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Evidence of bias of self-reported smoking cessation during pregnancy is reported in high-income countries but not elsewhere. We sought to evaluate self-reported smoking cessation during pregnancy using biochemical verification and to compare characteristics of women with and without biochemically confirmed cessation in Argentina and Uruguay. In a cross-sectional study from October 2011 to May 2012, women who attended one of 21 prenatal clinics and delivered at selected hospitals in Buenos Aires, Argentina and Montevideo, Uruguay, were surveyed about their smoking cessation during pregnancy. We tested saliva collected from women <12 h after delivery for cotinine to evaluate self-reported smoking cessation during pregnancy. Overall, 10.0% (44/441) of women who self-reported smoking cessation during pregnancy had biochemical evidence of continued smoking. Women who reported quitting later in pregnancy had a higher percentage of nondisclosure (17.2%) than women who reported quitting when learning of their pregnancy (6.4%)., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)

Background: Comprehensive tobacco advertising/promotion bans are effective against adolescent smoking but many developing countries have implemented only partial bans. This study examines the association between advertising/promotions exposure and adolescent cigarette smoking risk in North Africa, and possible mediation of this association by parent and peer smoking., Methods: Adolescent data (n=12 329) from the Global Youth Tobacco Survey were analyzed (Libya, 2007; Egypt, 2005; Morocco, 2006; Tunisia 2007; and Sudan, 2005). Current smoking (any cigarette use in the past 30 days) and never-smokers' initiation susceptibility (composite of openness to accepting a cigarette from a friend and intention to start smoking in the next year) outcomes were examined. Advertising/promotion exposures included media and in-person contacts. Weighted univariate, bivariate and multivariable analyses were conducted., Results: Current smoking prevalence ranged from 5.6% (Egypt) to 15.3% (Tunisia) among boys, and 1.1% (Libya and Egypt) to 2.0% (Morocco and Sudan) among girls. Initiation susceptibility ranged from 14.1% (Sudan) to 25.0% (Tunisia) among boys, and from 13.3% (Sudan) to 15.0% (Libya) among girls. Ninety-eight percent of adolescents reported exposure to at least one type of advertising/promotion. In multivariable analyses adjusting for demographics, each type of advertising/promotion was significantly and positively associated with boys' current smoking status; most advertising/promotion exposure types were also positively associated with initiation susceptibility among boys and girls. Peer smoking only partially mediated these associations., Conclusions: Tobacco advertising/promotion exposure was highly prevalent and associated with adolescents' smoking risk in these countries. The comprehensiveness and enforcement of advertising/promotion bans needs to be enhanced.

Introduction: The co-use of alcohol and tobacco by adolescents is a public health problem that continues well into adulthood and results in negative behavioral, social, and health consequences. The purpose of this study was to examine the co-use of alcohol and tobacco among ninth-graders in south-central Louisiana., Methods: We created a health habits survey to collect data from 4,750 ninth-grade students, mean age 15.4 years. Cross-sectional analysis used chi2, 1-way analysis of variance, and logistic regression methods., Results: Almost 20% of students were co-users. Students who were white, performed poorly in school, did not expect to graduate high school, and had more discretionary money to spend were more likely to be co-users. Co-users had friends who got drunk weekly and were more likely to approve of alcohol use among friends than among adults. Significant differences in attitudes toward drinking and smoking were observed between co-users and nonusers. For adolescent drinkers, including girls, hard liquor was the preferred beverage., Conclusion: These data for high school students are applicable for prevention strategies at a critical age when harmful health behaviors can mark the start of lifelong habits. Intervention efforts will be successful only if they account for multiple levels of influence.

A school-based environmental program to reduce adolescent smoking was conducted in 20 schools (10 intervention; 10 control) in south central Louisiana. The 9th grade cohort (n = 4,763; mean age = 15.4 yrs; 51% female; 61% Caucasian; 30-day smoking prevalence at baseline = 25%) was followed over four years for 30-day smoking prevalence with the school as the unit of analysis. Although prevalence decreased in intervention schools and increased in control schools in Year 2 the significant difference between the two groups at baseline was not overcome by the intervention and increases in prevalence were observed in both groups in Years 3 and 4. The higher the percentage of white students in a school the higher the prevalence rates regardless of intervention/control status. Boys' and girls' smoking rates were similar. These outcome data, student feedback and process evaluation provide a basis for continuing to create more innovative adolescent tobacco control programs.

Background: Tobacco use, underreported among Louisiana youth, was examined among 9th grade students in south central Louisiana; profiles of tobacco use were developed to inform adolescent tobacco control programs., Methods: Cross-sectional Health Habits Survey was administered to 4,808 students who were about 15 years old, predominantly white, with gender almost evenly distributed. Saliva samples were collected from 1,966 students. Analysis of a subsample resulted in good concordance between self-reported daily tobacco use and cotinine., Results: About 58% of students ever smoked a cigarette, 25% had a cigarette within the previous 30 days, 17% smoked within the past 7 days and almost 8% reported smokeless tobacco use. Smokeless tobacco use was greater for males than females. Caucasians, native Americans, and Latinos were more likely to smoke than African-Americans. Social relationships associated with adolescent smoking included having a friend, parent and/or sibling who smoked, having a friend who consumed alcohol, and being around people who used alcohol for "kicks." The attitudes of nonsmokers were consistently in the positive direction relative to disapproval of tobacco and alcohol use. The profiles differed demographically between black and white students., Conclusions: These data provide the needed information for guiding health promotion and tobacco control efforts, specifically regarding black/white differences.

CATCH provides multiethnic cohort data from third to eighth grades from four US geographic regions. This study examined smoking behaviors and predictors from fifth and eighth grades by ethnicity, gender, and geographic location through self-report data obtained from the cohort (N = 3,654). Overall, eighth grade prevalence for ever smoked was about 44%, 30-day prevalence was about 20%, 7-day prevalence 13.3%, and daily prevalence 7.4%. Prevalence was similar for Caucasians (21.5%) and Latinos (21.6%) and lowest for African Americans (13.1%). The 30-day prevalence for smokeless tobacco was higher for boys than for girls (9.8% vs 5.1%). Tobacco use by parents, siblings, and friends, and easy accessibility in the home in fifth grade, were significant predictors for smoking in eighth grade. Results did not differ by race, gender, or geographic location. The strongest correlate of smoking in eighth grade was having a best friend who smoked. Intention not to smoke in fifth grade predicted nonsmoking in eighth grade. Predictor strength across ethnic groups in different geographic regions was impressive. The social environment of young people continues to be an important instigator of smoking onset. The connection between intention and behavior over time suggests students' intentions not to smoke reflect decision-making at an early age.

Background Comprehensive tobacco advertising/ promotion bans are effective against adolescent smoking but many developing countries have implemented only partial bans. This study examines the association between advertising/promotions exposure and adolescent cigarette smoking risk in North Africa, and possible mediation of this association by parent and peer smoking. Methods Adolescent data (n=12,329) from the Global Youth Tobacco Survey were analyzed (Libya, 2007; Egypt, 2005; Morocco, 2006; Tunisia 2007; and Sudan, 2005). Current smoking (any cigarette use in the past 30 days) and never-smokers' initiation susceptibility (composite of openness to accepting a cigarette from a friend and intention to start smoking in the next year) outcomes were examined. Advertising/promotion exposures included media and in-person contacts. Weighted univariate, bivariate and multivariable analyses were conducted. Results Current smoking prevalence ranged from 5.6% (Egypt) to 15.3% (Tunisia) among boys, and 1.1% (Libya and Egypt) to 2.0% (Morocco and Sudan) among girls. Initiation susceptibility ranged from 14.1% (Sudan) to 25.0% (Tunisia) among boys, and from 13.3% (Sudan) to 15.0% (Libya) among girls. Ninety-eight percent of adolescents reported exposure to at least one type of advertising/promotion. In multivariable analyses adjusting for demographics, each type of advertising/promotion was significantly and positively associated with boys' current smoking status; most advertising/promotion exposure types were also positively associated with initiation susceptibility among boys and girls. Peer smoking only partially mediated these associations. Conclusions Tobacco advertising/promotion exposure was highly prevalent and associated with adolescents' smoking risk in these countries. The comprehensiveness and enforcement of advertising/promotion bans needs to be enhanced. [ABSTRACT FROM AUTHOR]

Chronic diseases have become leading causes of death among the general global population. Smoking and lack of physical activity are among two major risk factors that contribute to disease morbidity and mortality. Numerous health promotion programs have been designed to encourage increased exercise and smoking cessation. Objectives: This study was developed to identify 1) when is the most "opportune time" to implement a population-based health promotion program for maximum effectiveness, and 2) what health promotion strategies should be considered at these "opportune times"? Methods: Data used are derived from the Taiwan National Health Risk Behavior Survey of 2002. A total of 26,755 subjects interviewed in a national sampling survey were used in the study. All study respondents were over the age of 15 years. The survey resulted in a response rate of 81.92%. Results: The smoking rate within the Taiwan population reached its peak among the age group of 30- 34. After the age group of 30-34, the smoking rate among Taiwanese males began to decrease. The trend in physical activity also displayed a similar change pattern, although in a reversed order. Moreover, there was a clear gender difference in the change of physical activity behavior. Young females increased their physical activity beginning at the ages of 25-29, and males at the ages of 30-34. Conclusions: The relationship between these two risk factors within the Taiwanese population suggests that increases in smoking and decreases in physical activity develop at critical stages in life. This suggests that the most effective interventions for smoking cessation and the promotion of physical activity should be designed and targeted towards the age and gender groups at these stages. Planning and implementing population-based health promotion programs should 1) focus on health education for prevention before the ages of 30-34 for males, 25-29 for females, and 2) treat smoking and physical activity together in family-oriented campaigns for health promotion. [ABSTRACT FROM AUTHOR]

This case study examines the comparative effect of no-use school tobacco policies and restricted-use tobacco policies on teacher and student smoking behaviors and attitudes. Data from teachers (n = 1,041) and ninth-grade students (n = 4,763) at 20 schools in five districts in southern Louisiana were available. No significant difference was observed between teacher smoking (11% vs. 13%, p = .42) or student smoking (24.6% vs. 25.2%, p = .75) at nouse versus restricted-use policy schools. The proportion of teachers smoking on campus at no-use or restricted-use schools was not significantly different. Teachers at restricted-use schools were however less concerned about students seeing teachers smoke and less supportive of a no-use policy than teachers at no-use schools. Tobacco use policies are often not promoted, and enforcement of policies impacting teachers is complex. Changing social norms for smoking at high schools through policy promotion and enforcement is understudied. [ABSTRACT FROM AUTHOR]

The article presents a study which examined cigarette smoking attitudes, peer and parental influence, and first use among children in southeastern Louisiana. The Bogalusa Heart Study is a long-term investigation of the development of cardiovascular disease beginning in childhood in a semirural, biracial community in southeastern Louisiana. Data were collected by trained staff, and parental consent was obtained for examination. Few differences in attitudes toward smoking by parental education or smoking status were observed at the .01 significance level. Maternal education was inversely associated with maternal smoking, smoking by friends, and whether a sister smoked. Paternal education was negatively associated with paternal and maternal smoking. Access to cigarettes was greater among those from families where either parent smoked compared with those where neither parent smoked. African American children had a lower likelihood of smoking than White children in multivariate analysis. Females had a slightly lower likelihood of smoking than males.