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The Dominican Republic is a tobacco-growing country, and tobacco control efforts there have been virtually nonexistent. This study provides a first systematic surveillance of tobacco use in six economically disadvantaged Dominican Republic communities (two small urban, two peri-urban, two rural; half were tobacco growing). Approximately 175 households were randomly selected in each community (total N = 1,048), and an adult household member reported on household demographics and resources (e.g., electricity), tobacco use and health conditions of household members, and household policies on tobacco use. Poverty and unemployment were high in all communities, and significant gaps in access to basic resources such as electricity, running water, telephones/cell phones, and secondary education were present. Exposure to tobacco smoke was high, with 38.4% of households reporting at least one tobacco user, and 75.5% allowing smoking in the home. Overall, 22.5% reported using tobacco, with commercial cigarettes (58.0%) or self-rolled cigarettes (20.1%) the most commonly used types. Considerable variability in prevalence and type of use was found across communities. Overall, tobacco use was higher in males, illiterate groups, those aged 45 or older, rural dwellers, and tobacco-growing communities. Based on reported health conditions, tobacco attributable risks, and World Health Organization mortality data, it is estimated that at least 2,254 lives could potentially be saved each year in the Dominican Republic with tobacco cessation. Although it is expected that the reported prevalence of tobacco use and health conditions represent underestimates, these figures provide a starting point for understanding tobacco use and its prevalence in the Dominican Republic. [ABSTRACT FROM AUTHOR]

Physician office settings play an important role in tobacco cessation intervention. However, few tobacco cessation trials are conducted at these sites, in part because of the many challenges associated with recruiting community physician offices into research. The present study identified and implemented strategies for recruiting physician offices into a randomized clinical trial of tobacco screening and cessation interventions with adolescent patients. A total of 30 community physicians participated in focus groups to elicit their perceptions of facilitators of and barriers to initial engagement of physician practices and the subsequent enrollment of the practices in long‐term research projects. Physicians identified facilitators such as (a) the involvement of office staff in the recruitment process and (b) on‐site presentations of the study's background and aims. Some of the barriers identified were time commitment concerns and the lack of incentives in exchange for participation. These focus group findings were then integrated with theory‐based and empirically driven recruitment strategies for a 12‐month randomized tobacco intervention trial with adolescent patients. Of 185 office practices approached to participate (screened from a pool of 273 practices), 103 agreed to on‐site presentations of the study. Subsequently, almost all of the practices (101) that received the presentation agreed to enroll in the study. Conclusions are that (a) recruitment is a multicomponent process, (b) the processes of communication, engagement, and enrollment must be carefully planned and implemented to achieve maximal results, and (c) the development of effective strategies for recruiting health care provider practices presents an important infrastructure for testing adolescent smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Discusses abstinence measures used in trials of smoking cessation interventions. Recommendations regarding the trials; Initial 2-week grace period for prolonged abstinence definitions; Factors affecting the grace period for the trials.

In the absence of empirical literature from the resident perspective, this study provided a first assessment of smoking history, knowledge of the risks of smoking, the risks of environmental tobacco exposure, and the benefits of quitting among older (age 50+) nursing home unit residents, as well as readiness to quit, barriers to quitting, frequency of cessation advice by healthcare givers, and quit-attempt history of residents who smoke. Subjects were 25 smokers and 70 non-smokers housed on long-term nursing home units in a county hospital. Results indicated that smoking status for the majority of residents was similar to when they were admitted, although smokers smoked fewer cigarettes (M = 11.6, SD = 9.2) than prior to admission (M = 18.6, SD = 11.8). Smokers were less likely than non-smokers to agree that smoking is harmful to their health. Both smokers and non-smokers were not well informed of the dangers of passive smoke exposure. The majority of smokers were in precontemplation (no interest in quitting within the next 6 months). Fewer than half of residents who smoked reported receiving cessation advice from physicians (40%) or nurses (36%), and no in-house cessation programs were available. These results suggest gaps in knowledge and resources for smoking cessation in this setting and an opportunity for intervention. This study begins to build an evidence base from the residents' perspective that can be used by healthcare providers, administrators, and policy makers in addressing smoking in the nursing home. [ABSTRACT FROM AUTHOR]

The current paper focuses on the process evaluation of recruitment strategies and success in a large study of self-help smoking interventions with mid-life and older smokers in a 15-county area. Recruitment 'channels' were examined: (1) multiple paid newspaper advertisements, (2) free media (i.e., TV and radio), (3) referrals, (4) HMO newsletters, (5) targeted mailings, (6) face-to-face, and (7) passive recruitment. Data were analyzed to determine (1) which channels produced the greatest numbers of information requests, or initial 'recruits', and (2) which produced the greatest number of enrolled subjects. Overall, four channels resulted in the enrollment of 96.4% of the final sample of 1972 subjects. The most reliable, cost-controlled channel was paid newspaper advertisements ($18-19 per enrolled subject), while face-to-face recruitment was inefficient and costly (over $140 per subject). Results can be used to help guide other studies in selecting recruitment strategies for large, geographically diverse, smoking intervention trials. [ABSTRACT FROM AUTHOR]

Discusses the geriatric effects of smoking. Common smoking-related diseases that cause death; Impact of smoking on health care costs for the aged; Benefits of campaigning for smoking cessation among the aged.