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BackgroundSmoking increases the risk of morbidity and mortality and is particularly harmful to HIV-infected people.PurposeTo explore smoking trends and longitudinal factors associated with smoking cessation and recidivism among participants in the Women's Interagency HIV Study.MethodsFrom 1994 through 2011, a total of 2,961 HIV-infected and 981 HIV-uninfected women were enrolled and underwent semi-annual interviews and specimen collection. Smoking prevalence was evaluated annually and risk factors associated with time to smoking cessation and recidivism were analyzed in 2013 using survival models.ResultsThe annual cigarette smoking prevalence declined from 57% in 1995 to 39% in 2011 (p-trend10-year smoking duration, self-reported poor health rating, and having hypertension. Pregnancy in the past 6 months was associated with a shorter time to cessation. Among HIV-infected women, additional risk factors for longer time to cessation included lower household income, use of crack/cocaine/heroin, CD4 cell count ≤200, and highly active antiretroviral therapy (HAART) use. Predictors of smoking recidivism included marijuana use, enrollment in 1994-1996, and not living in one's own place. Among HIV-infected women, enrollment in 2001-2002 and crack/cocaine/heroin use were associated with a shorter time to recidivism, whereas older age and HAART use were associated with a longer time to recidivism.ConclusionsDespite declining rates of cigarette smoking, integrated interventions are needed to help women with and at risk for HIV infection to quit smoking and sustain cessation.

Objectives: We examined the relationship between acculturation and tobacco use behaviors among Chinese Americans. Methods: Using a Chinese-language instrument based on validated questions from several national surveys, we conducted in-person, household-based interviews with 712 representative adults aged 18-74 years. Results: Observed smoking prevalence was 29% for men and 4% for women. Predictors of smoking cessation included being 35 years and older and having a high level of tobacco-related knowledge. Acculturation was positively associated with a history of never smoking, as was being younger than 35 years and having a high level of tobacco-related knowledge. Conclusions: Acculturation was positively associated with never smoking among men but not with smoking cessation. However, knowledge of tobacco-related health risks was associated with both. Results indicate a need for language-specific educational interventions.

This study provides a cross-sectional analysis of the relations between group self-identification and adolescent drug use in 3 samples of youth: comprehensive high-school, continuation high-school, and runaway/street youth. Youth identified with discrete groups in all 3 samples, and similar general groups were formed. In most comparisons, a high-risk group showed greater levels of drug use than did other groups. This is the first study to demonstrate that group self-identification (a) is a generalizable construct across different types of adolescent samples, (b) is related to use of drugs other than tobacco, and (c) remains a significant correlate of drug use controlling for its relations with demographic variables and several other psychosocial variables.

Research suggests that the onset of tobacco use (smokeless tobacco, cigarettes) in adolescents is associated with alcohol use, risk taking, and low self-esteem. A sample of 842 seventh grade boys and girls from south California who had not used tobacco were identified and surveyed a year later. Risk taking was more associated with initiation of tobacco use in females. Social influence is a bigger factor in initiation of smoking among boys.

A one-year study of longitudinal relations between self-identification and adolescent smoking suggests that group self-identification predicts smoking and is more than a substitute for other psychosocial variables. Examination of six types of peer groups shows that seventh-grade group self-identification foretells eighth-grade cigarette smoking, while seventh-grade smoking does not predict eighth-grade group self-identification.

Objectives. We present 1-year follow-up data from a school-based tobacco use prevention project designed to test the effectiveness of three main components of social influence programs. The components teach refusal skills, awareness of social misperceptions about tobacco use, and misconceptions about physical consequences. Methods. Four different curricula were developed and tested in a randomized experiment involving 48 junior high schools. The outcome variables examined were changes in initial and weekly cigarette and smokeless tobacco use 1 year after the intervention. Results. Analyses indicated that each of the component programs were effective in decreasing both the initial and the weekly use of cigarettes except for the curriculum in which refusal skills were taught. Also, each curriculum was effective in decreasing the initial use of smokeless tobacco except for the one aimed at correcting social misperceptions. Only the combined curriculum showed an effect on the weekly use of smokeless tobacco. Conclusions. The combined intervention was the most effective overall in reducing the initial and weekly use of cigarettes and smokeless tobacco. This suggests that different reasons for use exist and need to be counteracted simultaneously. However, since single programs were also effective in reducing all but weekly smokeless tobacco use, any of these components may be worthwhile prevention tools. (Am J Public Health. 1993;83:1245-1250), Among junior high school students, tobacco prevention programs work, but some programs work better than others. A study involving 6,716 7th graders in 27 southern California school districts tested the effects of four different tobacco program curricula. After one year, participants were evaluated against four measures of behavioral change, two measuring the change in prevalence of attempting cigarette or smokeless tobacco and two measuring the change in weekly use of both products. The study found that cigarette use among this group did not differ by gender. However, more males both tried and used smokeless tobacco. Also, more rural students than urban students tried both cigarettes and smokeless tobacco. Weekly use of both products did not differ among urban and rural students. Regarding the curricula, the study also found that emphasizing physical consequences was as important as counteracting social influences; combatting peer pressure worked better against smokeless tobacco than against cigarettes; and that tobacco use school-based curricula can work equally well against both products.

Adolescents tend to categorize themselves and their peers into discrete ingroups and outgroups. A comparison of ingroup versus outgroup perceptions of the characteristics of high-risk youth was investigated. Based on current stereotype research, we examined the perspective that outgroup members would hold a more extreme stereotype of high-risk youth compared to the perceptions of ingroup members. A total of 955 7th- and 10th-grade southern California adolescents completed a questionnaire regarding the characteristics of their own peer group and a high-risk group. Support was obtained for an extremity of judgement effect. Outgroup youth perceived that their high-risk peers engaged in fewer school and nonschool low-risk activities, more high-risk activities, and greater drug use than did ingroup members. Outgroup members also held perceptions of high-risk youth as less likely to hold a white-collar job than did the ingroup members. The perceptions that adolescents have of these groups may play major roles in their own social behavior. The implications of these results for future tobacco use prevention programs are considered.

The relationship between cigarette smoking and peer-group affiliation among 340 seventh-grade and 615 tenth-grade boys and girls of mixed ethnic backgrounds was examined. Students completed a lengthy questionnaire to assess current and past tobacco or smokeless tobacco use, as well as personality and peer-group traits. They were assigned to one of five groups: hot-shots, regulars, jocks, dirts, or skaters. Hot-shots were popular academic or social leaders who had moderate ratings in risk-taking and self-esteem. Regulars were typical teens who scored low in risk-taking and high in self-esteem. Jocks were very interested in team and individual sport activities and had moderately low scores on measures of self-esteem and risk-taking. Dirts demonstrated problem behaviors such as smoking, drinking, poor grades and high risk-taking, and had the lowest ratings of self-esteem. Skaters tended to be risk-takers and interested in outdoor activities. Like the dirts, they had low self-esteem and low grade point averages, but they did not use alcohol or drugs. More girls than boys were in the regular (63 percent) and hot-shot groups (66 percent). More boys (72 percent) were jocks. Fifty-one percent of the dirts were girls. Most skaters (68 percent) were boys. Data analysis revealed that the dirts had the highest percentage of current tobacco use; skaters ranked second and regulars ranked third. Hot-shots had the lowest percentage of current use. Although the jocks, dirts and skaters rated high in having tried smokeless tobacco, the skaters ranked highest in current use, while the dirts ranked second highest. Patterns of smoking among the groups were not related to age, ethnicity or gender. (Consumer Summary produced by Reliance Medical Information, Inc.)

This study investigated the moderating influence of expectancy accessibility on the relation between outcome expectancies and drug use intentions. Specifically, it was hypothesized that expectancies made temporarily more accessible would predict smokeless tobacco intentions to a greater degree than would less accessible expectancies. In addition, it was anticipated that expectancies regarding positive outcomes of smokeless tobacco use would be better predictors of intention than would expectancies about negative outcomes. Results partially supported the accessibility hypothesis, but this effect occurred for positive outcome expectancies only. In addition, the anticipated prepotency of positive over negative expectancies in predicting drug use intentions was strongly supported. These findings are consistent with theories of problem behavior which differentiate between positive and negative outcome expectancies and which postulate that accessibility of expectancies plays an important role in expectancy-behavior relations.

This study examined the relationships between wantedness of pregnancy and the initiation of prenatal care as well as smoking and drinking alcohol during pregnancy. Three hundred and eighty postpartum women were interviewed in a randomly selected sample of Chicago area hospitals. Approximately half of the women said that they had wanted their recently completed pregnancy. Unadjusted analyses revealed that women who wanted their pregnancies were more likely to begin prenatal care in the first trimester and were less likely to smoke while there was no relationship between wantedness and alcohol use during pregnancy. After adjustment for sociodemographic variables, women who wanted their pregnancies were less likely to have smoked cigarettes or drunk alcohol during pregnancy, but were not more likely to have initiated prenatal care in the first trimester. These results suggest that positive health behaviors during pregnancy are influenced by wantedness of pregnancy as well as sociodemographic characteristics. Therefore, efforts to reduce unwanted pregnancies are an important strategy to improve the health of women and children. [Article copies available for a fee from The Haworth Document Delivery), Service: 1-800-342-9678. E-mail address: getinfo@haworth.com]