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This study examined the effects of childhood attention deficit hyperactivity disorder (ADHD) symptoms, both inattention and hyperactivity-impulsivity, on the development of smoking in male and female adolescents.Twin difference methods were used to control for shared genetic and environmental confounders in three population-based, same-sex twin samples (N=3,762; 64% monozygotic). One cohort oversampled female adolescents with ADHD beginning in childhood. Regressions of childhood inattentive and hyperactive-impulsive symptoms were conducted to predict smoking outcomes by age 17. ADHD effects were divided into those shared between twins in the pair and those nonshared, or different within pairs.Adolescents who had more severe ADHD symptoms as children were more likely to initiate smoking and to start smoking younger. The association of ADHD symptoms with daily smoking, number of cigarettes per day, and nicotine dependence was greater in females than in males. Monozygotic female twins with greater attentional problems than their co-twins had greater nicotine involvement, consistent with possible causal influence. These effects remained when co-occurring externalizing behaviors and stimulant medication were considered. Hyperactivity-impulsivity, while also more strongly related to smoking for female adolescents, appeared primarily noncausal.Smoking initiation and escalation are affected differentially by ADHD subtype and gender. The association of inattention with smoking in female adolescents may be causal, whereas hyperactivity-impulsivity appears to act indirectly, through shared propensities for both ADHD and smoking.

Aims: Epidemiological research on lesbian, gay and bisexual populations raises concerns regarding self-selection and group sizes. The aim of this research was to present strategies used to overcome these challenges in a national population-based web survey of self-reported sexual orientation and living conditions—exemplified with a case of daily tobacco smoking. Methods: The sample was extracted from pre-established national web panels. Utilizing an oversampling strategy, we established a sample including 315 gay men, 217 bisexual men, 789 heterosexual men, 197 lesbian women, 405 bisexual women and 979 heterosexual women. We compared daily smoking, representing three levels of differentiation of sexual orientation for each gender. Results: The aggregation of all non-heterosexuals into one group yielded a higher odds ratio (OR) for non-heterosexuals being a daily smoker. The aggregation of lesbian and bisexual women indicated higher OR between this group and heterosexual women. The full differentiation yielded no differences between groups except for bisexual compared with heterosexual women. Conclusions: The analyses demonstrated the advantage of differentiation of sexual orientation and gender, in this case bisexual women were the main source of group differences. We recommend an oversampling procedure, making it possible to avoid self-recruitment and to increase the transferability of findings.

BackgroundRecently, the US Institute of Medicine has proposed that raising the minimum age for tobacco purchasing/sales to 21 years would likely lead to reductions in smoking behavior among young people. Surprisingly few studies, however, have assessed the potential impacts of minimum-age tobacco restrictions on youth smoking.ObjectiveTo estimate the impacts of Canadian minimum age for tobacco sales (MATS) laws on youth smoking behaviour.DesignA regression-discontinuity design, using seven merged cycles of the Canadian Community Health Survey, 2000–2014.ParticipantsSurvey respondents aged 14–22 years (n=98 320).ExposureCurrent Canadian MATS laws are 18 years in Alberta, Saskatchewan, Manitoba, Quebec, the Yukon and Northwest Territories, and 19 years of age in the rest of the country.Main outcomesCurrent, occasional and daily smoking status; smoking frequency and intensity; and average monthly cigarette consumption.ResultsIn comparison to age groups slightly younger than the MATS, those just older had significant and abrupt increases immediately after the MATS in the prevalence of current smokers (absolute increase: 2.71%; 95% CI 0.70% to 4.80%; P=0.009) and daily smokers (absolute increase: 2.43%; 95% CI 0.74% to 4.12%; P=0.005). Average past-month cigarette consumption within age groups increased immediately following the MATS by 18% (95% CI 3% to 39%; P=0.02). There was no evidence of significant increases in smoking intensity for daily or occasional smokers after release from MATS restrictions.ConclusionThe study provides relevant evidence supporting the effectiveness of Canadian MATS laws for limiting smoking among tobacco-restricted youth.

BackgroundChronic lung disease is a leading contributor to the global disease burden; however, beyond tobacco smoke, we do not fully understand what risk factors contribute to lung function decline in low-income and middle-income countries.MethodsWe collected sociodemographic and clinical data in a randomly selected, age-stratified, sex-stratified and site-stratified population-based sample of 3048 adults aged ≥35 years from four resource-poor settings in Peru. We assessed baseline and annual pre-bronchodilator and post-bronchodilator lung function over 3 years. We used linear mixed-effects models to assess biological, socioeconomic and environmental risk factors associated with accelerated lung function decline.ResultsMean±SD enrolment age was 55.4±12.5 years, 49.2% were male and mean follow-up time was 2.36 (SD 0.61) years. Mean annual pre-bronchodilator FEV1 decline was 30.3 mL/year (95% CI 28.6 to 32.0) and pre-bronchodilator FVC decline was 32.2 mL/year (30.0 to 34.4). Using multivariable linear mixed-effects regression, we found that urban living, high-altitude dwelling and having hypertension accounted for 25.9% (95% CI 15.7% to 36.1%), 21.3% (11.1% to 31.5%) and 15.7% (3.7% to 26.9%) of the overall mean annual decline in pre-bronchodilator FEV1/height2, respectively. Corresponding estimates for pre-bronchodilator FVC/height2 were 42.1% (95% CI% 29.8% to 54.4%), 36.0% (23.7% to 48.2%) and 15.8% (2.6% to 28.9%) of the overall mean annual decline, respectively.ConclusionUrbanisation, living at high altitude and hypertension were associated with accelerated lung function decline in a population with low daily smoking prevalence.

INTRODUCTION Physical activity (PA) and smoking are inversely related. However, evidence suggests that some types of PA, namely work-related PA, may show an opposite effect. Despite growing knowledge, there remains a paucity of studies examining the context of these behaviors in naturalistic settings or in young adults, a high-risk group for escalation. METHODS Participants were 188 young adults (mean age = 21.32; 53.2% female; 91% current smokers) who participated in an electronic diary week to assess daily smoking and urges and a PA recall to examine daily PA. PA was coded into non-work-related and work-related activity to examine differential effects. We considered both participants' weekly average PA and their daily deviations from their average. RESULTS Mixed-effects regression models revealed that higher weekly average non-work PA was associated with lower smoking level and urges. Daily deviations in non-work PA did not predict urges; however, increased daily non-work PA relative to participants' weekly average was associated with lower smoking for females but higher levels for males. Regarding work PA, only higher weekly average work PA was associated with higher smoking level for both genders; work PA did not predict urges. CONCLUSIONS Results extend previous literature by documenting differential associations between non-work and work PA and young adult smoking and suggest that young adults engaged in work PA should be considered a high-risk group for escalation. Findings provide theoretical and clinical implications for the use of PA in intervention and highlight the necessity of considering PA as a multidimensional construct when examining its links to health behavior.

There are no large-scale, carefully designed cohort studies that provide evidence on whether menthol cigarette use is associated with a differential risk of initiating and/or progressing to increased smoking. However, questions of whether current menthol cigarette smokers initiated smoking at a younger age or are more likely to have transitioned from non-daily to daily cigarette use compared to non-menthol smokers can be addressed using cross-sectional data from U.S. government surveys. Analyses of nationally representative samples of adult and youth smokers indicate that current menthol cigarette use is not associated with an earlier age of having initiated smoking or greater likelihood of being a daily versus non-daily smoker. Some surveys likewise provide information on cigarette type preference (menthol versus non-menthol) among youth at different stages or trajectories of smoking, based on number of days smoked during the past month and/or cigarettes smoked per day. Prevalence of menthol cigarette use does not appear to differ among new, less experienced youth smokers compared to established youth smokers. While there are limitations with regard to inferences that can be drawn from cross-sectional analyses, these data do not suggest any adverse effects for menthol cigarettes on measures of initiation and progression to increased smoking.

Factors that might account for the probability of children being exposed to secondhand smoke compared to those who are unexposed and characteristics associated with the urinary cotinine level (UCL) of those who are exposed were investigated. All households in a German region with a child aged 3 years or younger (n = 3,570) were invited to participate in a study that tested the efficacy of an intervention for reducing secondhand smoke exposure. In 1,282 households, at least one parent reported daily smoking. Among these, 915 (71.3%) participated in the study. For data analyses, we used a two-part model. Characteristics of the households associated with SHSE of the youngest child were analyzed, as well as characteristics associated with UCL among those exposed. Exposure to secondhand smoke was defined using a UCL ≥ 10 ng/ml. Secondhand smoke exposure was detected in 57.1% of the samples. Nursery attendance was associated with secondhand smoke exposure, in addition to the number of smokers living in the household, extent of home smoking ban and parental education. Among children exposed, nursery attendance, season of urine collection and age of the child were associated with UCL. Consideration of seasonal smoking behavior and a child's age at the time of intervention may increase attention to the adverse health effects of secondhand smoke exposure.

Purpose This study updates nationally representative information on cigarette smoking behaviors among adults with mental illness, particularly serious mental illness (SMI), to serve as a new benchmark for smoking cessation initiatives. Methods Data are from the 2008–2012 National Surveys on Drug Use and Health. Prevalence estimates for past month daily smoking, heavy smoking, mean cigarettes consumed per day, nicotine dependence, past month quit ratio, and proportion of cigarettes consumed are presented by mental illness status. Results Adults with SMI were more likely than adults with any mental illness (AMI) but not SMI and adults without mental illness to engage in smoking behaviors. Adults with AMI but not SMI were more likely to engage in all smoking behaviors compared with adults without mental illness. The past month quit ratio was significantly lower among adults with SMI and among adults with AMI but not SMI than among adults without mental illness. Adults with SMI comprised 6.9% of past month smokers but consumed 8.7% of all cigarettes. Conclusions Adults with mental illness engage in more smoking behaviors and are less likely to quit than adults without mental illness. In this high-risk population, continued efforts to promote smoking cessation are needed.

We explore the effects of occasional smoking on body mass index (BMI) in comparison to non-smoking and daily smoking in adults age 18–50. Data are compiled from the 2005–2008 Behavioral Risk Factor Surveillance System. Though smaller than that of daily smoking, occasional smoking is found to have a negative and substantial effect on body weight. Differences in the effect of occasional smoking on body weight across BMI categories are small. Unlike daily smoking, the effects of occasional smoking on BMI are larger for females, exceeding 50% of the effects of daily smoking on BMI. These large effects constitute a threat as occasional smoking might be seen by females as an effective weight control strategy that carries lower health risks than daily smoking. Strategies to reduce smoking should then emphasize the proportional health risks of occasional smoking.

ObjectivesAlthough the smoking prevalence continues to decline in New Zealand (NZ) overall, little is known about smoking in university students. A 2013 survey of students aged 17–25 years found that 14% were current smokers, and 3% daily smokers. However, the sample did not include students from all NZ universities. This study examines the prevalence and patterns of cigarette smoking among students aged 18–24 years.SettingUniversity students across NZ.MethodsData came from a March to May 2018 survey of students from all NZ universities, and were weighted to account for undersampling and oversampling, based on gender and university size. χ2tests were used to compare smoking by age, gender and ethnicity.Participants1476 participants were included: 919 (62.3%) aged 18–20 years and 557 (37.7%) aged 21–24 years; 569 (38.6%) male and 907 (61.4%) female; and 117 (7.9%) Māori and 1359 (92.1%) non-Māori.Results49.8% (95% CI 47.2 to 52.4) of respondents reported ever smoking, 11.1% (95% CI 9.5 to 12.9) currently smoked (smoked at least once a month) and 5.9% (95% CI 4.8 to 7.3) smoked at least daily (daily smokers). Of current smokers, 63.6% smoked 1–5 cigarettes/day, 45.8% smoked daily, 73.4% smoked first cigarette >60 min after waking, 86.0% never/almost never smoked in indoor and 64.6% in outdoor smokefree spaces, 69.9% planned to quit and 32.4% had tried to quit. Ever, current and daily smoking were significantly higher in 21–24 compared with 18–20 years olds, and in males compared with females. Older participants were more likely to report smoking more cigarettes/day. Māori were more likely to report ever smoking than non-Māori.ConclusionsCurrent smoking among NZ university students aged 18–24 years appears to be declining but daily smoking could be increasing. However, many students appeared less addicted to nicotine, and willing to quit. We recommend increasing the availability of smokefree services for students who wish to quit.

Monitoring of tobacco use is one of the key tobacco control activities. This study aimed to assess the current prevalence and patterns of tobacco and e-cigarette in Poland as well as to investigate socioeconomic factors associated with cigarette smoking and e-cigarette use. This cross-sectional study was carried out in 2019, on a representative nationwide sample of 1011 individuals aged 15+ in Poland. Daily tobacco smoking was declared by 21.0% of participants, 1.3% of participants were occasional tobacco smokers, and 10.7% were former tobacco smokers. Heated tobacco was used by 0.4% of participants. Ever e-cigarette use was declared by 4.0% of participants and 1.4% were current e-cigarette users. A higher proportion of daily smokers was observed among men than women (24.4% vs. 18.0%, p &lt, 0.0001). The age group 30 to 49 years, of a lower educational level and living in a medium-sized city (between 20,000 and 500,000 residents), was significantly associated with current daily smoking. This is the most up-to-date study on the prevalence of smoking in Poland. Further tobacco control activities are needed to reduce tobacco use in Poland.

Introduction Public health surveillance of smoking prevalence is essential in gauging the magnitude of the problem, identifying groups most affected, and evaluating polices. However, little attention has focused on how prevalence is measured, particularly in low- and middle-income countries, where smoking patterns may not mirror those in high-income countries and where the burden of tobacco use is rapidly growing. Mexico provides a unique opportunity to gauge how the questions used to define established smokers can affect prevalence estimates. This study assesses how using the 100-cigarette lifetime question to define smoking status affects estimates of smoking prevalence. Methods We consider data from four nationally representative surveys in Mexico, from 2002 to 2016. These surveys ask about current smoking even for adults who do not indicate having smoked 100 cigarettes in their lifetime. We compare estimates of daily and nondaily smoking prevalence by age and gender with and without the 100-cigarette screen. Results The relative difference in prevalence estimates with and without the screen was greater for nondaily than daily smoking and for females than males. The difference was especially pronounced for nondaily smokers aged 15–24, where there was a 50%–75% relative difference in estimates, albeit smaller discrepancies (20–49% relative difference) were also found among older smokers. In recent years, the relative difference was greatest at lower levels of educational attainment. Conclusions With the growth in nondaily smoking, using the 100-cigarettes screen to define smoking status can have important implications regarding size of smoking population. Further research is warranted in other countries.

Background Family smoking environment and family management are associated with risk of teen smoking behaviors. However, less is known about whether these associations increase or decrease in strength across adolescence, and whether there are person-environment interactions. The current study examined 1) the age-varying main effects of family smoking and family management on adolescent daily smoking from ages 12–18 and tested 2) whether behavioral disinhibition and anxiety moderated these relationships. Methods Data were drawn from the Seattle Social Development Project (SSDP; N = 808), a longitudinal study examining prosocial and antisocial behavior. Analyses used time-varying effect modeling (TVEM), which tested the stability of the relationship between family smoking and family management and youth daily smoking across adolescence. Results Greater family smoking increased the likelihood of adolescent daily smoking, whereas greater family management reduced the likelihood of daily smoking. Significant interactions between family management and youth behavioral disinhibition and anxiety during early and mid-adolescence indicated that family management was more protective for adolescents with low (compared to high) behavioral disinhibition and anxiety. The effect of family smoking was not moderated by behavioral disinhibition or anxiety. Conclusions Family smoking and family management are key risk and protective factors that may be targeted for adolescent smoking prevention. Our interaction results for individual differences in behavioral disinhibition and anxiety suggest that certain types of youth may respond differently to family management practices. Findings also show periods during adolescence where family-centered preventive interventions could be optimally timed to prevent or reduce persistent adolescent smoking.

Objectives Although the harmful effects of smoking on periodontal disease and oral cancer are now indisputable, its effect on dental caries is less well known. This study assessed whether daily smoking predicts caries increment in adults over 4 years. Methods Data from 955 adults who participated in both the Health 2000 Survey and the Follow-Up Study of Finnish Adults' Oral Health were analysed. At baseline, participants provided information on demographic characteristics, education and dental behaviours. The 4-year net increment in the numbers of decayed (DT), filled (FT) and missing (MT) teeth and the DMFT index were calculated using the data from baseline and follow-up clinical oral examinations. Results Daily smoking was not associated with net DMFT increment. In subsequent analysis by components, daily smoking was associated with net DT increment, but not with net FT or MT increments. When daily smokers were split into two groups by consumption level (1–19 and 20+ cigarettes/day) and compared to nondaily smokers, a significant dose–response relationship was additionally found between levels of tobacco consumption and net DT increment. Although daily smokers reported less favourable behaviours than nonsmokers, these associations only explained partially the effect of daily smoking on net DT increment. Conclusions Daily smoking was independently related to caries development (net DT increment) in adults over 4 years, but not to caries treatment (net FT and MT increments) or caries experience (net DMFT increment).

BACKGROUND In recent decades, daily smoking has become less common, while occasional smoking has stayed at the same level. The purpose of the study is to describe occasional smokers on the basis of their smoking behaviour and socio-demographic characteristics. MATERIAL AND METHOD Data from Statistics Norway's quarterly surveys of tobacco use in 2010 and 2011 were used. Information on smoking habits, smoking-related behaviour and the respondents' attitudes to their own smoking was collected in telephone interviews. RESULTS Of the 8,700 men and women aged 16-74 (response rate 57%) who were included, altogether 1,583 were daily smokers and 907 occasional smokers. The occasional smokers were younger, more frequently lived in large cities and had a higher level of education and income than the daily smokers. Twenty-nine of 174 (17%) occasional smokers used snus on a daily basis, compared to 10 of 394 (3%) of the daily smokers. The occasional smokers had great confidence in their ability to quit: 95% responded that they would be smoke-free in five years, compared to 55% of the daily smokers (n = 2,158). Fifty-five (35%) of the occasional smokers lit up several times weekly (16 cigarettes per week on average), while the remaining (65%) smoked only once per week as a maximum (five cigarettes per week on average). Those who smoked several times each week had attitudes to their own smoking and usage pattern for tobacco that were similar to those of the daily smokers. Nearly half of the occasional smokers defined themselves as non-smokers. INTERPRETATION Norwegian occasional smokers are a heterogeneous group in terms of their smoking pattern and frequency, and many define themselves as non-smokers.

To assess whether socioeconomic inequalities in smoking in five regions across in Turkey have the same pattern as observed in southern Europe. Cross-sectional data of the World Health Survey 2002 from Turkey were analyzed (5,951 women and 4,456 men) to evaluate the association of smoking with wealth and education. Age-standardized prevalence rates and odds ratios were calculated separately by sex, region and age groups. Smoking prevalence was 16.7 % for women and 51.4 % for men. Smoking risk was increased in higher wealth and education groups among women in all regions and for both younger and older generations. In the East, Middle and Black Sea regions this female pattern was most pronounced. For men, smoking was less prevalent in the two highest wealth groups. Unlike among women, socioeconomic differences in smoking were approximately equally large in all regions. Patterns of inequalities in smoking across the five regions strongly resemble those observed in southern Europe. This fits the patterns predicted by the smoking epidemic model. Particular attention should be given to highly educated women, who may perceive smoking as a symbol of modernity, emancipation and independence.

Bipolar disorder (BD) and nicotine dependence (ND) often co-occur. However, the mechanisms underlying this association remain unclear. We aimed to examine, for the first time in a national and representative sample, the magnitude and direction of the temporal relationship between BD and ND; and to compare, among individuals with lifetime ND and BD, the sociodemographic and clinical characteristics of individuals whose onset of ND preceded the onset of BD (ND-prior) with those whose onset of ND followed the onset of BD (BD-prior). The sample included individuals with lifetime BD type I or ND (n = 7958) from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, n = 43093). Survival analyses and logistic regression models were computed to study the temporal association between ND and BD, and to compare ND-prior (n = 135) and BD-prior (n = 386) individuals. We found that ND predicted the onset of BD and BD also predicted the onset of ND. Furthermore, the risk of developing one disorder following the other one was greatest early in the course of illness. Most individuals with lifetime ND and BD were BD-prior (72.6%). BD-prior individuals had an earlier onset of BD and a higher number of manic episodes. By contrast, ND-prior individuals had an earlier onset of both daily smoking and ND, and an increased prevalence of alcohol use disorder. In conclusion, ND and BD predict the development of each other. The phenomenology and course of ND and BD varied significantly depending on which disorder had earlier onset.

Background The present study examined the role of emotional distress tolerance (DT) in predicting barriers to smoking cessation and number of quit attempts. Methods The sample consisted of regular daily smokers ( N = 126; 37 females; M age = 36.51, SD = 13.05) who completed self-report measures on affect and smoking. Results After controlling for daily smoking rate and anxiety sensitivity, emotional DT significantly predicted internal barriers to cessation (6.9% unique variance) but not external or addiction-related barriers to cessation. Inconsistent with prediction, emotional DT did not significantly predict number of quit attempts. Conclusions These results suggest that individuals who are low in emotional DT believe that quitting smoking will be difficult because it takes away an important affect regulation strategy, and there may be utility in targeting emotional DT in smoking cessation interventions.

Objectives : The purpose of this study was to compare three therapies - auricular acupuncture, transdermal nicotine patch and therapy - in combination with auricular acupuncture and nicotine patch. Methods : The subjects of this study included 188 male smokers in their 20s, 30s, 40s and 50s, who visited Wonmi Public Health Center. They were evaluated with the Fagerstrom test for nicotine dependence, amounts of daily smoking and success rate of smoking cessation. The subjects decided on a therapy method strictly of their own choice. They were divided into three groups according to the therapy; auricular acupuncture group (62 persons), nicotine patch group (69 persons) and combination therapy group (57 persons). Results : All three groups resulted in statistically significant reducing effects of nicotine dependence and amounts of daily smoking. In the combination therapy group, nicotine dependence was significantly decreased by more than those of the other groups. There were no statistically significant differences in decrements of daily smoking and success rate of smoking cessation among the three groups. Conclusions : The above results suggest that auricular acupuncture and transdermal nicotine patch have significant effects of smoking cessation. If they are combined, it is expected that therapies for smoking cessation would be developed.

Objectives : This study was performed to examine the effectiveness of auricular acupuncture to adult men on smoking cessation. Methods : 47 smoking people was divided two groups : experimental group(treated with auricular acupuncture therapy, n=22) and control group(not treated with auricular acupuncture therapy, n=25). We used Lung point, Shenmen point and Endocrine point twice a week for 4 weeks to experimental group. We assessed the changes in amount of daily smoking, desire of smoking, taste of smoking and nicotine dependence as well as subjective symptoms were studied. Results : The experimental group showed significant decrease in amount of daily smoking, desire of smoking, taste of smoking and nicotine dependence. Subjective symptoms also showed improvement comparing to control group. Conclusions : Acupuncturing lung, shenmen, and endocrine point showed effectiveness on decreasing smoking rates and subjective symptoms. Therefore the auricular acupuncture therapy is expected to helpful to smoking cessation and improve the health of smokers.

Backgrounds: Smoking in childhood has become an important public health concern. Previous studies have reported on secular trends in childhood smoking rates and compared with smoking rates at fixed ages. They also described secular trends regarding the prevalence of smoking at fixed ages. The variations in smoking rate of young children and adolescents by follow-up groups have not been studied by follow-up groups at a national level. Objective: We looked at trends and generational impacts on smoking rate by using follow-up groups of male Japanese high school students to quantitatively assess differences in trends, based on multiple nationwide data from the Japanese Youth Tobacco and Drinking Surveys gathered every 4 years between 1996 and 2008. Methods: The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from 1996 to 2008, using the single-stage cluster sampling methodology. The cluster unit of the sampling was school. The survey targeted junior and senior high school students from schools selected through Japan using the National School Directory. Students enrolled in the sampled schools were subjects of the study. Participants were 53,925 high school students from 7th grade to 11th grade in 1996, 2000, 2004 and 2008. We divided the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades, age 13. The end periods were 4 years later when they had become 11th graders, age 17, from 2000 to 2008. Main outcome measures in this study were life time smoking, current smoking within 30 days and daily smoking at 7th or 11th grade and the trend of the smoking rates between 7th to 11th grades. Results: Life time smoking rate, current smoking rate and daily smoking rate in Japanese high school students decreased at 7th grade from 1996 to 2004. They also decreased at 11th grade from 2000 to 2008. However, the slopes differed among their follow-up groups. The increments in their smoking rates from 7th grade to 11th grade in male high school students were smaller in recent follow-up groups both in 2000 and in 2004 than in follow-up groups in 1996. Then, those increments in follow-up groups between in 2000 and in 2004 were similar in lifetime smoking rate and current smoking rate. Conclusions: We have shown that monitoring trends by follow-up group are important in studying smoking for public health. Values of smoking rates from a young age to adolescence by follow-up group should be examined. Values of smoking rate and regular changes in smoking rate are important because smoking rate changes dynamically during adolescence. Not only trends in smoking rates at fixed ages, but also generational impacts should be considered by using follow-up groups to study smoking behaviors among students. We need to continue careful monitoring of follow-up group smoking prevalence. When long-term health promotions are planned or assessed, policy makers need to look at changes in follow-up groups.

Although an indicator of prenatal testosterone (PT), 2D:4D ratio, has been extensively studied in the domain of financial risk taking, other domains of risk have received less attention. It is thought that elevated levels of PT relate to more masculinised behaviours, including increased risk taking propensity. In this study, we report negative findings with regards to health (average weekly drinking and daily smoking) and sexual (lifetime number of sexual partners) risk in a sample of post-menopausal Finnish women (N = 146–262). Our results suggest that PT may not masculinise health and sexual risk taking in women, at least at an older age.

This study compared characteristics of Korean American men in two studies: a telephone survey with a random sample of Korean American men who reported daily smoking versus a smoking cessation clinical trial with a convenience sample of Korean American men who reported smoking at least 10 cigarettes a day. Guided by the Theory of Planned Behavior (TPB), both studies attempted to explain how much its theoretical variables (attitudes, perceived social norms, and self-efficacy) would explain quit intentions in Korean American men. Participants in the cessation study were less likely to have health insurance coverage (χ2 [2, 271] = 138.31, p = 0.001) than those in the survey study. The cessation group was more likely to smoke in indoor offices (χ2 [1, 231] = 18.09, p = 0.003) and had higher nicotine dependence than the survey group (t269 = 3.32, p = 0.001) but these differences became insignificant when only those who smoked 10 or more cigarettes were compared. Participants in the cessation study had more positive attitudes towards quitting (t267 = 4.99, p t269 = 5.63, p t268 = 9.86, p

Background: To our knowledge only one previous study has addressed effects of smoking on lung function in adult asthmatics, who may form a susceptible group. We assessed the relations between current, former and life-time cumulative smoking and lung function among adults with new asthma. Methods: In a population-based study 521 (response rate 86%) working-aged adults with clinically defined incident asthma answered a questionnaire on personal smoking and other factors potentially influencing lung function, and performed spirometry. Results: Among asthmatics FEV1 level was reduced on average 220 ml related to current smoking (effect estimate -0.22, 95% CI -0.38 to -0.06) and 230 ml in relation to former smoking quit less than a year ago (-0.23, 95% CI -0.49 to 0.03), but FEV1 was not related to occasional smoking or former smoking quit over a year ago. The relation with smoking was stronger in men and an exposure-response pattern related to both daily smoking rate and life-time cumulative smoking was seen both among men and women. Conclusions: This study provides new evidence that among working-aged adults with new asthma, regular smoking and former smoking are related to reduced FEV1 level. Men seemed to be more susceptible to this effect. The results indicate that those with asthma should not start smoking or should be encouraged to quit at their earliest convenience.

Background Certain population groups in the United States carry a disproportionate burden of cancer. This work models and analyzes the dynamics of lung and bronchus cancer age-adjusted incidence rates by race (White and Black), gender (male and female), and prevalence of daily smoking in 38 U.S. states, the District of Columbia, and across eight U.S. geographic regions from 1999 to 2012. Methods Data, obtained from the U.S. Cancer Statistics Section of the Centers for Disease Control and Prevention, reflect approximately 77% of the U.S. population and constitute a representative sample for making inferences about incidence rates in lung and bronchus cancer (henceforth lung cancer). A longitudinal linear mixed-effects model was used to study lung cancer incidence rates and to estimate incidence rate as a function of time, race, gender, and prevalence of daily smoking. Results Between 1999 and 2012, age-adjusted incidence rates in lung cancer have decreased in all states and regions. However, racial and gender disparities remain. Whites continue to have lower age-adjusted incidence rates for this cancer than Blacks in all states and in five of the eight U.S. geographic regions. Disparities in incidence rates between Black and White men are significantly larger than those between Black and White women, with Black men having the highest incidence rate of all subgroups. Assuming that lung cancer incidence rates remain within reasonable range, the model predicts that the gender gap in the incidence rate for Whites would disappear by mid-2018, and for Blacks by 2026. However, the racial gap in lung cancer incidence rates among Black and White males will remain. Among all geographic regions, the Mid-South has the highest overall lung cancer incidence rate and the highest incidence rate for Whites, while the Midwest has the highest incidence rate for Blacks. Between 1999 and 2012, there was a downward trend in the prevalence of daily smokers in both genders. However, males have significantly higher rates of cigarette smoking than females at all time points. The highest and lowest prevalence of daily smoking are found in the Mid-South and New England, respectively. There was a significant correlation between lung cancer incidence rates and smoking prevalence in all geographic regions, indicating a strong influence of cigarette smoking on regional lung cancer incidence rates. Conclusion Although age-adjusted incidence rates in lung cancer have decreased throughout the U.S., racial and gender disparities remain. This longitudinal model can help health professionals and policy makers make predictions of age-adjusted incidence rates for lung cancer in the U.S. in the next five to ten years.

Aim of the study. To examine differences in lung function between petroleum refinery workers and office workers and to evaluate working in petroleum refinery as a predictor of the values of lung function parameters. Methods. We performed a cross-sectional study including 90 male petroleum refinery workers, aged 32-60 years. In addition, 40 male office workers, aged 47-59 years were examined as a control. Evaluation of examined subjects included completion of a questionnaire on general and respiratory symptoms in the last 12 months and lung function testing (all parameters expressed in %predicted). Several multiple regression models were tested to examine the associations of working in a petroleum refinery to lung function parameters controlling for age, duration of employment, exposure duration, daily smoking, life-time smoking, and number of cigarettes per day. Results. Mean values of lung function parameters (FVC, FEV1, MEF75, MEF50 and MEF25) were similar in both groups. Mean FEV1/FVC value was significantly lower in petroleum refinery workers (83.13 ± 7.16) than in controls (87.1 ± 7.44) ( t =-2.88; p =0,005). Multiple regression analysis showed that daily smoking ( β = -.803) and cigarettes/day ( β = -.507) were significant predictors of lower FEV1 ( R 2 = .09, Δ R 2 = .08, Δ F =1.97, p =0.015). Working in a petroleum refinery ( β = -.228) negatively predicted FEV1/FVC ( R 2 = .097, Δ R 2 = .047, Δ F =6.36, p =0.013). Conclusion. Our data suggest important role of specific occupational exposure, daily smoking, and number of cigarettes per day in the development of reduced lung function.

Introduction: The aim of our study was to explore the major non-communicable risk factors (unhealthy diet, sedentarily, alcohol consumption) of smokers and nonsmokers in workplaces. Methods: A cross-sectional study was derived from an initial assessment in workplaces which was part of a community-based intervention to prevent chronic disease risk factors conducted in 2009 in the region of Sousse, Tunisia. The surveyed subjects were employees in six factories spread across three delegations in the region. Overall, 1770 of 2250 employees participated in the assessment. In this study, the clustering of non-communicable diseases risk factors with smoking habits was made only for male employees including in this study 1099 among 2250. Data were collected at worksites by a questionnaire, via interview or self-report .The main items assessed socio-demographics characteristics, smoking status, eating habits, level of physical activity and alcohol use of the participants. Results: The percentage of male smokers was 54.0%(n=594). Their average age of daily smoking initiation was 19.22 (±4.24 years). The percentage of male smokers consuming 5 fruits and vegetables per day was significantly lower than nonsmokers (57.2% vs 63.5%, p=0.04). The proportion of male smokers consuming alcohol was about three times that of nonsmokers (16.5% vs 5.8%, p=0.001). The proportion of male employees who agree with anti-smoking laws in work places was higher for nonsmokers than for smokers. Conclusion: A strong association existed between smoking and risky lifestyles factors in the work place. Such findings are potentially useful in directing intervention efforts regarding smoking cessation in occupational settings.Pan African Medical Journal 2016; 24

Background: Ischemic stroke is often a sequel of atherosclerotic risk factors. Carotid intima-media thickness (CIMT) is a surrogate marker of early atherosclerotic changes. Purpose: It was hypothesized that CIMT is associated with ischemic stroke in adults across all ages. Methods: A case control study was performed on 163 diagnosed cases of first-time ischemic stroke and age- (±1 SD) and gender-matched healthy control attendants reporting at a tertiary care hospital. Data were collected on atherosclerotic risk factors for ischemic stroke. CIMT from both the carotids was measured using carotid vascular Doppler. The demographic profile and CIMT with atherosclerotic risk factors of cases and controls across different age groups were compared using unpaired t test if they passed the test of normality, else the Mann-Whitney test was used. OR for vascular risk factors for the development of stroke was calculated. The relationship of CIMT to atherosclerotic risk factors was analyzed by using Spearman correlation and regression analysis. The level of significance was set at 0.05. Results: Age-specific value of CIMT was significantly higher in stroke cases than in age-matched controls across all age groups. Right CIMT, along with the history of hypertension (HTN; OR 2.3), are important risk factors for ischemic stroke in the younger age group (20-40 years). With increasing age along with the history of HTN and right CIMT (OR >7), presence of plaque (OR 6.3) and daily smoking (OR 5.1) are also significant risk factors. CIMT is significantly related to the daily alcohol and smoking intake and the presence of plaques. Right CIMT is positively related to increasing age in normal population ( R 2 = 0.041; p Conclusions: Right CIMT and comorbid HTN are significant risk factors associated with the development of ischemic stroke across all adult age groups.

After World War II, smoking among men was very common in Finland, and especially in North Karelia, contributing to the high rates of cardiovascular diseases and cancer. Thus, the North Karelia Project, from its very start in 1972, took reduction in smoking as one of its main targets. After 1977, the project actively contributed to national tobacco control work, including comprehensive legislation and many other activities. Smoking in North Karelia declined initially much more than in the rest of Finland, but thereafter there has been a steady national decline, resulting in a prevalence of daily smoking among adults of approximately 15% and contributing to the big reduction in the rates of heart disease and tobacco-related cancers, especially among men.HighlightsThe North Karelia Project reduced smoking first regionally and later in all of Finland.Regional campaigning against tobacco in North Karelia became nationwide.National tobacco control legislation was inspired by the North Karelia Project.Tobacco endgame target is now written in the Finnish Tobacco Act.

Becoming a smoker usually starts during adolescence and is a dynamic process involving experimentation before the establishment of daily smoking. It has been suggested that adolescents who smoke differ from those who do not in their attitudes to smoking. The purpose of this study was to find out whether attitudes related to smoking legislation and restrictions, social pressures in smoking and image of smokers are associated with smoking experimentation, daily smoking and best friends’ smoking. The data were gathered with a self-administered questionnaire in North Karelia, Eastern Finland and in the Pitkyaranta district, Republic of Karelia, Russia. The respondents were 15-year-old 9th grade pupils in local schools. In Pitkyaranta, the data analyses covered pupils in all eight schools in the area (n = 179). In North Karelia, the data analyses comprised of selected eight schools (n = 601). Data were analysed with exploratory factor analysis. The models revealed that attitudes related to restrictions and social pressure were significantly associated with experimenting with smoking [OR (95 % CI) 7.923 (5.787–10.847)], daily smoking [OR (95 % CI) 9.575 (6.727–13.628)] and the likelihood of best friends’ smoking [OR (95 % CI) 3.154 (2.579–3.858)]. The stronger the young peoples’ attitudes and opinions, for example, towards restrictions and with more difficulties in refusing smoking, the higher the likelihood for smoking experimentations, daily smoking as well as the likelihood for their best friends’ smoking. The country and factor interactions were not associated with smoking experimentations, daily smoking or best friends’ smoking. Regardless of cultural background, adolescents who smoke have more positive attitudes to smoking, and perceive more social support for smoking, than do adolescents who do not smoke. The study stresses the similarity of the results in both Karelia’s despite the enormous differences in culture, economy and public policy.

Adolescence is a time of initiation of behaviors leading to noncommunicable diseases (NCDs). We use tobacco to illustrate a novel method for assessing the contribution of adolescence to later burden.Data on initiation of regular smoking during adolescence (10-19 years) and current adult smoking were obtained from the 1958 British Birth Cohort, the U.S. National Longitudinal Study of Adolescent Health (Add Health), the Pelotas 1982 Birth Cohort, and the Victorian Adolescent Health Cohort Study. We estimated an "adolescent attributable fraction" (AAF) by calculating the proportion of persisting adult daily smoking initiatedage 20 years. We used findings to estimate AAFs for155 countries using contemporary surveillance data.In the 1958 British Birth Cohort, 81.6% of daily smokers at age 50 years initiatedage 20 years, with a risk ratio of 6.1 for adult smoking related to adolescent initiation. The adjusted AAF was 69.1. Proportions of smokers initiating20 years, risk ratio, and AAFs were 83.3%, 7.0%, and 70.4% for Add Health; 75.5%, 3.7%, and 50.2% in Victorian Adolescent Health Cohort Study; and 70.9%, 5.8%, and 56.9% in Pelotas males and 89.9%, 6.4%, and 75.9% in females. Initiation16 years resulted in the highest AAFs. Estimated AAFs globally ranged from 35% in China to 76% in Argentina.The contribution of adolescent smoking initiation to adult smoking burden is high, suggesting a need to formulate and implement effective actions to reduce smoking initiation in adolescents. Similar trends in other NCD risks suggest that adolescents will be central to future efforts to control NCDs.

Introduction: We evaluated an intervention to teach physicians how to help their smoking patients quit compared to usual care in Argentina. Methods: Physicians were recruited from six clinical systems and randomized to intervention (didactic curriculum in two 3-hour sessions) or usual care. Smoking patients who saw participating physicians within 30 days of the intervention (index clinical visit) were randomly sampled and interviewed by telephone with follow-up surveys at months 6 and 12 after the index clinical visit. Outcomes were tobacco abstinence (main), quit attempt in the past month, use of medications to quit smoking, and cigarettes per day. Repeated measures on the same participants were accommodated via generalized linear mixed models. Results: Two hundred fifty-four physicians were randomized; average age 44.5 years, 53% women and 12% smoked. Of 1378 smoking patients surveyed, 81% were women and 45% had more than 12 years of education. At 1 month, most patients (77%) reported daily smoking, 20% smoked some days and 3% had quit. Mean cigarettes smoked per day was 12.9 (SD = 8.8) and 49% were ready to quit within the year. Intention-to-treat analyses did not show significant group differences in quit rates at 12 months when assuming outcome response was missing at random (23% vs. 24.1%, P = .435). Using missing=smoking imputation rule, quit rates were not different at 12 months (15.6% vs. 16.4% P = .729). Motivated smokers were more likely to quit at 6 months (17.7% vs. 9.6%, P = .03). Conclusions: Training in tobacco cessation for physicians did not improve abstinence among their unselected smoking patients. Fil: Mejia, Raul Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro de Estudios de Estado y Sociedad; Argentina. Universidad de Buenos Aires; Argentina Fil: Stable, Eliseo J. Pérez. Universidad de California en San Francisco; Estados Unidos Fil: Kaplan, Celia P.. Universidad de California en San Francisco; Estados Unidos Fil: Gregorich, Steven E.. Universidad de California en San Francisco; Estados Unidos Fil: Livaudais Toman, Jennifer. Universidad de California en San Francisco; Estados Unidos Fil: Peña, Lorena. Centro de Estudios de Estado y Sociedad; Argentina Fil: Alderete, Mariela del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Schoj, Veronica. Fundacion Interamericana del Corazón Argentina; Argentina Fil: Alderete, Ethel del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina

Introduction Cigarette purchasing patterns may be linked with greater readiness to make a quit attempt and more quit attempts among domiciled samples. However, little is known about the cigarette purchasing patterns of homeless smokers or their potential relations to quitting intention and behaviors. This study redressed this gap among a convenience sample of homeless adult smokers from a large shelter in Dallas, Texas. Methods Participants (N = 207; Mage = 43; 71.5% male) smoked ≥100 cigarettes over the lifetime and endorsed current daily smoking. Variables assessed included cigarette dependence (time to first cigarette of the day), monthly income, quantity of cigarettes most recently purchased, average money spent on cigarettes weekly, readiness/motivation to quit smoking, and the number intentional quit attempts lasting ≥24h in the past year. Regression analyses were conducted to characterize associations of cigarette purchasing patterns with readiness to quit and quit attempts controlling for sex, age, cigarette dependence, and income. Results Most participants purchased cigarettes by the pack (61.4%), and more than half the sample spent ≤$20 on cigarettes per week. Results indicated that spending less money per week on cigarettes was associated with greater readiness to quit (P = .016), even when controlling for income, cigarette dependence, and other covariates. Stratified analyses indicated that this association was significant only for homeless smokers reporting no regular monthly income. Conclusions Homeless daily smokers with no reported income who spend little money on cigarettes may make particularly apt targets for cessation interventions due to potential associations with quitting motivation. Implications Adults who are homeless smoke at greater rates and quit at lower rates than domiciled adults, leading to significant smoking-related health disparities among this group. Findings suggest that cigarette purchasing patterns are linked with readiness to quit smoking among smokers who are homeless. Results elucidate one of the myriad factors that contribute to tobacco-related disparities among this group and findings may have implications for cessation interventions in homeless shelters and other contexts where resources are limited.

American Indian (AI) youth have a high risk of smoking initiation. Sensation-seeking, defined as the tendency to seek novel and thrilling experiences, has been associated with smoking initiation in other groups but has never been examined in AI youth.Data were from the Voices of Indian Teens Project (VOICES), a longitudinal study of AI youth from seven high schools in four AI communities in the western United States. Participants completed annual surveys in school over a three-year period. Our sample comprised 764 students who were non-smokers at baseline. Smoking initiation was defined as endorsement of daily smoking after baseline. We used binary logistic regression to evaluate the association of baseline sensation-seeking with odds of daily smoking initiation, stratified by gender.Participants were 353 males and 411 females aged 13 to 21years at baseline. After adjusting for covariates, baseline sensation-seeking correlated with smoking initiation differently in males and females. Sensation-seeking did not predict daily smoking in males. Among females, however, higher sensation-seeking scores at baseline predicted daily smoking in both the unadjusted (odds ratio=1.4; 95% CI=1.1-1.8; p=0.005) and covariate-adjusted (odds ratio=1.3; 95% CI=1.0-1.6; p=0.04) models.Gender-specific prevention programs may be warranted in addressing different risk-factor profiles in this high-risk population.

This study was conducted to investigate the differences between smokers and non-smokers` oral hygiene and college students` smoking awareness. The survey was carried out based on the 260 college students enrolled in four-year universities located in Kyungbuk, Daegu, Gangwon-do. Collected date used the SPSS 17.0 to perform the frequency and cross-analysis. 1. The daily smoking amounts of less than half pack and the smoking duration of more than 1 year and less than 3 years were to be the highest. The initiation of smoking was triggered by the curiosity and the proximal social environment. The reason of smoking was to relieve stress and habitual smoking respectively. 2. There was a significant difference between smokers and non-smokers` tooth brushing time, regular dentist visit, recent dental admission, the purpose of dental visits, scaling and oral health education. 3. There was a significant difference between smokers and non-smokers` awareness of oral hygiene in the subjective oral hygiene status. 4. There was a significant difference between smokers and non-smokers` awareness towards the impact of second-hand, after meal and one or two cigarette smoking. Based on the above results, smokers lack the awareness of smoking and oral hygiene compared to non-smokers. Therefore, the activation and the development of programs for the smoking and oral hygiene education targeting college students are considered to be necessary.

Background Raising cigarette prices through taxation is an important policy approach to reduce smoking. Yet, cigarette price increases may not be equally effective in all subpopulations of smokers. Purpose To examine differing effects of state cigarette price changes with individual changes in smoking among smokers of different intensity levels. Methods Data were derived from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults originally interviewed in 2001–2002 (Wave 1) and re-interviewed in 2004–2005 (Wave 2): 34 653 were re-interviewed in Wave 2, and 7068 smokers defined at Wave 1 were included in our study. Mixed effects linear regression models were used to assess whether the effects of changes in state cigarette prices on changes in daily smoking behaviour differed by level of daily smoking. Results In the multivariable model, there was a significant interaction between change in price per pack of cigarettes from Wave 1 to Wave 2 and the number of cigarettes smoked per day (p=0.044). The more cigarettes smoked per day at baseline, the more responsive the smokers were to increases in price per pack of cigarettes (ie, number of cigarettes smoked per day was reduced in response to price increases). Conclusions Our findings that heavier smokers successfully and substantially reduced their cigarette smoking behaviours in response to state cigarette price increases provide fresh insight to the evidence on the effectiveness of higher cigarette prices in reducing smoking.

North American Indigenous adolescents smoke earlier, smoke more, and are more likely to become regular smokers as adults than youth from any other ethnic group yet we know very little about their early smoking trajectories. We use multilevel growth modeling across five waves of data from Indigenous adolescents (aged 10 to 13 years at Wave 1) to investigate factors associated with becoming a daily smoker. Several factors, including number of peers who smoked at Wave 1 and meeting diagnostic criteria for major depressive episode and conduct disorder were associated with early daily smoking. Only age and increases in the number of smoking peers were associated with increased odds of becoming a daily smoker.

Objectives: Smoking among university students represents a formidable and global public health challenge.\ud We assessed the associations between socio-demographic, health and wellbeing variables as independent variables,\ud with daily smoking, attempts to quit smoking, and agreement with smoking ban as dependent variables. Methods:\ud A sample of 3258 undergraduate students from eleven faculties at Assiut University, Assiut, Egypt, completed a\ud general health questionnaire. Results: Overall daily or occasional smoking in last three months prior to the survey\ud was about 9% (8% occasional and 1% daily smokers), and smoking was generally more prevalent among males\ud (male=17%, female=0.6%, P < 0.001). After adjustment for confounders, not having normal BMI and having a\ud mother who completed at least bachelor’s degree education was positively associated with daily smoking, and\ud conversely, no history of illicit drug use was a protective factor. About 76% of smokers had attempted to quit\ud smoking within the last 12 months prior to the survey. Although a large proportion of students agreed/ strongly\ud agreed with the banning of smoking at university altogether (87%), such agreement was less likely among\ud smokers. Conclusion: There is need for implementation of non-smoking policies on university premises, as well\ud as regular up-to-date information on, and the periodic/yearly monitoring of tobacco use by university students\ud employing standardised data collection instruments and reference periods. In addition, it would be valuable to\ud develop campus-based educational/ awareness campaigns designed to counteract tobacco advertisement directed\ud towards young people in Middle East countries. Otherwise, the danger could be that the current relatively low\ud smoking prevalence among university students may escalate in the future.

Through the end of the 20th century, it was widely assumed that physical dependence on tobacco developed only after years of moderate-to-heavy daily smoking. A string of adolescent studies now establishes that physical dependence typically begins soon after the onset of very light nondaily smoking. Case series and surveys reveal that certain symptoms of physical dependence develop in a set sequence that appears to be characteristic of all dependent smokers. This sequence of symptom development provides the basis for an objective clinical approach to staging the progression of dependence. The identification of a set sequence in the development of the symptoms of physical dependence suggests that the as-yet-unidentified neurological cause of physical dependence also develops in a set sequence. This insight provides hope for identifying the cause of physical dependence and its cure.

Introduction: This study was conducted to compare gender differences in the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND). Methods: The sample comprised 334 Korean immigrants (97 women and 237 men) who reported daily smoking for the past 6 months. Item-by-item responses and exploratory factor analyses (EFA) were compared by gender. Promax rotation was selected based on findings from previous studies suggesting correlated factors. Results: Compared with men, women smoked fewer cigarettes per day, were more likely to smoke when ill in bed, and were less likely to smoke frequently in the morning. The entire sample and men within the sample had the same factor loading pattern, where three items (time to first cigarette, the cigarette most hate to give up, and smoke more frequently in the morning) were loaded on Factor 1 (morning smoking) and the remaining three items (difficult to refrain from smoking in public places, number of cigarettes smoked per day, and smoking even when ill in bed) on Factor 2 (daytime smoking). For women, however, neither the 1- nor 2-factor model fit the data well. Conclusions: For Korean American male smokers, the psychometric properties of the FTND were similar to those seen in other populations, but this was not the case with Korean American women. Clinicians may need to modify their interpretation of nicotine dependence severity if basing only on the FTND with Korean women. The FTND assesses smoking patterns which has a cultural influence and other measures of nicotine dependence should be considered.

Weather-related variables (temperature and rain) are examined for their association with daily cigarette smoking. Prior research has examined how the average monthly temperature and summer versus winter months are related to smoking, but daily fluctuations in weather have not been examined previously. The current research tests whether daily changes in weather are related to young adult cigarette use. In addition, nicotine dependency is tested as a moderator of such associations. Nine hundred and twelve participants were recruited to complete weekly measures of cigarette smoking for 35 weeks. Participants provided weekly self-reports of daily smoking for the last week and completed measures of nicotine dependence. In addition, data was obtained on daily temperature and presence of rain. A longitudinal growth curve model was calculated using daily temperature and rain data to predict daily cigarette smoking. A positive linear effect and negative quadratic effect of temperature was found along with a negative effect of rain. Nicotine dependency did not moderate the effect of temperature or rain on smoking. This study is the first to use daily measures of temperature and rain and corresponding daily measures of cigarette smoking to examine possible associations. Results support the relevance of weather-related variables in the prediction of cigarette smoking and the importance of considering environmental factors in understanding smoking behaviour.

INTRODUCTION: Monitoring tobacco consumption patterns is essential to define and evaluate strategies to control the tobacco epidemic. We aimed to quantify the use of smoked (manufactured/hand-rolled cigarettes) and smokeless (snuff/chew) tobacco, according to sociodemographic characteristics, in adult Mozambicans. METHODS: A national representative sample (n = 3,323) of subjects aged 25-64 years was evaluated in 2005 following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS), which included the assessment of tobacco consumption with the quantification of each type of tobacco used daily. We computed prevalences, and age- and education-adjusted prevalence ratios (PRs), with 95% CIs. RESULTS: Daily smoking was reported by 9.1% (95% CI = 5.0-13.1) of women (manufactured, 3.4%; hand-rolled, 5.6%) and 33.6% (95% CI = 29.3-38.0) of men (manufactured, 18.7%; hand-rolled, 14.8%). Daily manufactured cigarette smoking was significantly more frequent in men (urban: PR = 14.62, 95% CI = 7.59-28.55; rural: PR = 4.32, 95% CI = 2.42-7.71). Daily hand-rolled cigarette smoking was three- to fourfold more frequent among men and nearly 80% less frequent in urban areas, regardless of sex. The prevalence of daily smokeless tobacco use was 7.4% (95% CI = 4.6-10.2) in women (chew, 6.4%; snuff, 1.0%) and 3.4% (95% CI = 1.7-5.2) in men (chew, 1.6%; snuff, 1.8%). Daily smokeless tobacco consumption was significantly less frequent in urban areas only among men (PR = 0.05, 95% CI = 0.01-0.33). CONCLUSIONS: Despite the relatively low levels of manufactured cigarette smoking, traditional forms of tobacco consumption are frequent, especially among women and in rural settings, showing the need for control measures to target specifically different patterns of consumption.

Introduction: Intermittent smokers (ITS) are an increasingly prevalent segment of smokers, yet it is unknown whether or how dependence severity may vary across ITS. Methods: Participants were 217 ITS (70 never daily ITS [NITS], 138 converted ITS [CITS], 9 unknown), who smoked 4-27 days per month, and 197 daily smokers (DS), recruited for a study on smoking patterns. Participants completed questionnaires on dependence (time to first cigarette after waking, Fagerstrom Test of Nicotine Dependence [FTND], Nicotine Dependence Syndrome Scale [NDSS], Wisconsin Inventory of Smoking Dependence Motives [WISDM], and Hooked on Nicotine Checklist [HONC]), and recorded each cigarette in real time over 3 weeks using Ecological Momentary Assessment. Logistic regression assessed differences in dependence between groups (DS vs. ITS; CITS vs. NITS), and least squares regression examined associations between dependence and smoking behavior (mean, max cigarettes per day; proportion of days smoked; longest period of abstinence) within ITS. Results: As expected, DS were significantly more dependent than ITS: FTND, NDSS & WISDM discriminated between ITS and DS with > 90% accuracy. Similarly, among ITS, NITS demonstrated lower dependence than CITS. Within ITS, dependence measures also correlated with observed smoking rate and duration of abstinence. Conclusions: The study confirmed that DS are more dependent than ITS, and that CITS are more dependent than NITS. Importantly, ITS exhibit features of dependence, and there is meaningful variation in dependence within ITS, suggesting that some aspects of dependence may appear with very infrequent smoking. Future work should examine implications for ITS’ potential progression to daily smoking and cessation outcome.

Objective: This study examines the association between neurocognitive functioning and tobacco smoking in adolescence. Method: Data from three measurements of the longitudinal Tracking Adolescents' Individual Lives Survey (TRAILS), a large regional population-based cohort study of Dutch adolescents, were used. The first measurement took place in 2001-2002 (T1) when participants were age 11, with two follow-up measurements (2003-2004 and 2005-2007; T2 and T3, respectively). A total of 1,797 adolescents participated in all three waves. At T1, they performed a selection of tasks from the Amsterdam Neuropsychological Tasks program (De Sonneville, 1999), which enabled the assessment of the main aspects of neurocognitive functioning. Smoking was assessed with a self-report questionnaire at T1, T2, and T3. In the multivariate analyses we controlled for gender, age, socioeconomic status (SES) and baseline speed. Results: Multivariate logistic regression analyses showed that poor sustained attention increased the likelihood that the adolescent would initiate smoking between T1 and T2. Low inhibition of prepotent responses increased the likelihood of smoking initiation between T1 and T3. An increased ability to inhibit biased response tendencies reduced the likelihood of being a daily smoker at T2. Poor sustained attention increased the likelihood of being a daily smoker at T3. Conclusion: Poor sustained attention and low inhibition predicted adolescent smoking. However, the proportion of the variance in smoking risk accounted for by these neurocognitive predictors proved to be small. Thus, although neurocognitive functioning is related to adolescent smoking, it seems to explain only a small part of why adolescents initiate and continue smoking.

OBJECTIVE: This study aims to investigate the occurrence of nicotine dependence following the achievement of previous smoking milestones (initiation, weekly, and daily smoking). METHOD: Analyses are based on data from The National Comorbidity Survey-Adolescent, a nationally representative face-to-face survey of 10,123 adolescents (age 13–17) conducted between 2001 and 2004. RESULTS: Among adolescents who had ever smoked (36.0%), 40.7% reached weekly smoking levels and 32.8% had reached daily smoking. Approximately one in five adolescents who had ever smoked (19.6%) met criteria for nicotine dependence. An earlier age of smoking initiation, a shorter time since the onset of smoking and faster transitions among smoking milestones were independently associated with the onset of daily smoking and nicotine dependence. CONCLUSIONS: These findings shed new light on the course of smoking and nicotine dependence during adolescence by demonstrating a rapid transition across smoking stages for those most at risk for the development of chronic and dependent use.

Introduction Existing experimental studies indicate that young adults are more likely to smoke in the company of real-life smoking peers. However, it is still unclear whether imitation can explain these findings or whether alternatively the mere smell and not the smoking behavior may have been the trigger to smoke. One way to study this issue is by analyzing the exposure to real-life smoking peers without the possibility of smelling the smoker's cigarette, for example, during digital interaction on the Internet. Although many youngsters meet and interact with each other online, research on exposure to smoking peers through the Internet has not yet been investigated. Methods This experiment was conducted among 36 daily smoking young people aged 16-24 years. Smoking behavior was observed during a 30-min joint music assignment. During this assignment, the confederate and participant sat in 2 separate rooms and interacted with each other online and via webcam. Results The findings show that young adults interacting with heavy-smoking peers on the Internet and via webcam smoked significantly more cigarettes than those who interacted with nonsmoking peers. Conclusions Young adult smokers strongly imitate smoking in interaction with peers in online communication via webcam, without smelling the smoker's cigarette. Antismoking policies and smoking cessation programs should focus on (raising awareness of) avoiding smoking peers, even during digital interaction.

BACKGROUND: Reduced salivary flow may have a negative impact on general well-being, quality of life and oral health.OBJECTIVES: To examine xerostomia in 50-, 65- and 75-year-olds, background factors and effect on Oral Impacts on Daily Performances (OIDP).METHODS: In 1992, a questionnaire was sent to all 50-year-old persons (n = 8888) in two Swedish counties. In 2007, the same questionnaire was sent to all 65-year-olds (n = 8313) in the two counties and to all 75-year-olds (n = 5195). Response rate was for the 50, 65 and 75 year olds 71.4, 73.1 and 71.9%, respectively.RESULTS: Xerostomia was higher in women than in men in all age groups. There was higher prevalence of xerostomia with increasing age in both sexes and it was more frequent at night than during daytime. 'Often mouth dryness' was 2.6-3.4 times more prevalent in those who reported an impact from OIDP. The highest odd ratios were for daytime xerostomia and for the variables burning mouth (17.1), not feeling healthy (4.5), daily smoking (4.4), and medication (4.1).CONCLUSIONS: The dramatic increase of xerostomia between age 50 and 75, especially amongst women, needs to be considered in the management of this age group.

Purpose Understanding the interplay between genes and in-utero tobacco exposure in affecting child lung development is of great significance. In this study, we tested the hypothesis that tobacco-related lung-function reduction in children differs by maternal polymorphic genes Cytochrome P450 1A1 (CYP1A1) and Glutathione S-transferase Mu 1 (GSTM1). Materials and methods Data were collected among 370 children (6–10 years old, 81.6% African-Americans) and their biological mothers visiting a large children’s hospital. Study hypotheses were tested using multiple regression method. Results Among the study sample, 143 mothers smoked throughout pregnancy and 72 smoked on a daily basis. Spirometric measures (mean±SD) included were: forced vital capacity (FVC)=1635±431 mL, forced expiratory volume in the first 1 s (FEV1)=1440 ±360 mL, percent FEV1/FVC ratio=89±12, and forced expiratory flow between the 25% and 75% of FVC (FEF25–75)=1745±603 mL. In addition to a tobacco effect on FVC (−131 mL, 95% CI: −245, −17) and FEV1/FVC ratio (42, 95% CI: 1, 83), regression analysis controlling for covariates indicated that for the subsample of children whose mothers were CYP1A1⁎2A homozygous, maternal daily smoking was associated with −734 mL (95% CI: −1206, −262) reductions in FEV1 and −825 mL (95% CI: −909, −795) reductions in FVC; reduced smoking was still associated with −590 mL (95% CI: −629, −551) reductions in FVC. For children of mothers with GSTM1 deletion, persistent daily smoking was associated with −176 mL (95% CI: −305, −47) reductions in FVC. Discussion and conclusions Maternal smoking during pregnancy was significantly associated with lung-function reduction in children, particularly for those whose mothers possessed the polymorphic CYP1A1*2A and GSTM1 deletion.

International audience; BackgroundThis study assessed the associations of short-term employment, physical and psychological occupational demands, and job dissatisfaction with alcohol abuse (using the Audit-C test) and daily smoking among working French men and women in different age groups.MethodsThe sample included 13,241 working people, 18–29, 30–39, and 40–59-years-old, randomly selected in France and interviewed by phone. Occupation, type of employment, physical demands, psychological demands, job dissatisfaction, gender, age, educational level, and income were considered. Data were analyzed with logistic models.ResultsAlcohol abuse affected 20.4% of men and 7.5% of women; smoking 32.1% and 24.2%, respectively. Their patterns of association with the occupational factors varied with gender and age. Job dissatisfaction was the leading factor among young men (adjusted odds ratio for alcohol abuse and smoking: 1.71 and 2.02), whereas short-term employment was the leading factor among young women (1.69 and 1.58), this pattern being reversed in older generations. The pattern of associations of physical and psychological demands with outcomes is more complex, but overall psychological demands were more important for women (especially the younger ones) than men, especially for smoking (OR > 1.6). Smoking within 5 min after waking was much more common among male and female smokers with these occupational factors, suggesting a potential dependency.ConclusionsWorkers with short-term employment and occupational demands are subject to a higher risk for alcohol abuse and smoking with high gender and age disparities. Gender and age should be considered when designing measures to prevent substance abuse related to occupation.; Position du problèmeÉtude des associations entre conditions d’emploi (contrat à durée déterminée [CDD] ou d’intérim, contraintes physiques et psychologiques, insatisfactions relatives aux conditions de travail), usage abusif d’alcool (repéré par l’Audit-C) et tabagisme quotidien parmi des hommes et des femmes de différentes catégories d’âge.MéthodeL’échantillon aléatoire comprend 13 241 personnes de 18–29, 30–39 et 40–59 ans exerçant un emploi en France, interrogées par téléphone en 2005. Revenu du foyer, niveau de diplôme et catégorie d’emploi ont été pris en compte en plus des conditions d’emploi citées. Les associations ont été estimées à l’aide de régressions logistiques.RésultatsL’abus d’alcool concernait 20,4 % d’hommes et 7,5 % de femmes, le tabagisme 31,2 et 24,2 %. Ces usages étaient associés aux conditions d’emploi étudiées de façon variable suivant le sexe et l’âge. Les facteurs les plus importants était l’insatisfaction pour les hommes jeunes (OR = 1,71 pour l’abus d’alcool et 2,02 pour le tabagisme) et l’emploi en CDD pour les femmes (1,69 et 1,58), ces associations s’inversant dans les générations plus âgées. L’association entre contraintes physiques et psychologiques et usages est apparue plus complexe, mais contrastée par âge et par sexe. Les contraintes psychologiques étaient les plus associées au tabagisme parmi les femmes de moins de 40 ans (OR > 1,6) alors que les contraintes physiques l’étaient le plus chez les hommes (OR proches de 1,3 pour les deux usages).ConclusionsLa prévention devrait prendre en compte la variabilité des associations entre CDD, contraintes professionnelles et usages d’alcool et de tabac suivant l’âge et le sexe.