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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.

Introduction and Aims.Alcohol use has consistently been associated with smoking among nondaily smokers.However,this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long-term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non-smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol‐tobacco co-administration patterns. Design and Methods. 183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face-to-face interviews during which they provided details about their lifetime and past-week tobacco and alcohol administration patterns. Results.EOS were more likely to report having used alcohol at the time of their first-ever cigarette relative to the other subgroups (P ! 0.001), but there were no differences in past-week co-administration patterns between the subgroups.Overall,less than one-third of all smoking sessions occurred when drinking,but these accounted for more than half of all cigarettes consumed during the previous week.Moreover,while only 42% of drinking sessions involved tobacco co-administration,when drinking and smoking did co-occur,significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01). Discussion and Conclusions. Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co-administration is associated with mutual dose escalation. [Campbell ML, Bozec LJ, McGrath D, Barrett SP. Alcohol and tobacco co-use in nondaily smokers: An inevitable phenomenon? Drug Alcohol Rev 2011]

AIM The aim of this study was to determine whether an association exists between daily smoking and infrequent toothbrushing habits among adolescents. MATERIALS AND METHODS Nationally representative samples of 14-, 16- and 18-year-old Finns (N=5643) took part in the survey. A 12-page structured questionnaire was posted to the adolescents, asking them to complete it and return it in an enclosed pre-paid envelope. The χ(2)-test and a logistic regression model were used for analyses. RESULTS At the age of 14 years, 8.5% reported smoking daily, at 16 years 25.0% and at 18 years 33.2%. Only 28.3-54.7% of the adolescents reported brushing their teeth more than once a day. Among 14-year-olds, 6.5% of the adolescents reported both smoking daily and brushing less than twice a day. The respective figures were 17.7% for the 16-year-olds and 21.6% for the 18-year-olds. Among the 14-year-olds, the strongest association with smoking daily and brushing less than twice a day was found with low school performance (OR=8.2), and among 16- and 18-year-olds school career (studying at a vocational school, OR=3.4). CONCLUSION Daily smoking and infrequent toothbrushing are strongly associated in adolescence.

Many who smoke in college do so infrequently and smoking conditions are not well understood. We examined smoking patterns among college fraternity and sorority members (N = 207) from a Midwestern university in three successive fall semesters in 2006-2008. Participants completed calendar-assisted retrospective assessments of 30-day smoking at up to five assessment points over 96 days. Overall smoking rates declined over the course of each semester and higher smoking on weekends was observed, with more variability among daily smokers. The most frequent categories of events to cue recall of smoking were socializing, work, and school. Findings can be used to target prevention efforts.

Despite the uptake of tobacco smoking declining in the United Kingdom (UK), smoking is still the leading cause of preventable poor health and premature death. While improved approaches to smoking cessation are necessary, encouraging and assisting smokers to switch by using substantially less toxic non-tobacco nicotine products may be a possible option. To date, few studies have investigated the rates of smoking cessation and smoking reduction that are associated with the provision of free electronic-cigarettes (e-cigarettes) to smokers. In this exploratory study, the Blu Pro e-cigarette was given to a convenience sample of adult smokers (n = 72) to assist them in reducing and quitting over a 90-day period. The rates of smoking abstinence and daily smoking patterns were assessed at baseline, 30 days, 60 days, and 90 days. The response rate was 87%. After 90 days, the complete abstinence rate was 36.5%, up from 0% at baseline. The frequency of daily smoking reduced from 88.7% to 17.5% (p &lt, 0.001), and the median consumption of cigarettes/day reduced from 15 to five (p &lt, 0.001). The median number of days per month that participants smoked also reduced from 30 to 13 after 90 days (p &lt, 0.001). On the basis of these results, there may be value in smoking cessation services and other services ensuring that smokers are provided with e-cigarettes at zero or minimal costs for at least a short period of time.

Individuals who feel relaxed the first time they inhale from a cigarette are more likely to develop nicotine dependence. To determine if the relaxation response is associated only with specific aspects of dependence, a survey was administered to 1405 adolescents aged 14–18 years (mean 15.8 years) from four schools in Massachusetts. Nicotine dependence was measured with the Diagnostic and Statistical Manual (DSM-IV), and the loss of autonomy over tobacco was measured with the Hooked on Nicotine Checklist (HONC) and the Autonomy Over Smoking Scale. A feeling of relaxation was reported by 39.4% of 439 youth who had inhaled from a cigarette. Relaxation was associated with increased risk of current smoking (odds ratio (OR) = 5.7, p < 0.001), daily smoking (OR = 5.7, p < 0.001), a loss of autonomy on the HONC (OR = 5.0, p < 0.001), and a DSM-IV diagnosis (OR = 2.4, p < 0.02). In regression analyses, relaxation was not associated with psychological reliance on tobacco after controlling for nicotine withdrawal sy...

Background Subjective health complaints are common among adolescents. There is evidence that girls are more likely to register complaints than boys. This study examines gender differences in the relationship between daily smoking and recurrent subjective health complaints in school-age adolescents in the United States.

It was hypothesised that: (i) intentions to quit smoking were predictable from group identity, self-identity, moral norms and past quit attempts, beyond the components of the Theory of Planned Behaviour (TPB), and (ii) that past experiences with the behaviour (quit attempts) would increase the predictive utility of the extended TPB model on intentions. The data was collected among 357 daily smoking students (M = 24 years). The TPB components accounted for 12.3% of the variance in quitting intentions, while the extension variables added 16.5% to the explained variance in intentions beyond the impact of the TPB. Past behaviour had the strongest impact on intentions (α = 0.30), followed by moral norms (α = 0.25), perceived behavioural control (PBC, α = 0.20), attitude (α = 0.18) and group commitment (α = −0.11). By splitting the sample into three categories of past quit attempts the picture changed, revealing that the predictive utility of the TPB increased with the number of quit attempts (no past quit atte...

Summary Objective To compare five alternative self-report methods for assessing the smoking status of Chinese urban residents, and to estimate their reliability or agreement. Study design Cross-sectional survey with multistage sampling. Methods Cross-sectional survey data were collected from residents in two Chinese cities, and the prevalence of smoking and smoking frequency were estimated by means of six methods of self-report labelled SMD, SM1, SM6, SMF, SMC and SM. SM, the method of smoking assessment endorsed by the World Health Organisation (WHO), served as a referent in estimating agreement among the domestic methods. Cohen’s κ measured overall intermethod agreement. Results Data on 1167 eligible respondents were analysed. κ values ranged from 0.79 to 0.89 for current smoking, from 0.84 to 0.94 for daily smoking, and from 0.23 to 0.62 for occasional smoking. Compared with the referent (SM, 61%), SMD (53%), SM1 (57%), SM6 (54%) and SMC (55%) significantly understated the prevalence of current smoking among Chinese urban residents. SM1 (11%), SM6 (10%), SMD (6%) and SMC (6%) significantly understated the prevalence of occasional smoking compared with the refererent (SM, 14%). No variation emerged in prevalence estimates of daily smoking. Conclusions Despite some variability, the five domestic methods used to assess smoking status in China generally produced similar results to those based on SM, the method advocated by WHO. Discrepancies between domestic assessment methods peaked in estimating the prevalence of occasional smoking.

Objective: To estimate daily cigarette consumption among residents aged 15+ in five remote central Australian predominantly Aboriginal communities. Methods: Estimation of average daily cigarette consumption derived from a 12-month (2007) complete sales audit of cigarettes in isolated communities where no other tobacco supplies are available, using two assumptions of smoking prevalence (50% and 70%). Results: Across the five communities, daily smoking consumption averaged 8.3 cigarettes per day (assuming a 50% smoking prevalence) or 5.9 cigarettes per day (assuming a 70% smoking prevalence). The corresponding amounts spent per smoker per day were $4.13 or $2.95, representing 12.7%-9.1% of the maximum $453.30 per fortnight unemployment allowance for a single person. Conclusion: While smoking prevalence may be high in these Aboriginal communities, smoking frequency is low compared to that in the wider Australian community. These results are consistent with other studies. Approaches to cessation premised on assumptions of nicotine dependence in such populations are likely to be misconceived.

An adolescent's transition from experimental smoking (low-level cigarette smoking) to daily smoking (high-level cigarette smoking) is of great concern because if this happens, it is more difficult ...

Background: Higher smoking prevalence and quantity (cigarettes per day) has been linked to acculturation in the United States among Latinas, but not Latino men. Our study examines variation between a dif­ferent and increasingly important target behavior, smoking level (nondaily vs daily) and acculturation by sex.Methods: An online English-language sur­vey was administered to 786 Latino smokers during July through August 2012. The Brief Acculturation Rating Scale for Mexican Americans–II (ARSMA-II) and other accul­turation markers were used. Multinomial lo­gistic regression models were implemented to assess the association between smoking levels (nondaily, light daily, and moderate/ heavy daily) with acculturation markers.Results: Greater ARMSA-II scores (rela­tive risk ratio, RRR=.81, 95% CI: .72-.91) and being born inside the United States (RRR=.42, 95% CI: .24-.74) were associated with lower relative risk of nondaily smoking. Greater Latino orientation (RRR=1.29, 95% CI: 1.11-1.48) and preference for Spanish language (RRR=1.06, 95% CI: 1.02-1.10) and media (RRR=1.12, 95% CI: 1.05-1.20) were associated with higher relative risk of nondaily smoking. The relationship between acculturation and smoking level did not differ by sex.Conclusion: This study found that among both male and female, English-speaking Latino smokers, nondaily smoking was associated with lower acculturation, while daily smoking was linked with higher ac­culturation.Ethn Dis. 2018.28(2):105-114; doi:10.18865/ed.28.2.105.

Objective To evaluate the predictive validity of nicotine-dependence symptoms in 9th- and 10th-grade adolescents. Study design A total of 594 adolescents who had not smoked more than 100 cigarettes in their lifetime and 152 adolescents who had smoked more than 100 cigarettes in their lifetime were included in the analysis. The predictive validity of 10 nicotine-dependence items administered at baseline was evaluated at the 24-month follow-up assessment. Results For those who smoked fewer than 100 cigarettes, higher levels of experienced nicotine-dependence symptoms at baseline, as well as individual symptoms, predicted current and daily smoking behavior at the 24-month follow-up, over and above baseline smoking. For adolescents who had smoked more than 100 cigarettes at baseline, the level of nicotine dependence and individual symptom endorsement did not predict smoking behavior at the 24-month follow-up. Conclusions Our findings demonstrate that early emerging dependence symptoms reported at low levels of smoking exposure signal a greater propensity for continued smoking behavior not accounted for by current or past smoking exposure. Screening for these early emerging symptoms among novice adolescent smokers represents an important and unused tool in tobacco control efforts aimed at preventing the development of chronic smoking patterns.

Oral Diseases (2010) 16, 176–175 Objective: To evaluate the colonization of Candida at the tongue-piercing site of immunocompetent individuals. Subjects and methods: Swabs samples were obtained from the anterior lingual mucosa of healthy young adults with tongue piercing (N = 115); 86 subjects with (non-intra-oral) facial piercing served as a comparison group. Candida colonization was examined by light microscopy after 5-day incubation. Positive specimens were re-cultured on Chromagar™Candida plates for species identifying. Results: Candida colonization was more prevalent among tongue-pierced (20.0%) than facial-pierced subjects (9.4%; P = 0.048). All colonies were of Candida albicans. No difference was found between current tongue ornament wearers (21.2%) and non-wearers (19.5%; P = 0.803). In multivariate analysis, the only significantly positive influencing factors on colonization were tongue piercing (P = 0.034) and daily smoking of more than 10 cigarettes (P = 0.024). Conclusions: Piercing of the tongue was found to be a risk factor for colonization of Candida albicans, without an influence of whether or not an ornament is in place.

The increase of motorized vehicles In Indonesia amounted 114, 209, 360 units throughout the country in 2015 which was a 15% increase from the total number in 2016. Despite showing a good economic growth, it also poses some negative impacts. Road accident is the third leading cause of death in Indonesia. The most number of casualties and losses suffered is mostly caused by road accidents involving buses. The increase of vehicle also caused high pollution such as lead (Pb) especially in metropolitan cities and those who are prone to this are the people working every day on the roads. This research examined lead (Pb) levels in the air on 5 traffic congestion points in Surabaya and in the blood with and 11 Surabaya city bus drivers as the samples. The measurement of lead (Pb) levels in the air and in the blood applied AAS (Atomic Absorption Spectrophotometer) method. The measurement of Pb levels in the air was conducted 3 times for each traffic congestion point. For blood lead level, the measurement was only conducted 1 time in the afternoon after the bus drivers completed their activities. Age and daily smoking frequencies were the measured variables suspected to affect the lead concentration on the blood. The research result showed that the highest Pb concentration in the air was found to be consistent in the afternoon at five traffic congestion points while the data of blood lead level examination revealed that 8 out of 11 city bus drivers had high Pb concentration on their blood which exceeded the allowed threshold point.

The present study examined the prevalence of individual nicotine dependence symptoms among recent onset smokers across the continuum of nondaily and daily cigarette smoking behavior in a nationally representative sample of recent onset smokers from the National Surveys on Drug Use and Health (NSDUH). Rates of endorsement for 17 symptoms drawn primarily from the Nicotine Dependence Symptom Scale (Shiffman, Waters, & Hickcox, 2004) were calculated for four levels of nondaily (smoked 1-3, 4-10, 11-20, or 21-29 days in the past 30 days) and daily (smoked 1, 2-5, 6-15, or >15 cigarettes per day in the past 30 days) smoking. Logistic and linear regression analyses with polynomial contrasts controlling for age, gender, length of exposure, and smoking quantity tested trends in symptom endorsement across levels of smoking. Significant linear and quadratic trends indicated that increasing rates of endorsement differed most between the lowest levels of nondaily and daily smoking. Results suggest that, for some, infrequent smoking may not represent benign experimentation. Recognizing early symptoms of nicotine dependence may assist in early identification and intervention of those at risk for heavier smoking in the future. Adolescents can be taught to recognize the early symptoms of nicotine dependence to increase awareness of the rapidity at which these symptoms may appear.

This study compares tobacco use rates among two-year and four-year college students and explores the demographic variables that predicted that behavior.9,931 students at 14 two-year and four-year colleges in Minnesota participated.Students at 11 schools completed an online survey, and students at 3 schools completed a paper survey in 2007.After controlling for sex, age, ethnicity, relationship status, hours of work per week, and number of school credits, attending a two-year college predicted current and daily smoking (odds ratio [OR]) = 1.70, 95% confidence interval [CI] = 1.52-1.89; OR = 3.47, 95% CI = 2.94-4.11) and smokeless tobacco use (OR = 1.65, 95% CI = 1.32-2.06; OR = 1.64, 95% CI = 1.06-2.53).Although two-year college students comprise approximately two fifths of the college student population, surveys of college student tobacco use have focused nearly exclusively on four-year college students. Two-year college students should represent a priority population for tobacco control because attending a two-year college predicts increased tobacco use.

This study extends research on the association between smoking behavior and chronic disease by following a cohort from the time of initiation of regular smoking patterns into old age and by examining the association of lifetime smoking trajectories with chronic disease and mortality. Participants consisted of 232 males selected from the Harvard classes of 1942-1944 and followed biennially through 2003. Five distinct smoking trajectories were identified based on the age at which participants quit daily smoking. Participants following smoking trajectories with later cessation had a higher likelihood of developing lung disease and lived shorter lives than those who quit smoking at an earlier age. This study confirms that the earlier a smoker quits, the greater the health benefits, and that these benefits are observed even decades after smoking cessation. Additionally, by showing different survival rates between trajectory groups 25 and 40 years after quitting, the results run counter to previous work that has found no difference in mortality between smokers and non-smokers 15 years after cessation.

Aim: While many studies report determinants of adolescent cigarette smoking, few identify risk factors for nicotine dependence (ND). This study distinguished between risk factors for three hallmarks of ND including cravings, withdrawal symptoms and tolerance. Methods: A total of 319 novice smokers were followed every 3 months from first puff on a cigarette until the end of secondary school. Outcomes included time to first report of cravings, withdrawal symptoms and tolerance. Results: Female sex, inhalation, smoking a whole cigarette, weekly smoking, daily smoking and alcohol use each independently increased the incidence of the onset of cravings. Inhalation, weekly smoking, daily smoking and alcohol use predicted the onset of withdrawal symptoms. Withdrawal symptoms, smoking a whole cigarette, monthly smoking, daily smoking and friends and siblings smoking increased the incidence of the onset of tolerance. None of parental education, impulsivity, novelty seeking, self-esteem, depression, stress, parental smoking, physical activity, or participation in sports teams was associated with the outcomes. Conclusion: The hallmarks of early ND are related to intensity and frequency of cigarette use. Avoidance of daily smoking may be particularly important in preventing the onset of ND symptoms and sustained smoking.

The present investigation examined heart-focused anxiety and perceived physical health in terms of affect-relevant cigarette smoking motives and outcome expectancies. Participants were a community sample of 140 adult daily smokers (81 women, mean age = 29.60 years, SD = 11.98). In terms of smoking motives, both heart-focused anxiety and perceived physical health incrementally predicted smoking for negative affect reduction motives above and beyond relevant covariates (gender, weekly alcohol consumption, daily smoking rate). Yet heart-focused anxiety, but not perceived physical health, was incrementally predictive of habitual motives, relative to the same covariates. With regard to smoking outcome expectancies, heart-focused anxiety was incrementally predictive of negative reinforcement outcome expectancies, whereas perceived physical health was not. Alternatively, perceived physical health was incrementally predictive of negative personal consequence outcome expectancies, but heart-focused anxiety was not. Findings are discussed in relation to the role of perceived health vulnerabilities in clarifying affect-oriented smoking motives and expectancies.

INTRODUCTION Favorable views of cigarette use may be a potentiating factor that influences the progression of nicotine dependence among adolescents. METHODS Using data from the South Carolina Youth Tobacco Survey (2005-2007), a statewide two-stage cluster sample of students in Grades 6-12 (N = 7,385), we examined attitudes toward smoking and quit behaviors among adolescent smokers across a range of smoking frequencies. RESULTS Compared with past-30-day nonsmokers, adolescents who smoked 1-2 days in the past month were more likely to believe that (a) smokers have more friends, (b) smoking looks cool, and (c) it is safe to smoke in the short term and then quit, but less likely to think that (d) tobacco is as addictive as other drugs and (e) smoking few cigarettes per day is harmful. Those who smoked 1-2 days in the past month were similar to more frequent smokers, including those who smoked daily. Similar findings were found for lifetime exposure to smoking. Among those who smoked 1-2 days in the previous month, motivation to quit (54%) and incidence of quit attempts (52% in past year) were slightly higher compared with heavier smokers. DISCUSSION Even minimal levels of cigarette use are associated with favorable views of smoking, and adolescents with minimal levels of cigarette use resemble chronic smokers in several key ways. Adolescents at very early stages of cigarette use are at significant risk for chronic use. Tobacco control efforts should capitalize on motivation to quit with focused prevention strategies that arrest the progression from nondaily to daily smoking.

PURPOSE. This study examined factors affecting the transition from experimental smoking at baseline to two types of daily smoking, temporary daily smoking, and continued daily smoking, at 1-year follow-up. DESIGN AND METHODS. This study analyzed data from the National Longitudinal Study of Adolescent Health (n = 4,903 U.S. adolescents). Baseline predictors were selected based on Problem Behavior Theory. RESULTS. Important problem behavior theory-related predictors of smoking were the number of friends who smoke, academic performance, and alcohol, marijuana, and other illicit drug use. Other significant predictors were age, gender, race, depression, perceived general health, and cigarette availability at home. PRACTICE IMPLICATIONS. To prevent teens from progressing to daily smoking, nursing professionals should consider multifaceted factors based on multiple theories.

Anomie is a complex, dynamic concept that refers simultaneously to a social state and an individual state of mind. Generations of sociologists have attempted to clarify, extend, and measure the concept at various levels of analysis. This article summarizes these developments around the twin concepts of exteriority and constraint. Exteriority refers to experiencing the social world as an objective, predictable reality, while constraint refers to the extent to which one experiences a personal commitment to the demands and expectations of society. The Anomie Scale of Exteriority and Constraint (ASEC) is presented and tested across various psychological and social outcomes among adolescents in 18 European countries. Exteriority is found to be primarily associated with more depression and less self-esteem, while constraint is associated with a lower probability of daily smoking, illicit drug use, truancy, and suicide attempts. Societal anomie is higher in eastern European countries and it has a strong negative correlation with GDP per capita and a marginally positive correlation with GDP growth. Societal anomie is also associated with higher baseline levels of depression, self-esteem, and illicit drug use. These results lend strong support to the theoretical construct of anomie as exteriority and constraint.

Using the data from the South African World Health Survey (WHS), the current study aims to assess the self-reported prevalence of diabetes and associated risk factors by socio-economic characteristics in South Africa. A population-based survey of 2314 participants (1116 men and 1236 women) was conducted in South Africa in 2003. Results indicate an overall self-reported diabetes prevalence of 9.1%, 7.1% for men and 10.8% for women. In terms of diabetes risk factors, high rates of overweight or obesity (58.4%), physical inactivity (55.2%), less than 5 servings of fruits and vegetables in a day (69.3%), and medium or high stress levels (63.3%) were found; 18.4% were smoking daily and 7.3% were risky drinkers. Univariate regression analyses found that from the six different risk factors none apart from having high stress were associated with the occurrence of diabetes. Greater age was associated with obesity and inversely associated with insufficient consumption of fruits and vegetables. Daily smoking and bei...

This study attempts to evaluate the relative impacts of parents, siblings, and classmates on youth smoking by employing longitudinal data from the Waterloo Smoking Prevention Program (WSPP), a chronicle of smoking habits of students enrolled in various high schools in South Western Ontario, between 1993 and 1996. The empirical results reveal household and classmate smoking to be significant determinants of individual smoking participation as well as daily smoking. Specifically, an increase in the proportion of classmates who admit to smoking and cigarette consumption by an elder sibling, are both significantly correlated with a higher probability of youth smoking. This is a consistent finding across OLS, within-individual, and IV estimates. Finally, simple OLS estimates suggest the presence of non-linear effects with respect to classmate smoking.

Background: Nondaily smoking and heavy alcohol use are prevalent behaviors among young adults, with nondaily smoking occurring primarily in the context of alcohol use. Although the relationship between drinking and daily smoking has been well characterized in young adults, few epidemiological investigations have investigated the association between nondaily smoking and drinking behavior. Methods: We examined Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; Grant et al., 2003b; n = 43,093). Young adults (aged 18 to 25 years; n = 5,838) were stratified on current smoking behavior (daily, nondaily, and nonsmokers in the past 12 months) and differences in weekly quantity of alcohol use, frequency of alcohol use, frequency of binge drinking behavior, rates of NIAAA-defined hazardous drinking, and rates of DSM-IV alcohol diagnoses were investigated. College student status was examined. Results: Twenty-five percent were current smokers and 7% were smoking on a nondaily basis. Seventy-one percent were current drinkers, 39% reported binge drinking at least once a month, 41% met criteria for hazardous drinking, and 18% had alcohol use disorders. Across all measures of alcohol use, there was a significant effect of smoking status, with daily smokers having greater alcohol use patterns, compared with nondaily smokers, with nonsmokers consuming the least. Nondaily smokers were more likely to report any binge drinking in the past 12 months. However, daily smokers were more likely to report daily binge drinking. With regard to hazardous drinking and alcohol use disorders, nondaily smoking conferred the greatest risk, followed by daily smoking with nonsmoking as the reference group. Multinomial logistic regression demonstrated that the odds of being a hazardous drinker were 16 times greater (95% CI 9.46–26.48) in a nondaily smoker compared with a nonsmoker, whereas the odds for a daily smoker were increased by 7-fold (95% CI 5.54–9.36). A similar pattern of results was demonstrated for DSM-IV alcohol diagnoses. No differences across college student status were observed. Conclusions: The increased risk of hazardous drinking and alcohol use disorders conferred by nondaily smoking supports the findings that nondaily smoking and drinking are highly concomitant behaviors. Results such as these suggest that interventions disengaging alcohol and cigarette use patterns (e.g., smoking bans in alcohol venues) might serve to limit the occurrence of hazardous drinking among young adults at heightened risk for this behavior.

Aims Little is known about smoking during the transition to college. The current study examined trajectories of smoking among college freshmen, how trajectories predicted later smoking and the social context of smoking. Design Weekly assessments of daily smoking were collected via the web during the first year of college for a large cohort with a previous history of smoking. Participants and setting A total of 193 college freshmen from a large public university with a previous history of smoking who smoked frequently enough to be included in trajectory analysis.Measurements Measuresincludedweeklyreportsof dailysmoking,familysmoking,perceivedpeerattitudes and smoking, social norms and social smoking environment. Findings Seven trajectories were identified: one of low-level sporadic smoking, one of low-level smoking with a small increase during the year, two classes with a substantial decrease during the year, two classes with relatively small decreases and one class with a substantial increase in smoking. Trajectories of smoking in the freshman year predicted levels of sophomore year smoking, and some social context variables tended to change as smoking increased or decreased for a given trajectory class. Conclusions The transition into college is marked by changes in smoking, with smoking escalating for some students andcontinuingintothesophomoreyear.Shiftsinsocialcontextthatsupportsmokingwereassociatedwithtrajectories of smoking. Despite the focus of developmental models on smoking in early adolescence, the transition into college warrants further investigation as a dynamic period for smoking.

AIM: The purpose of this study was to measure students’ attitudes towards a total smoking ban in schools and towards impositions in cases of violation. METHOD: Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the “Heaviness of Smoking Index”. RESULTS: 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. CONCLUSIONS: The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

Objectives. We sought to establish the prevalence of physical activity among smokers, whether or not physically active smokers were more likely to attempt cessation, and who these physically active smokers were. Methods. We used logistic regression to contrast physically active and inactive smokers in a secondary data analysis of the Canadian Community Health Survey Cycle 1.1. Results. Physically active smokers represented almost one quarter of the smoking population. Compared with physically inactive smokers, physically active smokers were more likely to have attempted cessation in the past year. Physically active smokers were more likely to be young, single, and men compared with their inactive counterparts. Income had no influence in distinguishing physically active and inactive smokers. Conclusions. Skepticism persists regarding the practicality and potential risks of promoting physical activity as a harm-reduction strategy for tobacco use. We found that a modest proportion of the daily smoking population was physically active and that engagement in this behavior was related to greater cessation attempts. Interventions could be developed that target smokers who are likely to adopt physical activity.

To enhance prolonged smoking cessation or reduction, a better understanding of the process of change is needed. This study examines daily smoking rates following the end of an intensive smoking reduction program originally designed to evaluate the relationship of tobacco biomarkers with reduced levels of smoking. A novel pattern-oriented approach called time series-based typology is used to detect homogeneous smoking patterns in time-intensively (i.e., 40 occasions) observed smokers (n=57), who were predominantly Caucasian (94.7%), male (52.6%), and on average 47.9 years old (SD=11.3). The majority of the smokers exhibited a change in their daily smoking behavior over the course of 40 days with 47.4% increasing and 40.4% decreasing the number of cigarettes smoked per day, which is contrary to the results a group level approach would have found. Very few smokers (12.3%) maintained their average smoking rate, and exhibited an externally controlled smoking pattern. Trajectory type could be predicted by temporally proximal motivation and self-efficacy variables ((F(4, 106)=3.46, p=.011, eta2=.115), underscoring their importance in maintaining reduced smoking rates. Time series-based typology demonstrated good sensitivity to the identification of meaningfully different trajectories.

Binge drinking and non-daily cigarette smoking are behaviors that are both problematic and prevalent in young adults. Although the relationship between drinking and daily smoking has been well categorized, the intersection between drinking and smoking in non-daily smokers has not been heavily researched. Past 30-day and within-episode patterns of alcohol and cigarette use were collected in young adult non-daily smokers (N = 40). Results demonstrated that 79% of smoking occurred on drinking days. Alcohol use was significantly greater on smoking days with the result that drinking to risky binge levels was more likely to occur on a smoking day. Smoking typically occurred after a certain level of alcohol pre-load (2.87 drinks). Together these results confirm that young adult non-daily smokers often concurrently use alcohol and cigarettes. Research is needed to identify possible mechanisms underlying the association between binge drinking and cigarette use in this vulnerable population.

Objective. To assess the impact of the 1976 Tobacco Control Act (TCA) on smoking initiation across socioeconomic groups. Methods. Nationwide data from independent annual cross-sectional postal surveys in 1978–2002 in Finland. Subjects were 25–64-year-old men and women born 1926–1975 ( n = 68 071). Socioeconomic status was derived individually from population census data. Logistic regression was applied to assess the impact of the 1976 TCA on the prevalence of ever daily smoking in birth cohorts and socioeconomic groups. Results. Clear socioeconomic differences in ever daily smoking among men and women were found. In all socioeconomic groups a declining cohort trend was observed among men whereas women showed an increasing trend in early cohorts and a declining one thereafter. A statistically significant decline in the proportion of ever daily smokers compatible with the impact of the TCA was found in all socioeconomic groups except farmers. Among women the decline was roughly similar in each socioeconomic group, while among men it varied and was most pronounced among white collar employees. Conclusions. The impact of the 1976 TCA was less pronounced among male lower socioeconomic groups. In spite of the even impact of the TCA on female smoking across socioeconomic groups, large socioeconomic disparities remain. Tobacco control policy measures specifically directed at lower socioeconomic groups are needed.

Summary Retrospective reports of smoking in pregnancy are of importance for clinical or scientific purposes. Careful analyses of stability and accuracy of recalled behaviour are, therefore, needed. In 1998, the mothers of 2369 pre-teens born in Sweden retrospectively reported their smoking behaviour during the first trimester of the index pregnancy. We matched these reports with those recorded by midwives at the beginning of the index pregnancy, using information from the Swedish Medical Birth Registry. Using this registry as gold standard, the sensitivity and specificity of the retrospective reports containing any smoking were 83.9% and 92.8% respectively, but the sensitivity was low for daily smoking, 56.0%. Of the 222 discordant reports, 19.0% were due to mothers recalling daily smoking which was not reported at the time of pregnancy, and 42% were due to failure to recall smoking reported at the time of pregnancy, while the remaining 39% retrospectively reported occasional smoking, whereas they were registered as non-daily smokers when pregnant. Retrospective recall of pregnancy smoking is fairly stable over time.

ObjectiveThe association between cigarette smoking and psychiatric disorders is well established for adult populations. However, only limited number of studies has investigated whether the young onset age of daily smoking (DS) among adolescents is associated with psychiatric morbidity and vice versa.MethodsData from 508 adolescents admitted to psychiatric hospitalization were collected. Cox proportional hazard model were used to compare the initiation of DS between adolescents with and without substance use (SUD), and other psychiatric disorders.ResultsRates of DS were high in each diagnostic category. Boys started smoking at younger age (mean 12.4 years) than girls (13.0 years). Both boys and girls diagnosed with conduct or oppositional defiant disorders (COD) and also girls with SUD started daily smoking earlier as compared to those of same gender without these disorders.COD were found to be primary to the initiation of DS among boys. SUD, psychotic, and depressive disorders (DEP) were found to be secondary to DS among both genders.ConclusionsDS in adolescence is related with later SUD. COD are associated with subsequent initiation of DS among boys. The temporal gap between smoking initiation and COD is shorter among girls. Gender difference plays a role in association of DS and DEP. Initiation of DS at very early age should alert health care professionals of development of later psychopathology, especially SUD.

The purpose of this review is to synthesize the national prevalence data from eight surveys on tobacco use in South Africa over the past 13 years. Results from the national studies indicate that tobacco use among adults is on the decline in South Africa. The same applies to daily smoking and daily smokeless tobacco use among adolescents. However, onset of tobacco use and the prevalence of current smoking among adolescents seem not to have changed over the years. While exposure to tobacco smoke outside the home decreased from 56.5% in 1999 to 36.2% in 2002 among adolescents, exposure to tobacco smoke inside the home increased from 41.7% in 1999 to 73.3% in 2002. This change may be attributed to the introduction of the tobacco control act that from 2000 banned smoking in public places. The decline of overall daily smoking in South Africa may be attributed to the tobacco control strategy based on 1) rapidly increasing excise taxes on tobacco, and (2) comprehensive legislation, of which the most important fea...

The aims of the study were to describe changes in smoking habits and evaluate secular trends among all Norwegian pregnant women during the period 1999-2004. We wanted to investigate whether there was a general decline in smoking habits among pregnant women. We also wanted to identify population subgroups with diverging trends.The Medical Birth Registry of Norway (MBR) has national coverage of all births of 16 or more gestational weeks. Since 1999, women have been asked about tobacco smoking at the beginning and at the end of pregnancy. We included records from 304,905 women giving birth in the period January 1999 through April 2004. Women born outside Norway were handled separately. The selection left a dataset containing 259,573 Norwegian-born women.We obtained information on smoking habits from 86% at the end of pregnancy. Among those, the daily smoking prevalence was reduced from 17.3% in 1999-2001 to 13.2% in 2002-2004. Higher smoking prevalence was found among multiparous (3+), teenage mothers, single women, and women with low educational level.From 1999 to 2004, a substantial decline in smoking prevalence among Norwegian pregnant women was identified in all subgroups. However, an increasing social polarisation with regard to education and smoking habits was observed in the study period. In order to reduce the smoking-related risks for unsuccessful pregnancy outcome, special attention should be paid to smoking habits among multiparous, teenage women, single women and women with low education.

Bronchial Hyperresponsiveness in Women Cooks and CleanersThe aim of this cross-sectional study was to assess the prevalence and characteristics of bronchial hyperresponsiveness (BHR) in 43 women cleaners (aged 26 to 57) and 37 women cooks (aged 29 to 55) and compare them with 45 controls (women office workers aged 27 to 58). The evaluation of all subjects included a questionnaire, skin prick tests to common aeroallergens, spirometry, and histamine challenge (PC20≤8 mg mL-1). We found higher BHR prevalence in cleaners and cooks than in office workers (30.2 % and 29.7 %, vs. 17.7 %, respectively), but statistical significance was not reached. The prevalence of mild and moderate to severe BHR was similar in all groups. Borderline BHR prevalence was significantly higher in cleaners than in controls (16.2 %vs. 6.6 %, P=0.032) whereas the difference was on the verge of significance in cooks (13.5 %vs. 6.6 %, P=0.081). Moderate to severe BHR was strongly associated with positive family history of asthma and atopy in all groups. Mild BHR was significantly associated with daily smoking in cleaners (P=0.031) and cooks (P=0.021), as well as with the duration of exposure in cleaners (P=0.038). Borderline BHR was closely related to daily smoking and duration of exposure in both cleaners and cooks. Our findings indicate an important role of workplace exposure in borderline BHR development, as well as the significant effect of smoking on mild BHR development in women cleaners and cooks.

To compare trends in African-American (AA) and non-Hispanic white (NHW) smoking between states categorised as having three different levels of tobacco control practice in the 1990s.Analysis of 1992-3 to 2001-2 Tobacco Use Supplements to the Current Population Survey for differences in adult (20-64 years) daily smoking prevalence for AAs and NHWs across states: California (CA; high cigarette price/comprehensive programme), New York (NY) and New Jersey (NJ; high cigarette price/no comprehensive programme), and tobacco growing states (TGS; low cigarette price/no comprehensive programme).From 1992-3 to 2001-2, there were large declines in AA smoking across states (2.7-3.8% decrease/year, adjusted for age, income, education, gender; p0.05). Adjusted NHW smoking prevalence declined significantly only in CA. AA prevalence declined significantly and did not differ across state groups. In all years, in all state groups, adjusted prevalence was either not significantly different or was lower for AAs than for NHWs. More recent cohorts of AAs appeared to have taken up smoking at lower rates than older cohorts.There were uniformly large declines in AA smoking from 1992-3 to 2001-2 across states, independent of type of tobacco control strategy. Further research is needed into factors associated with smoking declines among AAs.

Objective. No previous studies have explored weight concerns in relation to smoking habits, or investigated how weight concerns affect smoking cessation in a general population. Method. Inter99 is a population-based lifestyle interventional study, conducted in 1999–2001 in Copenhagen, Denmark, comprising 30–60 year old men and women. All daily smokers (N = 2408) were offered help to quit. The baseline investigation (N = 6784) was used for analysing associations of smoking status with weight concerns (cross-sectional design). To analyse how weight concerns affected smoking cessation we included the 1387 daily smokers attending 1-year follow-up; 221 of these were verified quitters (longitudinal design). Results. Daily smoking men and women had a significantly lower body mass index than never smokers (men: 3%, women 5%) but reported to be significantly less concerned of their weight (men: OR = 0.64, 95%CI = 0.4–0.9), women: 0.78(0.6–1.0)). Ex-smoking normal weight women were significantly more likely to be frequently concerned of their weight than never smoking normal weight women (OR = 2.06, 95CI% = 1.6–2.7). Fifty-two percent of the women and 32% of the men with a previous quit attempt reported that weight gain was a reason for relapse. Neither weight concerns nor eating patterns were predictive of point abstinence at 1-year follow-up. Conclusion. Smokers are believed to be very concerned of their weight but in this population-based study, daily smokers more frequently ate what they wanted, had a lower BMI and were significantly less concerned of their weight than never smokers. Weight concerns and eating patterns did not predict abstinence at 1-year follow-up. It seems that weight gain and weight concerns are independent factors.

The aim of this paper isto determine factors associated with higher tobacco consumption in a large cohort of daily smoking Danish women 27–39 years of age with a main focus on the smoking habits of people in the women’s social environment and parity. A cohort of 12,023 Danish women was examined in a cross-sectional study design with a mailed questionnaire. Among the 3,672 daily smokers, 2,365 (64.4%) smoked more than 15 cigarettes per day. Smokers in the childhood home, living alone or cohabiting with a smoking partner, friends smoking, and colleagues smoking were associated with higher tobacco consumption, while short duration of smoking was associated with lower tobacco consumption. Anti-smoking programs should focus on the social network of the women. Furthermore, there is a need to target mothers who smoke, especially less educated mothers.

Objective:To determine the nationwide incidence of subarachnoid hemorrhage (SAH) and report nationwide changes in smoking rates between 1998 and 2012 in Finland.Methods:In this register-based study, we utilized the nationwide Causes of Death Register and Hospital Discharge Register in identifying SAH events between 1998 and 2012. Population statistics in Finland, which were obtained through a database of Statistics Finland, were used to calculate crude annual incidence rates of SAH. For the direct age standardization of crude incidence rates, we used the European Standard Population (ESP) 2013. Data on changes in nationwide smoking rates between 1998 and 2012 were extracted from a database of the National Institute for Health and Welfare.Results:For the total of 79,083,579 cumulative person-years, we identified 6,885 people with SAH. Sudden deaths from SAH away from hospitals or in emergency rooms accounted for 1,771 (26%) of the events. Crude nationwide annual incidence rates varied between 6.2 and 10.0 per 100,000 persons, and increased by age particularly in women. Among 70- to 75-year-old women, the incidence of SAH was highest (22.5 per 100,000 persons). The 3-year average of ESP standardized incidence decreased 24% from 11.7 in 1998–2000 to 8.9 per 100,000 persons in 2010–2012. Daily smoking decreased 30% between 1998 and 2012.Conclusions:The incidence of SAH seems to be decreasing. This tendency may be coupled with changes in smoking rates. The incidence of SAH in Finland is similar to other Nordic countries.

Daily smoking is associated with elevated blood pressure, CO toxicity, and impaired pulmonary lung functioning. The benefits of successful smoking cessation are readily apparent, given the health improvements associated with cessation, as well as the reduction of secondhand smoke to which nonsmoking coworkers and family members are exposed. Previous literature indicates that providing personalized information to smokers (versus general base rates) without engaging in confrontational pressure to quit smoking, leads to increased interest in quitting smoking and willingness to enter smoking cessation programs. The goal of this study was to examine the pre-treatment characteristics of the smokers entering a brief motivational enhancement intervention based on personally tailored health feedback. Participants (N = 28) were 88.2% Caucasian, 59% male, and were an average of 23.0 years of age. On average, they smoked 20.08 cigarettes per day (CPD), for a mean of 6.6 years, a mean Fagerstrom Test for Nicotine Dependence (FTND) score of 4.7, and obtained a mean breath carbon monoxide (CO) reading of 19.1 ppm. Smoking related adverse health outcomes were predictive of stages of change (SOC) motivation to quit smoking. Implication for cessation programs are discussed.

INTRODUCTION Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period. METHODS Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods. RESULTS Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002-2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (-.963, n = 5, p < .01). CONCLUSIONS As prevalence of daily smoking declined, daily smokers reported higher levels of complaints, suggesting increasing health problems within this group. Girls who smoke daily had particularly elevated levels of complaints. IMPLICATIONS This study indicates that the relationship between daily smoking and concurrent health symptomatology in adolescents is changing over time, with higher levels of health complaints reported as overall smoking prevalence declines. To our knowledge, this finding has not previously been reported. If youth are smoking to cope with distress, pain, or other health concerns, tobacco control objectives will be increasingly difficult to achieve with adolescents. Levels of health complaints are particularly high among girls who are daily smokers. The findings suggest that restrictive measures and persuasive communications may not be sufficient tobacco prevention strategies for adolescent populations. Young smokers may need counseling and support.

Aims: to evaluate and compare tobacco and other health behaviour risks between younger medical students and finalists; to assess associations between smoking and health behaviour risks. Setting: Medical school, UBI, Portugal. Methods: questionnaire-based cross-sectional study; 66.7% participation rate. Results: Participants: 365 students (154 finalists); 72.9% females; mean age: 21.3 ±2.8 years. Smoking prevalence was 23.5 % among younger students (9.1% daily smokers); 20.1 % among finalists (4.5% daily smokers), p=0.24; 28.1% in males and 20.0% in females, p = 0.019. Males reported more frequent daily smoking (13.5% vs 4.9 %, p = 0.019); higher rates of abusive alcohol consumption (41.4% vs 16.3%, p Conclusions: Medical students report high smoking prevalence, high rate of abusive alcohol consumption and unhealthy lifestyles. Health behavior risks are associated, highlighting the need to implement health promotion programs targeting multiple risk factors to prevent smoking and alcohol consumption in medical schools.

Introduction While overall tobacco consumption is declining in many countries, patterns of low-frequency smoking-such as nondaily and low-rate daily smoking-appear to be increasing. We aimed firstly to describe differences in demographic, smoking- and quitting-related characteristics between nondaily and daily smokers in young adults; secondly, to determine the proportion of low-frequency smokers who transition to a higher rate of smoking by age 38 and factors associated with this. Methods We assessed a cohort of individuals born in Dunedin, New Zealand, in 1972-1973, at regular intervals from age 21 to age 38 years. Smokers were categorized as either nondaily, low-rate daily (ie, defined as five or less cigarettes per day) or high-rate daily smokers (six or more cigarettes per day). Descriptive statistics, linear and logistic regression were used. Results Nondaily smokers at age 21 tended to self-identify as nonsmokers. Both nondaily smokers and low-rate daily smokers reported higher readiness and confidence in quitting compared to high-rate daily smokers. Around 40% of the age 21 low-rate daily smokers reported smoking daily at age 38, compared to 13% of the nondaily smokers and 4% of the nonsmokers. Nondaily smoking at age 21 was associated with increased odds of being a daily smoker by age 38 (OR: 3.6; 95% CI = 1.7% to 7.8%) compared to nonsmokers. Conclusions Different patterns of smoking are associated with differences in readiness to quit and confidence in quitting ability. For a considerable proportion of smokers, low-frequency smoking in young adulthood develops into daily smoking by adulthood. Implications Low-frequency smoking, including nondaily smoking, in early adulthood is a significant risk factor for being a daily smoker in the long-term. Cessation interventions should be tailored to low-frequency smokers, taking into account differences between them and heavier smokers in terms of smoking motivation and quitting-related cognitions.

BACKGROUND Increased pricing of cigarettes might be one of the most effective approaches for reducing the prevalence of smoking. This study aimed to investigate the effects of increasing cigarette prices through taxation by a tobacco intervention policy on the changes in smoking prevalence in Korean university students. MATERIALS AND METHODS The participants in this study were 23,047 healthy university students aged 18-29 years from a health examination in 2011-2015. We investigated the adjusted prevalence of daily and occasional smoking before and after increasing cigarette prices through taxation. RESULTS The prevalence of occasional smoking was significantly decreased in 2015 from 2014 in both male (from 10.7% in 2014 to 5.4%) and female (from 3.6% to 1.1%) students, but the prevalence of daily smoking did not decrease significantly. The frequency of individuals who had attempted smoking cessation during the past year was significantly higher among occasional smokers in male students (90.2%) compared with daily smokers (64.9%). For female students, there were no differences in experience of smoking cessation, willingness for smoking cessation, or E-cigarette experience between daily and occasional smokers. CONCLUSIONS We found that a policy of increasing cigarette prices through taxation is associated with decreases in the prevalence of occasional smokers, who have relatively lower nicotine dependence compared with individuals who smoke daily. The results of our study suggest that social support and direct intervention for smoking cessation at the community level are needed for university students alongside the pricing policy.

This article examined correlates of and gender differences in extreme dieting behaviours among 15,425 US adolescents from the 2011 Youth Risk Behavior Survey. Suicidal thoughts and plans and binge drinking were related to extreme dieting behaviours in females, but not in males. Suicide attempts, daily smoking and marijuana use were related to extreme dieting behaviours in males, but not females. Results suggest extreme dieting behaviours are associated with a range of negative psychosocial factors and substance use behaviours, and that these differ for boys and girls. Additional research is required to elucidate these relationships, and these results provide a focus for future research, prevention and intervention efforts.

Aims To estimate linear time-trends in substance use and primary prevention variables in adolescents in Iceland from 1997 to 2014. Design Repeated, cross-sectional population-based school surveys with seven waves of pooled data. Setting: Iceland. Participants All accessible students enrolled in the 9th and 10th grades in the national Icelandic school system during the spring of 1997, 2000, 2003, 2006, 2009, 2012 and 2014 (n = 50 412, boys = 50%). Response rates ranged between 81 and 90% of the population. Measurements Measures on substance use included smoking and alcohol use. Primary prevention measures included parental monitoring, parental social involvement, participation in organized sports and reduced participation in a party life-style. Findings Substance use decreased consistently during the study period. For example, 30-day drunkenness declined from 29.6 in 1997 to 3.6% in 2014 (linear trend: χ2(1) = 2846.8, P

Young adults are at risk for initiation of tobacco use and progression to tobacco dependence. Not every person who smokes cigarettes becomes tobacco dependent, however, and non-daily smoking is becoming more prevalent among those who use tobacco. It is likely that individual differences in psychosocial and behavioral factors influence risk for engaging in non-daily and daily cigarette smoking. The objective of this study was to investigate the associations between impulsivity and smoking status in young adults who vary in frequency of cigarette smoking. Young adult first-year college students between the ages of 18-24 (512) were classified to one of three groups: non-smokers, non-daily smokers, or daily smokers, and impulsivity was assessed using the UPPS-P (negative and positive urgency, lack of premeditation, lack of perseverance, sensation seeking). When all impulsivity dimensions were used simultaneously to predict smoking status, negative urgency predicted increased risk of membership in the daily smoking group and lack of premeditation predicted increased risk of membership in the non-daily smoking group. These results suggest that dimensions of impulsivity may contribute differentially to forms of smoking behavior in young adults.