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Smoking among students in a suburban high school appears to be part of a complex, symbolic process that is associated with a system of social differentiation between working class and middle class students. To be effective, anti-smoking programs should consider the social dynamics of smoking. (Author/MJL)

Outlines public policy goals regarding substance abuse, sexually transmitted diseases, unintended pregnancies, and violence. Concludes that the nation will continue to be high-risk until reforms are implemented that will equalize access to the opportunity structure. (DM)

Studies on illicit and licit drug use among homosexuals of both sexes have focused primarily on gay men, used limited drug measures, and been conducted in cities known for large homosexual populations. This paper examines (1) the prevalence of 12 illicit and licit drugs by sex and age group and (2) the demographic predictors of past-year frequency of marijuana, alcohol, and cigarette use. Organizational mailing lists were used to collect self-report data on 455 homosexuals living in a southern state. Differences were found between gay men and lesbians in the use of specific substances and in the demographic predictors of drug use. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we review evidence on smoking and lung cancer among Latinos, including findings from several unpublished studies and technical reports. Recent surveys of smoking behavior in California. Texas. and New Mexico indicate a notable sex difference in smoking among Latinos, with Latino males smoking at least as frequently as White males, while Latino females report smoking rates considerably lower than White females. Our analysis of the 1979 and 1980 National Health Interview Surveys corroborates this finding and also indicates that this pattern holds true for subgroups of the Latino population, including country of origin. Taken together, these findings suggest that among Latino males rates of lung cancer and other cigarette-linked diseases may increase in the near future. [ABSTRACT FROM AUTHOR]

Abstract: Recent studies have indicated higher rates of certain respiratory conditions among children who live in households with adults who smoke cigarettes. This paper analyzes data from the 1970 National Health Interview Survey. Children in families with no smokers had an average of 1.1 fewer restricted-activity days and 0.8 fewer bed-disability days per year than did children in families with two smokers. Children in families with one smoker were in between. Acute respiratory illness accounted for the difference in disability days among children in families with different smoking characteristics. Family smoking was also measured by the combined number of cigarettes smoked by adults; children in families which smoked 45 or more cigarettes a day had 1.9 more restricted activity days and 0.9 more bed-disability days due to acute respiratory conditions than did children in families who did not smoke cigarettes. The age of the child, the number of adults in the family, the education of the family head, and the family income were all controlled and did not eliminate the relationship between children's health and family smoking. [ABSTRACT FROM AUTHOR]

This paper uses findings from five nationally representative surveys of high school seniors from 1975 through 1979 to examine the correlates of licit and illicit drug use, and to consider whether recent changes in youthful drug use are linked to any changes in the correlates. Males still exceed females in use of alcohol and marijuana, but no longer in cigarette smoking. Black seniors now report less drug use than Whites. Other dimensions of family background, region, and urbanicity show only modest associations with drug use. Above average drug use occurs among those less successful in adapting to the educational environment, as indicated by truancy and low grades; those who spend many evenings out for recreation; and those with heavy time commitments to a job and/or relatively high incomes. Drug use is below average among seniors with strong religious commitments and conservative political views. From 1975 through 1979, among seniors cigarette use peaked and subsequently declined, marijuana use rose and then leveled off, and the (still infrequent) use of cocaine rose rapidly. However, these shifts in drug use were not accompanied by substantial shifts in the above correlates of use. The findings thus suggest that the kinds of young people most at risk remain much the same, while the types and amounts of substances they use shift somewhat from year to year. [ABSTRACT FROM AUTHOR]

Objectives. To estimate Tobacco-21 policies' relationships to 18- to 20 year-old youth cigarette, cigar, and electronic nicotine delivery system (ENDS) use, and to test for effect modification by policy attributes. Methods. In fall 2022, we used Tobacco 21 Population Coverage Database data to calculate the percentage of state residents covered by state or local Tobacco 21 (T21) laws monthly through June 2020. Matching T21 coverage to Population Assessment of Tobacco and Health and Behavioral Risk Factor Surveillance System data, we used 2-way fixed effect analyses to assess the relationship between T21 laws and 18- to 20-year-old youth cigarette, cigar, and ENDS use, and tested for differences by policy attributes: possession, use, or purchase (PUP) penalties, retailer noncompliance penalties, and compliance check requirements. Results. Increased T21 exposure yielded significant reductions in cigarette and cigar use, as well as in ENDS use, when accounting for policy attributes. These effects were dampened in T21 laws with PUP penalties relative to those without. Conclusions. Tobacco-21 laws yield reductions in 18- to 20-year-old youth cigarette, cigar, and ENDS use, with dampened effects when policies include PUP penalties. Public Health Implications. State policymakers should consider implementing T21 laws without PUP penalties to reduce underage nicotine and tobacco use. (Am J Public Health. 2024;114(1):90–97. https://doi.org/10.2105/AJPH.2023.307447) [ABSTRACT FROM AUTHOR]

Objectives. We characterized smokers who are likely to use electronic or "e-"cigarettes to quit smoking. Methods. We obtained cross-sectional data in 2010-2012 from 1567 adult daily smokers in Hawaii using a paper-and-pencil survey. Analyses were conducted using logistic regression. Results. Of the participants, 13% reported having ever used e-cigarettes to quit smoking. Smokers who had used them reported higher motivation to quit, higher quitting self-efficacy, and longer recent quit duration than did other smokers. Age (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.97, 0.99) and Native Hawaiian ethnicity (OR = 0.68; 95% CI = 0.45, 0.99) were inversely associated with increased likelihood of ever using e-cigarettes for cessation. Other significant correlates were higher motivation to quit (OR = 1.14; 95% CI = 1.08, 1.21), quitting self-efficacy (OR = 1.18; 95% CI = 1.06, 1.36), and ever using US Food and Drug Administration (FDA)-approved cessation aids such as nicotine gum (OR = 3.72; 95% CI = 2.67, 5.19). Conclusions. Smokers who try e-cigarettes to quit smoking appear to be serious about wanting to quit. Despite lack of evidence regarding efficacy, smokers treat e-cigarettes as valid alternatives to FDA-approved cessation aids. Research is needed to test the safety and efficacy of e-cigarettes as cessation aids. [ABSTRACT FROM AUTHOR]

Objectives: This paper provides misclassification rates for current cigarette smokers who report themselves as nonsmokers. Such rates are important in determining smoker misclassification bias in the estimation of relative risks in passive smoking studies., Methods: True smoking status, either occasional or regular, was determined for individual current smokers in 3 existing studies of nonsmokers by inspecting the cotinine levels of body fluids. The new data, combined with an approximately equal amount in the 1992 Environmental Protection Agency (EPA) report on passive smoking and lung cancer, yielded misclassification rates that not only had lower standard errors but also were stratified by sex and US minority majority status., Results: The misclassification rates for the important category of female smokers misclassified as never smokers were, respectively, 0.8%, 6.0%, 2.8%, and 15.3% for majority regular, majority occasional, US minority regular, and US minority occasional smokers. Misclassification rates for males were mostly somewhat higher., Conclusions: The new information supports EPA's conclusion that smoker misclassification bias is small. Also, investigators are advised to pay attention to minority/majority status of cohorts when correcting for smoker misclassification bias.

Objectives: This paper reexamines the work of Meier and Licari in a previous issue of the Journal., Methods: The impact of excise taxes on cigarette consumption and sales was measured via standard regression analysis., Results: The 1983 federal tax increase is shown to have an anomalous effect on the regression results. When those data are excluded, there is no significant difference between state and federal tax increases. Further investigation suggests that firms raised cigarette prices substantially in the years surrounding the 1983 federal tax increase, which accounts for the relatively large decrease in consumption during this period., Conclusions: Federal excise taxes per se do not appear to be more effective than state excise taxes in terms of reducing cigarette consumption. The reaction of cigarette firms to government policies appears to be an important determinant of the success of antismoking initiatives.

Objectives: This paper examines differences between joiners and nonjoiners of a voluntary smokers' registry., Methods: A baseline prevalence survey was used to identify characteristics of smokers who joined or did not join a smokers' registry., Results: Communities varied significantly in registry enrollment rates. Heavy-smoking joiners expressed more desire to quit, were more likely to live with nonsmokers, and were older than nonjoiners. Light-to-moderate joiners smoked more, were more addicted to cigarettes, and expressed more desire to quit than nonjoiners., Conclusions: Few baseline characteristics differentiated joiners from nonjoiners. Nonjoiners were significantly more likely to achieve cessation than joiners.

Objectives: This article examines health policy implications of providing smokers with numerical tar yield information in cigarette advertising., Methods: Results of a national probability telephone survey regarding smokers' knowledge and understanding of numerical tar yields and deliveries are reported., Results: Few smokers knew the tar level of their own cigarettes (the exception being smokers of 1- to 5-mg tar cigarettes), and a majority could not correctly judge the relative tar levels of cigarettes. Smokers were unsure whether switching to lower-tar cigarettes would reduce their personal health risks. Many smokers relied on absolute numbers in making trade-offs between number of cigarettes smoked and their tar levels, thus confusion machine-rated tar-yields with actual amounts ingested., Conclusions: The wisdom of the present method of providing tar and nicotine numbers in ads and recommendations for modifying the test protocol are now under discussion. This research indicates that these tar numbers and their implications are poorly understood. The paper recommends revisions in tar ratings to make them more useful and a required statement on cigarette packages to more explicitly relate tar levels to major health risks.

Objectives: The Minnesota Heart Health Program was a research and demonstration project designed to reduce risk factors for heart disease in whole communities. This paper describes smoking-specific interventions and outcomes., Methods: Three pairs of matched communities were included in the study. After baseline surveys, one community in each pair received a 5-year education program, while both cross-sectional and cohort surveys continued in all sites. Adult education programs for smoking cessation included Quit and Win contests, classes, self-help materials, telephone support, and home correspondence programs., Results: Encouraging short-term results were obtained for several adult education programs. Overall long-term outcomes were mixed, with evidence of an intervention effect only for women in cross-sectional survey data. Unexpectedly strong secular declines in smoking prevalence were observed in comparison communities., Conclusions: The findings suggest that community education may be unlikely to exceed dramatic secular reductions in smoking prevalence. The success of several key interventions and the incorporation of Minnesota Heart Health Program interventions by education communities are encouraging, however.

Objectives: A major assumption underlying youth health promotion has been that physiological risk factors track from childhood into adulthood. However, few studies have systematically examined how behaviors change during adolescence. This paper describes longitudinal tracking of adolescent health behaviors in two Minnesota Heart Health Program communities., Methods: Beginning in sixth grade (1983), seven annual waves of behavioral measurements were taken from both communities (baseline n = 2376). Self-reported data included smoking behavior, physical activity, and food preferences., Results: A progressive increase in the change to weekly smoking status was observed across the smoking status categories. As students began to experiment with smoking, they were more likely to either begin to be or remain regular smokers. Tracking of physical activity and food choice variables was also apparent. In nearly all the follow-up periods, the students identified at baseline as measuring high remained high, and those measuring low remained low., Conclusions: These results indicate that there is evidence of early consolidation and tracking of physical activity, food preference, and smoking behavior. The early consolidation of health behaviors implies that interventions should begin prior to sixth grade, before behavioral patterns are resistant to change. The smoking results suggest that students are experiencing difficulty quitting smoking; thus, youth smoking cessation interventions are warranted.

Objectives: Previous studies concluded that Black adolescents use tobacco and other drugs less than White adolescents. The Black-White differences typically were attributed to variations in background and life-style. The objective of the research reported in this paper was to determine whether the presumed difference in tobacco use is due to Black-White differences in the validity of self-reports., Methods: We used biochemical measures to compare the validity of self-reports of tobacco use by 1823 Black and White adolescents and to assess the contribution of variation in validity to Black-White differences in reported tobacco use., Results: The sensitivity of Blacks' reports was significantly less than the sensitivity of Whites' reports. The specificity of Whites' reports was significantly less than the specificity of Blacks' reports. Much of the Black-White differences in reports of cigarette smoking and tobacco use were due to Black-White differences in validity., Conclusions: Studies of Black-White differences should adjust for the invalidity of reports or acknowledge that much of the difference may be due to measurement error.

Objectives: Proposition 99 added 25 cents to the California state cigarette tax and mandated that 20% of the new revenues be spent on tobacco education and prevention programs. This paper examines the implementation of these programs and the tobacco industry's response to Proposition 99., Methods: Political expenditure data for twelve tobacco firms and associations were gathered from California's Fair Political Practices Commission and secretary of state's Political Reform Division. Tobacco education expenditure data were collected from Governor's Budgets and the Department of Finance., Results: Since Proposition 99 passed, tobacco industry political expenditures in California have risen 10-fold, from $790,050 in the 1985-1986 election to $7,615,091 in the 1991-1992 election. The tobacco industry is contributing more heavily to the California legislature than to Congress. A statistical analysis of data on campaign contributions indicates that California legislators' policy-making is influenced by campaign contributions from the tobacco industry. Since fiscal year 1989-1990, the state has ignored the voters' mandate and spent only 14.7% of the new revenues to tobacco education. Medical care programs received more money than permitted by the voters., Conclusions: The tobacco industry has become politically active in California following the passage of Proposition 99. One result may be that the state has underfunded tobacco education by $174.7 million through the 1993-1994 fiscal year. The estimated redirection of funds to medical care would essentially eliminate the tobacco education campaign by the year 2000.

Current evidence suggests a strong positive correlation between cigarette consumption and depression; this study examined the relationship between cigarettes and suicide. Over 100,000 predominantly White, middle-aged, female registered nurses were followed via biannual questionnaires from 1976 through 1988. Respondents smoking 1 through 24 cigarettes per day had twice the risk and those smoking 25 or more cigarettes four times the risk of committing suicide, compared with those who had never smoked. Although no information on causation was available, this paper links cigarettes to another major health problem.

Despite overwhelming evidence documenting the hazards of cigarette smoking, the tobacco industry denies that smoking has been proven to cause disease. The industry professes a desire to clear up the smoking and health "question" and often points to its support of the Council for Tobacco Research (CTR) as evidence of its interest in investigating the health dangers of smoking. This paper presents results of a survey of CTR-funded scientists regarding their beliefs about the health dangers posed by smoking cigarettes. The vast majority of scientists funded by the CTR believe that cigarette smoking is an addiction that causes a wide range of serious, often fatal, diseases. This result suggests that the tobacco industry is unwilling to accept even the opinions of scientists it has deemed worthy of funding. Scientists should consider the ethical implications of accepting funds from the CTR and other tobacco industry-supported institutions.

Background: This paper reports racial/ethnic differences in the use of licit and illicit drugs by high school seniors in the United States., Methods: The study uses questionnaire data from annual, nationally representative surveys of seniors from 1976 through 1989. Combined sample sizes were 57,620 for 1976-79; 75,772 for 1980-84; and 73,527 for 1985-89., Results: Native American had the highest prevalence rates for cigarettes, alcohol, and most illicit drugs; White students had the next highest rates for most drugs. Asian Americans had the lowest prevalence rates, and Black students had levels nearly as low except for marijuana. Prevalence rates for the Hispanic groups were mostly in the intermediate ranges except for relatively high cocaine use among the males. Trend patterns for most forms of drug use were similar across subgroups, although cigarette use declined more sharply for Black than White seniors, resulting in greater Black-White differences in recent years., Conclusions: This study, other school-based studies, and general population surveys all show relatively low levels of drug use by most non-White youth, especially Black Americans and Asian Americans. Multivariate analyses indicate that such subgroup differences in high school seniors' drug use are not primarily attributable to family composition, parents' education, region, or urban-rural distinctions.

Objectives. This paper presents the behavioral results of the Working Well Trial, the largest US work site cancer prevention and control trial to date. Methods. The Working Well Trial used a randomized, matched-pair evaluation design, with the work site as the unit of assignment and analysis. The study was conducted in 111 work sites (n = 28 000 workers). The effects of the intervention were evaluated by comparing changes in intervention and control work sites, as measured in cross-sectional surveys at baseline and follow-up. The 2-year intervention targeted both individuals and the work-site environment. Results. There occurred a net reduction in the percentage of energy obtained from fat consumption of 0.37 percentage points (P = .033), a net increase in fiber densities of 0.13 g/1000 kcal (P = .056), and an average increase in fruit and vegetable intake of 0.18 servings per day (P = .0001). Changes in tobacco use were in the desired direction but were not significant. Conclusions. Significant but small differences were observed for nutrition. Positive trends, but no significant results, were observed in trial-wide smoking outcomes. The observed net differences were small owing to the substantial secular changes in target behaviors. [ABSTRACT FROM AUTHOR]

Objectives. The Class of 1989 Study is part of the Minnesota Heart Health Program (MHHP), a populationwide research and demonstration project designed to reduce cardiovascular disease in three educated communities from 1980 to 1993. This paper describes an intensive, school-based behavioral intervention on cigarette smoking, comparing long-term outcomes in one of the intervention communities with those in a matched reference community. Methods. Beginning in sixth grade (1983), seven annual waves of cohort and cross-sectional behavioral measurements were taken from one MHHP intervention community and its matched pair. All students in each community were eligible to participate (baseline n = 2401). Self-reported data collected at each period described prevalence and intensity of cigarette smoking. Results. There were no differences at baseline for either weekly smoking prevalence or intensity of smoking. Throughout the follow-up period, however, smoking rates as determined by these measures were significantly lower in the intervention community: 14.6% of students were weekly smokers at the end of high school compared with 24.1% in the reference community. Cconclusions. These results suggest that multiple intervention components such as behavioral education in schools, booster programs to sustain training, and complementary communitywide strategies may all be needed for lasting reductions in adolescent tobacco use. [ABSTRACT FROM AUTHOR]

Background: This paper reports findings from -A field experiment that evaluated mass media campaigns designed to prevent cigarette smoking by adolescents. Methods: The campaigns featured radio and television messages on expected consequences of smoking and a component to stimulate personal encouragement of peers not to smoke. Six Standard Metropolitan Statistical Areas in the Southeast United States received campaigns and four served as controls. Adolescents and mothers provided pretest and posttest data in their homes. Results and Conclusions: The radio campaign had a modest influence on the expected consequences of smoking and friend approval of smoking, the more expensive campaigns involving television were not more effective than those with radio alone, the peer-involvement component was not effective, and any potential smoking effects could not be detected. [ABSTRACT FROM AUTHOR]

Background. This paper reports racial/ethnic differences in the use of licit and illicit drugs by high school seniors in the United States. Methods. The study uses questionnaire data from annual, nationally representative surveys of seniors from 1976 through 1989. Combined sample sizes were 57,620 for 1976-79; 75,772 for 1980-84; and 73,527 for 1985-89. Results. Native American had the highest prevalence rates for cigarettes, alcohol, and most illicit drugs; White students had the next highest rates for most drugs. Asian Americans had the lowest prevalence rates, and Black students had levels nearly as low except for marijuana. Prevalence rates for the Hispanic groups were mostly in the intermediate ranges except for relatively high cocaine use among the males. Trend patterns for most forms of drug use were similar across subgroups, although cigarette use declined more sharply for Black than White seniors, resulting in greater Black-White differences in recent years. Conclusions. This study, other school-based studies, and general population surveys all show relatively low levels of drug use by most non-White youth, especially Black Americans and Asian Americans. Multivariate analyses indicate that such subgroup differences in high school seniors' drug use are not primarily attributable to family composition, parents' education, region, or urban-rural distinctions. [ABSTRACT FROM AUTHOR]

This paper is a review of published reports, in English, of educational programs designed to change smoking behavior. Attempts to change the smoking behavior of young people have included anti-smoking campaigns, youth-to-youth programs, and a variety of message themes and teaching methods. Instruction has been presented both by teachers who were committed or persuasive and by teachers who were neutral or presented both sides of the issue. Didactic teaching, group discussion, individual study, peer instruction, and mass media have been employed. Health effects of smoking, both short- and long-term effects, have been emphasized. Most methods used with youth have shown little success. Studies of other methods have produced contradictory results. Educational programs for adults have included large scale anti-smoking campaigns, smoking cessation clinics, and a variety of more specific withdrawal methods. These methods have included individual counseling, emotional role playing, aversive conditioning, desensitization, and specific techniques to reduce the likelihood that smoking will occur in situations previously associated with smoking. Some of these techniques have produced poor results while studies of other methods have shown inconsistent results. The two methods showing the most promise are individual counseling and smoking withdrawal clinics. [ABSTRACT FROM AUTHOR]

The article presents a rebuttal on the views of Theodor D. Sterling in his paper "A Critical Reassessment of the Evidence Bearing on Smoking as the Cause of Lung Cancer." According to the author, Sterling has reiterated his stand against a generally accepted hypothesis, the basis for one of the most important advances in preventive medicine, during the past two decades. He argues that Sterling has ignored most of the clinical, autopsy, and experimental data and concentrate his criticism on the epidemiological evidence, when in fact, the criteria of consistency, strength, specificity, temporal relationship, and coherence is the basis in judging that smoking and lung cancer association is causal. Sterling's errors in the paper according to the author's understanding are elaborated.

In studies of variables that can be used to predict teenage smoking, there is a need for surveys using multiple prediction procedures. This paper is an attempt to select an optimum set of such predictors and to establish their interrelationships. Findings are presented and areas of research are discussed. [ABSTRACT FROM AUTHOR]

The article offers information on a research plan adopted by the U.S. National Cancer Institute to develop, test and spread effective smoking prevention and cessation interventions in the U.S. A number of smoking intervention trials were funded between 1984 and 1993. The institute also launched the Community Intervention Trial for Smoking Cessation to assess the effectiveness of these trials. The research also gave way to the culmination of the American Stop Smoking Intervention Study for Cancer Prevention.

This paper describes self-reported maintenance of nonsmoking at six months postpartum by women whose abstinence was verified beginning before the 20th week of pregnancy and continuing through delivery (n = 134). The overall maintenance rate of 37 percent was not related to sociodemographic characteristics, smoking and obstetric history, the time when quitting occurred, or a prenatal smoking cessation program. Although this rate is encouraging, more attention should be directed to sustaining prenatal abstinence from smoking beyond delivery. [ABSTRACT FROM AUTHOR]

Abstract: This paper identifies the correlates of smokeless tobacco use in a sample of 1,030 males representative of 7th through 12th grade students of Dane County (Madison), Wisconsin. Variables independently associated with frequent use of smokeless tobacco were: being White; living in other than a two-parent home; performing poorly in school; smoking cigarettes; consuming beer, wine, or hard liquor; and deviant/delinquent behavior. Participation in team sports was associated with some "experimentation" with smokeless products. [ABSTRACT FROM AUTHOR]

The article presents the author's view on the "A Critical Reassessment of the Evidence Bearing on Smoking as the Cause of Lung Cancer" by Theodore D. Sterling. According to Sterling, the level of lung cancer mortality in the U.S. among men especially non-white, the rates have increased and among women there was a dramatic increase in the rates during the 1950's. The smoking-lung cancer hypothesis sets the trends in women's mortality. Sterling cited the evidence that women have increased their smoking since 1955.

A correction to the article "The Tobacco Industry's Renewed Assault on Science: A Call for a United Public Health Response," published online, is presented.

Objectives. The purpose of this paper is to provide smokers with information on the relative benefits of mitigating radon and quitting smoking in reducing radon-related lung cancer risk. Methods. The standard radon risk model, linked with models characterizing residential radon exposure and patterns of moving to new homes, was used to estimate the risk reduction produced by remediating high-radon homes, quitting smoking, or both. Results. Quitting smoking reduces lung cancer risk from radon more than does reduction of radon exposure itself. Conclusions. Smokers should understand that, in addition to producing other health benefits, quitting smoking dominates strategies to deal with the problem posed by radon. [ABSTRACT FROM AUTHOR]

Smoking-related diseases comprise a large portion of hospital admissions. This paper reports the attitudes and behaviors of a group of hospital-based nurses toward counseling patients on smoking cessation. The majority of nurses do not counsel patients who smoke. Counseling practices vary with the smoking status of the nurse. Barriers to increased nursing participation in counseling efforts include the lack of counseling training and physician failure to utilize nurses in this role.

The article presents international public health news briefs on topics including Great Britain's Critical Thinking and Appraisal Resource Library which collects and distributes free learning resources to promote critical thinking in medical treatment decision making. A vertical governance structure and the mental health of teenagers (adolescents) in Porto Alegre, Brazil are addressed, along with tobacco-wrapping materials and informed health choices for primary school children in Uganda.

Objectives. The purpose of the study was to examine the effect of prenatal alcohol exposure on offspring's weight, height, and head circumference from birth through 14 years of age. Methods. This longitudinal prospective study examined a cohort of approximately 500 offspring (over-sampled for heavier drinkers and stratified for smoking from a population of 1529 women in prenatal care at the 5th gestational month) at birth; 8 and 18 months; and 4, 7, and 14 years of age. Covariates were examined by means of multiple regression. Birth size measures were also examined as predictors of 7-year neurodevelopmental outcomes. Results. Effects of alcohol were observed on weight, length, and head circumference at birth; these effects were not altered by adjustment for covariates including smoking. However, the birthweight effect is clearly transient: although alcohol effects remained observable at 8 months, they were not measurable thereafter through age 14 years. Conclusions. In this population-based sample, neither birthweight nor any later size measure was as useful an indicator of the enduring effects of prenatal alcohol exposure as were certain neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]

Objectives. The association between cigarette smoking and bone mineral density was examined prospectively in a population-based study of older Caucasian men and women. Methods. Smoking patterns were determined at a 1972-1974 base-line evaluation and, again, 16 years later when 544 men and 822 women had bone mineral density measurements taken. Results. Men and women who were cigarette smokers at baseline demonstrated significantly reduced bone mineral density of the hip compared with nonsmokers. Baseline smoking was not associated with significantly lower bone density at non-hip sites. Women demonstrated a significant dose-response relationship between baseline smoking status at all hip sites measured. Both sexes exhibited significant dose-response relationships between hip bone mineral density and change in smoking status between baseline and follow-up, demonstrating that smoking cessation in later life was beneficial in halting bone density loss associated with smoking. Conclusions. Smoking was positively and significantly associated with decreased hip bone mineral density in old age. Bone loss associated with smoking would be expected to predict an increased risk of hip fracture in those who do not succumb earlier to another complication of tobacco use. [ABSTRACT FROM AUTHOR]

Objectives. Sources of measurement error in assessing smoking status are examined. Methods. The Lung Health Study, a randomized trial in 10 clinical centers, includes 3923 participants in a smoking cessation program and 1964 usual care participants. Smoking at first annual follow-up was assessed by salivary cotinine, expired air carbon monoxide, and self-report. Each of these measures is known to contain some error. Sensitivity and specificity were calculated by comparing a biochemical measure with self-report to produce an undifferentiated estimate of error. Classification error rates due to imprecision of the biochemical measures and to the error in self-report were estimated separately. Results. For cotinine compared with self-report, the sensitivity was 99.0% and the specificity 91.5%. For carbon monoxide compared with self-report the sensitivity was 93.7% and the specificity 87.2%. The classification error attributed to self-report, estimated by comparing the results from intervention and control groups, was associated with the responses of 3% and 5% of participants, indicating a small but significant bias towards a socially desirable response. Conclusions. In absolute terms in these data, both types of error were small. [ABSTRACT FROM AUTHOR]

A field trial was conducted to evaluate the reliability of four widely used health risk appraisals (HRAs). A total of 338 randomly selected adults aged 25 to 65 years residing in the Boston metropolitan area completed an HRA on two occasions seven in 12 weeks apart. Test-retest reliability was assessed by comparing self-reported baseline risk scores in follow-up scores for heart attack risk and selected coronary heart disease risk factors. Respondents generally gave consistent reports for family history, cigarette smoking, and relative weight (test-retest r > .75), but self-reported scores for physiologic status (blood pressure and cholesterol) and lifestyle (diet, physical activity, and stress) were much less stables Coefficients for heart attack risk and appraised age ranged from .43 to 087 for the four HRAs. The reliabilities of two self-scored instruments were greatly reduced by mathematical errors made by respondents when computing their heart attack risk scores. These results were not affected by the length of the follow-up period (seven to 12 weeks). [ABSTRACT FROM AUTHOR]

The article presents a public health response to the war on drugs by the American Public Health Association. The response is focused on the reduction of alcohol, tobacco, and other drug problems among the American youth. One of the most pressing issues in the United states is the alcohol, tobacco, and other drug problems among the youth. There are several reasons why drug use prevention and reduction is not totally effective in the United States. One of the reasons is that the educational programs and mass media campaigns regarding the issue are poorly planned and inadequate.

A survey on brand preference and cigarette advertising recall in 1,195 school children was conducted in Sydney, Australia. Four of the 130 available brands accounted for the cigarettes smoked by 78.7 per cent of smokers. Smokers were nearly twice as likely to correctly identify edited cigarette advertisements and slogans than were non-smokers. Brand preference is considered an important descriptor of smoking profiles. [ABSTRACT FROM AUTHOR]

The present study examined the relationships between exposure to a smoking awareness curriculum, attitudes toward and knowledge about smoking, sociodemographic anti smoking exposure characteristics, and change in smoking starts over three years. During this period, 4.5 per cent of the students decreased their involvement with cigarettes, 56.6 per cent reported no change, and 38.9 per cent reported an increase. Exposure to the curriculum did not bear a significant relationship to change in smoking; however, changes in peer smoking, knowledge, and parental smoking were significant predictors. (Am J Public Health 1981; 71: 1401-1404.) [ABSTRACT FROM AUTHOR]

Abstract. The smoking cessation component of a residential program which attempts to concurrently intervene on several risk factors related to chronic disease is described. Seventy-two per ¢ of the 43 smokers in the first 13 cohorts were abstinent at discharge. Fifty-five per ¢ were abstinent at two months. Six-month data for the first nine cohorts show 53 per ¢ abstinence. Possible advantages and disadvantages of a multiple behavior change program in a residential setting are discussed. (Am J Public Health 1981: 71:844-847.) [ABSTRACT FROM AUTHOR]

The impact of the anti-smoking campaign on the consumption of cigarettes is measured by fitting cigarette demand functions to pre-campaign date, projecting "ahead" as if the campaign had not occurred, and then comparing these predictions with realized consumption. The analysis suggests that major "events" in the campaign (e.g., Surgeon General's Report) caused immediate though transitory decreases of 4 to 5 per cent in annual per capital consumption. However, the cumulative effect of persistent publicity supported by other public policies, has been substantial: in the absence of the campaign, per capita consumption likely would have exceeded its actual 1975 value by 20 to 30 per cent. This is a conservative indication of the effectiveness of the campaign, for it ignores other potentially important and desirable behavior changes, such as the shift to low "tar" and nicotine cigarettes. [ABSTRACT FROM AUTHOR]

Objectives. Trends in attitudes and current practices concerning smoking in the home were examined. Methods. Data from population-based surveys of adults in Ontario, Canada, were analyzed. Results. Between 1992 and 1996, the percentage of respondents who agreed that parents spending time at home with small children should not smoke increased from 51% to 70%. In 1996, 34% of the homes surveyed were smoke-free. Smoke-free homes were associated with nonsmoking respondents and with the presence of children and no daily smokers in the home. Only 20% of homes with children and any daily smokers were smoke-free. Conclusions. Efforts are needed to assist parents in reducing children's exposure to environmental tobacco smoke in the home. [ABSTRACT FROM AUTHOR]

Conclusions. Despite increasing knowledge of adverse effects, smoking during pregnancy has not declined in Finland over the past decade. (Am J Public Health. 2001 ;91:284-286) [ABSTRACT FROM AUTHOR]

A letter to editor is presented in response to an article relating to the risk of passive smokers, published in a previous issue of this periodical.

The article reflects on the various efforts toward prevention of smoking among adolescents. It discusses the papers published within the issue which focus on smoking among teenagers while emphasizing the positive result brought by smoking cessation programs and health risk assessment in improving the health of the youth.

Previous studies have demonstrated that acculturation is associated with negative birth outcomes among mothers in numerous immigrant populations, including Latinas. This study used structural equation models to reanalyze data employed in the 1989 Scribner and Dwyer study on the effect of acculturation (measured through the Cuellar scale) on mothers' low-birthweight status. Data revealed that language components dominate the effects of acculturation on low-birthweight status. Acculturation appears to affect low-birth- weight status indirectly through smoking and dietary intake but not through parity. Acculturation has a persistent direct effect on low -birthweight status, suggesting that other intervening variables are operant. [ABSTRACT FROM AUTHOR]

We evaluated the effect of state cigarette tax increases on cigarette sales in the 50 states for the years 1955 to 1988. State cigarette tax increases were associated with an average decline in cigarette consumption of three cigarette packs per capita (about 2.4%). Larger tax increases were associated with larger declines in consumption. Raising state cigarette taxed appears to be an effective public health intervention that can reduce cigarette consumption and its associated health consequences. [ABSTRACT FROM AUTHOR]