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Biomedical subjects

Andrew Hyland

Publications and source records attributed to Andrew Hyland.

At least 37 records · Page 2Linked to original sources
PubMed2004

Obtaining DNA from a geographically dispersed cohort of current and former smokers: use of mail-based mouthwash collection and monetary incentives.

The feasibility of collecting DNA through the mail from a cohort of current and former smokers was assessed. Also examined was whether monetary incentives would increase response rates. A random sample of 300 subjects, stratified by 20 U.S. communities, was selected to participate. The sampling frame included the 6,726 people who were in both the Community Intervention Trial for Smoking Cessation (COMMIT) between 1988 and 1993 and the follow-up study in 2001, and who consented to being contacted again. Subjects were further randomized within communities to incentive arms of 10 US dollars, 2 US dollars, or 0 US dollars. A total of 110 usable samples were returned (37%), and the 10 US dollars incentive arm had the highest response (43%). Logistic regression revealed no significant predictors of sending a DNA sample, although in a larger study, similar-sized odds ratios would be statistically significant for subjects who received the 10 US dollars incentive and for those who were White, female, or college graduates or whose household incomes were more than 60,000 US dollars per year. The spectrophotometer-determined median DNA yield was 44.93 microg (range=4.00-425.86 microg). Assuming that 50 ng of DNA would be needed for polymerase chain reaction amplification to determine any given genotype, 80-8,517 runs would be attainable. Qualitative findings suggest several methodological improvements to boost response rates. Institutional review board requirements, which are standardized on the inpatient, clinical protocol model, stipulated that noninstitutionally based subjects needed a witness to initial and date every page as well as sign the consent form. This pilot study showed that this requirement could pose some challenges in population-based research.

Adult↗
PubMed2004

Do smokers want to know more about the cigarettes they smoke? Results from the EDUCATE study.

The present study (a) assessed smokers' receptivity to receiving information about the product features of their cigarette brand, (b) tested whether the use of targeted (personalized), brand-specific information affected participants' attention to the information, and (c) tested whether attention to the targeted information affected participants' beliefs about the product features and their smoking behavior. The study population included current cigarette smokers who called the New York State Smokers' Quit Line seeking assistance to stop smoking in February and March 2003. Subjects were randomized to one of three experimental groups. Group 1 received telephone counseling and the quit line's stop-smoking booklet, which included information on ingredients found in cigarettes. Group 2 received the same intervention as Group 1 plus a basic brochure with a generic cover. Group 3 received the same intervention as Group 2 except that the cover to the brochure was targeted to individual cigarette brand and type. All smokers who called the quit line were receptive to receiving information about their cigarette brand. In a 6-week follow-up interview, 60% of those who received the targeted product information brochure recalled receiving it vs. 51% of those who received the identical guide with the nontargeted cover. Recall of the material discussed in the brochure was slightly higher (not statistically significant) among subjects who received the brochure with the targeted cover compared with the same brochure with a basic cover. Regardless of whether the brochure was targeted, smokers' beliefs about different product features or their smoking behavior were not affected measurably, although those who reported reading some or all of the brochure had higher levels of awareness regarding low-tar, filtered, and no-additive cigarettes. Smokers are receptive to receiving information about their cigarette brand, but either persistent efforts or possibly more potent interventions to personalize the information are needed to ensure that they recall information about the cigarette brand they smoke.

Adult↗
PubMed2004

Stop-smoking medications: who uses them, who misuses them, and who is misinformed about them?

This study assessed smokers' beliefs about nicotine and the safety of nicotine medications and examined how these beliefs influence the use of nicotine medications. The data for this paper came from a nationally representative, random-digit-dialed telephone survey of 1,046 adults (18 years of age and older) current cigarette smokers conducted between May and September 2001. Respondents were questioned about their use of stop smoking medications, beliefs about nicotine, and the safety/efficacy of nicotine medications. Nearly all adult smokers in our survey had heard of nicotine patches (97%) or gum (94%), with lower levels of awareness reported for the nicotine inhaler (41%), and nasal spray (9%). Thirty-eight percent of smokers had previously used nicotine medications, with the nicotine patch being the most commonly used medication. The data reveal that most smokers are misinformed about the health risks of nicotine and the safety/efficacy of nicotine medications. Approximately half incorrectly reported that the reduction in nicotine in cigarettes has made cigarettes less dangerous to health and only one-third correctly reported that nicotine patches were less likely to cause a heart attack than smoking cigarettes. Smokers who were more knowledgeable about the health risks of nicotine and the safety and efficacy of nicotine medications were more likely to report past use of nicotine medications. Misperceptions about the health risks of nicotine and the safety/efficacy of nicotine medications may discourage some smokers from considering the use of these medications to help them stop smoking.

Adult↗
PubMed2004

What do Marlboro Lights smokers know about low-tar cigarettes?

The present study examined the extent to which Marlboro Lights smokers perceive lower health risks associated with using a low-tar cigarette and the extent to which they are aware of filter vents in their cigarettes. The data for this study came from a nationally representative random-digit-dialed telephone survey of 1,046 adult current cigarette smokers (aged 18 years or older) conducted between May and September 2001. Respondents were asked about the brand and type of cigarettes smoked, beliefs about the health benefits associated with low-tar and filtered cigarettes, and awareness of ventilation holes in the filters of their cigarettes. Marlboro Lights was the most popular brand, smoked by 19% of survey respondents. Only 32% of Marlboro Lights smokers reported that the filters on their cigarettes were ventilated. Many Marlboro Lights smokers believed incorrectly that lower tar, light, and ultra-light cigarettes were less harmful compared with higher tar, full-flavored cigarettes. For example, only 11% of Marlboro Lights smokers knew that the tar delivery of a light cigarette was about the same as that of a full-flavored cigarette. The responses of Marlboro Lights smokers to questions about the hazards of low-tar cigarettes were similar to those expressed by smokers of other cigarette brands. The data presented in this paper reveal that smokers of the leading light cigarette brand sold in the United States today, Marlboro Lights, are for the most part unaware of filter vents in the cigarettes they smoke and are misinformed about the health risk of using low-tar and filtered cigarettes.

Adult↗
PubMed2004

Are smokers adequately informed about the health risks of smoking and medicinal nicotine?

The present study assessed smokers' beliefs about the health risks of smoking and the benefits of smoking filtered and low-tar cigarettes, and their awareness of and interest in trying so-called reduced-risk tobacco products. Results were based on a nationally representative random-digit-dialed telephone survey of 1,046 adult (aged 18 years or older) current cigarette smokers. Data were gathered on demographic characteristics, tobacco use behaviors, awareness and use of nicotine medications, beliefs about the health risks of smoking, content of smoke and design features of cigarettes, and the safety and efficacy of nicotine medications. In addition, respondents were asked about their interest in and perceived ability to stop smoking and about their desire for more information about the health risks of smoking. Smokers were least knowledgeable about low-tar and filter cigarettes (65% of responses were incorrect or "don't know") and most knowledgeable about the health risks of smoking (39% of responses were incorrect or "don't know"). The smokers' characteristics most commonly associated with misinformation when all six indices were combined into a summary index were as follows: those aged 45 years or older, smokers of ultralight cigarettes, smokers who believe they will stop smoking before they experience a serious health problem caused by smoking, smokers who have never used a stop-smoking medication, and smokers with a lower education level. Those who believed they would stop smoking in the next year were more knowledgeable about smoking. Some 77% of respondents reported a desire for additional information from tobacco companies on the health dangers of smoking. The present findings demonstrate that smokers are misinformed about many aspects of the cigarettes they smoke and stop-smoking medications and that they want more information about ways to reduce their health risks.

Adult↗
PubMed2004

Predictors of cessation in a cohort of current and former smokers followed over 13 years.

The present study attempted to identify predictors of smoking cessation in a cohort of cigarette smokers followed over 13 years. Data are reported on 6,603 persons who resided in one of 20 U.S. communities involved in the National Cancer Institute's Community Intervention Trial for Smoking Cessation (COMMIT) study, were current smokers in the COMMIT trial in 1988, and completed detailed tobacco use telephone surveys in 1988, 1993, and 2001. A person was classified as a former smoker if at the time of follow-up he or she reported not smoking for at least 6 months prior to the interview. Reasons and methods for quitting also were assessed in 1993 and 2001. Among smokers in 1988, 24% had stopped smoking by 1993 and 42% were not smoking by 2001. The most frequently cited reasons for quitting were health and cost reasons, while assisted methods to quit were more common in more recent years. Measures of nicotine dependence were much more strongly associated with cessation than measures of motivation. Other predictors included male gender, older age, higher income, and less frequent alcohol consumption, although the gender effect no longer existed when cessation from cigarettes as well as other tobacco products was considered as the outcome. The present study shows that nicotine dependence is a major factor predicting long-term cessation in smokers. This finding has implications for tobacco control policy and treatment approaches.

Adult↗
PubMed2004

The relative risks of a low-nitrosamine smokeless tobacco product compared with smoking cigarettes: estimates of a panel of experts.

A nine-membered panel of experts was asked to determine expert opinions of mortality risks associated with use of low-nitrosamine smokeless tobacco (LN-SLT) marketed for oral use. A modified Delphi approach was employed. For total mortality, the estimated median relative risks for individual users of LN-SLT were 9% and 5% of the risk associated with smoking for those ages 35 to 49 and > or =50 years, respectively. Median mortality risks relative to smoking were estimated to be 2% to 3% for lung cancer, 10% for heart disease, and 15% to 30% for oral cancer. Although individual estimates often varied between 0% and 50%, most panel members were confident or very confident of their estimates by the last round of consultation. In comparison with smoking, experts perceive at least a 90% reduction in the relative risk of LN-SLT use. The risks of using LN-SLT products therefore should not be portrayed as comparable with those of smoking cigarettes as has been the practice of some governmental and public health authorities in the past. Importantly, the overall public health impact of LN-SLT will reflect use patterns, its marketing, and governmental regulation of tobacco products.

Adult↗
PubMed2003

Switching to lower tar cigarettes does not increase or decrease the likelihood of future quit attempts or cessation.

This study examined whether switching to low-tar cigarettes predicts future quit attempts or smoking cessation. Prior studies of whether switching to low-tar cigarettes increases or decreases cessation behavior have produced contradictory results. We believed a large, prospective population-based study was needed. Participants in the Community Intervention Trial for Smoking Cessation (COMMIT), who were smokers in 1989 and 1991 and provided their smoking status in a 1993 interview, provided product code information so that the tar categories of their cigarettes could be identified. Smokers' brands were classified as ultralight (0-6 mg tar), light (7-15 mg tar), and regular (16+ mg tar). The main predictor measure was switching to a lower tar yield category: 8% of baseline light smokers and 19% of baseline regular smokers switched to a lower yield product between 1989 and 1991. The main outcome measures were attempts to quit and successful 6-month cessation. Despite greater desire to quit among switchers, switching down was not associated with increased or decreased number of attempts to quit or the likelihood of future cessation. No evidence of differential effects was found for subgroups of smokers, including those who did and did not believe that low-tar cigarettes are safer. The data show that switching to a low-tar cigarette does not appear to increase or decrease the likelihood of future cessation, though motivation to stop smoking may be associated with switching.

Adult↗
PubMed2003

Nurse practitioners' knowledge, practice and attitudes about tobacco cessation & lung cancer screening.

PURPOSE: To determine nurse practitioners' (NPs') knowledge, practice, and attitudes about tobacco cessation counseling and lung cancer early detection. DATA SOURCE: A descriptive, cross-sectional survey design was used to examine NPs' approaches to primary and secondary prevention of tobacco use among patients in western New York. CONCLUSIONS: Among the 175 respondents, NPs appropriately counseled tobacco users on tobacco cessation. However, there was limited understanding of first-line pharmacological agents used for tobacco cessation and of how to manage treatment for a patient at high risk for lung cancer. IMPLICATIONS FOR PRACTICE: These findings suggest the need to implement professional educational programs aimed at conveying not only the importance of tobacco cessation counseling but also information on the most effective first-line pharmacological agents and appropriate management options for patients at increased risk of developing lung cancer.

Adult↗
PubMed2003

Is the prevalence of youth smoking affected by efforts to increase retailer compliance with a minors' access law?

This study correlated measures of youth smoking behavior with community-level indicators of retailer compliance with a minors' tobacco access law. The study was carried out between 1992 and 1996 in 12 communities in Erie County, New York. Retailer compliance was assessed by having adolescents attempt to purchase tobacco products in licensed tobacco-selling outlets in fall 1994 and fall 1995 after implementation of an aggressive enforcement program. Communities were grouped in two ways: (a) those that did or did not increase retailer compliance rates by 200% or more between 1994 and 1995 and (b) those that did or did not achieve an 80% retailer compliance rate in 1995. School-based surveys conducted in 1992 and 1996 assessed the tobacco use behaviors of ninth-grade public school students. Between 1994 and 1995, retailer compliance increased in all 12 communities by an average of 155%. In 1995, six of the 12 communities achieved retailer compliance rates in excess of 80%. Indicators of youth smoking behavior did not vary significantly between communities that increased their retailer compliance rates by more or less than 200%. The prevalence of past 30-day smoking remained stable between 1992 and 1996 in the six communities that achieved a retailer compliance rate of at least 80% and increased slightly in the remaining communities. The prevalence of frequent smoking decreased between 1992 and 1996 in the communities that achieved a retailer compliance rate of at least 80% and increased slightly in the six communities that failed to achieve this rate. Achieving a high rate of retailer compliance with a minors' access law appears to have caused youths to rely more on noncommercial sources of cigarettes and may have had a small effect on adolescent smoking prevalence, especially frequent smoking.

Adolescent↗
PubMed2002

Provider case volume and outcome in the evaluation and treatment of patients with mammogram-detected breast carcinoma.

BACKGROUND: Practice volume may affect the outcome of patients with breast carcinoma. Defining factors that influence the relation of volume and outcome for the diagnosis and treatment of breast carcinoma is important, because breast carcinoma is common, and care is decentralized. METHODS: Community-wide diagnosis and treatment of mammogram-detected breast carcinoma was examined using claims data from a single insurer representing 25% of the regional population. Among 1001 mammogram-directed breast biopsies, the rate of breast carcinoma diagnosed by stereotactic core needle biopsy (SCNB) or excisional biopsy with needle localization (EBNL) and the rate at which breast-conserving surgery (BCS) was used were analyzed. Outcome and practice volume were examined for surgeons, radiologists, and medical centers. RESULTS: Two hundred twenty-four tumors were diagnosed by EBNL (604 diagnoses) and SCNB (397 tumors), for a 22.4% positive biopsy rate. The median number of procedures per physician was one. Positive biopsy rates for radiologists, surgeons, and medical centers did not correlate with practice volume. Positive biopsy rates for high-volume physician providers and medical centers ranged from 9% to 46%. The BCS rate was 45% and 64% for surgeons treating one or more than one claim, respectively. Tumor stage and surgeon case volume were the only independent predictors of BCS (P < 0.05). CONCLUSIONS: There is wide variation in diagnosis and treatment outcomes for patients with mammogram-detected breast carcinoma. Overall, practice volume was correlated with the use of BCS but not with the rate of positive biopsy. A wide variation in the positive biopsy rate among high-volume providers and medical centers suggests that volume of practice is not a surrogate for quality in the diagnosis of breast carcinoma.

Biopsy↗
PubMed2002

Prognostic significance of molecular genetic aberrations on chromosome segment 11p15.5 in non-small-cell lung cancer.

PURPOSE: The assessment of prognosis and decisions on treatment for patients with non-small-cell lung cancer (NSCLC) are determined on the basis of disease stage and performance status. NSCLC frequently manifests loss of heterozygosity (LOH) at chromosome segment 11p15.5. Whether LOH at 11p15.5 is an independent prognostic variable has yet to be determined. PATIENTS AND METHODS: We developed five novel markers, which can be assessed by polymerase chain reaction and restriction enzyme digestion. LOH at 11p15.5 was assessed in 193 patients who underwent surgical resection for pathologic stage I and II of the disease. RESULTS: LOH at 11p15.5 was associated with poor survival (P =.021). Multivariate logistic regression analysis showed that after disease stage, performance status, weight loss, sex, age at diagnosis, and smoking history were controlled for, patients with LOH were two times more likely to die than those without LOH (relative risk [RR] = 2.01, P =.021). Cox regression analysis with disease stage and LOH revealed that the survival of patients with stage I disease and LOH was similar to the survival of patients with stage II disease, and it was significantly worse than the survival of stage I patients without LOH (RR = 2.38, P =.038). CONCLUSION: LOH in a 310-kb region on chromosome segment 11p15.5 that includes the gene for the regulatory subunit of the enzyme ribonucleotide reductase is highly predictive of poor survival from NSCLC. The future utility of analysis of the allelic status of this region may involve treatment decisions, such as the use of neoadjuvant and adjuvant chemotherapy for patients with stage I disease.

Carcinoma, Non-Small-Cell Lung↗
PubMed2002

The effect of a smoke-free law on restaurant business in South Australia.

BACKGROUND: Despite evidence to the contrary from overseas research, the introduction of smoke-free legislation in South Australia (SA), which required all restaurants to go smoke-free in January 1999, sparked concerns among the hospitality industry about loss of restaurant business. This study aimed to determine whether the law had a detrimental impact on restaurant business in SA. METHODS: Using time series analysis, we compared the ratio of monthly restaurant turnover from restaurants and cafés in SA to (a) total retail tumover in SA (minus restaurants) for the years 1991 to 2001 and (b) Australian restaurant tumover (minus SA, Westem Australia and the Australian Capital Territory) for the years 1991-2000. RESULTS: There was no decline in the ratio of (a) SA restaurant turnover to SA retail turnover or (b) SA restaurant tumover to Australian restaurant turnover. CONCLUSION: The introduction of a smoke-free law applying to restaurants in SA did not adversely affect restaurant business in SA.

Commerce↗
PubMed2002

Evaluation of smoke-free dining in South Australia: support and compliance among the community and restaurateurs.

OBJECTIVES: To evaluate the impact of smoke-free dining legislation introduced in South Australia on 4 January 1999. Specifically, to determine changes in public support and support among the restaurant and cafe industry; to determine changes to self-reported experiences of dining out; and to assess compliance with the legislation. METHODS: A series of independent, representative, cross-sectional surveys were undertaken over time. Study 1: 3000+ South Australians, aged 15 and over, were interviewed about opinions of the legislation and about dining out, in an annual household survey in October-November in 1997, 1998 and 1999. Study 2: 500+ owners and managers of public dining venues were interviewed about their opinions about and experiences of the legislation in face-to-face surveys in May-June 1999 and July 2000. RESULTS: Study 1: Public support for smoke-free dining increased from 73.4% in 1997 to 84.2% in 1999. In 1999, 60.2% reported the ban had made dining out more enjoyable and 35.1% indicated no difference. Study 2: 88.2-92.3% of restaurants were complying with the legislation at five months and 95.7-99.6% at 18 months. In 2000, 82% of restaurateurs reported that they had spent no money in order to implement the law. CONCLUSIONS AND IMPLICATIONS: Smoke-free dining in South Australia is popular and has resulted in increased perceived enjoyment for patrons. The legislative change has apparently been adhered to by both the majority of restaurateurs and customers, and was inexpensive for restaurateurs to implement. Smoke-free dining legislation can be implemented with confidence.

Attitude to Health↗