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1.
Tob Control ; 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019893

RESUMO

INTRODUCTION: Mexico was the first Latin American country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004, after which it implemented some key FCTC policies (e.g., taxes, smoke-free, pictorial warnings and ad bans). This study assessed trends in the prevalence of current, daily and non-daily smoking in Mexico before and after the implementation of key FCTC policies. METHODS: Data were analysed from two comparable, nationally representative surveys (i.e., the National Survey on Addictions 2002, 2011 and 2016, and the Global Adult Tobacco Survey 2009 and 2015). The pooled sample comprised 100 302 persons aged 15-65 years. Changes in the prevalence of current, daily and non-daily smoking were assessed. RESULTS: From 2002 to 2016, the prevalence of current smoking fell 11% in relative terms (from 21.5% to 19.0%). The decrease was registered between 2002 and 2009, and after that, a slight increase was observed (from 16.5% in 2009 to 19% in 2016). The prevalence of daily smoking decreased by about 50% between 2002 and 2016 (from 13.5% to 7.0%) with most of the decrease occurring by 2009. Conversely, the prevalence of non-daily smoking increased by 35% between 2009 and 2016 (from 8.8% to 11.9%). CONCLUSIONS: Full implementation of the FCTC is necessary to further reduce smoking. Specific interventions may be needed to target non-daily smokers, who now comprise more than half of current smokers in Mexico.

2.
Int J Behav Med ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925674

RESUMO

BACKGROUND: Sexual and gender minority (SGM) adolescents are more likely than their heterosexual and cisgender peers to smoke cigarettes. Family rejection has been associated with adverse health outcomes; however, few studies have examined whether SGM-specific family rejection is associated with cigarette smoking among SGM adolescents. METHOD: A non-probability sample of 11,005 SGM adolescents (M = 15.58, SD = 1.27) completed an online cross-sectional survey. Bivariate and multivariable analyses were conducted to examine associations between SGM-specific family rejection, sociodemographic variables, and smoking. RESULTS: Approximately 7% of the sample currently smoked cigarettes. Pansexual, asexual, trans boys, and non-binary assigned female at birth adolescents had the highest SGM family rejection scores. In multivariable regression analyses, SGM-specific family rejection was independently associated with smoking after adjusting for covariates (AOR = 1.15, 95% CI 1.04, 1.28). Family support (AOR = 0.80, 95% CI 0.73, 0.88) and experiencing violence (AOR = 1.64, 95% CI 1.49, 1.82) were also associated with smoking in multivariable models. Adolescents who identified as bisexual versus gay/lesbian (AOR = 1.50, 95% CI 1.21, 1.85) and trans boys versus cisgender girls (AOR = 2.05, 95% CI 1.13, 3.71) had an increased odds of smoking. Those who disclosed their sexual orientation identity to most (AOR = 1.95, 95% CI 1.45, 2.63) and all (AOR = 1.60, 95% CI 1.21, 2.11) of their family/parents had increased odds of smoking. CONCLUSION: Our findings underscore the importance of attending to the role of SGM-specific family rejection and distinctions with SGM adolescents in tobacco prevention and smoking cessation efforts.

3.
Nicotine Tob Res ; 22(1): 96-103, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-30053141

RESUMO

BACKGROUND: Tobacco control policies and other denormalization strategies may reduce tobacco use by stigmatizing smoking. This raises an important question: Does perceived smoking-related stigma contribute to a smoker's decision to quit? The aim of this study was to evaluate if perceived smoking-related stigma was associated with smoking cessation outcomes among smokers in Mexico and Uruguay. METHODS: We analyzed prospective data from a panel of adult smokers who participated in the 2008-2012 administrations of the International Tobacco Control Policy Evaluation Surveys in Mexico and Uruguay. We defined two analytic samples of participants: the quit behavior sample (n = 3896 Mexico; n = 1525 Uruguay) and the relapse sample (n = 596 Mexico). Generalized estimating equations were used to evaluate if different aspects of perceived stigma (ie, discomfort, marginalization, and negative stereotype) at baseline were associated with smoking cessation outcomes at follow-up. RESULTS: We found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico. CONCLUSIONS: This study suggests that perceived smoking-related stigma may be associated with more quit attempts, but less successful quitting among smokers. It is possible that once stigma is internalized by smokers, it may function as a damaging force. Future studies should evaluate the influence of internalized stigma on smoking behavior. IMPLICATIONS: Although perceived smoking-related stigma may prompt smokers to quit smoking, smoking stigma may also serve as a damaging force for some individuals, making quitting more difficult. This study found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico.

4.
Am J Prev Med ; 57(6): e203-e210, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31753273

RESUMO

INTRODUCTION: This study sought to empirically evaluate whether the Medicaid expansion under the Affordable Care Act increased smoking cessation among low-income childless adult smokers. METHODS: The effects of the Medicaid expansion on smoking quit attempts and the probability of 30- and 90-day smoking cessation were evaluated using logistic regression and data from the 2010-2011 and 2014-2015 waves of the Tobacco Use Supplement to the Current Population Survey. Using boosted logistic regression, the Tobacco Use Supplement was restricted to an analytic sample composed of childless adults with high probability of being <138% of the federal poverty level. Propensity score weighting was used to compare changes in smoking cessation among a sample of current and past smokers in states that expanded Medicaid with a control sample of current and past smokers in states that did not expand Medicaid with similar sociodemographic characteristics and smoking histories. This study additionally controlled for state socioeconomic trends, welfare policies, and tobacco control policies. Analysis was conducted between January 2018 and June 2019. RESULTS: After weighting by propensity score and adjusting for state socioeconomic trends, welfare policies, and tobacco control policies, the Medicaid expansion was not associated with increases in smoking quit attempts or smoking cessation. CONCLUSIONS: The Medicaid expansion did not appear to improve smoking cessation, despite extending health insurance eligibility to 2.3 million low-income smokers. Greater commitments to reducing barriers to cessation benefits and increasing smoking cessation in state Medicaid programs are needed to reduce smoking in low-income populations.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31480698

RESUMO

(1) Background: Smoking restrictions have been shown to be associated with reduced smoking, but there are a number of gaps in the literature surrounding the relationship between smoke-free policies and cessation, including the extent to which this association may be modified by sociodemographic characteristics. (2) Methods: We analyzed data from the Tobacco Use Supplement to the Current Population Survey, 2003-2015, to explore whether multiple measures of smoking restrictions were associated with cessation across population subgroups. We examined area-based measures of exposure to smoke-free laws, as well as self-reported exposure to workplace smoke-free policies. We used age-stratified, fixed effects logistic regression models to assess the impact of each smoke-free measure on 90-day cessation. Effect modification by gender, education, family income, and race/ethnicity was examined using interaction terms. (3) Results: Coverage by workplace smoke-free laws and self-reported workplace smoke-free policies was associated with higher odds of cessation among respondents ages 40-54. Family income modified the association between smoke-free workplace laws and cessation for women ages 25-39 (the change in the probability of cessation associated with coverage was most pronounced among lower-income women). (4) Conclusions: Heterogeneous associations between policies and cessation suggest that smoke-free policies may have important implications for health equity.


Assuntos
Política Antifumo , Abandono do Hábito de Fumar/legislação & jurisprudência , Adulto , Idoso , Grupos Étnicos , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pobreza , Autorrelato , Estados Unidos , Local de Trabalho/legislação & jurisprudência , Adulto Jovem
6.
Salud Publica Mex ; 2019 Apr 05.
Artigo em Espanhol | MEDLINE | ID: mdl-31314210

RESUMO

OBJECTIVE: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. MATERIALS AND METHODS: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. RESULTS: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. CONCLUSIONS: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.

7.
J Womens Health (Larchmt) ; 28(7): 919-928, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31259671

RESUMO

Background: CenteringPregnancy group prenatal care (GPNC) has been shown to reduce rates of preterm birth (PTB). We evaluated the impact of GPNC on spontaneous PTB (sPTB) as a first step in exploring the possible mechanism by which GPNC may decrease rates of PTB. We also evaluated whether attending more than five GPNC sessions affected PTB risk and examined all differences by race/ethnicity. Materials and Methods: We conducted a retrospective cohort study among women delivering at a single institution between April 2009 and March 2014. Birth outcome data from vital statistics records were appended to patient records, and detailed chart abstraction was used to determine spontaneous versus indicated PTB. The association between GPNC and attending more than five GPNC sessions and birth outcomes (i.e., PTB, sPTB, low birth weight [LBW], and neonatal intensive care unit [NICU] admissions) was analyzed using generalized estimating equation log binomial regression models. We examined effect modification of the associations by race/ethnicity. Results: The analysis included 1,292 women in GPNC and 8,703 in traditional individual prenatal care (IPNC). After controlling for potential confounders, the risk of PTB (risk ratio [RR] 0.38; 95% confidence interval [CI] 0.31-0.47), sPTB (RR 0.49; 95% CI 0.38-0.63), LBW (RR 0.46; 95% CI 0.37-0.56), and NICU admissions (RR 0.46; 95% CI 0.37-0.57) was lower in GPNC compared to IPNC women. Results differed by maternal race/ethnicity, with the strongest associations among non-Hispanic white mothers and the weakest associations among Hispanic mothers, especially for sPTB. Similarly, the risk of PTB, LBW, and NICU admissions was lower among GPNC women who attended more than five sessions. Conclusion: Participation in GPNC demonstrated a decreased risk for sPTB, as well as other adverse birth outcomes. In addition, participation in more than five GPNC sessions demonstrated a decreased risk for adverse birth outcomes. Prospective longitudinal studies are needed to further explore mechanisms associated with these findings.

8.
Artigo em Inglês | MEDLINE | ID: mdl-31220294

RESUMO

BACKGROUND: There is conflicting evidence regarding whether men and women are equally likely to quit smoking. We assessed whether gender differences in smoking cessation varied between different sociodemographic groups and across e-cigarette use. METHODS: The 2014-15 cross-section of the Current Population Survey Tobacco Use Supplement was weighted to represent the US adult population of current/former smokers (N = 16 040). Log binomial models tested whether gender modified the relationships between race/ethnicity, education, income or e-cigarette use and 90-day smoking cessation in the past year. RESULTS: Gender was not associated with cessation in adjusted models (RR = 0.97, CI: 0.85, 1.11). There were no statistically significant interactions between gender and sociodemographic covariates. Current e-cigarette use was associated with higher cessation (RR = 1.53, CI: 1.30, 1.81), and the association varied by gender (Interaction P = 0.013). While male e-cigarette users had a 15% predicted cessation in the past year (CI: 12, 18%), female users had a 9% predicted cessation (95% CI: 7, 11%). Probability of cessation for female e-cigarette users was not different from non-users. CONCLUSIONS: These findings suggest that there are no gender differences in smoking cessation in the USA overall, or by sociodemographic groups. Current e-cigarette use is associated with higher likelihood of recent successful smoking cessation, particularly for men.

9.
Public Health Nutr ; 22(14): 2581-2590, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31097047

RESUMO

OBJECTIVE: We explored how positive and negative life experiences of caregivers are associated with household food insecurity. DESIGN: The Midlands Family Study (MFS) was a cross-sectional study with three levels of household food security: food secure, food insecure without child hunger and food insecure with child hunger. Ordinal logistic regression analysis was used for analyses of negative and positive life experiences (number, impact, type) associated with food insecurity. SETTING: An eight-county region in South Carolina, USA, in 2012-2013. PARTICIPANTS: Caregivers (n 511) in households with children. RESULTS: Caregivers who reported greater numbers of negative life experiences and greater perceived impact had increased odds of household food insecurity and reporting their children experienced hunger. Each additional negative life experience count of the caregiver was associated with a 16 % greater odds of food insecurity without child hunger and a 28 % greater odds of child hunger. Each one-unit increase in the negative impact score (e.g. a worsening) was associated with 8 % higher odds of food insecurity without child hunger and 12 % higher odds of child hunger. Negative work experiences or financial instability had the strongest association (OR = 1·8; 95 % CI 1·5, 2·2) with child hunger. Positive life experiences were generally not associated with food security status, with one exception: for each unit increase in the number of positive experiences involving family and other relationships, the odds of child hunger decreased by 22 %. CONCLUSIONS: More research is needed to understand approaches to build resilience against negative life experiences and strengthen positive familial, community and social relationships.

10.
JAMA Netw Open ; 2(5): e194270, 2019 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-31125099

RESUMO

Importance: A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical. Objective: To evaluate whether an association exists between life purpose and all-cause or cause-specific mortality among older adults in the United States. Design, Setting, and Participants: The Health and Retirement Study (HRS) is a national cohort study of US adults older than 50 years. Adults between the ages of 51 to 61 were enrolled in the HRS, and their spouses or partners were enrolled regardless of age. Initially, individuals born between 1931 and 1941 were enrolled starting in 1992, but subsequent cohort enrichment was carried out. The present prospective cohort study sample was drawn from 8419 HRS participants who were older than 50 years and who had filled out a psychological questionnaire during the HRS 2006 interview period. Of these, 1142 nonresponders with incomplete life purpose data, 163 respondents with missing sample weights, 81 participants lost to follow-up, 1 participant with an incorrect survival time, and 47 participants with missing information on covariates were excluded. The final sample for analysis was 6985 individuals. Data analyses were conducted between June 5, 2018, and April 22, 2019. Exposures: Purpose in life was assessed for the 2006 interview period with a 7-item questionnaire from the modified Ryff and Keyes Scales of Psychological Well-being evaluation using a Likert scale ranging from 1 to 6, with higher scores indicating greater purpose in life; for all-cause and cause-specific mortality analyses, 5 categories of life purpose scores were used (1.00-2.99, 3.00-3.99, 4.00-4.99, 5.00-5.99, and 6.00). Main Outcomes and Measures: All-cause and cause-specific mortality were assessed between 2006 and 2010. Weighted Cox proportional hazards models were used to evaluate life purpose and mortality. Results: Of 6985 individuals included in the analysis, 4016 (57.5%) were women, the mean (SD) age of all participants was 68.6 (9.8) years, and the mean (SD) survival time for decedents was 31.21 (15.42) months (range, 1.00-71.00 months). Life purpose was significantly associated with all-cause mortality in the HRS (hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category). Some significant cause-specific mortality associations with life purpose were also observed (heart, circulatory, and blood conditions: hazard ratio, 2.66; 95% CI, 1.62-4.38). Conclusions and Relevance: This study's results indicated that stronger purpose in life was associated with decreased mortality. Purposeful living may have health benefits. Future research should focus on evaluating the association of life purpose interventions with health outcomes, including mortality. In addition, understanding potential biological mechanisms through which life purpose may influence health outcomes would be valuable.

11.
Matern Child Health J ; 23(6): 787-801, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30569299

RESUMO

Objectives To describe the creation of a multigenerational linked dataset with social mobility measures for South Carolina (SC), as an example for states in the South and other areas of the country. Methods Using unique identifiers, we linked birth certificates along the maternal line using SC birth certificate data from 1989 to 2014, and compared the subset of records for which linking was possible with two comparison groups on sociodemographic and birth outcome measures. We created four multi-generational social mobility measures using maternal education, paternal education, presence of paternal information, and a summary score incorporating the prior three measures plus payment source for births after 2004. We compared social mobility measures by race/ethnicity. Results Of the 1,366,288 singleton birth certificates in SC from 1989 to 2014, we linked 103,194, resulting in 61,229 unique three-generation units. Mothers and fathers were younger and had lower education, and low birth weight was more common, in the multigenerational linked dataset than in the two comparison groups. Based on the social mobility summary score, only 6.3% of White families were always disadvantaged, compared to 30.4% of Black families and 13.2% of Hispanic families. Moreover, 32.8% of White families were upwardly mobile and 39.1% of Black families were upwardly mobile, but only 29.9% of Hispanic families were upwardly mobile. Conclusions for Practice When states are able to link individuals, birth certificate data may be an excellent source for examining population-level relationships between social mobility and adverse birth outcomes. Due to its location in the Deep South, the multigenerational SC dataset may be particularly useful for understanding racial/ethnic difference in social mobility and birth outcomes.


Assuntos
Declaração de Nascimento , Grupos de Populações Continentais/etnologia , Pai/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Registro Médico Coordenado , Mães/estatística & dados numéricos , Mobilidade Social , Grupos de Populações Continentais/educação , Grupos de Populações Continentais/estatística & dados numéricos , Bases de Dados Factuais , Pai/educação , Feminino , Humanos , Lactente , Mortalidade Infantil/etnologia , Recém-Nascido , Masculino , Mães/educação , Vigilância da População/métodos , Saúde Pública , Fatores Socioeconômicos , South Carolina
12.
J Public Health (Oxf) ; 41(1): 130-137, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29447404

RESUMO

BACKGROUND: Personal (i.e. egocentric) network characteristics are associated with health outcomes, including overweight and obesity. Previous research suggests educational attainment may interact with network characteristics to buffer these relationships. Limited research has examined the personal network characteristics of Black Americans, who have increased risk of overweight and obesity. The purpose of the current study was to examine associations between network characteristics and body mass index (BMI), and whether educational attainment modified these associations among Black Americans. METHODS: In 2014, using respondent-driven sampling, we recruited 430 adult residents of eight low-income neighborhoods in Greenville, SC. Self-administered questionnaires assessed structural and compositional characteristics (i.e. size, density) of respondents' personal networks, socio-demographic characteristics, and health-related behaviors and conditions. Multilevel regression models with robust sandwich estimation accounted for clustering within respondent chains. RESULTS: Among Black adults overall, network density-the number of connections among network members-was positively associated with BMI. Higher education moderated this relationship; among Black adults with a college degree, higher network density was inversely associated with BMI. CONCLUSIONS: Our data suggest low educational attainment may reflect more homogenous and less resourceful networks. Multiple pathways are discussed for how education interacts with network density on BMI among Black Americans.

13.
Tob Control ; 28(1): 81-87, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29519935

RESUMO

OBJECTIVE: To examine how point-of-sale (POS) display bans, tobacco retailer density and tobacco retailer proximity were associated with smoking cessation and relapse in a cohort of smokers in Canada, where provincial POS bans were implemented differentially over time from 2004 to 2010. METHODS: Data from the 2005 to 2011 administrations of the International Tobacco Control (ITC) Canada Survey, a nationally representative cohort of adult smokers, were linked via residential geocoding with tobacco retailer data to derive for each smoker a measure of retailer density and proximity. An indicator variable identified whether the smoker's province banned POS displays at the time of the interview. Outcomes included cessation for at least 1 month at follow-up among smokers from the previous wave and relapse at follow-up among smokers who had quit at the previous wave. Logistic generalised estimating equation models were used to determine the relationship between living in a province with a POS display ban, tobacco retailer density and tobacco retailer proximity with cessation (n=4388) and relapse (n=866). RESULTS: Provincial POS display bans were not associated with cessation. In adjusted models, POS display bans were associated with lower odds of relapse which strengthened after adjusting for retailer density and proximity, although results were not statistically significant (OR 0.66, 95% CI 0.41 to 1.07, p=0.089). Neither tobacco retailer density nor proximity was associated with cessation or relapse. CONCLUSIONS: Banning POS retail displays shows promise as an additional tool to prevent relapse, although these results need to be confirmed in larger longitudinal studies.


Assuntos
Comércio/legislação & jurisprudência , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Produtos do Tabaco/economia , Fumar Tabaco/prevenção & controle , Adulto , Canadá , Estudos de Coortes , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Marketing/legislação & jurisprudência , Pessoa de Meia-Idade , Recidiva , Prevenção do Hábito de Fumar/métodos , Inquéritos e Questionários , Produtos do Tabaco/legislação & jurisprudência , Fumar Tabaco/epidemiologia
14.
Int J Soc Psychiatry ; : 20764018808326, 2018 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-30375248

RESUMO

BACKGROUND:: Network- and cohesion-based social capital may play an important role in improving mental health. However, there is limited understanding about these relationships among adults in Taiwan. AIM:: The aim of this study was to examine the association between individual-level network and cohesion-based social capital and depressive symptoms among a population-based sample of Taiwanese adults. METHODS:: Data were obtained from the 1997 Taiwan Social Change Survey ( n = 2,598). The 20-item Center for Epidemiological Studies Depression Scale was used to measure depressive symptom scores; ⩾16 represented high depressive symptoms. Network-based social capital was measured using a position generator. Two dimensions of cohesion-based social capital were assessed: cognitive (perceived neighborhood trust and reciprocity) and structural (local community participation and organizational participation). Multivariable log-binomial regression models, weighted to account for the complex sampling design and adjusted for confounders, estimated prevalence ratios and 95% confidence intervals (CIs) to examine the association between each social capital measure and depressive symptoms. RESULTS:: In this study, 29.6% of respondents were classified as having high depressive symptom scores. Higher scores of composite cognitive social capital (adjusted Prevalence Ratios (aPR) = 0.92, 95% CI = [0.90, 0.95]) and structural social capital (aPR = 0.80, 95% CI = [0.65, 0.99]) were associated with a lower likelihood of high depressive symptom scores after controlling for confounders. However, there was no association between network social capital and depressive symptoms. CONCLUSION:: The findings suggest that the relationship between social capital and depressive symptoms in Taiwan differs according to the specific dimension of social capital assessed. Differentiating between network- and cohesion-based social capital merits greater attention to inform our understanding of building social capital to promote and improve mental health outcomes.

15.
Addict Behav Rep ; 8: 154-163, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30364679

RESUMO

Background: Light and intermittent smoking has become increasingly prevalent as smokers shift to lower consumption in response to tobacco control policies. We examined changes in cigarette consumption patterns over a four-year period and determined which factors were associated with smoking transitions. Methods: We used data from a cohort of smokers from the 2008-2012 ITC Mexico Survey administrations to investigate transitions from non-daily (ND; n = 669), daily light (DL; ≤5 cigarettes per day (cpd); n = 643), and daily heavy (DH; >5 cpd; n = 761) smoking patterns. To identify which factors (i.e., sociodemographic measures, perceived addiction, quit behavior, social norms) were associated with smoking transitions, we stratified on smoking status at time t (ND, DL, DH) and used multinomial (ND, DL) and binomial (DH) logistic regression to examine transitions (quitting/reducing or increasing versus same level for ND and DL, quitting/reducing versus same level for DH). Results: ND smokers were more likely to quit at follow-up than DL or DH smokers. DH smokers who reduced their consumption to ND were more likely to quit eventually compared to those who continued as DH. Smokers who perceived themselves as addicted had lower odds of quitting/reducing smoking consumption at follow-up compared to smokers who did not, regardless of smoking status at the prior survey. Quit attempts and quit intentions were also associated with quitting/reducing consumption. Conclusions: Reducing consumption may eventually lead to cessation, even for heavier smokers. The findings that perceived addiction and quit behavior were important predictors of changing consumption for all groups may offer insights into potential interventions.

16.
Prev Med Rep ; 11: 202-208, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29998052

RESUMO

Research on the role of neighbourhood-level deprivation in low- and middle-income countries with respect to tobacco use is relatively nascent. In South Africa, where race and deprivation are closely linked due to the history of apartheid, smoking disparities exist by individual risk factors such as gender, race, and socioeconomic status. However, less is known about how community-level factors affect smoking disparities in the country, or how the relationship between deprivation and smoking differs by race. We used data from the 2008 South African National Income Dynamics Study (NIDS) and Poisson generalised estimating equations to assess the relationship between neighbourhood deprivation and current smoking for individuals nested within neighbourhoods, while controlling for individual-level and household-level covariates. Subgroup analyses for racial categories Black and Coloured were performed. We found that the relationship between neighbourhood deprivation and smoking prevalence was non-linear: the smoking prevalence ratio was highest among those in the middle range for our deprivation index, and lower at extremely high and low levels of deprivation. Both Black and Coloured subsamples exhibited this inverted U-shape, although the relationship was weaker in the latter group. That the relationship between neighbourhood deprivation and smoking is non-linear contrasts with what has been found in high-income countries, where the relationship between neighbourhood deprivation and smoking is linear. Moreover, these findings are relevant to assess the potential differential impact of smoking interventions as a function of socioeconomic and environmental context.

17.
Am J Public Health ; 108(3): 372-378, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29345998

RESUMO

The Appalachian Region has among the highest rates of smoking and smoking-related illness in the United States. Strong smoke-free legislation could help protect nonsmoking residents from the harmful effects of secondhand smoke. However, there is a dearth of state, county, city, and subcounty smoke-free law coverage throughout Appalachia. As of July 2016, only 21% of Appalachian residents were covered by comprehensive smoke-free laws (i.e., 100% coverage for workplaces, restaurants, and bars). Only 46% of Appalachians lived in places with 100% smoke-free workplace laws, only 30% lived in places with 100% smoke-free restaurant laws, and only 29% lived in places with 100% smoke-free bar laws. Reasons for this lack of smoke-free law coverage include socioeconomic disadvantage, the historical importance of tobacco in Appalachian economies, and preemptive state legislation. By understanding the contextual issues that have inhibited smoke-free legislation, smoke-free advocates will be better prepared to lead efforts that expand smoke-free coverage in this region.


Assuntos
Política Antifumo/legislação & jurisprudência , Política Antifumo/tendências , Fumar/epidemiologia , Governo Estadual , Região dos Apalaches/epidemiologia , Humanos , Restaurantes/legislação & jurisprudência , Restaurantes/estatística & dados numéricos , Fumar/efeitos adversos , Fatores Socioeconômicos , Local de Trabalho/legislação & jurisprudência , Local de Trabalho/estatística & dados numéricos
18.
Artigo em Inglês | MEDLINE | ID: mdl-28257125

RESUMO

Few studies examine nativity disparities in smoking in the U.S., thus a major gap remains in understanding whether immigrant Latinos' smoking prevalence is stable, converging, or diverging, compared with U.S.-born Latinos. This study aimed to disentangle the roles of period changes, duration of U.S. residence, and immigrant arrival cohort in explaining the gap in smoking prevalence between foreign-born and U.S.-born Latinos. Using repeated cross-sectional data spanning 1998-2013 (U.S. National Health Interview Survey), regressions predicted current smoking among foreign-born and U.S.-born Latino men and women (n = 12,492). We contrasted findings from conventional regression analyses that simply include period and duration of residence effects, to two methods of assessing arrival cohort effects: the first accounted for baseline differences in smoking among arrival cohorts, while the second examined smoking probabilities by tracking foreign-born arrival cohorts as they increase their duration of U.S. residence. Findings showed that Latino immigrants maintained lower prevalence of current smoking compared with U.S.-born Latinos over the period 1998-2013, and that longer duration of U.S. residence is associated with lower odds of smoking among men. Two findings are particularly novel: (1) accounting for immigrant arrival cohort dampens the overall protective effect of duration of residence among men; and (2) the earliest arrival cohort of Latino immigrant men experienced the steepest decline in smoking over duration of U.S. residence. Results have methodological and theoretical implications for smoking studies and the Latino mortality paradox.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Fumar/tendências , Adulto , Estudos Transversais , Feminino , Humanos , Internacionalidade , Masculino , Prevalência , Análise de Regressão , Fumar/epidemiologia , Estados Unidos/epidemiologia
19.
Prev Med ; 97: 26-32, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28087468

RESUMO

Mexican immigrants have lower smoking rates than US-born Mexicans, which some scholars attribute to health selection-that individuals who migrate are healthier and have better health behaviors than their non-migrant counterparts. Few studies have examined smoking selectivity using binational data and none have assessed whether selectivity remains constant over time. This study combined binational data from the US and Mexico to examine: 1) the extent to which recent Mexican immigrants (<10years) in the US are selected with regard to cigarette smoking compared to non-migrants in Mexico, and 2) whether smoking selectivity varied between 2000 and 2012-a period of declining tobacco use in Mexico and the US. We combined repeated cross-sectional US data (n=10.901) on adult (ages 20-64) Mexican immigrants and US-born Mexicans from the 1999/2000 and 2011/2012 National Health Interview Survey, and repeated cross-sectional Mexican data on non-migrants (n=67.188) from the 2000 Encuesta Nacional de Salud and 2012 Encuesta Nacional de Salud y Nutrición. Multinomial logistic regressions, stratified by gender, predicted smoking status (current, former, never) by migration status. At both time points, we found lower overall smoking prevalence among recent US immigrants compared to non-migrants for both genders. Moreover, from the regression analyses, smoking selectivity remained constant between 2000 and 2012 among men, but increased among women. These findings suggest that Mexican immigrants are indeed selected on smoking compared to their non-migrating counterparts, but that selectivity is subject to smoking conditions in the sending countries and may not remain constant over time.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Fumar/epidemiologia , Adulto , Fatores Etários , Feminino , Humanos , Masculino , México/epidemiologia , México/etnologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/tendências , Estados Unidos/epidemiologia
20.
Glob Public Health ; 12(7): 830-845, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-26837721

RESUMO

We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.


Assuntos
Política de Saúde , Fumar/epidemiologia , Fumar/mortalidade , Uso de Tabaco/legislação & jurisprudência , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
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