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AimsTo demonstrate that intentions predict long-term future levels of smoking, irrespective of level of past smoking experience. A growing body of research suggests that intentions about future smoking might play an important role in addition to the influence of past smoking experience on the likelihood of smoking in future.DesignUsing logistic regression analyses, we assessed the relationship between baseline smoking experience and a firm intention 'not to be smoking cigarettes 5 years from now' with four outcome measures of smoking at follow-up: 30-day smoking at a 3/4- and 5/6-year follow-up and current established smoking (self-described regular smokers or former smokers who had smoked in the past 30 days) at a 3/4- and 5/6-year follow-up.ParticipantsUS nationally representative samples of 12th graders who responded to the Monitoring the Future (MTF) survey from the years 1976 to 1993, inclusive. For these panels, we linked stage of smoking and intentions at 12th grade to follow-up measures of smoking collected at 3/4 years after baseline and 5/6 years after baseline.FindingsAnalysis of 3/4-year follow-up data (weighted n = 4544) and 5/6-year follow-up data (weighted n = 3885) for both definitions of smoking outcome indicated that there was a dose-response relationship between levels of baseline smoking experience and the likelihood of future smoking. In addition, independent of baseline smoking experience, there was a statistically significant protective effect for a firm intention not to smoke in five year's time on future smoking behavior.ConclusionsThe findings suggest that evaluative studies of tobacco control policies and programs might usefully employ smoking uptake categories that incorporate smoking intentions as early indicators of outcome.

The 1986 Adult Use of Tobacco Survey conducted by the Office on Smoking and Health of the Centers for Disease Control asked detailed questions on smoking behavior from a representative sample of 13,031 Americans. Using a smoking continuum developed from that survey as an index, it was postulated that a hard-core group of smokers would be overrepresented in some categories of this continuum in certain groups of the population. In this survey, more women than men who had quit in the preceding year had relapsed to smoking by the time of the survey. However, the fact that similar proportions of men and women had quit smoking for between one and five years suggested that the difference might not have involved the proportion who relapsed but only the timing of that relapse. Smokers over the age of 65 are more likely both to attempt to quit and to continue abstaining than those between ages 25 and 64. Results from this survey do not indicate a major group of smokers who either resist change or who feel unable to quit successfully.

We examined whether smokers who purchased low-taxed cigarettes from American Indian reservations had lower quit attempt and cessation rates than did smokers who purchased cigarettes from full-price outlets. Smokers who bought cigarettes from American Indian reservations were half as likely to make a quit attempt and had a non-significant trend toward lower cessation rates (20% vs 10%) compared with those who bought full-priced cigarettes. Interventions that reduce price differentials are suggested to maximize the public health benefit of cigarette excise taxes. (Am J Public Health. 2005;95:994-995. doi: 10.2105/AJPH.2004.057687)

Introduction: Although multiple factors likely influence the differences between African Americans (AAs) and whites in cardiovascular disease and lung cancer mortality rates, historical patterns of tobacco use, particularly cigarette smoking, are the major contributors. This issue of Nicotine & Tobacco Research presents original research, a review, and commentaries that will serve to advance our understanding of several relevant behavioral similarities and differences between AAs and whites.Behavioral Analysis: Here, we illustrate how the diverging trends in cigarette smoking between AA and white high school seniors observed since the mid-1970s were influenced by patterns of ever use and current use among ever users. During 1977 to 2014, the percentage of current users among ever users was higher, but less variable, among whites than AAs. Among adults, trends in self-reported cigarette smoking among non-Hispanic AAs and non-Hispanic whites are available since 1978. The trends observed were likely due in part to the maturation of the high school senior cohorts from the 1970s and 1980s when AA smoking rates declined sharply relative to whites. Later age of initiation among AAs and less quitting among older AAs, relative to whites, also contribute.Conclusions: Further research on multiple topics, including the continuation of use among ever users, use of multiple combusted and noncombusted products, provision of cessation support services, influence of discrimination, and validity of self-report would expand the science base. Strategies to reduce the marketing and availability of menthol and other characterizing flavorings and to enrich environments would promote the public's health. [ABSTRACT FROM AUTHOR]

Introduction: Cross-sectional studies consistently find that cigarette smokers consume fewer fruits and vegetables each day than do nonsmokers. However, there are no published cohort studies on this relationship. This study evaluated the longitudinal relationship between fruit and vegetable consumption (FVC) and cigarette smoking, including measures of dependence and abstinence in a national population-based cohort analysis. Methods: A national random-digit-dialed sample of 1,000 smokers (aged 25 years and older) assessed baseline FVC and indicators of general health orientation. Multivariable analyses were used to assess whether baseline FVC was associated with smoking intensity, time to first cigarette (TTFC), and total score on an abbreviated version of the Nicotine Dependence Syndrome Scale (NDSS), adjusting for age, gender, race/ethnicity, education, and household income. The study also assessed whether baseline FVC predicted 30-day abstinence from all tobacco products at 14-month follow-up among baseline cigarette smokers, with additional adjustment for indicators of general health orientation (heavy drinking, exercise, and illicit drug use). Results: Higher FVC was associated with fewer cigarettes smoked per day, longer TTFC, and lower NDSS score. Those in the highest quartile of FVC were 3.05 times more likely (p < .01) than those in the lowest quartile to be abstinent for at least 30 days at follow-up. Conclusions: FVC was inversely associated with indicators of nicotine dependence and predicted abstinence at follow-up among baseline cigarette smokers. Further observational studies and experimental research would provide useful information on the consistency of the relationship and help elucidate possible mechanisms. [ABSTRACT FROM AUTHOR]

Cigarettes with candy, fruit and alcohol flavors have been introduced in recent years as extensions to popular cigarette brands, raising concerns in the public health community that the enticing names, creative packaging, and intense flavorings of these products may be especially appealing to youth. This study used two national surveys to examine the prevalence of use of Camel Exotic Blends, Kool Smooth Fusion, and Salem Silver Label brands during 2004-2005 among older adolescents and young adult smokers aged 17-26 years and adult smokers aged ≥25 years. Overall use of any of these flavored brands in the past 30 days was 11.9% among smokers aged 17-26 years and 6.7% among smokers aged ≥25 years. A significant gradient in use was seen across age, with the highest rates of utilization among 17-year-old (22.8%) and 18-19-year-old smokers (21.7%) (p<.001). Uniquely flavored cigarette brands seem to be most attractive to the youngest smokers and should be prohibited. [ABSTRACT FROM AUTHOR]

Objective. We examined the relationship between state-level tobacco control expenditures and youth smoking prevalence and cigarette consumption. Methods. We estimated a 2-part model of cigarette demand using data from the 1991 through 2000 nationally representative surveys of 8th-, 10th-, and 12th-grade students as part of the Monitoring the Future project. Results. We found that real per capita expenditures on tobacco control had a negative and significant impact on youth smoking prevalence and on the average number of cigarettes smoked by smokers. Conclusions. Had states represented by the Monitoring the Future sample and the District of Columbia spent the minimum amount of money recommended by the Centers for Disease Control and Prevention, the prevalence of smoking among youths would have been between 3.3% and 13.5% lower than the rate we observed over this period. (Am J Public Health. 2005;95:338-344.). [ABSTRACT FROM AUTHOR]

This year's surgeon general's report on smoking and health is the first such report to focus on young people. From extensive data that indicate that tobacco use is a pediatric epidemic, the report reached six major conclusions: (1) Nearly all first use of tobacco occurs by age 18. (2) Most adolescent smokers are addicted to nicotine. (3) Tobacco is often the first drug used by young people who subsequently use illegal drugs. (4) There are identified psychosocial risk factors for the onset of tobacco use. (5) Cigarette advertising also appears to increase young people's risk of smoking. (6) Community wide efforts have successfully reduced adolescent use of tobacco. This commentary restates each of the six conclusions, summarizes the data that support each, and then considers the implications of the conclusions for public health action. [ABSTRACT FROM AUTHOR]