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Objectives. We examined the effectiveness of a program to increase exposure to national 'truth' tobacco countermarketing messages among youths in rural and low-population-density communities. Methods. A longitudinal survey of 2618 youths aged 12 to 17 years was conducted over 5 months in 8 media markets receiving supplemental advertising and 8 comparison markets receiving less than the national average of 'truth' messages. Results. Confirmed awareness of 'truth' increased from 40% to 71% among youths in treatment markets while remaining stable in comparison markets. Over 35% of all youths who were unaware of the campaign at baseline became aware of it as a direct result of the increased advertising. Youths living in rural and low-population-density communities were receptive to the campaign's messages. Conclusions. Through purchase of airtime in local broadcast media, the reach of a national tobacco countermarketing campaign was expanded among youths living in rural and low-population-density areas. This strategy of augmenting delivery of nationally broadcast antitobacco ads can serve as a model for leveraging limited tobacco control resources to increase the impact of evidence-based tobacco prevention campaigns. (Am J Public Health. 2009;99: 2210-2216. doi: 10.2105/AJPH.2008.155127)

Objectives. Our study presents national estimates of the proportion of youths in each of 7 stages of smoking and investigates the associations between risk/protective factors and progression to established smoking. Methods. We analyzed data from the 1999 and 2000 National Youth Tobacco Surveys. Results. In 1999 and 2000, 48.6% of US adolescents had at least experimented with tobacco, and 7.8% were established smokers. Important correlates of progression to established smoking included parental advice not to smoke, antismoking lessons in school, susceptibility to tobacco industry advertising and promotion, peer smoking, and exposure to smoking at home. Conclusions. Interventions to stop adolescent progression to established smoking should target susceptible never smokers and early experimenters as well as those in later stages of smoking.

Objective. This study sought to reassess the relationship between cigarette smoking and education. Methods. Data from the 1983 to 1991 National Health Interview survey for participants aged 25 years and older were used to plot the prevalence of current smoking, ever smoking, heavy smoking and smoking cessation, as well as the adjusted log odds ratios, by years of education. Results. The "less than high school graduate" category consisted of two groups with distinct smoking patterns: persons with 0 to 8 years and persons with 9 to 11 years of education. The latter were the most likely to be current, ever, and heavy smokers and the least likely to have quit smoking, whereas the former were similar to persons having 12 years of education. After 11 years of education, the likelihood of smoking decreased and that of smoking cessation increased with each successive year of education. These results persisted after the statistical adjustment for age, sex, ethnicity, poverty status, employment status, marital status, geographic region, and year of survey. Conclusions. The relationship between smoking and education is not monotonic. Thus, when evaluating smoking in relation to education, researchers should categorize years of education as follows: 0 to 8, 9 to 11, 12, 13 to 15, and 16 or more years. [ABSTRACT FROM AUTHOR]

A response by P. Z. Siegal, J. R. Qualters and P. D. Mowery to a letter to the editor about their article "Subgroup-Specific Effects of Questionnaire Wording on Population-Based Estimates of Mammography Prevalence" in the May 2001 issue is presented.

Data from a nationally representative sample of smokers (ages 12-22 years, n=2,091) was examined to investigate the prevalence of symptoms of diminished autonomy over cigarettes. Six symptoms were assessed: failed cessation, smoking despite a desire to quit, and a need or urge to smoke, irritability, restlessness, or disrupted concentration attributed to nicotine withdrawal. One or more of the six symptoms were present in 18.9% of subjects who smoked less often than once per week. Among subjects who had not smoked 20 cigarettes in their lifetime, 12.6% had symptoms of nicotine withdrawal, and 25% had made an unsuccessful quit attempt.