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Abstract: Smoking is a worldwide public health problem, and various communication strategies aimed at its cessation have been used. The objective of this paper was to explore differences over time of two communication strategies (gain-framed versus loss-framed) in encouraging calls to a Quitline, according to smoker''s degree of dependence. A study was conducted for four weeks among passengers of two selected subway stations in the city of Rio de Janeiro-Brazil (N average =12,500 passengers a day per station). The interventions – large posters with images and text based on central theme “shortness-of-breath” – also contained the Quitline number. Call rate differences between the strategies, overall and specific per study week, were calculated. Light smokers exposed to the positive-content message called on average 2.2 times more often than those exposed to the negative-content message (p <0.001). The absolute difference in call rates decreased after the first week of the study (p for the additive interaction between intervention and study week, 0.02). For heavy smokers, no differences between the two stations were observed. Additive interaction was found between type of smoker – light or heavy – and intervention (p =0.02). The results suggest that short-term positive-content campaigns based on issues pertaining to individuals'' daily routine could be effective in capturing light smokers. These results may have considerable public health impact, as the prevalence of less dependent smokers is much higher than that of heavier smokers. [Copyright &y& Elsevier]

In this paper, we propose an approach to investigate the hypothesis that the residential concentration of poverty affects health status more deeply than when poverty is randomly scattered in a given geographical area. To characterize the geographic pattern of poverty in the city of Rio de Janeiro, Brazil, an index that measures the heterogeneity of poverty concentration among sub-areas was proposed. We used census data and defined poverty by means of the household head monthly income. The 153 neighborhoods that compose the city were used as the geographic units, and the census tracts as the sub-areas. The proposed index measures differences of poverty concentration across census tracts within a neighborhood. The effects of geographic poverty clustering on infant mortality related variables (early neonatal mortality rate; post-neonatal mortality rate; proportion of adolescent mothers; and fertility rate among adolescents) were estimated by partial correlation coefficients, controlling for the neighborhood poverty rate. Our study revealed that intra-city variations of the post-neonatal mortality rate are associated with geographic patterns of poverty, and that pregnancy in adolescence is strongly and contextually correlated with intra-neighborhood poverty clustering, even after adjustment for the poverty rate. The evidence of relevant health differences associated with the spatial concentration of poverty supports the hypothesis that properties of the environment of residence contextually influence health. Our findings suggest that prevention of some infant mortality related problems has to be focused directly on features of communities, considering their physical, cultural and psychosocial characteristics, being of particular concern the health of communities segregated from the society at large by extreme poverty. [Copyright &y& Elsevier]