Smoking behavior and related factors among Japanese nursing students: a cohort study.

BACKGROUND: Although there have been several surveys on smoking behavior among Japanese nursing students, most have been cross-sectional studies. No longitudinal studies, such as a prospective cohort study, have ever been carried out. We therefore conducted a cohort study on, and analyzed smoking behavior and related factors among, Japanese nursing students. METHODS: A survey on smoking behavior using a confidential questionnaire was conducted on nursing students at two vocational schools of nursing and two nursing colleges/universities located in the Tokyo metropolitan area. Another survey was subsequently conducted in the same manner among the same subjects 1 year later. The surveys were conducted between 1997 and 1999. RESULTS: Over the 1-year period, the prevalence of smoking among nursing students increased by 10% for students at the vocational schools of nursing (n = 224) and by 3% for students at the nursing colleges/universities (n = 222). The average score for nicotine dependence for students who were daily smokers at both time points rose from 3.6 to 4.4 (P < 0.05). Two factors found to significantly predict smoking behavior were having friends who smoke and living alone. CONCLUSION: Smoking prevalence is increasing among Japanese nursing students. Smoking prevention and cessation interventions should be instituted in all nursing training programs.

Relation between smoking prevalence and various social factors in Japan.

Although the smoking prevalence among women is significantly low compared to that among men in Japan, the prevalence in young Japanese women has been steadily increasing recently. The relationship between the prevalence of smoking among the general population and various social factors was investigated with a special emphasis regarding the influence of household size on the smoking prevalence of young Japanese women. Thirty-one thousand and six hundreds twenty-seven subjects of 20 years and older were randomly selected from the general population of Japan. The Ministry of Health and Welfare, Japan planned and conducted the survey. Subjects were divided into male and female, and smoking prevalence was investigated in terms of age, place of residence, occupation and household size factors. Statistical analyses were performed using chi-square test and multiple logistic regression. Multiple logistic regression analyses suggested that for men there was a strong relationship between becoming a smoker and living in a municipality with a smaller population, and that for women who were living in a municipality with a larger population. For women, as the size of a household increased from living alone to a two- or three-generation household, the tendency to becoming a smoker decreased, but this tendency was not observed among men. As to reasons for quitting smoking, more women than men living in two- and three-generation households gave "family's advice" as a major reason (p < 0.01). The steady replacement of the traditional three-generation household by smaller households in Japan may lead to an increase in the number of young women who smoke.

[Estimating cost functions of cancer screening programs provided by municipalities].

OBJECTIVE: To estimate cost functions of cancer screening programs for stomach, lung, colorectal, cervical, and breast cancers provided by municipalities and to describe the relationship between the costs and the scale of cancer screening programs. METHODS: Subjects were all the municipalities in Japan. Questionnaires were sent to 3,182 subjects and 1,860 responses were received. Data obtained from questionnaires were the number of persons screened and the total cost of each program in the 1998 fiscal year. A cost function of each program was specified as a linear model, a power model, and a cubic model, and the fitness of each model was estimated. RESULTS: Long-run cost functions of all the cancer screening programs allowed better explanation of the relationship between the number of persons screened and the total cost than short-run cost functions. The average costs of stomach, colorectal, and cervical cancer screening programs increased and the average cost of the lung cancer screening program decreased, as the number of persons screened increased. The cost function of the breast cancer screening program could not be identified. CONCLUSIONS: It is necessary to estimate not only cost functions but also production functions of cancer screening programs using the data related to products, costs, and factors of production to evaluate the efficiency of cancer screening programs.

[Costs of health services for the elderly and related factors in cities of Japan].

OBJECTIVES: To estimate the costs of health services for the elderly in 1994 and to examine factors affecting them. METHODS: Questionnaires were sent to 631 cities and responses from 339 cities were received. Data obtained from questionnaires were total cost, proportion of labor sent to total cost, cost per user, cost per person eligible to receive Health services for the elderly. These variables were measured for health counseling service, health education, health examinations, functional training, and home-visit guidance. RESULTS: The proportion of labor cost was smaller for health examinations than for other services. Health examinations and home-visit guidance showed higher correlation coefficients between the number of users and the total cost than other services. In most services, cost per eligible person were negatively correlated with the number of residents in the city and positively correlated with the number of public health nurses per resident. However, costs per user did not show a correlation. The cities which established municipal health centers had lower costs per user of health education and functional training than the cities which did not. Standardized mortality ratios of cerebrovascular disease and stomach cancer were not correlated with total cost, proportion of labor cost, cost per user, cost per eligible person in most services. CONCLUSIONS: For the economic evaluation of health services for the elderly, it is necessary to examine the relationship between cost, both quantity and quality, and effectiveness of health services.

[A simplified method for the assessment of C1 esterase inhibitor function].

From the result that the activated form of C1-s(C1-s) prolonged the kinetics of hemolysis via complement, this assay was applied to assess C1 esterase inhibitor (C1INH) function. In the kinetic assay, the complement hemolytic activity was evaluated by the time which required to cause 50% reduction of the initial turbidity of sensitized sheep erythrocytes, and was expressed as T1/2. (1) T1/2 of pooled normal human sera (p-NHS) showed dose-dependent prolongation by the addition of various amounts of C1-s. (2) Preincubation of various amounts of functionally pure C1INH with the constant amounts of C1-s inhibited dose-dependently the prolongation of T1/2 by C1-s. (3) The C1INH activity of NHS was 840 +/- 80 units/ml (n = 6) and that of the C1INH deficient serum was 80 units/ml, which were calculated from the standard curve established by the addition of various amounts of purified C1INH. This test requiring only C1-s and sensitized sheep erythrocytes is simple technically and high in sensitivity, and seems to be useful for the routine assay for C1INH function of human sera.