Biomedical subjects

Joanna E Cohen

Publications and source records attributed to Joanna E Cohen.

9 recordsLinked to original sources

PubMed2006

The Heaviness of Smoking Index as a predictor of smoking cessation in Canada.

Nicotine addiction is believed to be a major impediment for many people in quitting smoking, but measures of nicotine dependence such as the Heaviness of Smoking Index (HSI) have had mixed success in predicting cessation. Using the National Population Health Survey, the relationship between HSI at baseline in cycle 2 (1996-1997) and successful smoking cessation at cycle 3 (1998-1999) and cycle 4 (2000-2001) was examined in 2938 Canadian adult smokers. A logistic regression model was developed for HSI as a predictor of smoking cessation, and then tested for interaction and confounding. The odds ratio of not smoking in cycle 3 was 2.08 (95% CI: 1.51, 2.86; p<0.001) for low HSI (<2) compared to medium HSI. When the period of follow-up was extended, individuals with both high (>4) HSI scores (OR 2.16; 95% CI: 1.11, 4.21; p=0.02) and low scores (OR 2.22; 95% CI: 1.41, 3.49) had higher odds of not smoking at both cycle 3 and cycle 4 than those with medium HSI scores. The likelihood of reporting cessation was higher than expected in the Canadian population among highly dependent smokers, particularly among older smokers, those with middle or greater income adequacy, and those with no intention to quit smoking. There were no substantial changes to the results when those lost-to-follow-up were treated as continuing smokers. These findings indicate that nicotine dependence is only one factor in succeeding at a quit attempt. Individual and population strategies for smoking cessation may need to consider other influences such as cognitive, affective and environmental factors.

Adolescent↗

PubMed2002

Predictors of Canadian legislators' support for tobacco control policies.

It is clear that regulatory strategies can be effective in reducing tobacco use. Because legislators ultimately determine whether many of these policies are enacted, they are a key focus for tobacco policy research. This study identifies political and personal predictors of Canadian legislators' support for tobacco control policies. Data are from a 1996-97 survey of federal, provincial and territorial legislators. Multivariate regression analysis was used to assess relationships between five groups of variables (political factors including political ideology, personal characteristics, tobacco experiences, tobacco knowledge, interest group saliency) and support for tobacco control based on an 11-item scale. Support for tobacco control varied by political party. Support was higher among legislators who thought government had a duty to promote healthy lifestyles, knew second-hand smoke could cause lung cancer, knew tobacco caused more deaths than alcohol, and said they wanted more contact with medical associations about tobacco issues. Support was lower among current smokers and those with tobacco industry jobs in their ridings. The findings indicate that political party membership cannot be ignored in enlisting legislator support for tobacco control. It also appears that legislators who oppose tobacco control measures may not be opposed to tobacco control per se, but are more generally opposed to a government role in health promotion. Thus, public health professionals and tobacco control advocates need to be more attentive to the way tobacco control issues are framed for particular legislators. Further, meetings with health groups about tobacco issues would be welcomed by many legislators; non-governmental organizations and other health advocates could work to increase tobacco knowledge among legislators.

Attitude to Health↗

PubMed2002

Tobacco harm reduction: a call to address the ethical dilemmas.

The 2001 Institute of Medicine report Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction has helped to focus attention on the scientific basis for assessing tobacco harm reduction products. As the tobacco research and policy communities tackle the challenges of evaluating harm reduction, there are ethical issues that must also be addressed. There has, however, been very little writing on the ethics of this field. In an effort to spur research into answering these ethical questions, we present two complementary approaches. First we outline three overarching topics in tobacco harm reduction that would particularly lend themselves to study: (a) Is the pursuit of tobacco harm reduction an ethical goal? (b) What are the ethical considerations of tobacco harm reduction vis-à-vis pharmaceutical companies? and (c) What are the ethical considerations for harm reduction vis-à-vis tobacco companies? We then present one possible framework for analyzing the ethical issues that accompany particular tobacco harm reduction strategies. By considering the ethical dilemmas attendant to tobacco harm reduction in a prospective and thoughtful manner, we will be better prepared to handle the challenges that face us individually as researchers and collectively as a tobacco control community.

Drug Industry↗

PubMedDate not supplied

Is 'stage of change' related to knowledge of health effects and support for tobacco control?

We examine the heterogeneity among current and former smokers categorized by 'stage of change' with respect to their perceptions about tobacco and tobacco control. Current and former smokers (n = 846) from a general population sample of adults in Ontario, Canada, were subdivided according to the stages of change categories (precontemplation, contemplation, preparation, action, maintenance, and termination) and compared on measures of knowledge, attitudes, and support. Multivariate analyses were conducted adjusting for sociodemographic covariates. Adjusted overall increases across the six stages were observed for seven of eight knowledge items and for all attitude and support items. Among current smokers, adjusted increases across the three stages were detected for a majority of items. However, statistically significant differences from one stage to the next, across all three current smoker stages, were detected only for one item. Among former smokers, adjusted increases across the three stages were observed for a minority of items. The stages of change classification was useful for differentiating subgroups of current smokers with regard to knowledge, attitudes, and support for tobacco control measures.

Adolescent↗

PubMedDate not supplied

The relationship between body weight perceptions, weight control behaviours and smoking status among adolescents.

OBJECTIVES: This paper examines the relation between body weight perceptions, weight control behaviours and smoking status among a representative sample of Ontario students. METHODS: Bivariate and multivariate logistic regression analysis was used to evaluate the association between smoking status and perception of being overweight, and between smoking status and specific weight control behaviours. RESULTS: Among females, the odds of being a smoker were significantly higher among those who perceived themselves to be overweight and who had employed weight control behaviours in the last 12 months. Among males, the adjusted odds of being a smoker was higher only among those who skipped meals in the past 12 months. CONCLUSIONS: Body weight perceptions and the use of weight control behaviours were significantly associated with predictors of smoking among adolescent females. This suggests a need to incorporate discussion on body weight perception and body image in smoking prevention and cessation programs targeted toward adolescent females.

Adolescent↗

PubMedDate not supplied

The early 1990s cigarette price decrease and trends in youth smoking in Ontario.

BACKGROUND: Youth are especially vulnerable to fluctuations in cigarette price, and both the smuggling increase during the early 1990s and the 1994 tax decrease made purchasing easier for youth. The purpose of this study is to examine the relation between these price decreases, and trends in smoking prevalence and amount smoked among Ontario youth. METHODS: Data from the Ontario Student Drug Use Survey were analyzed for trend using: 1) polynomial regression, and 2) discontinuity regression with an "event time" of 1993 to capture effects of both pre-tax cut smuggling and the tax cut. RESULTS: Overall, smoking prevalence decreased from 1977 to 1993, jumped upward at this time, and decreased after 1993. Among daily smokers, mean number of cigarettes smoked daily showed an increase followed by a decrease over the 24 years, and a negative quadratic trend. Trends for subgroups are also reported. CONCLUSIONS: These findings suggest that the early 1990s cigarette price decrease may have played a role in increasing youth smoking in Ontario.

Adolescent↗

PubMedDate not supplied

Support for tobacco control policies: how congruent are the attitudes of legislators and the public?

OBJECTIVES: To examine the congruence in perceptions and attitudes of legislators and the public regarding tobacco and tobacco control policies. METHODS: Two cross-sectional surveys were used, one of elected federal and provincial legislators and one of adult residents in Ontario, Canada. Perceptions and attitudes were analyzed as dependent variables using multiple logistic regression, and adjusted for age, sex, educational attainment, and smoking status. FINDINGS: Congruence was found in most instances, however, some differences were found. Legislators were more likely than the public to agree that most smokers are addicted and were more supportive of a smoking ban in workplaces, but these differences disappeared after controlling for socio-demographic characteristics. Legislators were also more aware than the public of the magnitude of deaths due to tobacco compared to alcohol, whereas the public was more supportive of strong penalties against stores that sell cigarettes to minors. CONCLUSIONS: Our findings provide considerable evidence for congruence in the "real-world" (unadjusted) perceptions and attitudes of Ontario legislators and the Ontario public toward tobacco control policies. Such findings are positive for tobacco control advocates and should be leveraged to bring forward strong tobacco policies in the political arena.

Adult↗

PubMedDate not supplied

Tobacco industry links to faculties of medicine in Canada.

BACKGROUND: The tobacco industry uses various strategies to promote itself as a socially responsible, ethical industry, including establishing links with health institutions and medical research. The purpose of this study was to identify the relationships between the tobacco industry and Canadian faculties of medicine, specifically research funding and donations from tobacco industry sources, and faculty-specific policies regarding the acceptance of tobacco industry funds. METHODS: Information about policies and practices regarding research funding and donations from 1996-1999 was requested from the 16 Canadian faculties of medicine and their parent universities, as part of a larger cross-sectional survey-centred study that examined links between the tobacco industry and Canadian universities. RESULTS: All 16 faculties of medicine (100%) reported on research funding and 11/16 (70%) reported on donations from the tobacco industry. Twenty-five percent (4/16) of the faculties received research funding from the tobacco industry and 27% (3/11) received donations. No Canadian medical school had a policy that banned tobacco industry research funding or donations. INTERPRETATION: The tobacco industry have made donations and given research funding to faculties of medicine in Canada. This may present major conflicts of interest that undermine public health and have implications for the scientific integrity of the medical research enterprise. Faculties of medicine should consider developing policies that prohibit tobacco industry research funding and donations, with the intent of preventing conflicts and precluding ethical dilemmas arising from links with the tobacco industry. They should also encourage parent universities to establish similar policies at an institutional level.

Attitude of Health Personnel↗

PubMedDate not supplied

Youth attitudes towards tobacco control: a preliminary assessment.

The attitudes of Ontario youth toward the sale and price of cigarettes, making smoking against the law, and tobacco company truthfulness were assessed in 2001 and compared to adult attitudes in 2000 and youth attitudes in 2003. Youth were more supportive of restricting cigarette sales and raising prices than adults, and more likely to agree that the government should make smoking against the law, but they were less distrustful of tobacco companies. In 2003, youth were more supportive of sales restrictions and making smoking illegal, and more distrustful of tobacco companies, than in 2001. More comprehensive assessments and continued monitoring of youth attitudes are needed.

Adolescent↗