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Households are a significant source of SARS-CoV-2 transmission, even during periods of low community-level spread. Comparing household transmission rates by SARS-CoV-2 variant may provide relevant information about current risks and prevention strategies. This investigation aimed to estimate differences in household transmission risk comparing the SARS-CoV-2 Delta and Omicron variants using data from contact tracing and interviews conducted from November 2021 through February 2022 in five U.S. public health jurisdictions (City of Chicago, Illinois; State of Connecticut; City of Milwaukee, Wisconsin; State of Maryland; and State of Utah). Generalized estimating equations were used to estimate attack rates and relative risks for index case and household contact characteristics. Data from 848 households, including 2,622 individuals (median household size = 3), were analyzed. Overall transmission risk was similar in households with Omicron (attack rate = 47.0%) compared to Delta variant (attack rate = 48.0%) circulation. In the multivariable model, a pattern of increased transmission risk was observed with increased time since a household contact's last COVID-19 vaccine dose in Delta households, although confidence intervals overlapped (0–3 months relative risk = 0.8, confidence interval: 0.5–1.2; 4–7 months relative risk = 1.3, 0.9–1.8; ≥8 months relative risk = 1.2, 0.7–1.8); no pattern was observed in Omicron households. Risk for household contacts of symptomatic index cases was twice that of household contacts of asymptomatic index cases (relative risk = 2.0, 95% confidence interval: 1.4–2.9), emphasizing the importance of symptom status, regardless of variant. Uniquely, this study adjusted risk estimates for several index case and household contact characteristics and demonstrates that few characteristics strongly dictate risk, likely reflecting the complexity of the biological and social factors which combine to impact SARS-CoV-2 transmission. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine alcohol use (particularly heavy drinking) and social normative estimations of alcohol use according to student residence (fraternity, sorority, residence hall, or apartment complex). To achieve this purpose, a survey was conducted in all 34 sections of a general education core English class at a northwestern public university. Students living in fraternities, compared with males living in apartment complexes and residence halls, consumed more alcohol, engaged more frequently in heavy episodic drinking, and drank more when "partying." A similar pattern was true for females living in sororities relative to females students living in apartment complexes and residence halls. In most cases, social normative estimations were higher than reported use among those living in fraternities, sororities, residence halls, and apartment complexes. As hypothesized, social normative estimates of alcohol use were highest among students living in fraternities and sororities. Thus, it appears that social normative estimations of frequent and heavy drinking may contribute to alcohol use patterns, particularly among members of fraternities and sororities. These results confirm that students' choice of residence is a dominant influence when it comes to drinking behavior.

Children are capable of initiating COVID-19 transmission into households, but many questions remain about the impact of vaccination on transmission. Data from a COVID-19 Delta variant outbreak at an overnight camp in Texas during June 23–27, 2021, were analyzed. The camp had 451 attendees, including 364 youths aged  < 18 years and 87 adults. Detailed interviews were conducted with 92 (20.4%) of consenting attendees and 117 household members of interviewed attendees with COVID-19. Among 450 attendees with known case status, the attack rate was 41%, including 42% among youths; attack rates were lower among vaccinated (13%) than among unvaccinated youths (48%). The secondary attack rate was 51% among 115 household contacts of 55 interviewed index patients. Secondary infections occurred in 67% of unvaccinated household members and 33% of fully or partially vaccinated household members. Analyses suggested that household member vaccination and camp attendee masking at home protected against household transmission. [ABSTRACT FROM AUTHOR]

The B.1.1.529 (Omicron) variant, first detected in November 2021, was responsible for a surge in U.S. infections with SARS-CoV-2, the virus that causes COVID-19, during December 2021-January 2022 (1). To investigate the effectiveness of prevention strategies in household settings, CDC partnered with four U.S. jurisdictions to describe Omicron household transmission during November 2021-February 2022. Persons with sequence-confirmed Omicron infection and their household contacts were interviewed. Omicron transmission occurred in 124 (67.8%) of 183 households. Among 431 household contacts, 227 were classified as having a case of COVID-19 (attack rate [AR] = 52.7%).† The ARs among household contacts of index patients who had received a COVID-19 booster dose, of fully vaccinated index patients who completed their COVID-19 primary series within the previous 5 months, and of unvaccinated index patients were 42.7% (47 of 110), 43.6% (17 of 39), and 63.9% (69 of 108), respectively. The AR was lower among household contacts of index patients who isolated (41.2%, 99 of 240) compared with those of index patients who did not isolate (67.5%, 112 of 166) (p-value <0.01). Similarly, the AR was lower among household contacts of index patients who ever wore a mask at home during their potentially infectious period (39.5%, 88 of 223) compared with those of index patients who never wore a mask at home (68.9%, 124 of 180) (p-value <0.01). Multicomponent COVID-19 prevention strategies, including up-to-date vaccination, isolation of infected persons, and mask use at home, are critical to reducing Omicron transmission in household settings. [ABSTRACT FROM AUTHOR]

Background Performance characteristics of SARS-CoV-2 antigen tests among children are limited despite the need for point-of-care testing in school and childcare settings. We describe children seeking SARS-CoV-2 testing at a community site and compare antigen test performance to real-time reverse transcription-polymerase chain reaction (RT-PCR) and viral culture. Methods Two anterior nasal specimens were self-collected for BinaxNOW antigen and RT-PCR testing, along with demographics, symptoms, and exposure information from individuals ≥5 years at a community testing site. Viral culture was attempted on residual antigen or RT-PCR-positive specimens. Demographic and clinical characteristics, and the performance of SARS-CoV-2 antigen tests, were compared among children (<18 years) and adults. Results About 1 in 10 included specimens were from children (225/2110); 16.4% (37/225) were RT-PCR-positive. Cycle threshold values were similar among RT-PCR-positive specimens from children and adults (22.5 vs 21.3, P =.46) and among specimens from symptomatic and asymptomatic children (22.5 vs 23.2, P =.39). Sensitivity of antigen test compared to RT-PCR was 73.0% (27/37) among specimens from children and 80.8% (240/297) among specimens from adults; among specimens from children, specificity was 100% (188/188), positive and negative predictive values were 100% (27/27) and 94.9% (188/198), respectively. Virus was isolated from 51.4% (19/37) of RT-PCR-positive pediatric specimens; all 19 had positive antigen test results. Conclusions With lower sensitivity relative to RT-PCR, antigen tests may not diagnose all positive COVID-19 cases; however, antigen testing identified children with live SARS-CoV-2 virus. [ABSTRACT FROM AUTHOR]

We evaluated the performance of self-collected anterior nasal swab (ANS) and saliva samples compared with healthcare worker-collected nasopharyngeal swab specimens used to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used the same PCR diagnostic panel to test all self-collected and healthcare worker-collected samples from participants at a public hospital in Atlanta, Georgia, USA. Among 1,076 participants, 51.9% were men, 57.1% were >50 years of age, 81.2% were Black (non-Hispanic), and 74.9% reported >1 chronic medical condition. In total, 8.0% tested positive for SARS-CoV-2. Compared with nasopharyngeal swab samples, ANS samples had a sensitivity of 59% and saliva samples a sensitivity of 68%. Among participants tested 3-7 days after symptom onset, ANS samples had a sensitivity of 80% and saliva samples a sensitivity of 85%. Sensitivity varied by specimen type and patient characteristics. These findings can help physicians interpret PCR results for SARS-CoV-2. [ABSTRACT FROM AUTHOR]

Repeating the BinaxNOW antigen test for severe acute respiratory syndrome coronavirus 2 using 2 groups of readers within 30 minutes resulted in high concordance (98.9%) in 2110 encounters. Same-day repeat antigen testing did not significantly improve test sensitivity (77.2% to 81.4%) while specificity remained high (99.6%). [ABSTRACT FROM AUTHOR]

The article discusses a study on women's perspectives about adverse outcomes caused by smoking during pregnancy and their reactions to graphic warnings depicting an infant with cleft lip with or without cleft palate and an infant in an incubator. Topics discussed include the low to moderate awareness of many outcomes of the participants, strong reactions to graphic warnings, and recommendations for communicating to other women. Barriers to smoking cessation during pregnancy are also mentioned.

Objective: To assess current and former smokers' reactions to US warning labels as a baseline for comparison to new labels. Methods: The mail-in Consumer- Styles survey was sent to a representative sample of US adult consumers in 2010 (N = 10,328). Results: Among current smokers, 51.5% (95% CI: 47.5-55.5) reported that they had 'never/rarely' seen or looked closely at the labels in the past 30 days. Current smokers (91.1%) reported that warning labels never stopped them from having a cigarette (95% CI: 89.1- 93.1) and that the labels had no effect on their likelihood of quitting (75.5%; 95% CI: 71.6-79.4). Conclusions: Current warning labels do not make smokers think about the risks of smoking or have an effect on their likelihood of forgoing cigarettes or quitting. [ABSTRACT FROM AUTHOR]

We explored whether dual use of smokeless and cigarettes among adolescents predicts continued smoking. Data came from Waves I (1994-95) and II (1996) of the National Longitudinal Study of Adolescent Health, using information from 3,284 Wave I current smokers. Multivariate models were used to assess whether use of smokeless tobacco at Wave I was associated with continuation of cigarette smoking at Wave II, controlling for possible confounders. The prevalence of current cigarette smoking at Wave 1 was 27.9%; among this group of adolescents and young adults, 14.5% also used smokeless tobacco. AtWave II, 73.6% of dual product users and 78.4% of cigarette-only users in Wave I reported continued smoking (OR = 0.71 [95% CI 0.52-0.98]). Combined use of cigarette and smokeless tobacco does not appear to be related to continued smoking one year later. Longer-term followups are needed to determine the stability of this relationship for =1 year. [ABSTRACT FROM AUTHOR]

Objectives. We sought to modify an instrument and to use it to collect information on smoking knowledge, attitudes, beliefs, and behaviors among Hispanics/Latinos, and to adapt survey methods to obtain high participation levels. Methods. Promotoras (outreach workers) conducted face-to-face interviews with 1485 Hispanic adults (July 2007-April 2008). The project team used Geo-Frame field enumeration methods to develop a sampling frame from households in randomly selected colonias (residential areas along the Texas-Mexico border that may lack some basic necessities (e.g. portable water), in El Paso, Texas. Results. The revised questionnaire included 36 unchanged items from the State Adult Tobacco Survey, 7 modified items, and 17 new items focusing on possible culturally specific quitting methods, secondhand smoke issues, and attitudes and knowledge about tobacco use that might be unique for Hispanic/ Latino groups. The eligibility rate was 90.2%, and the conservative combined completed screener and interview response rate was 80.0%. Conclusions. Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods. [ABSTRACT FROM AUTHOR]

Objective. In 2002, the First Conference on Menthol Cigarettes brought together researchers from diverse backgrounds to summarize what is known about menthol cigarettes and the people who smoke them, and to identify areas of needed research on menthol cigarettes. Since the conference, PubMed reports 24 articles, including the conference proceedings, on menthol cigarettes and African Americans. Many of the articles address epidemiological or biomedical topics. While there has been some focus on social influences and marketing issues, more research and a greater focus on this topic are needed. Design. To stimulate research on a population disproportionately burdened by the health effects of smoking, we conducted small-group discussions in 2005 with adult African American smokers in Atlanta, Georgia. Each group discussion focused on a different topic: smoking behavior and preferences, perceptions of social influences, health effects and perceived harmfulness of menthol, quitting menthol cigarette smoking, or the influence of marketing and advertising of menthol cigarettes. Results. Themes emerged from the discussions: (1) emulation of black culture by white youth and racial integration of neighborhoods and communities may have modified the perception that African Americans smoke menthol cigarettes and whites smoke non-menthol cigarettes; (2) non-menthol cigarette smokers were thought to be 'hardcore' smokers with less interest in quitting; (3) switching to non-menthol cigarettes was discussed as a way of quitting cigarettes for habitual menthol smokers; and, (4) smoking menthol cigarettes was thought to lead to fewer negative health effects. Conclusion. Some topics suggested by the participants warrant further investigation. More research is needed to assess the pervasiveness of these beliefs and their potential utility for smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Objective: To describe adult smokers' reactions to PREP print advertisements and promotional materials. Methods: Focus groups with adult smokers. Participants reacted to print advertisements and promotional materials for Omni®, Accord®, Advance Lights®, Ariva®, and Eclipse®. Results: Images and text in PREP product advertising and promotional materials influence participants' decision to try PREPs. Participants believed the PREP ads target smokers who are trying to quit or smokers who are health conscious. Conclusion: Tracking and monitoring the reactions of smokers to novel products, their perceptions about them, and their use of these products are necessary for the design of effective health communication strategies. [ABSTRACT FROM AUTHOR]

Objective: To explore risk perceptions of traditional and nontraditional tobacco products (NTPs) among young adult smokers. Methods: Focus groups with African Americans, non-Hispanic whites, and Hispanics. Risk ratings of light, regular, and menthol cigarettes and of NTPs and marijuana and cigarettes were compared. Results: Participants tended to view light cigarettes as safer than regular cigarettes. Shisha and herbal products were rated as safer than traditional cigarettes, but there were differences in ratings by race/ethnicity, related to preferred cigarette variety. Conclusions: Health communication messages about the use of cigarettes and NTPs should consider risk perceptions about the products and racial/ethnic differences. [ABSTRACT FROM AUTHOR]

Abstract: Current cigarette smoking combined with ever use of other tobacco products (lifetime polytobacco use) is important to examine as users may be at greater risk for illicit drug use, nicotine addiction, and adverse health outcomes. We determined estimates and patterns of lifetime polytobacco use and conducted multivariable analyses to determine demographic, family and friend, psychosocial, and lifestyle factors associated with use among a sample of Canadian young adults. Overall prevalence was 36.3% for current cigarette use; 10.1% for current cigarette use only and 26.2% for lifetime polytobacco use. Among polytobacco users, current cigarette use and ever cigar use was most frequent (67.2%). For males, the final model contained demographic, family and friends, and lifestyle factors. For females, the final model also included psychosocial factors. Illicit drug use was the strongest significant predictor for lifetime polytobacco use among males. We found gender specific differences when comparing lifetime polytobacco users to current cigarette-only users, in particular; male lifetime polytobacco users were more likely to use drugs and alcohol. Interventions focusing on individual substances should consider addressing combinations of use. [Copyright &y& Elsevier]