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1.
Tob Control ; 29(Suppl 1): s13-s19, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31992659

RESUMEN

A working group (WG) of experts from diverse fields related to nicotine and tobacco addiction was constituted to identify constructs and measures for the PhenX (Phenotypes and eXposures) Tobacco Regulatory Research (TRR) Host: Biobehavioral Collection with potential relevance to users of both conventional and newer tobacco products. This paper describes the methods and results the WG used to identify, select, approve and place measures in the PhenX TRR Collection. The WG recognised 13 constructs of importance to guide their categorisation of measures already in the PhenX Toolkit ('complementary measures') and to identify novel or improved measures of special relevance to tobacco regulatory science. In addition to the 22 complementary measures of relevance to tobacco use already in the PhenX Toolkit, the WG identified and recommended nine additional Host: Biobehavioral measures characterising the use, exposure and health outcomes of tobacco products for application to TRR. Of these, five were self-administered or interviewer-administered measures: amount, type and frequency of recent tobacco use; flavor preference in e-cigarette users (adult and youth); pregnancy status and tobacco use; pregnancy status-mother and baby health and withdrawal from tobacco use. The remaining four measures were laboratory-based: cotinine in serum, expired carbon monoxide, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in urine and cue reactivity. Although a number of validated tools are now available in the Host: Biobehavioral Collection, several gaps were identified, including a need to develop and test the identified measures in adolescent samples and to develop or identify measures of nicotine dependence, tolerance and withdrawal associated with newer non-combusted tobacco products.

2.
Nicotine Tob Res ; 22(3): 307-316, 2020 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-31204787

RESUMEN

INTRODUCTION: Previous qualitative reviews have summarized evidence of an association between menthol cigarette use and likelihood of smoking cessation. The objective of this meta-analysis was to provide a quantitative summary of effect sizes, their variability, and factors related to the variability in effect size for the association between menthol use and likelihood of smoking cessation. METHODS: We systematically searched Medline, PsycINFO, and Embase for prospective and cross-sectional studies of the association between menthol use and smoking cessation. We analyzed data with random effects meta-analyses and meta-regression. RESULTS: Our review identified 22 reports from 19 studies of the association between menthol use and cessation. All identified study samples included only US smokers, with one exception that included both Canadian and US smokers. Our overall model did not demonstrate a significant association between menthol use and cessation; however, menthol users were significantly less likely to quit among blacks/African American smokers (odds ratio = 0.88). CONCLUSIONS: Among blacks/African Americans predominantly in the US menthol users have approximately 12% lower odds of smoking cessation compared to non-menthol users. This difference is likely the result of the tobacco industry's ongoing marketing influence on the black/African American Community, suggesting that a menthol ban may have a unique public health benefit for black/African American smokers by encouraging quitting behavior. IMPLICATIONS: This study adds a quantitative summary of the association between menthol cigarette use and smoking cessation in the United States. Findings of an association with lower likelihood of cessation among black/African American smokers, likely resulting from the tobacco industry's marketing influence, support the ban of menthol flavoring as part of a comprehensive tobacco control effort to increase cessation among black/African American smokers.

3.
Women Health ; 60(4): 367-381, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31370742

RESUMEN

Women are more likely to delay seeking care for coronary heart disease (CHD) symptoms than men. We tested whether this was because they are more likely to misattribute CHD symptoms. Data were collected in December 2016. Participants were 714 Amazon's Mechanical Turk (crowdsourcing marketplace) workers with US Internet Protocol (IP) addresses; 52% female (ages 35-77 years) made judgments about patients of their same gender described in vignettes. We used adjusted multivariable logistic, ordinal, and linear regression to test our hypotheses. Women had a higher odds of misattributing the symptoms of the target in the vignettes to non-cardiac causes than men (adjusted odds ratio [AOR] = 2.08, p < .001), despite having higher mean knowledge scores about CHD (4.49 vs. 4.03, p < .001) and rating their CHD risk as higher (25% more likely to get CHD vs. 19%, p = .025) than men. Women were also less likely than men to intend to seek care at an emergency department (b = -0.33, p = .024), and if they did intend to seek care, they were more likely to intend to wait to seek care (AOR = 2.37, p = .003). Symptom misattribution may partially account for women's lower likelihood of intending to seek care from an emergency department, which would be especially critical in emergency situations.

4.
Prev Chronic Dis ; 16: E138, 2019 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-31603405

RESUMEN

INTRODUCTION: Use of 2 or more types of tobacco products is common among youth and young adults, highlighting the need for monitoring and intervention activities to encompass products beyond combustible cigarettes. This study documented patterns and trends of ever, current, and frequent hookah use among high school students in New Jersey by other tobacco product use status. METHODS: We analyzed data from the 2008, 2010, 2012, 2014, 2016 waves of the New Jersey Youth Tobacco Survey. Point estimates and 95% confidence intervals described hookah use stratified by use of other tobacco products. Multivariable logistic regression models assessed trends and correlates of hookah use, controlling for the use of other tobacco products and users' sociodemographic characteristics. Negative binomial regression models examined the association between total number of tobacco products used and hookah use while controlling for sociodemographic variables and survey year. RESULTS: The adjusted odds of current and frequent hookah use among New Jersey high school students were significantly higher in 2014, but not in 2016, compared to 2008. In recent years, hookah use among students who had ever smoked hookah, currently smoked hookah, or frequently smoked hookah was more common among students who had ever or currently smoked cigarettes or e-cigarettes. Hookah users consumed a wider variety of other tobacco products than those who did not use hookah. CONCLUSION: Hookah use remains a public health concern for adolescents; it is more common among users of other tobacco products, especially cigarette and e-cigarette smokers. Questions remain as to whether users of multiple tobacco products are being adequately reached by existing policies and regulations.

5.
PLoS One ; 14(9): e0220223, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31490958

RESUMEN

INTRODUCTION: Tobacco smoking is often more prevalent among those with lower socio-economic status (SES) in high-income countries, which can be driven by the inequalities in initiation and cessation of smoking. Smoking is a leading contributor to socio-economic disparities in health. To date, the evidence for any socio-economic inequality in smoking cessation is lacking, especially in low- and middle-income countries (LMICs). This study examined the association between cessation behaviours and SES of smokers from eight LMICs. METHODS: Data among former and current adult smokers aged 18 and older came from contemporaneous Global Adult Tobacco Surveys (2008-2011) and the International Tobacco Control Surveys (2009-2013) conducted in eight LMICs (Bangladesh, Brazil, China, India, Mexico, Malaysia, Thailand and Uruguay). Adjusted odds ratios (AORs) of successful quitting in the past year by SES indicators (household income/wealth, education, employment status, and rural-urban residence) were estimated using multivariable logistic regression controlling for socio-demographics and average tobacco product prices. A random effects meta-analysis was used to combine the estimates of AORs pooled across countries and two concurrent surveys for each country. RESULTS: Estimated quit rates among smokers (both daily and occasional) varied widely across countries. Meta-analysis of pooled AORs across countries and data sources indicated that there was no clear evidence of an association between SES indicators and successful quitting. The only exception was employed smokers, who were less likely to quit than their non-employed counterparts, which included students, homemakers, retirees, and the unemployed (pooled AOR≈0.8, p<0.10). CONCLUSION: Lack of clear evidence of the impact of lower SES on adult cessation behaviour in LMICs suggests that lower-SES smokers are not less successful in their attempts to quit than their higher-SES counterparts. Specifically, lack of employment, which is indicative of younger age and lower nicotine dependence for students, or lower personal disposable income and lower affordability for the unemployed and the retirees, may be associated with quitting. Raising taxes and prices of tobacco products that lowers affordability of tobacco products might be a key strategy for inducing cessation behaviour among current smokers and reducing overall tobacco consumption. Because low-SES smokers are more sensitive to price increases, tobacco taxation policy can induce disproportionately larger decreases in tobacco consumption among them and help reduce socio-economic disparities in smoking and consequent health outcomes.


Asunto(s)
Países en Desarrollo/estadística & datos numéricos , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adolescente , Adulto , Anciano , Bangladesh , Brasil , China , Femenino , Humanos , India , Malasia , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Fumar Tabaco/terapia
6.
Addiction ; 113(10): 1905-1926, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29749059

RESUMEN

AIMS: This review provides an up-to-date curated source of information on alcohol, tobacco and illicit drug use and their associated mortality and burden of disease. Limitations in the data are also discussed, including how these can be addressed in the future. METHODS: Online data sources were identified through expert review. Data were obtained mainly from the World Health Organization, United Nations Office on Drugs and Crime and Institute for Health Metrics and Evaluation. RESULTS: In 2015, the estimated prevalence among the adult population was 18.4% for heavy episodic alcohol use (in the past 30 days); 15.2% for daily tobacco smoking; and 3.8, 0.77, 0.37 and 0.35% for past-year cannabis, amphetamine, opioid and cocaine use, respectively. European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use. The age-standardized prevalence of alcohol dependence was 843.2 per 100 000 people; for cannabis, opioids, amphetamines and cocaine dependence it was 259.3, 220.4, 86.0 and 52.5 per 100 000 people, respectively. High-income North America region had among the highest rates of cannabis, opioid and cocaine dependence. Attributable disability-adjusted life-years (DALYs) were highest for tobacco smoking (170.9 million DALYs), followed by alcohol (85.0 million) and illicit drugs (27.8 million). Substance-attributable mortality rates were highest for tobacco smoking (110.7 deaths per 100 000 people), followed by alcohol and illicit drugs (33.0 and 6.9 deaths per 100 000 people, respectively). Attributable age-standardized mortality rates and DALYs for alcohol and illicit drugs were highest in eastern Europe; attributable age-standardized tobacco mortality rates and DALYs were highest in Oceania. CONCLUSIONS: In 2015 alcohol use and tobacco smoking use between them cost the human population more than a quarter of a billion disability-adjusted life years, with illicit drugs costing further tens of millions. Europeans suffered proportionately more, but in absolute terms the mortality rate was greatest in low- and middle-income countries with large populations and where the quality of data was more limited. Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately the geographical and temporal trends in substance use and its disease burden.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Fumar Tabaco/epidemiología , Alcoholismo/epidemiología , Carga Global de Enfermedades , Salud Global , Humanos , Mortalidad , Prevalencia , Uso de Tabaco/epidemiología , Naciones Unidas , Organización Mundial de la Salud
7.
Subst Use Misuse ; 53(11): 1869-1877, 2018 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-29533684

RESUMEN

BACKGROUND: Limited data exist on what young adults report as their first-ever nicotine product; some evidence suggests that they report hookah as their first product smoked. OBJECTIVES: This study reports on the first nicotine product used among undergraduates who had ever tried tobacco, and explores correlates of hookah as that first product. METHODS: Participants included a convenience sample of undergraduate students (n = 1538) at four universities in upstate New York during fall 2013. Descriptive statistics assessed first nicotine product used and prevalence of current use. Logistic regression was used to examine correlates of hookah as the first nicotine product used. RESULTS: Among the 832 students who reported ever use of any nicotine product, 25.4% reported hookah as their first product smoked; only combustible cigarettes (39.5%) were reported more frequently. Among students who ever smoked cigarettes, most reported cigarettes as their introductory product. Among students who never smoked cigarettes, nearly half reported hookah as their introductory product. Among ever nicotine users, current hookah smoking was common (34.9%), and greater than current e-cigarette (25.9%) and current combustible cigarette (26.4%) use. Never users of cigarettes, females, and non-Hispanic African Americans, had higher adjusted odds of reporting hookah as their introductory product. CONCLUSIONS: The results of this study have implications for the identification of risk factors for tobacco initiation, the assessment of tobacco use patterns and behaviors, and the tailoring of tobacco prevention initiatives among youth. Our findings suggest that broadening prevention efforts beyond a focus on combustible cigarettes may be warranted.


Asunto(s)
Pipas de Agua/estadística & datos numéricos , Fumar/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Femenino , Humanos , Masculino , New York/epidemiología , Prevalencia , Factores de Riesgo , Universidades , Adulto Joven
8.
Am J Health Behav ; 42(2): 21-35, 2018 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-29458512

RESUMEN

OBJECTIVES: In this study, the aim was to document trends of ever, past 30-day, and frequent (use on > 10 days/month) hookah use among New Jersey (NJ) high school students. METHODS: Data were analyzed from the 2008-2014 waves of the NJ Youth Tobacco Survey, a biennial survey of public high school students in grades 9-12 with a mean age of 15 years. Multivariable logistic regressions assessed trends and correlates of hookah use. Descriptive statistics were used to summarize the use of cigarettes, electronic cigarettes, and other tobacco products (including cigars, smokeless tobacco, and bidis). RESULTS: In 2014, past 30-day hookah use (11.8%) was as high as e-cigarette use (12.1%) and higher than other tobacco products. The adjusted odds of ever, past 30-day, and frequent hookah use were significantly higher in 2014 than 2008. Past 30-day hookah use was more common among users of other tobacco products. CONCLUSIONS: Effective strategies have been used in cigarette tobacco control, and cigarette consumption has decreased as a result. Similar strategies should be employed to encompass emerging tobacco products, with necessary modifications to reduce the prevalence of all tobacco use among youth.


Asunto(s)
Pipas de Agua , Fumar en Pipa de Agua/epidemiología , Adolescente , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , New Jersey/epidemiología , Prevalencia , Estudiantes , Fumar en Pipa de Agua/tendencias
9.
J Public Health Manag Pract ; 24(5): E12-E19, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29278577

RESUMEN

CONTEXT: Cancer patients' continued tobacco use results in poorer therapeutic outcomes including decreased quality of life and survival. OBJECTIVE: To assess reach and impact of a free, opt-out, telephone-based tobacco cessation program for thoracic cancer center patients. DESIGN: Observational study. SETTING: Comprehensive Cancer Center in Western New York. PARTICIPANTS: Current or recent (within past 30 days) tobacco-using thoracic cancer center patients referred to a tobacco cessation support service between October 2010 and October 2012 at a Comprehensive Cancer Center (n = 942/1313 referrals were eligible for cessation support). INTERVENTION: A free, opt-out, telephone-based cessation service that was implemented as standard of care. Cessation specialists had patient-guided conversations that assessed readiness to quit; methods used in the past provided cessation strategies and worked to set up a quit date. There was an average of 35.9 days between referral and first contact. MAIN OUTCOME MEASURES: Program reach (referral and participation rates) and impact (as self-reported cessation outcomes measured twice after referral). RESULTS: Of 942 patients, 730 (77.5%) referred to and called by a tobacco cessation service participated in at least 1 cessation support call, of which 440 of 730 (60.3%) were called for follow-up and 89.5% (394/440) participated. In total, 20.2% (69/342) of current smokers at referral reported at least 7-day abstinence at follow-up. Among current smokers at referral and first contact, being married (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.01-4.18) and having a lower Eastern Cooperative Oncology Group (ECOG) performance score (OR = 4.05; 95% CI, 1.58-10.39) were associated with quitting at follow-up, after controlling for demographic, clinical, and health behavior characteristics. CONCLUSIONS: Our results demonstrate that 78% of thoracic cancer center patients, if contacted, participated at least once in this cessation support service; for current smokers at referral and first contact, being married and having a lower ECOG performance score were associated with self-reported quitting at follow-up. Other organizations may find our results useful while implementing a systematic way to identify tobacco-using patients as part of routine care and to improve available cessation support services.


Asunto(s)
Cuidados Posteriores/normas , Neoplasias/psicología , Cese del Hábito de Fumar/métodos , Apoyo Social , Adulto , Cuidados Posteriores/métodos , Cuidados Posteriores/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/prevención & control , New York , Oportunidad Relativa , Evaluación de Programas y Proyectos de Salud/métodos , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Calidad de Vida/psicología , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Teléfono , Tórax/anomalías , Tórax/fisiopatología
10.
Lancet Public Health ; 2(4): e166-e174, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-29253448

RESUMEN

BACKGROUND: The WHO Framework Convention on Tobacco Control (WHO FCTC) has mobilised efforts among 180 parties to combat the global tobacco epidemic. This study examined the association between highest-level implementation of key tobacco control demand-reduction measures of the WHO FCTC and smoking prevalence over the treaty's first decade. METHODS: We used WHO data from 126 countries to examine the association between the number of highest-level implementations of key demand-reduction measures (WHO FCTC articles 6, 8, 11, 13, and 14) between 2007 and 2014 and smoking prevalence estimates between 2005 and 2015. McNemar tests were done to test differences in the proportion of countries that had implemented each of the measures at the highest level between 2007 and 2014. Four linear regression models were computed to examine the association between the predictor variable (the change between 2007 and 2014 in the number of key measures implemented at the highest level), and the outcome variable (the percentage point change in tobacco smoking prevalence between 2005 and 2015). FINDINGS: Between 2007 and 2014, there was a significant global increase in highest-level implementation of all key demand-reduction measures. The mean smoking prevalence for all 126 countries was 24·73% (SD 10·32) in 2005 and 22·18% (SD 8·87) in 2015, an average decrease in prevalence of 2·55 percentage points (SD 5·08; relative reduction 10·31%). Unadjusted linear regression showed that increases in highest-level implementations of key measures between 2007 and 2014 were significantly associated with a decrease in smoking prevalence between 2005 and 2015). Each additional measure implemented at the highest level was associated with an average decrease in smoking prevalence of 1·57 percentage points (95% CI -2·51 to -0·63, p=0·001) and an average relative decrease of 7·09% (-12·55 to -1·63, p=0·011). Controlling for geographical subregion, income level, and WHO FCTC party status, the per-measure decrease in prevalence was 0·94 percentage points (-1·76 to -0·13, p=0·023) and an average relative decrease of 3·18% (-6·75 to 0·38, p=0·079). This association was consistent across all three control variables. INTERPRETATION: Implementation of key WHO FCTC demand-reduction measures is significantly associated with lower smoking prevalence, with anticipated future reductions in tobacco-related morbidity and mortality. These findings validate the call for strong implementation of the WHO FCTC in the WHO's Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2020, and in advancing the UN's Sustainable Development Goal 3, setting a global target of reducing tobacco use and premature mortality from non-communicable diseases by a third by 2030. FUNDING: Health Canada, Canadian Institutes of Health Research, Ontario Institute for Cancer Research and Canadian Cancer Society Research Institute.


Asunto(s)
Salud Global/estadística & datos numéricos , Cooperación Internacional , Prevención del Hábito de Fumar/organización & administración , Fumar/epidemiología , Humanos , Prevalencia , Organización Mundial de la Salud
11.
Am J Epidemiol ; 186(4): 405-410, 2017 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-28369184

RESUMEN

Accurate surveillance is critical for monitoring the epidemiology of emerging tobacco products in the United States, and survey science suggests that survey response format can impact prevalence estimates. We utilized data from the 2014 New Jersey Youth Tobacco Survey (n = 3,909) to compare estimates of the prevalence of 4 behaviors (ever hookah use, current hookah use, ever e-cigarette use, and current e-cigarette use) among New Jersey high school students, as assessed using "check-all-that-apply" questions, with estimates measured by means of "forced-choice" questions. Measurement discrepancies were apparent for all 4 outcomes, with the forced-choice questions yielding prevalence estimates approximately twice those of the check-all-that-apply questions, and agreement was fair to moderate. The sensitivity of the check-all-that-apply questions, treating the forced-choice format as the "gold standard," ranged from 38.1% (current hookah use) to 58.3% (ever e-cigarette use), indicating substantial false-negative rates. These findings highlight the impact of question response format on prevalence estimates of emerging tobacco products among youth and suggest that estimates generated by means of check-all-that-apply questions may be biased downward. Alternative survey designs should be considered to avoid check-all-that-apply response formats, and researchers should use caution when interpreting tobacco use data obtained from check-all-that-apply formats.


Asunto(s)
Conducta del Adolescente , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Diseño de Investigaciones Epidemiológicas , Vigilancia de la Población/métodos , Fumar/epidemiología , Encuestas y Cuestionarios/normas , Adolescente , Humanos , Incidencia , New Jersey/epidemiología , Prevalencia , Estados Unidos/epidemiología
12.
Am J Prev Med ; 52(3): e77-e84, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27939236

RESUMEN

INTRODUCTION: The inter-relationships between smoking habits and weight gain are complex. However, few studies have examined the association of smoking habits with weight gain over the life course. METHODS: Major smoking parameters and weight gain over time were examined in a large cohort of postmenopausal women aged 50-79 years at enrollment between 1993 and 1998 (N=161,808) and followed through 2014 (analyses conducted in 2016). Cross-sectional analyses were used to assess the association of smoking and body weight at baseline. Retrospective data were used to correlate smoking status with body weight over a 45-year period prior to enrollment. In addition, the association of smoking with weight gain over 6 years of follow-up was examined. RESULTS: At baseline, women who had quit smoking prior to enrollment weighed 4.7 kg more than current smokers and 2.6 kg more than never smokers. Former, never, and current smokers all gained weight over the 45-year period from age 18 years to time of enrollment (average age, 63 years): 16.8, 16.4, and 14.6 kg, respectively. In prospective analyses, women who were current smokers at baseline but who quit smoking during follow-up gained more than 5 kg by Year 6 compared with current smokers at baseline who continued to smoke. Among long-term quitters, greater intensity of smoking and more recent quitting were associated with greater weight gain. CONCLUSIONS: These results suggest that excess weight gain associated with smoking cessation occurs soon after quitting and is modest relative to weight gain in never smokers over the adult lifespan.


Asunto(s)
Peso Corporal/fisiología , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Aumento de Peso/fisiología , Anciano , Estudios Transversales , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Posmenopausia , Estudios Prospectivos , Estudios Retrospectivos
13.
Nicotine Tob Res ; 19(12): 1418-1424, 2017 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-27634956

RESUMEN

Introduction: We examine the trajectory of adult smoking prevalence in the United States over the period 1990-2014 to investigate whether the smoking cessation rate has changed during this period. Methods: We employ a dynamic model of smoking prevalence, and data from the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH), to estimate the adult cessation rate in 6-year intervals. We use weighted nonlinear least squares to perform the estimation. We then employ a meta-regression model to test whether the cessation rate has increased. Results: The annual cessation rate has increased from 2.4% in 1990 to 4.5% in 2014 according to the NHIS data, and from 3.2% in 2002 to 4.2% in 2014 according to the NSDUH data. The increasing trend is statistically significant (p value = 1.57×10-6) and the two independent surveys produced nearly identical results, which makes it unlikely that our findings are a product of chance. Conclusions: Our analysis finds that the smoking cessation rate in the United States has almost doubled since 1990. This increase is responsible for at least 2 million fewer smokers in 2014. If current conditions persist, by the year 2020 the increase in cessation rates will be responsible for 3.5 million fewer smokers. Our findings can assist in predicting the future path of the smoking epidemic and determining the correct allocation of resources to eradicate it. Implications: We show that the adult smoking cessation rate has greatly increased since 1990. We demonstrate this by studying prevalence trajectories from two independent population surveys, which yielded nearly identical results. Different from other studies, we focus on permanent quit rates (net of relapses) which we estimate from a dynamic model of prevalence. Our results do not stem from self-reported quitting behavior, but from the analysis of observed prevalence and its inherent variability. Our findings can contribute to predicting the future path of the smoking epidemic and to determining the optimal allocation of resources to eradicate it.


Asunto(s)
Encuestas Epidemiológicas/tendencias , Cese del Hábito de Fumar/métodos , Fumar/tendencias , Fumar/terapia , Adulto , Femenino , Conductas Relacionadas con la Salud , Encuestas Epidemiológicas/métodos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Fumar/epidemiología , Fumar Tabaco/terapia , Fumar Tabaco/tendencias , Estados Unidos/epidemiología
14.
Tob Control ; 25(Suppl 2): ii14-ii20, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27729565

RESUMEN

INTRODUCTION: National data from 2004 to 2010 showed that despite decreases in non-menthol cigarette use prevalence, menthol cigarette use prevalence remained constant in adolescents and adults and increased in young adults. The purpose of the current study was to extend these analyses through 2014. METHODS: We estimated the prevalence of menthol cigarette smoking in the USA during 2004-2014 using annual cross-sectional data on persons aged ≥12 years from the National Survey on Drug Use and Health. Self-reported menthol status for selected brands that were either exclusively menthol or non-menthol were adjusted based on retail sales data. Data were weighted to provide national estimates. RESULTS: Although overall smoking prevalence has decreased, the proportion of past 30-day cigarette smokers using menthol cigarettes was higher (39%) in 2012-2014 compared to 2008-2010 (35%). Youth smokers remain the most likely group to use menthol cigarettes compared to all other age groups. Menthol cigarette prevalence has increased in white, Asian and Hispanic smokers since 2010. Menthol cigarette prevalence exceeded non-menthol cigarette prevalence in youth and young adult smokers in 2014. Among smokers, menthol cigarette use was positively correlated with co-use of cigars. Menthol cigarette and smokeless tobacco co-use also increased from 2004 to 2014. CONCLUSIONS: The youngest smokers are most likely to use menthol cigarettes. Among smokers, increases in overall menthol cigarette use and menthol cigarette use in whites, Asians and Hispanics since 2010 are of concern. There is tremendous urgency to limit the impact of menthol cigarettes on public health, particularly the health of youth and young adults.


Asunto(s)
Comercio/estadística & datos numéricos , Mentol , Fumar/epidemiología , Productos de Tabaco/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Niño , Grupos de Población Continentales/estadística & datos numéricos , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Fumadores/estadística & datos numéricos , Fumar/etnología , Productos de Tabaco/economía , Tabaco sin Humo/economía , Tabaco sin Humo/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto Joven
15.
Subst Abus ; 37(4): 571-578, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27093192

RESUMEN

BACKGROUND: Studies have consistently reported associations among depression, cigarette smoking, and fruit and vegetable intake (FVI). This study evaluated FVI as a moderator of the association between depressive symptoms and smoking. METHODS: The authors analyzed data from the National Longitudinal Survey of Youth 1979: Child and Young Adult. The study sample was adults aged 19-33 years at baseline in the year 2004 from the Young Adult Survey portion. Moderation analyses were performed using the Johnson-Neyman technique to assess whether baseline FVI moderated the association between depressive symptoms and smoking status cross-sectionally and as a predictor of smoking cessation longitudinally at 4-year follow-up. RESULTS: Cross-sectionally, at lower levels of FVI (<4.9 times/day), there was a significant association between smoking and depressive symptoms (P < .05), but not at higher levels of FVI (≥4.9 times/day; P > .05). Longitudinally, there was an inverse association between depressive symptoms and quitting smoking at FVI <1.2 times/day (P < .05), but there was not a significant association at FVI ≥1.2 times/day (P ≥ .05). CONCLUSIONS: FVI moderated the association between depressive symptoms and cigarette smoking cross-sectionally and longitudinally. The cross-sectional findings might be partially explained by the longitudinal findings paired with prior research; there might be fewer smokers with high FVI because depressive symptoms are removed as an impediment to cessation. Further experimental research is warranted to test the efficacy of increased FVI as an adjunct to smoking cessation, with a possible mechanism of action being reduced depressive symptoms during quit attempts.


Asunto(s)
Depresión/psicología , Ingestión de Alimentos , Frutas , Fumar/psicología , Verduras , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Cese del Hábito de Fumar/psicología , Adulto Joven
16.
Nicotine Tob Res ; 18 Suppl 1: S1-6, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26980859

RESUMEN

INTRODUCTION: Although multiple factors likely influence the differences between African Americans (AAs) and whites in cardiovascular disease and lung cancer mortality rates, historical patterns of tobacco use, particularly cigarette smoking, are the major contributors. This issue of Nicotine & Tobacco Research presents original research, a review, and commentaries that will serve to advance our understanding of several relevant behavioral similarities and differences between AAs and whites. BEHAVIORAL ANALYSIS: Here, we illustrate how the diverging trends in cigarette smoking between AA and white high school seniors observed since the mid-1970s were influenced by patterns of ever use and current use among ever users. During 1977 to 2014, the percentage of current users among ever users was higher, but less variable, among whites than AAs. Among adults, trends in self-reported cigarette smoking among non-Hispanic AAs and non-Hispanic whites are available since 1978. The trends observed were likely due in part to the maturation of the high school senior cohorts from the 1970s and 1980s when AA smoking rates declined sharply relative to whites. Later age of initiation among AAs and less quitting among older AAs, relative to whites, also contribute. CONCLUSIONS: Further research on multiple topics, including the continuation of use among ever users, use of multiple combusted and noncombusted products, provision of cessation support services, influence of discrimination, and validity of self-report would expand the science base. Strategies to reduce the marketing and availability of menthol and other characterizing flavorings and to enrich environments would promote the public's health.


Asunto(s)
Afroamericanos/psicología , Fumar/etnología , Adulto , Afroamericanos/estadística & datos numéricos , Investigación Biomédica/métodos , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Humanos , Masculino , Mentol/efectos adversos , Salud Pública/métodos , Fumar/tendencias , Cese del Hábito de Fumar/etnología , Prevención del Hábito de Fumar , Uso de Tabaco/etnología , Uso de Tabaco/tendencias , Estados Unidos/epidemiología
17.
Nicotine Tob Res ; 18 Suppl 1: S79-87, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26980868

RESUMEN

INTRODUCTION: While cigarette smoking prevalence is declining among US adults, quit rates may differ between white and African American smokers. Here, we summarize the literature on smoking cessation behaviors in whites and African Americans across four study designs and report the findings of new analyses of International Tobacco Control (ITC) US Survey cohort data. METHODS: We reviewed 32 publications containing 39 relevant analyses that compared quit attempts and abstinence between US whites and African Americans. Two additional longitudinal analyses were conducted on 821 white and 76 African American cigarette smokers from Waves 7 and 8 of the ITC US Survey (mean follow-up = 19 months). RESULTS: Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community- and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. CONCLUSIONS: Of 11 population- or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. IMPLICATIONS: This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit further study.


Asunto(s)
Afroamericanos/psicología , Cese del Hábito de Fumar/etnología , Fumar/etnología , Afroamericanos/estadística & datos numéricos , Estudios Transversales , Grupo de Ascendencia Continental Europea/psicología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Encuestas Epidemiológicas/métodos , Humanos , Estudios Retrospectivos , Cese del Hábito de Fumar/métodos , Cese del Hábito de Fumar/estadística & datos numéricos , Prevención del Hábito de Fumar , Tabaquismo/etnología , Tabaquismo/rehabilitación , Estados Unidos/epidemiología
18.
Cancer Epidemiol Biomarkers Prev ; 25(4): 624-33, 2016 04.
Artículo en Inglés | MEDLINE | ID: mdl-26809277

RESUMEN

BACKGROUND: Evidence of anticancer properties of garlic for different cancer sites has been reported previously in in vitro and in vivo experimental studies but there is limited epidemiologic evidence on the association between garlic and lung cancer. METHODS: We examined the association between raw garlic consumption and lung cancer in a case-control study conducted between 2005 and 2007 in Taiyuan, China. Epidemiologic data was collected by face-to-face interviews from 399 incident lung cancer cases and 466 healthy controls. We used unconditional logistic regression models to estimate crude and adjusted ORs (aOR) and their 95% confidence intervals (CI). Adjusted models controlled for age, sex, average annual household income 10 years ago, smoking, and indoor air pollution. RESULTS: Compared with no intake, raw garlic intake was associated with lower risk of development of lung cancer with a dose-response pattern (aOR for <2 times/week = 0.56; 95% CI, 0.39-0.81 and aOR for ≥2 times/week = 0.50; 95% CI, 0.34-0.74; Ptrend = 0.0002). Exploratory analysis showed an additive interaction of raw garlic consumption with indoor air pollution and with any supplement use in association with lung cancer. CONCLUSIONS: The results of the current study suggest that raw garlic consumption is associated with reduced risk of lung cancer in a Chinese population. IMPACT: This study contributes to the limited research in human population on the association between garlic and lung cancer and advocates further investigation into the use of garlic in chemoprevention of lung cancer. Cancer Epidemiol Biomarkers Prev; 25(4); 624-33. ©2016 AACR.


Asunto(s)
Ajo/química , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad
19.
Health Psychol ; 34(9): 966-9, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25581702

RESUMEN

OBJECTIVE: Health behaviors, including smoking and fruit and vegetable consumption, are both associated with psychological distress and vary by race/ethnicity. The relation of global psychological distress to behavior also varies by race/ethnicity, but the specific negative affective states responsible for this effect are not known. This study examined how the relation of feelings of depression and anxiety to health behaviors differs by race/ethnicity. METHOD: Secondary data analysis of the HINTS nationally representative population survey was conducted. Survey participants reported their current symptoms of depression and anxiety, as well as smoking status and fruit and vegetable consumption. Survey weighted linear and logistic regression analyses were used to assess whether race/ethnicity moderated the relation of symptoms of depression and anxiety to smoking and fruit and vegetable consumption. RESULTS: For symptoms of depression, but not anxiety, there was a significant interaction between race/ethnicity and psychological distress in predicting both smoking status and fruit and vegetable consumption. Greater depressive symptoms were related to a greater likelihood of smoking and lower fruit and vegetable consumption for White, but not Black respondents. For Hispanic respondents, depressive symptoms were associated with a greater likelihood of currently smoking, but were not associated with fruit and vegetable consumption. CONCLUSION: The association between depressive symptoms and both smoking and fruit and vegetable consumption differs as a function of race/ethnicity. These findings have implications for understanding the extent to which negative affective states influence health behaviors across different racial/ethnic groups, and for developing interventions that effectively target smoking and fruit and vegetable consumption among different racial/ethnic subgroups.


Asunto(s)
Trastornos de Ansiedad/psicología , Trastorno Depresivo/psicología , Conductas Relacionadas con la Salud/etnología , Adulto , Grupos de Población Continentales , Depresión , Grupos Étnicos/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
Tob Control ; 24(1): 28-37, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23997070

RESUMEN

INTRODUCTION: Mentholated cigarettes are at least as dangerous to an individual's health as non-mentholated varieties. The addition of menthol to cigarettes reduces perceived harshness of smoke, which can facilitate initiation. Here, we examine correlates of menthol use, national trends in smoking menthol and non-menthol cigarettes, and brand preferences over time. METHODS: We estimated menthol cigarette use during 2004-2010 using annual data on persons ≥12 years old from the National Surveys on Drug Use and Health. We adjusted self-reported menthol status for selected brands that were either exclusively menthol or non-menthol, based on sales data. Data were weighted to provide national estimates. RESULTS: Among cigarette smokers, menthol cigarette use was more common among 12-17 year olds (56.7%) and 18-25 year olds (45.0%) than among older persons (range 30.5% to 34.7%). In a multivariable analysis, menthol use was associated with being younger, female and of non-Caucasian race/ethnicity. Among all adolescents, the percentage who smoked non-menthol cigarettes decreased from 2004-2010, while menthol smoking rates remained constant; among all young adults, the percentage who smoked non-menthol cigarettes also declined, while menthol smoking rates increased. The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic Caucasians, during the study period. CONCLUSIONS: Young people are heavy consumers of mentholated cigarettes. Progress in reducing youth smoking has likely been attenuated by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands. This study should inform the Food and Drug Administration regarding the potential public health impact of a menthol ban.


Asunto(s)
Comportamiento del Consumidor , Mentol , Fumar/tendencias , Adolescente , Adulto , Factores de Edad , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto Joven
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