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Objective: To assess trends and correlates of youth cigarette purchasing behavior on the Internet., Methods: In 2000-2001, Roswell Park Cancer Institute conducted a survey asking 7,019 ninth grade students in Erie and Niagara Counties in New York State about their tobacco use and purchasing habits, including use of the Internet to buy cigarettes. The 2004-2005 survey is a replication of the 2000-2001 survey. Both surveys used an anonymous, self-administered questionnaire survey. These data were combined in order to examine trends in youth smoking behavior., Results: Students surveyed in 2004-2005 were 2.6 times more likely (95% CI: 1.5, 4.6) to have purchased cigarettes over the Internet in the 30 days prior to the survey than those surveyed in 2001 (5.2% to 1.6%); however, the intention to use the Internet as a cigarette source in the future did not change between survey periods., Conclusion: Youth online cigarette purchasing has increased but intention to use the Internet to purchase cigarettes in the future has remained the same, suggesting that this trend may be reaching a plateau. Recent public efforts to reduce online cigarette sales will need to be evaluated in order to determine which policy or combination of policies are most effective.

This study compares the participant characteristics, program costs, and outcomes of a Quit & Win contest and a nicotine replacement therapy (NRT) voucher giveaway promotion. Both programs were conducted simultaneously so that smokers could enroll in either one program alone (n = 849 and 690, respectively) or both programs (Combination group; n = 230). A follow-up telephone survey of a random sample of participants was conducted 4 to 7 months after enrollment to evaluate smoking status. At enrollment, participants in the three groups were comparable on most smoking and demographic variables, although Quit & Win participants were, on average, younger than those who signed up to get the NRT voucher. Compared with the characteristics of smokers in the region, those who enrolled in the intervention programs were heavier smokers and had more years of formal education. At follow-up, the self-reported quit rates were similar across the three intervention groups, ranging between 25 percent and 30 percent. The only evidence for a higher quit rate among those in the Combination group was among younger smokers. On a simple estimated cost per quit basis, the Quit & Win (130 dollars) and NRT (179 dollars) voucher interventions appear roughly comparable. In all groups, abstinence rates were higher among lighter smokers (<21 cigarettes per day), participants who did not live with another smoker, and those who were married. Both the Quit & Win and NRT voucher giveaway programs were effective in recruiting smokers to make a quit attempt, although combining both interventions did not generally increase abstinence rates.

Background: The prevalence of smoking remains higher among the Medicaid population compared with the general population. To reduce this disparity, the majority of state Medicaid programs now provide coverage for smoking cessation pharmacotherapy. The objectives of this study were to (1) assess awareness of this benefit among Medicaid smokers and (2) compare the use of pharmacotherapy among a sample of Medicaid smokers with smokers in the general population of western New York., Methods: This report summarizes findings from two cross-sectional studies conducted in western New York State during 2002 to 2003: (1) Medicaid smokers (n = 1,174) completed an interviewer-administered questionnaire in the Office of Medicaid Management and (2) smokers from the general population (n = 852) completed a telephone survey., Results: The majority of Medicaid smokers (54%) remain unaware of the program benefit providing coverage for smoking cessation pharmacotherapies. Medicaid smokers were much less likely (odds ratio = 0.33, 95% confidence interval = 0.25-0.44) than the general population to report having ever used pharmacotherapies., Conclusions: Highlighting the availability of the smoking cessation pharmacotherapy benefit to Medicaid program participants may be one strategy to enhance quit attempts among this population. Future research should identify other potential barriers to the use of effective pharmacotherapies among poorer smokers.

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 nonsignificant 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.

The objective of the present study was to describe how college students perceive the risks of cigarette smoking and addiction to nicotine. Data came from a self-administered survey of 1,020 college students enrolled in two 4-year liberal arts colleges in the United States. The survey was conducted in the fall of 2001. Smokers and nonsmokers differed markedly in their perceptions about the health risks associated with short-term exposure to smoking. College students in this sample who smoked did not fully comprehend the risks associated with smoking. Smokers were half as likely as nonsmokers to believe that there are health risks from smoking only on weekends or a couple of days a week. Anti-tobacco messages for young adult smokers need to communicate more effectively the concept that each cigarette they smoke is doing them damage.

The objective of this study was to determine the extent to which people avoid smoky restaurants, bars, bowling alleys, casinos, and bingo halls because of secondhand smoke. Data were collected with telephone interviews of a sample of 1,548 randomly selected adults in Erie and Niagara Counties between October 2002 and March 2003. Most nonsmokers (71%) reported that they are bothered by secondhand smoke. Thirty-four percent of nonsmokers and 10% of smokers responded that they had avoided patronizing a smoky establishment in the past 12 months. The places that were most often avoided were restaurants (17%), bars or taverns (13%), and bingo halls (9%).

The objective of this study was to assess the cigarette purchase patterns of smokers in Erie and Niagara Counties following recent increases in the state excise tax for cigarettes. Data were collected with telephone interviews of a sample of 1,548 randomly selected people in Erie and Niagara Counties between October 2002 and March 2003. Purchase patterns were assessed for the 908 smokers in the sample who responded to questions about cigarette purchasing patterns. Thirty-three percent reported that their usual source of cigarettes is from a small store, large store, pharmacy, or vending machine, while 67% reported that their usual source is from an Indian reservation. Only one smoker reported the Internet was a usual source of cigarettes. The average price paid per pack was $4.80 in a small store and $1.91 on an Indian reservation. Price influences smoking behavior; however, the majority of smokers are taking advantage of readily available venues where less expensive, untaxed cigarettes are sold. This may undermine the public health benefit of higher prices and cause lost revenue to state and local governments.