Health Warnings, Smoking Rules, and Smoking Status: A Cross-National Comparison of Turkey and the United States.

OBJECTIVES: This study aimed to compare the prevalence of smoking status (i.e., current, former and never) between the United States and Turkey in terms of age and gender, and examine how smoking rules and health warnings are associated with smoking status within and between the two countries. METHODS: The study used data from the 2012-2013 National Adult Tobacco Survey (U.S. sample, N = 60,196) and the 2012 Global Adult Tobacco Survey (Turkey sample, N = 9,581). SAS PROC SURVEYLOGISTIC with a weighted variable was used to examine the associations between demographics (age, gender and education), smoking rules, health warnings, and smoking status within and between the two countries. RESULTS: There was an 18% current smoking prevalence among U.S. sample, compared to 27% of the Turkey sample. The U.S. sample had a higher rate of former smoking compared to the Turkey sample (25% vs. 22%). In both countries, being older and male gender predicted former smoking while being younger and female gender predicted never smoking. Having seen a health warning, and not allowing smoking in the vehicle and home positively predicted former and never smoking status. Higher education predicted both smoking statuses in the U.S. only. CONCLUSIONS: It is important to work with partners particularly in low- and middle-income countries (e.g., Turkey) to combat the global tobacco epidemic. In both counties, cessation endeavors should emphasize a comprehensive understanding of smoking status in terms of smoking rules in personal spaces and health warnings.

Identifying patterns of tobacco use among US middle and high school students: A latent class analysis.

OBJECTIVES: This study sought to (a) understand patterns of tobacco use among US middle and high school students based on their lifetime or current use of tobacco products: cigarettes, cigars, chewing tobacco, pipes, e-cigarettes, and hookah tobacco, and (b) examine differences in the underlying patterns by sociodemographic and tobacco-related characteristics (e.g., exposure to tobacco products, tobacco advertising, parental disapproval of tobacco use and feedback from healthcare providers). METHODS: We analyzed self-report data from the 2013 National Youth Tobacco Survey (n=18,046). Latent Class Analysis was conducted to identify patterns of tobacco use and tested how sociodemographic and tobacco-related characteristics are associated with such patterns. RESULTS: Four subtypes of tobacco use were identified: "Very Low Risk (VLR)," "Lifetime Smoking (LS)," "Lifetime Multiple Tobacco Use (LMT)," and "Past Month Multiple Tobacco Use (PMT)." Latino and Asian American youth were more likely to be in PMT. Compared with students in LS, students in VLR were less likely to receive advice not to use tobacco from their healthcare providers, but more likely to have parental disapproval of smoking. Students in LMT (vs. LS) were more likely to use tobacco coupons and promotional materials, report greater access to tobacco, and receive advice from a healthcare professional. Students in PMT (vs. LS) were more likely to use coupons, take part in tobacco promotions, and be exposed to smoking in a vehicle. CONCLUSIONS: Our study suggests that it may be important to consider the underlying patterns and correlates of tobacco use in designing tobacco control programs for youth.

Can Smoke-Free Policies Reduce Tobacco Use Disparities of Sexual and Gender Minorities in Missouri?

OBJECTIVE: The purpose of this study is to explore the associations between smoke-free policies, current and former smoking status, personal smoking restrictions, and intention to quit among sexual and gender minority (SGM) and non-SGM individuals in Missouri. AIMS AND METHODS: The current analysis derives from the Out, Proud and Healthy project. Chi-squares examined differences between SGM (N = 2210) and non-SGM (N = 586) respondents and former (N = 836) and current (N = 1960) smokers on smoking-related variables. Odds ratios and 95% confidence intervals from logistic regression identified variables associated with former (vs. current) smoking. RESULTS: SGM current smokers (25%) were significantly more likely than SGM former smokers (19%) to live in a community without a smoke-free policy. Among SGM current smokers, significantly greater intention to quit was seen in those living in a smoke-free community with a smoke-free policy of two or more years (94%) compared with those living in a community without a smoke-free policy (76%). CONCLUSIONS: Living in an area with smoke-free policies is related to greater intention to quit among SGM current smokers, greater support for smoke-free policies, and lower smoking prevalence for this community. The SGM community may collectively accrue greater public health benefits from the adoption of smoke-free policies than the non-SGM community. IMPLICATIONS: Prior to this study, no data are available regarding current and former smoking status among SGM individuals following the implementation of a local smoke-free policy. The purpose of this study was to explore the relationship between smoke-free policies, current and former smoking status, and intention to quit among SGM and non-SGM individuals in Missouri. This study finds evidence of lower current smoking prevalence and greater intentions to quit among SGM current smokers who live in communities with smoke-free policies. The SGM community may collectively accrue greater public health benefits from the adoption of smoke-free policies than the non-SGM community.

"I Have to Age in This Body": Lesbian and Bisexual Older Women's Perspectives on a Health Behavior Intervention.

BACKGROUND: Despite the body of literature that suggests lesbian and bisexual (LB) women are more likely to be overweight or obese than heterosexual women and the overwhelming evidence that tailored interventions are most effective at changing behavior, a vacuum of culturally appropriate programs designed specifically for LB women still exists. The purpose of this study was to qualitatively examine LB women's perceptions of Project LOLA (Living Out, Living Actively), a 16-week intentional health promotion program tailored specifically for LB women aged 40 and older. METHODS: Researchers conducting this qualitative descriptive study employed a template approach to text analysis to capture insights into participants' perceptions of Project LOLA. Data were derived from two primary sources: weekly support group facilitator notes of participants' comments and participant focus group interviews conducted at the conclusion of the study. PEN-3, an ecologically oriented model that identifies individual, family, community, and systemic influences on behavior change, guided the analysis. FINDINGS: Study participants emphasized the importance of incorporating culture into health interventions for LB women. They valued having a safe space to talk about their health issues and health-related changes. Interacting with people who understood the culturally specific norms of the LB community was cited as particularly beneficial. CONCLUSIONS: Interventions tailored to LB women may generate stronger results and/or be better received if they are designed in a culturally relevant and supportive manner. Such interventions hold promise as a tool to help address health disparities faced by this population.

Comparison of Lesbian and Bisexual Women to Heterosexual Women's Screening Prevalence for Breast, Cervical, and Colorectal Cancer in Missouri.

Sexual minority women may be at higher risk of breast, cervical, and colorectal cancer compared to heterosexual women. In addition, sexual minority women may use preventive cancer-related screening services less than heterosexual women. Using a population-based probability sample of Missouri women, we compared cancer screening behavior of heterosexual (n=29,847), self-identified lesbian (n=114), and bisexual (n=162) women. Sexual minority women were significantly younger by approximately 10 years and comprised less than 1% of the sample. In this sample, sexual minority and heterosexual women did not differ in the proportion having ever obtained breast, cervical or colorectal cancer screenings.