an enzymatic system for the inversion of this chiral center in order to continue producing (7R)-PA-derived pheromones. (2) The inversion would be due to the evolution of a enzyme system specialized in the transport of (7R)-PAs to the integument; the failure of this system to carry (7S)-PAs led to an enzymatic system to invert them to transportable (7R)-PAs. In this case, the 7R configuration is an effect and not a cause of (7R)-PA-derived pheromones. In both hypotheses, the partial inversion of the 3'-asymmetric center, when the butterfly was fed intermedine (3), rinderine (4), and supinine (6), could be fortuitous due to the conformation of the molecule and/or the enzymatic system.

Using student and school factors to differentiate adolescent current smokers from experimental smokers in Canada: a multilevel analysis

OBJECTIVE

In order to understand the factors that differentiate adolescents who have tried smoking from those who have become established smokers, this study examined which student- and school-level factors differentiated current smokers from experimental smokers among a nationally representative sample of Canadian secondary school students.

METHOD

Student-level secondary data from the 2008-2009 Canadian Youth Smoking Survey was linked with school-level data from the 2006 Census and one built environment characteristic, and examined using multilevel logistic regression analyses.

RESULTS

The current smoking rates varied (P<0.001) across schools. The number of tobacco retailers surrounding the schools was associated with current smoking when adjusting for student characteristics. Additionally, students were more likely to be current smokers if they were: male, in higher grades, believed that smoking can help when they are bored, reported low school connectedness, used marijuana, had a sibling or close friend who smoked, and had no smoking bans at home.

CONCLUSIONS

These study findings suggest that school anti-smoking strategies need to target males, increase students' attachment to their school, address tobacco-related beliefs, and include interventions targeting smoking siblings and friends. The government should consider zoning restrictions to limit sales of tobacco products near schools.

Transitions in smoking status over time in a population-based panel study of smokers

INTRODUCTION

Few studies have examined the transitions of smokers in the general population through multiple periods of daily, occasional smoking, or abstinence over time. Transitions from daily to occasional smoking are particularly of interest as these may be steps toward cessation.

METHODS

The Ontario Tobacco Survey panel study followed 4,355 baseline smokers, semiannually for up to 3 years. Probabilities of all possible changes in smoking status more than 6 months were estimated using 13,000 repeated measures observations generated from sets of 3 consecutive interviews (n = 9,932 daily smokers, 1,245 occasion smokers, and 1,823 abstinent for at least 30 days, at Time 1).

RESULTS

For initial daily smokers, an estimated 83% remained daily smokers more than 2 follow-ups. The majority of those who had been abstinent for 30 days at 1 interview, were also former smokers at the following interview. In contrast, occasional smoking status was unstable and future smoking status was dependent upon smoking history and subjective dependence. Among daily smokers who became occasional smokers 6 months later, an estimated 20% became a former smoker, at the next interview, but 50% returned to daily smoking. Daily, turned occasional smokers who rebounded back to daily smoking were more likely to describe themselves as addicted at Time 1. Continuing occasional smokers were somewhat less likely to intend to quit, or have tried, despite considering themselves less addicted.

CONCLUSIONS

Reducing to occasional smoking can be a stepping stone toward cessation but entails a greater risk of return to daily smoking, compared with complete abstinence.

Effectiveness of telephone-based follow-up support delivered in combination with a multi-component smoking cessation intervention in family practice: a cluster-randomized trial

OBJECTIVE

To determine whether telephone-based smoking cessation follow-up counseling (FC), when delivered as part of a multi-component intervention program is associated with increased rates of follow-up support and smoking abstinence.

METHODS

A cluster randomized controlled-trial was conducted within family medicine practices in Ontario, Canada. Consecutive adult patients who smoked were enrolled at two time points, the baseline period (2009) and the post-intervention period (2009-2011). Smoking abstinence was determined by telephone interview 4 months following enrollment. Both groups implemented a multi-component intervention program. Practices randomized to the FC group could also refer patients to a follow-up support program which involved 5 telephone contacts over a 2-month period.

RESULTS

Eight practices, 130 providers, and 928 eligible patients participated in the study. No statistically significant difference in 7-day point-prevalence abstinence was observed between intervention groups. There was a significant increase in referral to follow-up in both intervention groups. Significantly higher rates of smoking abstinence [25.7% vs. 11.3%; adjusted OR 3.1 (95% CI: 1.1, 8.6), p<0.05] were documented among the twenty-nine percent of FC participants who were referred to the follow-up support program compared to the MC group.

CONCLUSION

Access to external follow-up support did not increase rates at which follow-up support was delivered.

Changes in tobacco use, susceptibility to future smoking, and quit attempts among Canadian youth over time: a comparison of off-reserve Aboriginal and non-Aboriginal youth

The purpose of this study was to determine whether there is a growing inequity in tobacco use, susceptibility to future smoking, and quit attempts among Off-Reserve Aboriginal (ORA) youth in Canada relative to Non-Aboriginal youth. Current smoking, susceptibility to future smoking and quit attempts were examined among a nationally representative sample of ORA and Non-Aboriginal Canadian youth. Data are from cross-sectional surveys of 88,661 respondents in Grades 6 to 9 across the 2004, 2006 and 2008 survey waves of the Youth Smoking Survey (YSS). At each wave, ORA youth were more likely to be current smokers (overall OR = 3.91, 95% CI 3.47 to 4.41), to be susceptible to future smoking (overall OR = 1.37, 95% CI 1.27 to 1.48), and less likely to have ever made a quit attempt compared to Non-Aboriginal youth (overall OR = 0.74, 95% CI 0.57 to 0.96). Although susceptibility to future smoking declined for Non-Aboriginal youth, the prevalence of susceptibility remained stable among ORA youth. The percentage of ORA youth reporting making a quit attempt increased, however, current smoking rates among ORA youth did not decline. These findings suggest that the disparity in susceptibility to future tobacco use among ORA and Non-Aboriginal youth has increased over time. Despite increased rates of quit attempts, current smoking rates remain significantly higher among ORA youth. Tobacco control programs for Aboriginal youth should be a public health priority.

International field trials of pyrethroid-treated wood exposed to Coptotermes acinaciformis in Australia and Coptotermes formosanus (Isoptera: Rhinotermitidae) in China and the United States

Coptotermes Wasmann is one of the most important genera of wood-destroying insect pests, both in its native and introduced countries. Pyrethroids are among the most widely used insecticides in wood preservation around the world. Consequently, they have often been evaluated against different species of Coptotermes. However, because various test methods have been used between countries, comparing results is problematic. These field trials, using a single aboveground method of exposure, assessed a range of retentions of two pyrethroids (bifenthrin and permethrin) in Pinus radiata D. Don sapwood against two species of Coptotermes in three countries to provide directly comparable results. Coptotermes acinaciformis (Froggatt) in Australia consumed the most nontreated wood, followed by Coptotermes formosanus Shiraki in China, then C. formosanus in the United States, although these data were not significantly different. Both termite species demonstrated a dose-response to wood treated with the two pyrethroids; less wood was consumed as retention increased. Overall, C. acinaciformis consumed relatively little of the treated wood. In comparison, C. formosanus consumed 20-90% of the wood treated at the lowest retentions of the pyrethroids evaluated. Results indicated that C. acinaciformis was more sensitive to pyrethroid toxicity/repellency compared with C. formosanus. Factors that may have influenced the results are discussed. However, using a single aboveground method of exposure across three countries, that suited both species of Coptotermes, made it possible to determine unambiguously the actual differences between the species in their tolerances to the two pyrethroid insecticides.

Young adult smoking cessation: predictors of quit attempts and abstinence

We examined young adult smoking cessation behaviors, coding cessation behavior as no attempt, quit attempt (< 30 days), or abstinence (≥ 30 days) during follow-up from July 2005 through December 2008, observed in 592 young adult smokers from the Ontario Tobacco Survey. One in 4 young adults made an attempt; 14% obtained 30-day abstinence. Cessation resources, prior attempts, and intention predicted quit attempts, whereas high self-efficacy, using resources, having support, and low addiction predicted abstinence, indicating that young adult smokers require effective and appropriate cessation resources.

School and community predictors of smoking: a longitudinal study of Canadian high schools

OBJECTIVES

We identified the most effective mix of school-based policies, programs, and regional environments associated with low school smoking rates in a cohort of Canadian high schools over time.

METHODS

We collected a comprehensive set of student, school, and community data from a national cohort of 51 high schools in 2004 and 2007. Hierarchical linear modeling was used to predict school and community characteristics associated with school smoking prevalence.

RESULTS

Between 2004 and 2007, smoking prevalence decreased from 13.3% to 10.7% in cohort schools. Predictors of lower school smoking prevalence included both school characteristics related to prevention programming and community characteristics, including higher cigarette prices, a greater proportion of immigrants, higher education levels, and lower median household income.

CONCLUSIONS

Effective approaches to reduce adolescent smoking will require interventions that focus on multiple factors. In particular, prevention programming and high pricing for cigarettes sold near schools may contribute to lower school smoking rates, and these factors are amenable to change. A sustained focus on smoking prevention is needed to maintain low levels of adolescent smoking.

Planned quit attempts among Ontario smokers: impact on abstinence

AIMS

To examine the use and role of planned quit attempts by smokers and their impact on abstinence.

DESIGN

Retrospective, using longitudinal data from the Ontario Tobacco Survey.

SETTING

Ontario, Canada.

PARTICIPANTS

A total of 551 adult smokers who reported having made a quit attempt during 2007-08.

MEASUREMENTS

Reported planning of the most recent quit attempt (i.e. unplanned or planned some time in advance), engaging in preparatory behaviours believed to be related to planning (i.e. use of quit aids such as pharmacotherapy, formal support or health professionals) and abstinence at 1 week and 1 month following the attempt.

FINDINGS

Of the smokers, 73.6% planned their quit attempt in advance. Reported planning was more likely among those who thought they were very addicted, compared with those who were less addicted [odds ratio (OR)=2.22, 95% confidence interval (CI): 1.15-4.28]. Smokers who planned a quit attempt were much more likely to use a quit aid (OR=3.50, 95% CI: 1.80-6.79), particularly pharmacotherapy (OR=6.13, 95% CI: 3.05-12.34). The odds of abstaining for 1 week were lower among those who planned (OR=0.45, 95% CI: 0.22-0.89), independent of perceived addiction. No significant difference was observed for abstinence lasting 1 month. Other factors associated with abstinence were smoking fewer cigarettes per day and having personal support.

CONCLUSIONS

Although most quit attempts were planned and planners had higher odds of using quit aids, planning did not increase the likelihood of success.

Nurse case-managed tobacco cessation interventions for general hospital patients: results of a randomized clinical trial

This randomized clinical trial was designed to test the efficacy of intensive versus brief smoking cessation interventions for hospital patients. The interventions included advice and pamphlets for Brief and bedside counselling, take-home materials, and 7 post-discharge telephone counselling calls over 2 months for Intensive. Confirmed 1-year abstinence was 28% for Intensive (85/301) and 24% for Brief (76/315). Abstinence was significantly higher for patients who did not use pharmacotherapy (36%) versus those who did (16%) and for patients with CVD (40%) versus other diagnoses (20%). Because this was a replication trial, benchmarks for planning can be suggested: 12% to 15% recruitment of identified smokers, 90% plus completion for Intensive, 15% drop-out, and 75% abstinence corroboration. The results consolidate findings for general inpatients, including expected absolute abstinence and treatment outcomes, the effect of CVD patients on outcomes, the reproducibility of high abstinence in a universal health-care system, and the need for more research to inform practice.

Healthy eating index-C is positively associated with family dinner frequency among students in grades 6-8 from Southern Ontario, Canada

BACKGROUND/OBJECTIVES

Unhealthy eating behaviours may contribute to the rising prevalence of childhood obesity in Canada. The purpose of this study was to describe family dinner frequency (FDF) and its associations with overall diet quality.

SUBJECTS/METHODS

The sample included grades six (n=372), seven (n=429) and eight (n=487) students from Southern Ontario. Data were collected with the Food Behaviour Questionnaire, including a single 24-h dietary recall and questions about individual meals. Diet quality was calculated using the Healthy Eating Index-C (HEI-C), which is a recently modified diet quality index.

RESULTS

The majority of participants (65%) reported frequent family dinner meals (6-7 days/week versus 20% on 3-5 days/week and 15% on 0-2 days/week). Diet quality scores were higher among participants reporting 6-7 dinners/week (HEI-C=66.2 versus 62.1 and 62.8 for 0-2 and 3-5 days/week, respectively, P<0.001). Adjusted models reported that diet quality scores were also associated with whom participants consumed breakfast (P<0.001), lunch (P<0.001) and dinner (P<0.001), yet they were most strongly associated (negatively) with participants who skipped the meal altogether.

CONCLUSIONS

Increased family dinner meals were positively associated with daily diet quality and negatively associated with breakfast and lunch skipping. Promoting family dinner meals in healthy living intervention strategies is advised.

Additions to the known U.S. distribution of Latrodectus geometricus (Araneae: Theridiidae)

The range of the brown widow spider Latrodectus geometricus C. L. Koch includes much of Africa and South and Central America. This medically important spider has been recently introduced to Japan, Indonesia, Papua New Guinea, Australia, Hawaii, and California. After the identification of the brown widow spider in New Orleans, LA, and southern Mississippi, surveys in the southeastern United States were conducted from the fall of 2006 through February 2008. We found populations of brown widow spiders in Georgia, Texas, and multiple localities in southeastern Louisiana and Mississippi. In Mississippi, specimens were collected as far north as a county bordering Tennessee. In New Orleans, the brown widow spider has been commonly collected from various locations where human contact is likely.

Evolutionary patterns in chromosome numbers in neotropical Lepidoptera. I. Chromosomes of the Heliconiini (family Nymphalidae: subfamily Nymphalinae)

Chromosome counts in meiotic metaphase plates in the gonads of 67 of the probable 68 species of mimetic neotropical heliconian butterflies (Nymphalidae), representing 1524 individuals in 617 subspecies and geographically separate populations from southern Texas to northern Argentina, revealed a consistent haploid number of n = 21 in the genus Heliconius (except for the most advanced species with n = 33, 37, 56, and 60) and n = 31 in the more primitive genera (Eueides, Dryas, Dryadula, Agraulis, and Dione), with a transitional genus (Neruda) showing three species with n = 28-32, 21-22 + 5-10 "microchromosomes", and 20-22 + 1-5 "microchromosomes". The genus Laparus, with a single polymorphic species doris, probably an offshoot of early Heliconius, shows wide karyotypic variation (n = 20-30, 38) sometimes even within a single individual. The two most primitive genera also show much variation: Podotricha has two species with n = 9 and n = 26-29; and Philaethria shows many phenotypically similar species, two with n = 29 and a still uncertain number (at least 3) with n = 88 (most common), 67-72 (most widespread), 62 (very restricted geographically), 52, 21, and 12. Several interspecific hybrids (Heliconius cydno x H. melpomene) showed normal chromosome pairing, while deficient pairing was seen in intersubspecific hybrids in Eueides tales and Heliconius sara. The importance of these results in the evolutionary study of polytypic tropical species is discussed.

Optimal experimental design in an epidermal growth factor receptor signalling and down-regulation model

We apply the methods of optimal experimental design to a differential equation model for epidermal growth factor receptor signalling, trafficking and down-regulation. The model incorporates the role of a recently discovered protein complex made up of the E3 ubiquitin ligase, Cbl, the guanine exchange factor (GEF), Cool-1 (beta -Pix) and the Rho family G protein Cdc42. The complex has been suggested to be important in disrupting receptor down-regulation. We demonstrate that the model interactions can accurately reproduce the experimental observations, that they can be used to make predictions with accompanying uncertainties, and that we can apply ideas of optimal experimental design to suggest new experiments that reduce the uncertainty on unmeasurable components of the system.

Severe fibrosis in hepatitis C virus-infected patients is associated with increased activity of the mannan-binding lectin (MBL)/MBL-associated serine protease 1 (MASP-1) complex

Mannan-binding lectin (MBL) binds microorganisms via interactions with glycans on the target surface. Bound MBL subsequently activates MBL-associated serine protease proenzymes (MASPs). A role for MBL in hepatitis C virus (HCV) infection had been indicated by previous studies examining MBL levels and polymorphisms in relation to disease progression and response to treatment. We undertook this study to investigate a possible relationship between disease progression and functional MBL/MASP-1 complex activity. A functional assay for MBL/MASP-1 complex activity was employed to examine serum samples from patients with chronic HCV infection, non-HCV liver disease and healthy controls. Intrapatient consistency of MBL/MASP-1 complex activity levels was assessed in sequential samples from a subgroup of patients. Median values of MBL/MASP-1 complex activity were higher in sera from patients with liver disease compared with healthy controls. MBL/MASP-1 complex activity levels correlate with severity of fibrosis after adjusting for confounding factors (P = 0.003). MBL/MASP-1 complex activity was associated more significantly with fibrosis than was MBL concentration. The potential role of MBL/MASP-1 complex activity in disease progression is worthy of further study to investigate possible mechanistic links.

Integrating public health policy, practice, evaluation, surveillance, and research: the school health action planning and evaluation system

The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country's systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada's School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school's students, and these data are used to produce computer-generated school "health profiles." SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research.

A Multi-Level Analysis Examining how Smoking Friends, Parents, and Older Students in the School Environment are Risk Factors for Susceptibility to Smoking Among Non-Smoking Elementary School Youth

The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of Ontario, Canada. Multi-level logistic regression analysis was used to examine how smoking friends, parents, and the prevalence of smoking among grade 8 students at a school were related to smoking susceptibility among the 2,478 non-smoking grade 6 and 7 students. Findings indicate that non-smoking grade 6 and 7 students are more likely to be susceptible to smoking if they have (a) smoking friends, (b) a mother who smokes, or (c) two or more close friends who smoke and attend a school with a relatively high smoking rate among the grade 8 students. Sub-populations of non-smoking youth may be at increased risk for smoking because of the elementary school they attend. Future school-based smoking prevention programs might benefit from targeting prevention programming activities to the schools that are putting students at the greatest risk for smoking.

The influence of friends, family, and older peers on smoking among elementary school students: low-risk students in high-risk schools

BACKGROUND

This study examined how older smoking peers at school and the smoking behaviour of friends and family members are related to youth smoking.

METHODS

Multi-level logistic regression analysis was used to examine correlates of ever smoking in a sample of 4286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada (2001).

RESULTS

Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker [OR 1.05, 95% CI 1.02 to 1.08]. A low-risk student (no family or friends who smoke) was almost three times more likely to try smoking if he/she attended an elementary school with a relatively high prevalence of senior students who smoke than if he/she attended a school with a low prevalence of senior students who smoke.

CONCLUSION

Low-risk grade 6 and 7 students are at significantly greater risk of smoking if they attend an elementary school with a relatively high prevalence of smoking among senior students. Prevention programs should target both at-risk schools and at-risk students.

A multilevel analysis examining the relationship between social influences for smoking and smoking onset

OBJECTIVES

To examine how older smoking peers at school and the smoking behavior of friends and family members are related to youth smoking.

METHODS

The School Smoking Profile was used to collect data on tobacco use and determinants of tobacco use from 22,091 students from 29 secondary schools in Ontario, Canada. Correlates of occasional and regular smoking were examined using multilevel logistic regression analyses.

RESULTS

Students are at increased risk for smoking if they (a) have smoking friends, (b) have smoking family members, and (c) attend a school with a relatively high senior-student smoking rate.

CONCLUSION

These findings suggest that prevention programs should target both at-risk schools and at-risk students.

The statistical mechanics of complex signaling networks: nerve growth factor signaling

The inherent complexity of cellular signaling networks and their importance to a wide range of cellular functions necessitates the development of modeling methods that can be applied toward making predictions and highlighting the appropriate experiments to test our understanding of how these systems are designed and function. We use methods of statistical mechanics to extract useful predictions for complex cellular signaling networks. A key difficulty with signaling models is that, while significant effort is being made to experimentally measure the rate constants for individual steps in these networks, many of the parameters required to describe their behavior remain unknown or at best represent estimates. To establish the usefulness of our approach, we have applied our methods toward modeling the nerve growth factor (NGF)-induced differentiation of neuronal cells. In particular, we study the actions of NGF and mitogenic epidermal growth factor (EGF) in rat pheochromocytoma (PC12) cells. Through a network of intermediate signaling proteins, each of these growth factors stimulates extracellular regulated kinase (Erk) phosphorylation with distinct dynamical profiles. Using our modeling approach, we are able to predict the influence of specific signaling modules in determining the integrated cellular response to the two growth factors. Our methods also raise some interesting insights into the design and possible evolution of cellular systems, highlighting an inherent property of these systems that we call 'sloppiness.'

Social modeling in the school environment, student characteristics, and smoking susceptibility: a multi-level analysis

PURPOSE

To examine how social models in the school environment and individual student characteristics are related to smoking susceptibility.

METHODS

Using data from the School Smoking Profile Project, multi-level logistic regression analysis was used to identify school and student characteristics related to smoking susceptibility among 6679 never smokers from 29 secondary schools in Ontario, Canada.

RESULTS

If a nonsmoking student attended a school where there was student smoking on the school periphery, he or she was less likely to be susceptible to smoking (OR 0.71, 95% CI 0.57-0.89). A significant contextual interaction between the smoking on the school periphery and friends' disapproval of smoking was identified (beta = 0.68 [0.23], p < .01]; students with friends who disapprove of smoking were more likely to be susceptible to smoking if they attended a school with student smoking on the school periphery.

CONCLUSION

Nonsmoking students who attend a school with student smoking on the school periphery are at an increased risk for being susceptible to smoking if they have friends who disapprove of smoking. Future school-based smoking prevention programs might benefit from targeting both individual students and entire schools with programming activities.

Senior student smoking at school, student characteristics, and smoking onset among junior students: a multilevel analysis

BACKGROUND

Current research on the etiology of tobacco use has largely focused on identifying the influential psychosocial characteristics of individual students; the influences of characteristics in the school environment are generally ignored. The purpose of this study was to simultaneously examine how school and individual student characteristics were related to smoking onset.

METHOD

Multilevel logistic regression analysis was used to examine how the senior student smoking rate at a school and the psychosocial characteristics of students were able to differentiate tried-once smokers from experimental smokers in a sample of 4850 grade 9, 10, and 11 students from the School Smoking Profile (SSP) project.

RESULTS

Each 1% increase in smoking rate among high school seniors increased the odds that a junior student was an experimental smoker vs. a tried-once smoker (OR 1.07, 95% CI 1.03-1.12). A significant contextual interaction was identified where the senior student smoking rate at a school moderates the negative influence of having close friends who smoke. Influential student characteristics were also identified.

CONCLUSIONS

The smoking prevalence of older students at a school is directly related to smoking onset among younger students at that school. Prevention programs should target schools that put students at-risk.

Total homocysteine is not a determinant of arterial pulse wave velocity in young healthy adults

AIMS

Hyperhomocysteinaemia has been associated with reduced pulse wave velocity (PWV) in patients with end-stage renal disease and in those with hypertension. The aim of this study was to examine the association between total homocysteine (tHcy) concentrations, the biochemical and genetic determinants of tHcy and PWV in healthy young adults.

METHODS AND RESULTS

A total of 489 subjects aged 20-25 years participated. A fasting blood sample was taken and PWV measured using a non-invasive optical method. tHcy did not correlate with PWV, whether assessed at the aorto-iliac segment (P = 0.18), the aorto-radial segment (P = 0.39) or the aorto-dorsalis-pedis segment (P = 0.22). When tHcy was classified into normal (<15) and high (> or =15micromol/l), PWV did not differ between the two groups at any segment. PWV did not differ by MTHFR C677T or NOS3 G894T genotype, even when smoking and folate sub-groups were considered. Considering aortic PWV as a dependent variable, stepwise regression analysis showed that the only parameter entering the model for all segments was systolic blood pressure (aorto-iliac, P < 0.001; aorto-radial, P = 0.01; aorto-dorsalis-pedis, P = 0.001). Age, sex, COL1A1 genotype and triglycerides entered the model significantly for two of three segments.

CONCLUSION

This study shows that arterial PWV is not associated with tHcy in a healthy young population.

Graphic Canadian cigarette warning labels and adverse outcomes: evidence from Canadian smokers

OBJECTIVES

We assessed the impact of graphic Canadian cigarette warning labels.

METHODS

We used a longitudinal telephone survey of 616 adult smokers.

RESULTS

Approximately one fifth of participants reported smoking less as a result of the labels; only 1% reported smoking more. Although participants reported negative emotional responses to the warnings including fear (44%) and disgust (58%), smokers who reported greater negative emotion were more likely to have quit, attempted to quit, or reduced their smoking 3 months later. Participants who attempted to avoid the warnings (30%) were no less likely to think about the warnings or engage in cessation behavior at follow-up.

CONCLUSIONS

Policymakers should not be reluctant to introduce vivid or graphic warnings for fear of adverse outcomes.

The impact of cigarette warning labels and smoke-free bylaws on smoking cessation: evidence from former smokers

BACKGROUND

To effectively address the health burden of tobacco use, tobacco control programs must find ways of motivating smokers to quit. The present study examined the extent to which former smokers' motivation to quit was influenced by two tobacco control policies recently introduced in the Waterloo Region: a local smoke-free bylaw and graphic cigarette warning labels.

METHODS

A random digit-dial telephone survey was conducted with 191 former smokers in southwestern Ontario, Canada in October 2001. Former smokers who had quit in the previous three years rated the factors that influenced their decision to quit and helped them to remain abstinent.

RESULTS

Thirty-six percent of former smokers cited smoke-free policies as a motivation to quit smoking. Former smokers who quit following the introduction of a total smoke-free bylaw were 3.06 (CI95 = 1.02-9.19) times more likely to cite smoking bylaws as a motivation to quit, compared to former smokers who quit prior to the bylaw. A total of 31% participants also reported that cigarette warning labels had motivated them to quit. Former smokers who quit following the introduction of the new graphic warning labels were 2.78 (CI9 = 1.20-5.94) times more likely to cite the warnings as a quitting influence than former smokers who quit prior to their introduction. Finally, 38% of all former smokers surveyed reported that smoke-free policies helped them remain abstinent and 27% reported that warning labels helped them do so.

CONCLUSION

More stringent smoke-free and labelling policies were associated with a greater impact upon motivations to quit.

The impact of cigarette warning labels and smoke-free bylaws on smoking cessation: evidence from former smokers

BACKGROUND

To effectively address the health burden of tobacco use, tobacco control programs must find ways of motivating smokers to quit. The present study examined the extent to which former smokers' motivation to quit was influenced by two tobacco control policies recently introduced in the Waterloo Region: a local smoke-free bylaw and graphic cigarette warning labels.

METHODS

A random digit-dial telephone survey was conducted with 191 former smokers in southwestern Ontario, Canada in October 2001. Former smokers who had quit in the previous three years rated the factors that influenced their decision to quit and helped them to remain abstinent.

RESULTS

Thirty-six percent of former smokers cited smoke-free policies as a motivation to quit smoking. Former smokers who quit following the introduction of a total smoke-free bylaw were 3.06 (CI95 = 1.02-9.19) times more likely to cite smoking bylaws as a motivation to quit, compared to former smokers who quit prior to the bylaw. A total of 31% participants also reported that cigarette warning labels had motivated them to quit. Former smokers who quit following the introduction of the new graphic warning labels were 2.78 (CI9 = 1.20-5.94) times more likely to cite the warnings as a quitting influence than former smokers who quit prior to their introduction. Finally, 38% of all former smokers surveyed reported that smoke-free policies helped them remain abstinent and 27% reported that warning labels helped them do so.

CONCLUSION

More stringent smoke-free and labelling policies were associated with a greater impact upon motivations to quit.

Outcome evaluation of a high school smoking reduction intervention based on extracurricular activities

BACKGROUND

An outcome evaluation of a high school tobacco control intervention using extracurricular activities developed by teachers and students is reported.

METHODS

Eligible subjects (n = 3,028) had participated in a randomized trial of an elementary school smoking prevention curriculum. Their high schools were matched in pairs; one school in each pair was randomly assigned to the intervention condition, the second to a "usual-care" control condition. Data were collected at the end of Grades 9 and 10.

RESULTS

For Grade 8 never smokers, regular smoking rates were significantly lower for males from intervention schools (9.8 vs 16.2%, P = 0.02) at the end of Grade 10. There were no significant differences among Grade 10 smoking rates for females, or for students of either gender with previous smoking experience in Grade 8.

CONCLUSIONS

The extracurricular activities approach to tobacco control is practical to implement and has promise.

Gender differences in predictors for long-term smoking cessation following physician advice and nicotine replacement therapy

We evaluated gender differences in demographic, smoking history, nicotine dependence, transtheoretical, and perceived stress variables as predictors of smoking cessation. Participants (n = 381) smoked at least 15 cigarettes per day and were motivated to quit. The outcome variable was 7-day abstinence at 1-year follow-up. Predictor variables included: age, education level, number of years smoking, cigarettes per day, quit attempts, nicotine dependence, stage of change, decisional balance, processes of change, self-efficacy, and perceived stress. Logistic regression analysis was used to derive predictive models for women and men. In women, lower scores for pre- and mid-treatment perceived stress significantly increased the likelihood of being abstinent at follow-up. For men, a higher level of education or number of quit attempts lasting > 24 hours in the past year, along with less frequent use of behavioural processes of change at baseline increased the probability of being abstinent at follow-up.

Gender differences in predictors for long-term smoking cessation following physician advice and nicotine replacement therapy

We evaluated gender differences in demographic, smoking history, nicotine dependence, transtheoretical, and perceived stress variables as predictors of smoking cessation. Participants (n = 381) smoked at least 15 cigarettes per day and were motivated to quit. The outcome variable was 7-day abstinence at 1-year follow-up. Predictor variables included: age, education level, number of years smoking, cigarettes per day, quit attempts, nicotine dependence, stage of change, decisional balance, processes of change, self-efficacy, and perceived stress. Logistic regression analysis was used to derive predictive models for women and men. In women, lower scores for pre- and mid-treatment perceived stress significantly increased the likelihood of being abstinent at follow-up. For men, a higher level of education or number of quit attempts lasting > 24 hours in the past year, along with less frequent use of behavioural processes of change at baseline increased the probability of being abstinent at follow-up.