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Background: Calls have been made to relax current Australian regulations related to e-cigarettes to increase the accessibility of the devices for smoking cessation purposes. However, e-cigarettes have been found to increase risk of initiation of conventional cigarette smoking, especially among young adults. To assist in guiding the development of policy in Australia, the present study examined whether e-cigarette use among Australian young adults who have never smoked a tobacco cigarette is associated with susceptibility to future tobacco cigarette use.Method: An online web panel provider recruited 519 never smokers aged 18-25 years (55% female; average age = 21.21 years, SD = 2.32). Respondents completed an online survey that assessed their curiosity about tobacco smoking, willingness and intentions to smoke, and a number of individual and social factors. Cross-sectional regression analyses were conducted to assess the association between e-cigarette use and susceptibility to tobacco cigarette use while controlling for multiple covariates.Results: Curiosity about tobacco smoking, willingness to smoke, and intentions to smoke were significantly higher among users of e-cigarettes than never users. The relationship between e-cigarette use and susceptibility to future tobacco cigarette use remained significant after controlling for numerous covariates.Conclusion: E-cigarette use, even just one or two puffs, has the potential to increase susceptibility to tobacco cigarette use among Australian young adults. Findings suggest that increasing the availability of e-cigarettes by relaxing current strict regulations surrounding their sale may have unintended consequences. [ABSTRACT FROM AUTHOR]

There is a well-established socioeconomic gradient in smoking behavior: those with lower socioeconomic status smoke more. However, much less is known about the mechanisms explaining how SES is linked to smoking. This study takes a social-ecological perspective by examining whether socioeconomic status affects smoking behavior by differential exposure to places where smoking is allowed. Exposure to smoking restrictions was assessed in real-time using Ecological Momentary Assessment methods. A sample of 194 daily smokers, who were not attempting to quit, recorded their smoking and information about situational and contextual factors for three weeks using an electronic diary. We tested whether a smoker's momentary context mediated the relationship between socioeconomic status (educational attainment) and cigarettes smoked per day (CPD). Momentary context was operationalized as the proportion of random assessments answered in locations where smoking was allowed versus where smoking was not allowed. Data were analysed using multilevel regression (measurements nested within participants) with a lower level mediation model (2-1-1 mediation). Although no significant direct effect of SES on CPD were observed, there was a significant indirect effect of SES on CPD via the momentary context. Compared to participants with higher education, lower educated participants were more likely to encounter places where smoking was allowed, and this in turn, was associated with a higher number of CPD. These findings suggest that SES is associated with smoking at least partially via differential exposure to smoking-friendly environments, with smokers from lower SES backgrounds accessing more places where smoking is allowed. Implications for current smoke-free legislation are discussed. [ABSTRACT FROM AUTHOR]

Background and Aims: Models of tobacco smoking behaviour propose that anticipated pleasure or satisfaction, the need to alleviate a nicotine-induced drive state and a stimulus-driven impulse potentially play an important role. This study aimed to provide a preliminary assessment of how far urges to smoke are reported by smokers and whether the strength of such urges prior to a quit attempt predicts short-term success at quitting.Methods: In a prospective study, 566 smokers attending a treatment programme to help smokers quit completed a written questionnaire covering frequency of different types of urge to smoke (automatic impulse - 'automatic urges', anticipated pleasure - 'pleasure urges', and fulfilling a need - 'need urges'). They were asked to rate this for whichever of these urges was dominant for them. The questionnaire also assessed daily cigarette consumption, time to first cigarette of the day, age and gender. Carbon monoxide verified smoking status was recorded at 1 and 4weeks after the target quit date.Findings: A total of 47.9% (271) of smokers reported that automatic urges were dominant, 21.7% (123) reported pleasure urges to be dominant, and 30.4% (172) reported need urges to be dominant. The strength of automatic urges predicted abstinence at both 1week (OR=0.74, p=0.005, 95%CI=0.60-0.92) and 4weeks (OR=0.73, p=0.008, 95%CI=0.59-0.92). Associations between other urge types and abstinence were not statistically significant.Conclusions: A substantial proportion of smokers attending a clinic for help with quitting report that their dominant urges to smoke occur without any anticipation of pleasure or relief and the strength of the automatic urges predicts failure to sustain abstinence following a quit attempt. [ABSTRACT FROM AUTHOR]

Introduction: We investigated whether established risk factors for initiating cigarette smoking during adolescence (parents, siblings, friends smoke; home smoking rules, smokers at home, exposure to smoking in cars, academic performance, susceptibility to smoking, depressive symptoms, self-esteem, school connectedness, use of other tobacco products) are associated with initiation in preadolescents, and whether the effects of these factors differ by gender.Methods: In spring 2005, baseline data were collected in self-report questionnaires from 1801 5th grade students including 1553 never-smokers (mean age=10.7years), in the longitudinal AdoQuest I Study in Montréal, Canada. Follow-up data were collected in the fall and spring of 6th grade (2005-2006). Poisson regression analyses with robust variance estimated the effects of each risk factor on initiation and additive interactions with gender were computed to assess the excess risk of each risk factor in girls compared to boys.Results: 101 of 1399 participants in the analytic sample (6.7% of boys; 7.7% of girls) initiated smoking during follow-up. After adjustment for age, gender and maternal education, all risk factors except academic performance and school connectedness were statistically significantly associated with initiation. Paternal and sibling smoking were associated with initiation in girls only, and girls with lower self-esteem had a significant excess risk of initiating smoking in 6th grade.Conclusions: Risk factors for smoking initiation in preadolescents mirror those in adolescents; their effects do not differ markedly by gender. Preventive programs targeting children should focus on reducing smoking in the social environment and the dangers of poly-tobacco use. [ABSTRACT FROM AUTHOR]

This study assessed racial/ethnic moderation of the association between school prevalence of lifetime e-cigarette use and students' use. Using multilevel regression methods and data from the 2014 US National Youth Tobacco Survey, we found attending schools with high rates of e-cigarette use was positively associated with students' lifetime use of e-cigarettes, especially for white students. A cross-level interaction term indicated a weaker association between non-Hispanic black race and attending high-use schools (odds ratio [OR] =0.61, 95% confidence interval [CI] =0.39, 0.95). Results implicate race/ethnicity as an important effect modifier in the link between school contexts and teenage e-cigarette use. [ABSTRACT FROM AUTHOR]

Introduction: The Patient Reported Outcomes Measurement Information System (PROMIS®) Smoking Initiative has developed six item banks for assessing smoking behaviors and biopsychosocial correlates of smoking among daily and nondaily adult cigarette smokers. This paper presents new validity evidence for the item banks including correlations of the item banks to the existing legacy measures of smoking (Fagerström Test of Nicotine Dependence (FTND), Questionnaire of Smoking Urges (QSU), and the Wisconsin Inventory of Smoking Dependence Motives (WISDM)).Methods: Using data from a follow-up sample (N=491) and a community sample (N=369) of adult daily and nondaily smokers, we replicated the findings from Edelen et al. (2014a) and examined the correlations of legacy smoking measures with the new item bank scores.Results: Preliminary validity findings were largely replicated with the new data. Correlations among the banks are moderate and bank score associations with measures of smoking behavior, quitting history, and other PROMIS measures follow expected patterns (e.g., nicotine dependence is most strongly associated with smoking quantity and time to first cigarette of the day; health and psychosocial expectancies are most related to quitting recency and interest). Correlations of bank scores with legacy measures are moderate to strong. The PROMIS nicotine dependence scores were most strongly associated with the legacy instruments.Conclusions: These analyses provide strong evidence for the validity of the PROMIS Smoking item banks in two independent samples. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the study was to better understand early risk for positive smoking expectancies, which have been shown to be consistent predictors of smoking initiation among youth. Two affect-based risk factors-negative urgency and emotion dysregulation-associated with smoking behaviors among youth, were examined for unique and interactive effects on positive smoking expectancies among substance-naïve youth.Methods: Participants were 61 10-14-year-old children with virtually no drug use (less than 5 substance use incidents across the lifetime), who were drawn from the community.Results: Both negative urgency and emotion dysregulation were significantly associated with positive social facilitation smoking expectancies. Further, negative urgency was significantly related to positive social facilitation smoking expectancies at higher levels of emotion dysregulation (b=.09, p=.001).Conclusion: The findings provide evidence that both emotion dysregulation and negative urgency are positively associated with positive social-related smoking expectancies among a sample of 10-14-year-olds. Children who are emotionally dysregulated and who act rashly in response to negative emotions appear more likely to endorse beliefs regarding the socially enhancing effects of smoking, suggesting that these youth may be at high risk for smoking initiation. [ABSTRACT FROM AUTHOR]

Background “Social smoking” – smoking mostly or even only with others – may be an important pattern that implies smoking motivated extrinsically by social influences. Non-daily smokers (intermittent smokers; ITS) are often assumed to be social smokers, with some authors even assuming that all ITS are social smokers (SS+). We sought to identify and characterize social smokers in a sample of ITS. Methods 204 adult ITS (smoking 4–27 days/month) recorded the circumstances of smoking in their natural settings using Ecological Momentary Assessment, while also recording their circumstances in nonsmoking moments. SS+ were defined as ITS who were with others when they smoked most of their cigarettes, and who were ≥50% more likely to be with others when smoking than when not. Results Only 13% of ITS were SS+. Although defined solely on the basis of presence of others, SS+ showed a distinct pattern of smoking across multiple dimensions: compared to other ITS (who were significantly less likely to smoke when with others), SS+ smoking was more associated with socializing, being with friends and acquaintances, drinking alcohol, weekends, evening or nighttime, being in other people's homes, but not their own home. SS+ smoking was low in the morning and increased in the evening. SS+ smoked fewer days/week and were less dependent, but did not differ demographically. Conclusions Social smoking does constitute a highly distinct smoking pattern, but is not common among adult ITS. [ABSTRACT FROM AUTHOR]

Background Smoking rates are higher among low socioeconomic (SES) groups, and there is evidence that inequalities in smoking are widening over time in many countries. Low SES smokers may be more likely to smoke and less likely to quit because smoking is heavily concentrated in their social contexts. This study investigated whether low SES smokers (1) have more smoking friends, and (2) are more likely to gain and less likely to lose smoking friends over time. Correlates of having more smoking friends and gaining or losing smoking friends were also considered. Method Respondents included 6321 adult current smokers (at recruitment) from Wave 1 (2002) and Wave 2 (2003) of the International Tobacco Control Project (ITC) Four Country Survey, a nationally representative longitudinal cohort survey of smokers in Australia, Canada, UK, and US. Results Low SES smokers reported more smoking friends than moderate and high SES smokers. Low SES smokers were also more likely to gain smoking friends over time compared with high SES smokers. Smokers who were male, younger, and lived with other smokers reported more smoking friends, and were also more likely to gain and less likely to lose smoking friends. Smoking behaviours, such as higher nicotine dependence were related to reporting more smoking friends, but not to losing or gain smoking friends. Conclusions Smoking is highly concentrated in the social networks of lower SES smokers and this concentration may be increasing over time. Cessation interventions should consider how the structure of low SES smokers’ social networks affects quitting. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Various studies have demonstrated that environmental smoking cues elicit smoking-related responses in smokers. However, cue reactivity studies among adolescent smokers are scarce. Therefore, the aim of this study was to examine the effect of smoking portrayal in movies on immediate smoking behavior in adolescent smokers. Method: A total of 65 adolescent daily smokers (between the ages of 16 and 18years) were exposed to a one-hour movie clip, with or without smoking characters, and were allowed to smoke while watching the movie. Results: The exposure to smoking cues in movies had no effect on immediate smoking behavior. This association was not affected by several smoking- and movie-related variables. Conclusions: No influence of smoking cues in movies on immediate smoking behavior in adolescent daily smokers was found. More experimental research on the effects of environmental cues on adolescent smokers in different stages of addiction is needed. [Copyright &y& Elsevier]

Abstract: Heterogeneity in time and risk preferences has been proposed as one of the mechanisms involved in the educational gradient in smoking, but this mechanism has scarcely been explored empirically. Subjective scales were introduced in the 2008 French National Health, Health Care and Insurance Survey in order to elicit measures of time and risk preferences for a representative sample of 5188 men and 5684 women. Men and women were treated separately. First, logistic regressions were used to test the associations between preferences and education and between preferences and smoking. Second, nested logistic models were built to investigate the mediating role of preferences in the educational gradient in smoking, with an econometric treatment of the rescaling problem. Preference for the present and risk loving were found to be: inversely related to educational level; strongly related to each other, and; strongly associated to current smoking, even after adjustment for educational level. There was a weakening of the educational gradient after the control for preferences, which supports the role of these two preferences as partial mediators in the educational gradient in smoking. Among men, time preference was more strongly associated with smoking than risk aversion, while the reverse was found for women. We provide convincing evidence in favour of the mediating role of time preference and risk aversion in educational inequalities in smoking and highlight the connection between those two dimensions. Gender patterns are discussed and potential implications in terms of designing targeted anti-tobacco programmes are delineated. [Copyright &y& Elsevier]

Abstract: Background: As adolescents grow, protective parental influences become less important and peer influences take precedence in adolescent''s initiation of smoking. It is unknown how and when this occurs. We sought to: prospectively estimate incidence rates of smoking initiation from late childhood through mid-adolescence, identify important risk and protective parental influences on smoking initiation, and examine their dynamic nature in order to identify key ages. Methods: Longitudinal data from the National Survey of Parents and Youth of 8 nationally representative age cohorts (9–16years) of never smokers in the U.S. were used (N=5705dyads at baseline). Analysis involved a series of lagged logistic regression models using a cohort-sequential design. Results: The mean sample cumulative incidence rates of tobacco use increased from 1.8% to 22.5% between the 9 and 16years old age cohorts. Among risk factors, peer smoking was the most important across all ages; 11–15year-olds who spent time with peers who smoked had 2 to 6.5 times higher odds of initiating smoking. Parent–youth connectedness significantly decreased the odds of smoking initiation by 14–37% in 11–14year-olds; parental monitoring and punishment for smoking decreased the odds of smoking initiation risk by 36–59% in 10–15year-olds, and by 15–28% in 12–14year-olds, respectively. Conclusions: Parental influences are important in protecting against smoking initiation across adolescence. At the same time, association with peers who smoke is a very strong risk factor. Our findings provide empirical evidence to suggest that in order to prevent youth from initiating smoking, parents should be actively involved in their adolescents'' lives and guard them against association with peers who smoke. [Copyright &y& Elsevier]

Abstract: Patterns of smoking can vary among youth smokers. The purpose of this study was to examine three different patterns of smoking among youth (daily smoking, smoking sporadically on weekdays and weekends, and smoking during weekdays only), and to examine the sociodemographic characteristics that are associated with each smoking pattern in a representative sample of Canadian youth smokers. Data were collected as part of the 2010/2011 Youth Smoking Survey (YSS) from 31,396 students in grades 9 to 12 from secondary schools in 9 Canadian provinces. Data from the YSS were used to assess smoking behaviors and sociodemographic factors that are associated with smoking patterns among youth. We used logistic regression models to examine factors associated with week day only and some day smoking patterns relative to daily smoking patterns. Results indicate that among current youth smokers, the majority are daily smokers (62.0%), followed by some day (23.5%) and week day only (13.5%) smokers. Students who smoke some days were more likely than daily smokers to share cigarettes with others; however, they were less likely than daily smokers to have a parent, step-parent or guardian who smokes cigarettes and less likely to have close friends who smoke cigarettes. Conversely, students who smoke week days only were less likely than daily smokers to have a sibling who smokes cigarettes. These data suggest that the school environment continues to play an important role in reducing youth smoking rates in Canada, especially among youth who only smoke week days. The high percentage of week day only smokers suggests that current school-level tobacco control initiatives may be insufficient for preventing youth smoking onset. [Copyright &y& Elsevier]

Abstract: The current study utilized regression analyses to explore the relationships among demographic and linguistic indicators of acculturation, gender, and tobacco dependence among Spanish-speaking Latino smokers in treatment. Additionally, bootstrapping analyses were used to examine the role of dependence as a mediator of the relationship between indicators of acculturation and cessation. Indicators of time spent in the United States were related to indicators of physical dependence. Preferred media language was related to a multidimensional measure of dependence. Gender did not impact the relationships between acculturation indicators and dependence. A multidimensional measure of dependence significantly mediated the relationship between preferred media language and cessation. Future research would benefit from consideration of acculturation and multidimensional measures of dependence when studying smoking cessation among Latinos, and from further examination of factors accounting for relationships among acculturation, dependence, and cessation. [Copyright &y& Elsevier]

Abstract: Recent research on adolescent smokers suggests that there are important differences in the types of nicotine dependence (ND) symptoms that emerge and different patterns of ND symptoms. The purpose of this study was to use data from the longitudinal Social and Emotional Contexts of Adolescent Smoking Patterns Study to identify latent subgroups of adolescent experimental and nondaily smokers varying in number and types of endorsed ND symptoms. Profiles were identified using baseline level of smoking, individual patterns of ND symptoms and other ND risk factors. Discrete time survival analysis was used to examine profile differences in probability of becoming daily smokers 48months later. Four distinct subgroups of smokers with different patterns of smoking behavior, ND symptoms, and alcohol and other substance use emerged. Heavier smoking adolescents with high symptom endorsement, particularly the need to smoke in the morning, were most likely to become daily smokers 48months later. A subgroup of social smokers had high smoking exposure and symptom endorsement (except need to smoke in the morning), and high levels of other substance use. Despite lower rates of smoking frequency and quantity compared to the heavier smoking class, 36% of these adolescents smoked daily by 48months, with a steeper decline in survival rates compared to other lighter smoking classes. Morning smoking symptoms and symptoms prioritizing smoking (i.e., choosing to spend money on cigarettes instead of lunch or smoking when ill or where smoking is forbidden) might quickly identify adolescent non-daily smokers with more severe dependence and higher risk for daily smoking. A focus on skills for avoiding social situations involving use of alcohol and other drugs and reducing peer smoking influences may be an important focus for reducing smoking and other substance use among social smokers. [Copyright &y& Elsevier]

Abstract: Background: Studies often demonstrate homophily in adolescent smoking behavior, but rarely investigate the extent to which this is due to the peer network processes of selection versus influence. Applying the concept of social distance, this study examines these two processes for smoking initiation. Methods: We analyzed socio-centric network data from the National Longitudinal Study of Adolescent Health (N =2065; grades=7th–12th). Social distance (degrees of separation), combined with stability and change in friendship networks, was used to derive indicators of peer selection and influence on initiation. Multilevel modeling was used to predict initiation from these indicators, and propensity score modeling was used to determine whether these associations remained after adjusting for pre-existing differences between initiators and consistent non-smokers. Results: We found that both peer influence and selection effects increased the likelihood of initiation even after adjusting with propensity score weights and demographic controls. While the effect size for peer influence depended on the overall proportion of smokers at the school, the selection effect was independent of the school environment. De-selection and indirect influence effects were not significant after controlling for school norm interactions. Conclusions: The association between peer smoking and adolescent smoking initiation appears to be due to both peer selection and direct influence. However, “friends of friends” effects are likely to be confounded with contextual factors. Given that smoking initiation is primarily associated with close personal interactions between the adolescent and his/her friends, prevention efforts should focus on the role of smoking in fostering personal relationships among adolescents. [Copyright &y& Elsevier]

Background: Social acceptance of smoking is associated with smoking prevalence. Higher smoking rates and ETS exposure might be considered as important indicators for pro-tobacco social norms or social climate. Among studies indicating the association between youth smoking and adult smoking behaviors, most were from individual-level study designs. Objectives: An ecological study was conducted to determine the role of social climate, i.e., adult smoking behaviors and exposure to environmental tobacco smoke (ETS), on youth smoking behaviors. Methods: Data on the smoking behavior and ETS of 16,688 Taiwanese adults were collected in 2004 by telephone administration of the Taiwan Adult Smoking Survey. Similar data on 22,339 junior high school students were collected in 2004 by school-based administration of the Taiwan Youth Tobacco Survey. City/county-level data were analyzed across 25 counties by descriptive statistics, Pearson's' correlation, and hierarchical multiple regression. Results: In both adult and youth populations, overall or gender-specific smoking prevalence and ETS varied widely across counties/cities. The current youth smoking rate within counties was significantly positively correlated with the current adult smoking prevalence as well as home ETS exposure in adults or youth. For male youth, a 1% increase in the rate of home ETS exposure reported by youth increased the current male youth smoking rate by 0.20% after controlling the female youth smoking rate and home ETS exposure reported by adults (p =0.0197). For female youth, male youth smoking prevalence was the only variable that contributed significantly (Beta=0.46, p <0.001). Conclusions: Community health nurses should develop tobacco-control interventions that are tailored to support smoke-free environments by decreasing the social acceptability of smoking. [Copyright &y& Elsevier]

Background: Social smoking is increasingly prevalent and poses a challenge to traditional cessation practices. Tobacco companies conducted extensive research on social smokers long before health authorities did and marketed products to promote this smoking behavior. Purpose: Research is described and mechanisms identified that are used to promote social smoking to help improve cessation strategies in this growing group. Evidence acquisition: Searches from 2006 to 2008 of previously secret tobacco industry documents using keywords social smoker, light smoker, casual smoker, youth smoker, and occasional smoker, followed by snowball searching. Data analysis was conducted in 2008. Evidence synthesis: Tobacco industry research identified characteristics of social smokers that include: (1) denial of personal nicotine addiction; (2) self-categorization as a nonsmoker; (3) propensity for decreased tobacco use in response to smoke-free laws; (4) variations in age, education, ethnicity, and socioeconomic backgrounds; and (5) a perceived immunity to personal health effects of tobacco but fear of consequences to others. Tobacco companies developed marketing strategies aimed at social smokers, including “non–habit forming” cigarettes. Conclusions: Previously considered a transient behavior, social smoking is also a stable consumption pattern. Focused clinical questions to detect social smoking are needed and may include, “Have you smoked any cigarettes or used any tobacco products in the past month?” as opposed to “Are you a smoker?” Clinicians should recognize that social smokers might be motivated to quit after education on the dangers of secondhand smoke rather than on personal health risks or with pharmacotherapy. [Copyright &y& Elsevier]

Abstract: Recent social network analyses have suggested that common chronic disease risk factors are more mutable than expected; raising practical considerations for public health interventions. Within this context, it is timely to assess the alternative social science reasoning being offered to explain behavioural health risk transitions. This paper takes up this challenge by critically reviewing the major theories applied to the temporal trends and sub-population variations in affluent country smoking behaviour. Three explanations dominate: a materialist approach; Bourdieu''s distinctive class-based cultures; and, the spread of norms and emotions within social networks. We note conceptual tension when integrated theories are adopted. We also report on the relative absence of theoretical interrogation for the persistent adoption of smoking behaviours among present and successive lower socio-economic status (SES) cohorts. While unequal rates of persistence within cohorts has received some attention, the ongoing adoption of a non-innovative and health damaging behaviour is not well understood. To this end, we suggest the incorporation of several underused concepts: namely Bourdieu''s ‘rules of the game’ and ‘symbolic violence’ and ‘mimesis’, an aspect of social contagion. We conclude by describing the implications for social action of the alternative theories, and argue that theory driven research designs could deliver more efficacious evidence for interventions than the post hoc application of theories to existing data sets. [Copyright &y& Elsevier]

In Australia, tobacco smoking is more than twice as common among Indigenous people as non-Indigenous people. Some of the highest smoking rates in the country are in remote Indigenous communities in the Northern Territory of Australia. Owing to this high prevalence, tobacco use today is the single biggest contributing risk factor for excess morbidity and mortality among Indigenous Australians. Despite this, there is a lack of published research which qualitatively explores the social context of Indigenous smoking behaviour or of meanings and perceptions of smoking among Indigenous people. The aim of this study was to understand why Indigenous people start to smoke, the reasons why they persist in smoking and the obstacles and drivers of quitting. We conducted semi-structured interviews with a purposive sample of 25 Indigenous community members in two remote communities in the Northern Territory and 13 health staff. The results indicate that there is a complex interplay of historical, social, cultural, psychological and physiological factors which influence the smoking behaviours of Indigenous adults in these communities. In particular, the results signal the importance of the family and kin relations in determining smoking behaviours. While most community participants were influenced by family to initiate and continue to smoke, the health and well being of the family was also cited as a key driver of quit attempts. The results highlight the importance of attending to social and cultural context when designing tobacco control programs for this population. Specifically, this research supports the development of family-centred tobacco control interventions alongside wider policy initiatives to counter the normalisation of smoking and assist individuals to quit. [Copyright &y& Elsevier]

Background: Televised anti-tobacco advertising has been shown to be effective for discouraging smoking initiation; however, purchasing broadcasting time is very costly. This study investigated the relative impact of the broadcast volume (media weight) and the emotional content of an ad as predictors of advertising recall. Methods: The data come from a random-digit-dialed survey conducted in 2001 and 2002 of 3863 youth aged 12–17. Media weight was based on commercial TV ratings data. The emotional intensity of advertisements was derived from the ratings made by independent youth judges. Results: Data analyses were conducted between 2005 and 2007. Results indicated that media weight was a significant predictor of recall, but the emotional content of the ad was an even stronger predictor. Also, ads low in emotional intensity required more media weight than those high in emotional intensity to achieve the same amount of increase in recall. Conclusions: This study extends prior research that highlights the importance of emotional intensity for effective anti-tobacco advertising. It also indicates that, relative to unemotional advertisements, emotionally arousing advertisements require fewer broadcasts to achieve the same level of recall, and hence are likely to be less costly to a public health campaign. [Copyright &y& Elsevier]

Few studies have examined the influence of marriage on health-related behavior in Asian populations. The present study examined the effect of marital status on smoking in Korea. Data from two rounds of a nationally representative survey (1999 and 2003) were analyzed (57,246 women and 52,769 men). Marital status-specific prevalence ratios for smoking were estimated using log binomial regression after adjusting for age, survey year, occupation and education level. Smoking prevalence declined with age for men, but rose for women. Smoking rates were higher for unmarried men and women compared to their married counterparts. However, the gap in smoking rates between unmarried and married women (especially younger women <45 years) was much greater than the gap between unmarried and married men. The study found that marital status had a stronger protective influence on smoking in women than men, which contrasts with the gender pattern reported previously in western studies. The findings suggest the influence of a culture which discourages married women from smoking, and “liberates” divorced women from cultural sanctions against smoking in marriage. [Copyright &y& Elsevier]

Abstract: Breathing tobacco smoke is linked to poor health in young children, with their homes identified as the primary place of exposure. This UK study uses focus group discussions to explore how mothers living in disadvantaged areas use space within their homes to smoke while looking after children aged 0–4 years, and critically examines how they define non-smoking or smoking homes. Many women imposed temporary and ad hoc restrictions, and this research highlights how the mothers’ desire to create a smoke-free environment for their children competes with their caring responsibilities, and how their efforts are restricted by the limitations of the physical environment of their homes. [Copyright &y& Elsevier]

Background. As well as causing sickness and death, smoking has high socio-economic costs. The aim of this paper was to examine how closely smoking is associated with sickness absence among heatthcare workers. Subjects and methods. Cases and controls were paired by age, gender and occupation among primary healthcare workers in Tenerife, Canary Islands, Spain. Cases were selected from workers that had been absent from work due to sickness for I or more days in an entire year, regardless of the cause. Controls were those workers who were not absent due to sickness over the same period. Tobacco consumption was verified by telephone poll. Matched pairs analysis was performed. Results. Among the 292 cases, 40% were smokers, compared with 31% of controls [odds ratio (OR)= 1.51, 95% confidence intervals (CI)= 1.06-2.14]. The association between smoking and sickness absence was stronger in those aged 30-45 years (OR= 1.60, 95%CI=1.04-2.44) and among nurses (OR=2.08, 95%CI=1.05-4.14). When the cause of sickness absence was a respiratory disease, no association was found with smoking. However, an association was found with back pain (OR =5, 95%CI 1.45-17.27). Duration of tobacco consumption was higher in cases (a) when only current smokers were considered (P=0.002), and (b) when including the smoking duration of former smokers (P=0.0004). Conclusions. Smoking is associated with a higher risk of sickness absence among healthcare workers, particularly due to back pain. This could be used as an incentive to persuade healthcare workers to stop smoking and reinforce the non-smoking message given to their patients. [ABSTRACT FROM AUTHOR]

Background: Social cognitive theory posits that children develop intentions and positive expectations (utilities) about smoking prior to initiation. These attitudes and values result, in part, from observing others modeling the behavior. This study examines, for the first time, the association between viewing tobacco use in movies and attitudes toward smoking among children who have never smoked a cigarette.Design/setting: Cross-sectional school-based survey was used among randomly selected Vermont and New Hampshire middle schools. The sample consisted of 3766 middle school students (grades 5-8). The sample was primarily white and equally distributed by gender. The primary exposure was number of movie tobacco-use occurrences viewed. We first counted occurrences of tobacco use in each of 601 recent popular motion pictures. Each student was asked to select movies they had seen from a random subset of 50 movies. Based on movies the adolescent had seen, movie tobacco-use occurrences were summed to determine exposure . The outcome was susceptibility to smoking, positive expectations, and perceptions of smoking as normative behavior for adolescents or adults.Results: The movies in this sample contained a median of five occurrences of tobacco use (interquartile range=1, 12). The typical adolescent never-smoker had viewed 15 of the 50 movies on his/her list. From movies adolescents reported seeing, exposure to movie tobacco-use occurrences varied widely: median=80, and interquartile range 44 to 136. The prevalence of susceptibility to smoking increased with higher categories of exposure: 16% among students who viewed 0 to 50 movie tobacco occurrences; 21% (51 to 100); 28% (101 to 150); and 36% (>150). The association remained statistically significant after controlling for gender, grade in school, school performance, school, friend, sibling and parent smoking, sensation-seeking, rebelliousness, and self-esteem. Compared with adolescents exposed to < or =50 occurrences of tobacco use, the adjusted odds ratio of susceptibility to smoking for each higher category was 1.2 (95% confidence interval 0.9, 1.5), 1.4 (1.1, 1.9), and 1.6 (1.3, 2.1), respectively. Similarly, higher exposure to tobacco use in movies significantly increased the number of positive expectations endorsed by the adolescent and the perception that most adults smoke, but not the perception that most peers smoke.Conclusions: This study provides empirical evidence that viewing movie depictions of tobacco use is associated with higher receptivity to smoking prior to trying the behavior. [ABSTRACT FROM AUTHOR]

Investigates the impact of smoking on mortality among men and women from different social classes from the West of Scotland. Interaction between material/social circumstances and health related behavior; Similarity of survival rate between smokers and never smokers; Impact of social status on mortality rate.

Examine ward-level effects for smoking and deprivation by applying multilevel modelling techniques to data from the British Health and Lifestyle Survey and ward level deprivation scores based on four variables from the national Census. Individual interaction effects; Individual main effects; Neighborhood (ward) effects; Between-individual variation; Between-neighborhood variation.

Examines gender differences in the perception of social constraints against smoking and the role of other sociodemographic and smoking factors that influence the perception of social pressure. Comparison of pressure to quit smoking for women and men; Difference in the sources of pressure to stop smoking; Discussion of tobacco control efforts.

Abstract: When major disease processes move from processes that humans cannot control to processes we do understand and do control at least to some extent a social shaping of health disparities occurs. When humans control, it is their policies, their knowledge, and their behaviors that shape the consequences of biomedical knowledge and technology to achieve a powerful social shaping of extant patterns of disease and death. Evidence to support this approach is garnered from data showing dramatic improvements in population health and in the uneven distribution of those improvements across persons, places and times. Health improvements suggest that humans have gained control of disease whereas the uneven and very slow spread of such improvements underscores the critical importance of social factors. Smoking beliefs and behaviors gathered in surveys conducted over the past 50 years conform to this social shaping notion providing insights into the current distribution of beliefs and behaviors. [Copyright &y& Elsevier]

Abstract: We compare life course characteristics of a cohort of African American women (N =457) by their smoking status at age 42: never smoker (34.1%), former smoker (27.8%), or current smoker (38.1%). The Woodlawn population from which our sample is drawn has been followed from first grade (1966–67) to mid adulthood (2002–3) and is a cohort of children from a disadvantaged Chicago community. Examination of the effects of cumulative disadvantage on smoking behavior showed that nearly half of women who first lived in poverty as children, dropped out of school, became teen mothers, and were poor as young adults currently smoked; less than 22% of women with none of these difficulties were current smokers. Regression analyses focusing on smoking and evidence of social disadvantage in childhood, adolescence, and young adulthood showed that women with more education were much less likely to be current smokers. Women reporting low parental supervision in adolescence and less frequent church attendance in young adulthood and those whose mothers’ reported regular smoking were significantly more likely to be current smokers. Poverty and marital status in young adulthood varied significantly among smoking categories in bivariate relationships, but not in final multivariate regression models. Few other studies have examined smoking careers with data from age 6–42, comparing social disadvantage characteristics over the life course. While marital status, church involvement and parental supervision are not usually included as measures of socioeconomic status, they represent advantages in terms of social capital and should be considered mechanisms for transmitting disparities. [Copyright &y& Elsevier]