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1.
MMWR Morb Mortal Wkly Rep ; 68(46): 1081-1086, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31751322

RESUMO

CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders are investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). CDC has published recommendations for health care providers regarding EVALI (2-4). Recently, researchers from Utah and New York published proposed diagnosis and treatment algorithms for EVALI (5,6). EVALI remains a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis, and evaluation should be guided by clinical judgment. Because patients with EVALI can experience symptoms similar to those associated with influenza or other respiratory infections (e.g., fever, cough, headache, myalgias, or fatigue), it might be difficult to differentiate EVALI from influenza or community-acquired pneumonia on initial assessment; EVALI might also co-occur with respiratory infections. This report summarizes recommendations for health care providers managing patients with suspected or known EVALI when respiratory infections such as influenza are more prevalent in the community than they have been in recent months (7). Recommendations include 1) asking patients with respiratory, gastrointestinal, or constitutional symptoms about the use of e-cigarette, or vaping, products; 2) evaluating those suspected to have EVALI with pulse oximetry and obtaining chest imaging, as clinically indicated; 3) considering outpatient management for clinically stable EVALI patients who meet certain criteria; 4) testing patients for influenza, particularly during influenza season, and administering antimicrobials, including antivirals, in accordance with established guidelines; 5) using caution when considering prescribing corticosteroids for outpatients, because this treatment modality has not been well studied among outpatients, and corticosteroids could worsen respiratory infections; 6) recommending evidence-based treatment strategies, including behavioral counseling, to help patients discontinue using e-cigarette, or vaping, products; and 7) emphasizing the importance of annual influenza vaccination for all persons aged ≥6 months, including patients who use e-cigarette, or vaping products.


Assuntos
Surtos de Doenças , Lesão Pulmonar/terapia , Guias de Prática Clínica como Assunto , Vaping/efeitos adversos , Humanos , Lesão Pulmonar/epidemiologia , Estados Unidos/epidemiologia
2.
Am J Health Behav ; 38(5): 755-64, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24933145

RESUMO

OBJECTIVES: To explore women's knowledge, attitudes, and beliefs about adverse outcomes associated with smoking during pregnancy and which outcomes might motivate cessation; to explore reactions to graphic warnings depicting 2 adverse outcomes. METHODS: Twelve focus groups were conducted with women of childbearing age who were current smokers. RESULTS: Participants had low to moderate awareness of many outcomes and believed it was acceptable to smoke in the first trimester before knowledge of pregnancy. Perceived susceptibility to outcomes was low. Motivators included risk-focused information, especially serious risks to the baby (eg, stillbirth, SIDS). Graphic warnings produced strong reactions, especially the warning with a real photo. CONCLUSIONS: Despite barriers to reducing rates of smoking during pregnancy, educational information and photos depicting babies' risks could motivate women to quit.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Motivação , Gestantes/psicologia , Rotulagem de Produtos , Abandono do Hábito de Fumar/psicologia , Fumar/legislação & jurisprudência , Adulto , Feminino , Grupos Focais , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Fatores de Risco , Saúde da Mulher
3.
Am J Health Behav ; 37(5): 654-9, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23985288

RESUMO

OBJECTIVE: To assess current and former smokers' reactions to US warning labels as a baseline for comparison to new labels. METHODS: The mail-in Consumer-Styles survey was sent to a representative sample of US adult consumers in 2010 (N = 10,328). RESULTS: Among current smokers, 51.5% (95% CI: 47.5-55.5) reported that they had 'never/rarely' seen or looked closely at the labels in the past 30 days. Current smokers (91.1%) reported that warning labels never stopped them from having a cigarette (95% CI: 89.1-93.1) and that the labels had no effect on their likelihood of quitting (75.5%; 95% CI: 71.6-79.4). CONCLUSIONS: Current warning labels do not make smokers think about the risks of smoking or have an effect on their likelihood of forgoing cigarettes or quitting.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Rotulagem de Produtos , Fumar/psicologia , Adolescente , Adulto , Fatores Etários , Escolaridade , Grupos Étnicos/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Sexuais , Fumar/epidemiologia , Estados Unidos/epidemiologia
4.
Am J Health Behav ; 37(2): 248-56, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23026106

RESUMO

OBJECTIVE: To determine prevalence of smoking, quit ratios, and home smoking rules among Hispanics residing in colonias in El Paso, Texas. METHODS: Face-to-face interviews with 1485 Hispanic adults. GeoFrame™ field enumeration methods were used to develop a sampling frame from households in randomly selected colonias. RESULTS: The overall percent of current cigarette smoking was 14.6% (95% CI 12.4 to 16.8); Over 55% of smokers reported a serious quit attempt. Participants overwhelmingly reported that smoking was not allowed in their homes. CONCLUSIONS: Prevalence estimates for current smoking and restriction in the home were similar to those reported for recent national surveys.


Assuntos
Hispano-Americanos , Habitação , Abandono do Hábito de Fumar , Prevenção do Hábito de Fumar , Fumar/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Texas/epidemiologia , Adulto Jovem
5.
Am J Public Health ; 100 Suppl 1: S159-64, 2010 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-20147687

RESUMO

OBJECTIVES: We sought to modify an instrument and to use it to collect information on smoking knowledge, attitudes, beliefs, and behaviors among Hispanics/Latinos, and to adapt survey methods to obtain high participation levels. Methods. Promotoras (outreach workers) conducted face-to-face interviews with 1485 Hispanic adults (July 2007-April 2008). The project team used GeoFrame field enumeration methods to develop a sampling frame from households in randomly selected colonias (residential areas along the Texas-Mexico border that may lack some basic necessities (e.g. portable water), in El Paso, Texas. RESULTS: The revised questionnaire included 36 unchanged items from the State Adult Tobacco Survey, 7 modified items, and 17 new items focusing on possible culturally specific quitting methods, secondhand smoke issues, and attitudes and knowledge about tobacco use that might be unique for Hispanic/Latino groups. The eligibility rate was 90.2%, and the conservative combined completed screener and interview response rate was 80.0%. CONCLUSIONS: Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods.


Assuntos
Competência Cultural , Inquéritos Epidemiológicos , Inquéritos e Questionários/normas , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos , Humanos , Entrevistas como Assunto , Masculino , Fumar/epidemiologia , Texas/epidemiologia , Adulto Jovem
6.
Addict Behav ; 34(12): 1069-72, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19646820

RESUMO

Current cigarette smoking combined with ever use of other tobacco products (lifetime polytobacco use) is important to examine as users may be at greater risk for illicit drug use, nicotine addiction, and adverse health outcomes. We determined estimates and patterns of lifetime polytobacco use and conducted multivariable analyses to determine demographic, family and friend, psychosocial, and lifestyle factors associated with use among a sample of Canadian young adults. Overall prevalence was 36.3% for current cigarette use; 10.1% for current cigarette use only and 26.2% for lifetime polytobacco use. Among polytobacco users, current cigarette use and ever cigar use was most frequent (67.2%). For males, the final model contained demographic, family and friends, and lifestyle factors. For females, the final model also included psychosocial factors. Illicit drug use was the strongest significant predictor for lifetime polytobacco use among males. We found gender specific differences when comparing lifetime polytobacco users to current cigarette-only users, in particular; male lifetime polytobacco users were more likely to use drugs and alcohol. Interventions focusing on individual substances should consider addressing combinations of use.


Assuntos
Fumar/epidemiologia , Tabagismo/epidemiologia , Canadá/epidemiologia , Estudos de Coortes , Família , Feminino , Humanos , Estilo de Vida , Masculino , Grupo Associado , Fatores de Risco , Fatores Sexuais , Meio Social , Adulto Jovem
7.
Ethn Health ; 13(2): 171-82, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18425713

RESUMO

OBJECTIVE: In 2002, the First Conference on Menthol Cigarettes brought together researchers from diverse backgrounds to summarize what is known about menthol cigarettes and the people who smoke them, and to identify areas of needed research on menthol cigarettes. Since the conference, PubMed reports 24 articles, including the conference proceedings, on menthol cigarettes and African Americans. Many of the articles address epidemiological or biomedical topics. While there has been some focus on social influences and marketing issues, more research and a greater focus on this topic are needed. DESIGN: To stimulate research on a population disproportionately burdened by the health effects of smoking, we conducted small-group discussions in 2005 with adult African American smokers in Atlanta, Georgia. Each group discussion focused on a different topic: smoking behavior and preferences, perceptions of social influences, health effects and perceived harmfulness of menthol, quitting menthol cigarette smoking, or the influence of marketing and advertising of menthol cigarettes. RESULTS: Themes emerged from the discussions: (1) emulation of black culture by white youth and racial integration of neighborhoods and communities may have modified the perception that African Americans smoke menthol cigarettes and whites smoke non-menthol cigarettes; (2) non-menthol cigarette smokers were thought to be 'hardcore' smokers with less interest in quitting; (3) switching to non-menthol cigarettes was discussed as a way of quitting cigarettes for habitual menthol smokers; and, (4) smoking menthol cigarettes was thought to lead to fewer negative health effects. CONCLUSION: Some topics suggested by the participants warrant further investigation. More research is needed to assess the pervasiveness of these beliefs and their potential utility for smoking cessation interventions.


Assuntos
Afro-Americanos/psicologia , Aromatizantes , Mentol , Fumar/etnologia , Fumar/psicologia , Feminino , Georgia , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Entrevistas como Assunto , Masculino , Marketing , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Percepção Social
8.
Am J Health Behav ; 31(5): 526-34, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17555383

RESUMO

OBJECTIVE: To describe adult smokers' reactions to PREP print advertisements and promotional materials. METHODS: Focus groups with adult smokers. Participants reacted to print advertisements and promotional materials for Omni, Accord, Advance Lights, Ariva, and Eclipse. RESULTS: Images and text in PREP product advertising and promotional materials influence participants' decision to try PREPs. Participants believed the PREP ads target smokers who are trying to quit or smokers who are health conscious. CONCLUSION: Tracking and monitoring the reactions of smokers to novel products, their perceptions about them, and their use of these products are necessary for the design of effective health communication strategies.


Assuntos
Atitude Frente a Saúde , Fumar/psicologia , Indústria do Tabaco , Tabaco sem Fumaça , Adulto , Tomada de Decisões , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Fumar/efeitos adversos , Abandono do Hábito de Fumar/psicologia , Tennessee , Texas , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/prevenção & controle
9.
Prev Chronic Dis ; 4(2): A27, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17362618

RESUMO

INTRODUCTION: For the past 20 years, there have been no changes to the text-only cigarette warning labels in the United States. During this same time period, other countries placed large graphic warning labels on cigarette packages. The purpose of this study was to investigate the reactions of U.S. young adult smokers and nonsmokers aged 18 to 24 years to Canadian cigarette label text and graphic warnings. The study focused on determining their perceptions and the potential impact of Canadian labels on smoking, and study participants were asked for suggestions for modifications of U.S. cigarette warning labels so they would be effective for smoking deterrence and cessation. METHODS: During January and February 2002, 11 focus groups consisting of 54 smokers and 41 nonsmokers were conducted in the Detroit metropolitan area. Current smokers were defined as those who had smoked a cigarette within the past 30 days. Participants were asked about their knowledge and perceptions of current U.S. cigarette warning labels and their impressions of Canadian cigarette warning labels. ANALYSIS: A content analysis and a word index were applied to the transcripts of all focus groups to identify and clarify themes and domains that appeared in group discussions and to compare results across different groups. RESULTS: Focus group participants reported that Canadian cigarette warning labels were more visible and informative than U.S. cigarette warning labels. Messages perceived to be relevant to smokers were considered effective. Education level did not appear related to how participants responded to warning labels. There were some differences for warning labels that had sex-specific messages. DISCUSSION: Warning labels are one component of comprehensive tobacco control and smoking cessation efforts. Stronger warnings on cigarette packages need to be part of a larger U.S. public health educational effort.


Assuntos
Educação em Saúde/métodos , Rotulagem de Produtos , Fumar/efeitos adversos , Percepção Social , Adolescente , Adulto , Canadá , Feminino , Grupos Focais , Humanos , Masculino , Michigan , Prevenção do Hábito de Fumar , Estados Unidos
10.
Am J Health Behav ; 30(3): 302-12, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16712444

RESUMO

OBJECTIVE: To explore risk perceptions of traditional and nontraditional tobacco products (NTPs) among young adult smokers. METHODS: Focus groups with African Americans, non-Hispanic whites, and Hispanics. Risk ratings of light, regular, and menthol cigarettes and of NTPs and marijuana and cigarettes were compared. RESULTS: Participants tended to view light cigarettes as safer than regular cigarettes. Shisha and herbal products were rated as safer than traditional cigarettes, but there were differences in ratings by race/ethnicity, related to preferred cigarette variety. CONCLUSIONS: Health communication messages about the use of cigarettes and NTPs should consider risk perceptions about the products and racial/ethnic differences.


Assuntos
Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Fumar Maconha/efeitos adversos , Fumar/efeitos adversos , Tabaco/efeitos adversos , Adulto , Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Exercício/psicologia , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos/psicologia , Humanos , Fumar Maconha/epidemiologia , Fumar Maconha/etnologia , Fumar Maconha/psicologia , Medição de Risco , Fumar/epidemiologia , Fumar/etnologia , Fumar/psicologia , Fatores Socioeconômicos , Tennessee , Texas
11.
Am J Prev Med ; 30(6): 467-73, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16704939

RESUMO

BACKGROUND: In 1984, the United States Congress enacted legislation requiring four new warning labels for cigarettes; warning labels in the United States have not changed since then. Other countries, such as Canada, have taken a more active and aggressive approach. The purpose of this study was to examine how U.S. smokers and former smokers might respond to stronger and more graphic warnings for U.S. cigarettes packages. METHODS: Data were collected in 2003 and analyzed in 2004. The perceived impact and effectiveness of the more-explicit Canadian labels was examined among young adult smokers (n=572) and former smokers (n=191) between the ages of 18 and 24 years in the United States, using a web-based survey that allowed participants to view both the text-only and the text-plus-graphic warning labels. RESULTS: Both current and former smokers thought that cigarette warning labels with text plus graphics were substantially more of a deterrent than text-only labels. The perceived effectiveness of these labels was not only higher overall, but also for the specific areas of smoking-related health effects, prevention, cessation, and maintenance of abstinence. Few differences were noted by gender. CONCLUSIONS: The findings from this study support previous research that has found that text-plus-graphic warning labels are more salient and potentially more effective than text-only labels.


Assuntos
Rotulagem de Produtos/métodos , Fumar/efeitos adversos , Adolescente , Adulto , Feminino , Humanos , Masculino , Fumar/psicologia , Prevenção do Hábito de Fumar , Inquéritos e Questionários , Estados Unidos
12.
Can J Public Health ; 96(5): 353-6, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16238153

RESUMO

BACKGROUND: Since 1989 when health warning labels appeared on Canadian cigarette packages, the labels have changed from text only covering less than one quarter of the package to text and graphics covering over half the package. This study examines how Canadians in their 20s feel about the current graphic warning labels and their potential to prevent smoking and encourage quitting. METHODS: Participants between 20 and 24 years of age were part of a 10-year cohort study begun when the group was in Grade 6, with the purpose of examining factors that may affect smoking. Five questions about warning labels were added to the 2002 questionnaire requesting information on perceptions of the labels and their potential impact on smoking behaviours of young adults. One item had been included in previous questionnaires. RESULTS: 32.8% (n = 1267) of the respondents were smokers, with males (35.6%) being more likely to smoke than females (30.4%). Current smokers were less likely than experimental/ex-smokers to believe that warning labels with stronger messages would make people their age less likely to smoke. Female current smokers were more likely to think about quitting. CONCLUSION: Despite the efforts taken in developing the labels, some young adults are skeptical about their effects. Warning labels may have to be modified to target issues that are relevant to young adults; gender differences are important in this modification. Warning labels can offer an additional component to a comprehensive tobacco control program, in that they provide health information.


Assuntos
Atitude Frente a Saúde , Promoção da Saúde , Rotulagem de Produtos/legislação & jurisprudência , Assunção de Riscos , Fumar/efeitos adversos , Percepção Social , Adulto , Feminino , Regulamentação Governamental , Humanos , Masculino , Ontário , Medição de Risco , Fatores de Risco , Prevenção do Hábito de Fumar , Inquéritos e Questionários
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