Unifying Public Health Surveillance: A Scoping Review of Global Use of the Youth Risk Behavior Survey.

PURPOSE: The Youth Risk Behavior Survey (YRBS) is a well-established surveillance tool designed to document the health risk behaviors of youth. However, there is limited insight into the use of the survey outside of the United States. The aim of this scoping review was to assess the global presence and utilization of the YRBS. METHODS: A structured electronic search of all publication years (through February 2020) was conducted to identify articles in PubMed and EBSCOhost. The search identified 128 articles that used the YRBS beyond the United States. RESULTS: More than one-third of all countries, territories, and dependencies were represented in the articles, with the greatest use among upper-middle and high-income economies and those in the East Asia and Pacific geographic region. Priority health-risk behaviors identified were alcohol and other drug use (51%), tobacco use (48%), and unintentional and intentional injuries (44%). The articles predominantly suggested that the survey data be used to influence programs, policies, and practices (57%). DISCUSSION: The development and proliferation of surveillance systems has allowed for important contributions to public health. Extensive use of the YRBS is notable; however, greater efforts are needed to support more systematic and collaborative approaches for evaluating youth behaviors around the world.

Dual home screening and tailored environmental feedback to reduce radon and secondhand smoke: an exploratory study.

Combined exposure to secondhand smoke (SHS) and radon increases lung cancer risk 10-fold. The authors assessed the feasibility and impact of a brief home screening and environmental feedback intervention to reduce radon and SHS (Freedom from Radon and Smoking in the Home [FRESH]) and measured perceived risk of lung cancer and synergistic risk perception (SHS x radon). Participants (N = 50) received home radon and SHS kits and completed baseline surveys. Test results were shared using an intervention guided by the Teachable Moment Model. Half of the participants completed online surveys two months later. Most (76%) returned the radon test kits; 48% returned SHS kits. Of the returned radon test kits, 26% were >4.0 pCi/L. Of the returned SHS kits, 38% had nicotine > .1 microg/m3. Of those with high radon, more than half had contacted a mitigation specialist or planned contact. Of those with positive air nicotine, 75% had adopted smoke-free homes. A significant increase occurred in perceived risk for lung cancer and synergistic risk perception after FRESH.

Political climate and smoke-free laws in rural Kentucky communities.

The purpose was to determine factors associated with rural communities' political readiness to enact smoke-free laws. Data from baseline assessment of a longitudinal intervention study to promote smoke-free policy in rural Kentucky communities; key informants (n = 144) and elected officials (n = 83) from 29 counties participated in cross-sectional telephone interviews. Controlling for population size and county-level smoking rate, the following factors predicted elected officials' perception of the likelihood of a local smoke-free law passing in the next 12 months: (1) support from the local board of health; (2) support from local leaders; and (3) smoke-free hospitals. Communities with lower adult smoking prevalence were more ready for smoke-free laws. Rural health advocates can increase political readiness for smoke-free laws by educating and engaging Board of Health members and local leaders, promoting the voluntary adoption of smoke-free policies in rural hospitals, and investing in effective population-based approaches to evidence-based tobacco treatment in rural communities.

Farm elders define health as the ability to work.

Thirty percent of America's 2.2 million farms are operated by individuals older than 65 years. This study examined how older farmers define health and determined whether demographic characteristics, farm work, and physical and mental health status predict health definition. Data were collected via telephone and mailed surveys during the baseline wave of data collection in a longitudinal study of family farmers residing in two southern states (n=1,288). Nearly 42% defined health as the "ability to work" compared to a physical health-related definition. Predictors of defining health as the ability to work included being White, performing more farm tasks in the past week, taking prescription medications daily, and having minimal health-related limitations to farm work. Health behaviors are centered on the individual's perception of health. Understanding the defining attributes of health can support better approaches to health care and health promotion, particularly among rural subcultures such as farmers, whose identity is rooted in their work.

Smoke-free policy and alcohol use among undergraduate college students.

OBJECTIVES: The purpose of this study was to assess attitudes and behaviors related to smoke-free policy among undergraduate student alcohol drinkers on a campus in a community with smoke-free bars. DESIGN AND SAMPLE: This was a secondary data analysis of a study in which participants completed mailed surveys assessing demographic characteristics, attitudes and behaviors related to alcohol and tobacco use and smoke-free policy (n = 337). Opinion and behavior items were summarized descriptively; associations were examined using Kruskal Wallis tests and chi-square tests of association. Logistic regression tested for predictors of importance of smoke-free policy. RESULTS: Respondents were predominantly female and Caucasian; mean age 20.3 years. One fourth were current smokers. Seventy-nine percent said the community smoke-free law had no effect on frequency of visiting bars. Eighty-seven percent said smoke-free policy in campus buildings was "somewhat" or "very important." Predictors of perceived importance of smoke-free policy included gender and smoking status. CONCLUSIONS: Most smokers in this sample did not experience a change in their motivation to quit smoking or in number of cigarettes smoked daily. Implementation of a community smoke-free law did not reduce the likelihood of visiting bars. Women and nonsmokers were more likely to rate smoke-free campus policy as very important.

Rural print media portrayal of secondhand smoke and smoke-free policy.

The purpose of this article is to describe how the print media portrays secondhand smoke and smoke-free policy in rural communities. Baseline print media clips from an ongoing 5-year study of smoke-free policy development in 40 rural communities were analyzed. The authors hypothesized that community population size would be positively associated with media favorability toward smoke-free policy. Conversely, pounds of tobacco produced and adult smoking prevalence would be negatively associated with media favorability. There was a positive correlation between population size and percentage of articles favorable toward smoke-free policy. The authors did not find a correlation between adult smoking or tobacco produced and media favorability toward smoke-free policy, but we did find a positive relationship between tobacco produced and percentage of pro-tobacco articles and a negative relationship between adult smoking prevalence and percentage of articles about health/comfort. Implications for targeting pro-health media in rural communities as well as policy-based initiatives for tobacco control are discussed.

Menthol smoking, smoke-free policies and cessation services.

AIMS: This study examined whether menthol cigarette smoking is related to exposure to smoke-free home and work-place policies, availability of cessation services at work and knowledge of cessation resources among current smokers. DESIGN: Secondary analysis was conducted using logistic regression of cross-sectional data. SETTING: The 2003 and 2006/07 Tobacco Use Supplement (TUS) to the Current Population Survey, administered by the National Cancer Institute, the Centers for Disease Control and Prevention (CDC) and the Census Bureau, formed the basis for this investigation. PARTICIPANTS: A total of 66,145 current smokers who participated in the TUS CPS administrations in 2003 and 2006/07. MEASUREMENTS: Demographic characteristics (gender, race/ethnicity, age, education, income), smoking frequency, menthol cigarette use, status of smoking bans in the work-place and at home, availability of cessation services at work and knowledge of quitting resources were assessed. FINDINGS: Among all current smokers with an indoor job, with no smoke-free restrictions at either work or home as the reference, those who smoked menthol cigarettes were about one-third as likely to have a smoke-free policy at both work and home [odds ratio (OR) = 0.32; 95% confidence interval (CI): 0.27-0.38]. In the comparison of those with an indoor smoke-free policy at work only versus those with no restrictions, menthol status was a risk factor for not having a work-place restriction (OR = 0.79; 95% CI: 0.67-0.93); similarly, within this sample, menthol use was a risk factor for not having a home restriction (OR = 0.38; 95% CI: 0.31-0.46). Among all current smokers, the use of menthol cigarettes was a risk factor for not having a smoking restriction at home (OR = 0.93; 95% CI: 0.88-0.98). Menthol smoking was not related to availability of cessation services offered at work or knowledge of cessation services. CONCLUSIONS: This study suggests that menthol smoking is associated with lack of policy protection from second-hand smoke exposure. Policymakers and tobacco control professionals should monitor tobacco control efforts to ensure that policies and interventions reach all menthol smokers.

Do smoke-free laws in rural, distressed counties encourage cessation?

The authors examined the association between smoke-free laws and smoking/cessation behaviors and secondhand smoke exposure among current and former smokers in rural, distressed counties. A quasi-experimental, two-group design compared outcomes between participants from a county with a longstanding smoke-free law (n = 252) and those living in four demographically similar counties without smoke-free laws ( n = 250). Participants were recruited using random digit dialing. Controlling for demographic factors, those in the treatment group reported greater nicotine dependence, were more likely to have smoke-free workplaces, and less likely to have smoke-free homes. There were no differences in smoking status, past-year quit attempts, intent to quit in 5 years, cigarettes per day, or time since last cigarette. Smokers in the treatment group were just as likely to attempt to quit, despite greater nicotine dependence. Findings showed that making nonsmoking the social norm through policy change may be more difficult in rural, distressed areas.