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PubMed2006

Continuation of smoking cessation and following weight change after intervention in a healthy population with high smoking prevalence.

Smoking prevalence among males is conspicuously high in Asian countries including Japan. There are few prospective intervention studies on the duration of smoking cessation within regions with a high prevalence of smokers, such as Asia. We investigated the extent to which subjects continued abstaining from smoking after receiving smoking cessation support provided for all smokers in an occupational setting, regardless of their willingness to quit smoking. The subjects were 251 male workers who were smokers and had received a smoking cessation intervention in 1997 in an occupational setting. Smoking cessation rates and body mass index (BMI) at 10, 18, 30, 42, 54, and 66 months after the initial intervention were confirmed during annual health check-ups. Those who quit smoking following the intervention and continuously abstained from smoking throughout the study period were separately examined for BMI. After five years, 10.6% of the smokers continued smoking cessation. Of the abstainers who quit following the intervention, the abstinence rate decreased in the first and second year, but it stabilized at approximately 45% after the third year. High nicotine dependence and a self-reported lack of willingness to quit smoking did not lower long-term abstinence rates. Abstainers initially gained 1.55 BMI on average, but decreased the weight gain to 0.96 BMI over six years. Introducing smoking cessation support without nicotine replacement therapy is an effective long-term strategy in a healthy population with a high smoking prevalence. Abstainers maintain their smoking cessation if they refrain from smoking for three years.

Adult↗
PubMed2005

Exposure to movie smoking: its relation to smoking initiation among US adolescents.

OBJECTIVE: Regional studies have linked exposure to movie smoking with adolescent smoking. We examined this association in a representative US sample. DESIGN/METHODS: We conducted a random-digit-dial survey of 6522 US adolescents aged 10 to 14 years. Using previously validated methods, we estimated exposure to movie smoking, in 532 recent box-office hits, and examined its relation with adolescents having ever tried smoking a cigarette. RESULTS: The distributions of demographics and census region in the unweighted sample were almost identical to 2000 US Census estimates, confirming representativeness. Overall, 10% of the population had tried smoking. Quartile (Q) of movie smoking exposure was significantly associated with the prevalence of smoking initiation: 0.02 of adolescents in Q1 had tried smoking; 0.06 in Q2; 0.11 in Q3; and 0.22 in Q4. This association did not differ significantly by race/ethnicity or census region. After controlling for sociodemographics, friend/sibling/parent smoking, school performance, personality characteristics, and parenting style, the adjusted odds ratio for having tried smoking were 1.7 (95% confidence interval [CI]: 1.1, 2.7) for Q2, 1.8 (95% CI: 1.2, 2.9) for Q3, and 2.6 (95% CI: 1.7, 4.1) for Q4 compared with adolescents in Q1. The covariate-adjusted attributable fraction was 0.38 (95% CI: 0.20, 0.56), suggesting that exposure to movie smoking is the primary independent risk factor for smoking initiation in US adolescents in this age group. CONCLUSIONS: Smoking in movies is a risk factor for smoking initiation among US adolescents. Limiting exposure of young adolescents to movie smoking could have important public health implications.

Adolescent↗
PubMed2004

Two-year follow-up of a smoking cessation trial in patients with schizophrenia: increased rates of smoking cessation and reduction.

BACKGROUND: Long-term success rates of smoking cessation programs for patients with schizophrenia are unknown. This study, conducted between June 2001 and November 2002, evaluated the rate of smoking cessation and reduction in patients with schizophrenia (DSM-IV) 2 years after they had participated in a smoking cessation study in order to determine whether subjects who significantly reduced smoking during the original trial resumed their previous level of smoking at 2 years. METHOD: Two years following a double-blind placebo-controlled trial of bupropion sustained release, 150 mg/day, added to cognitive-behavioral therapy for smoking cessation in patients with schizophrenia, subjects were interviewed, medical charts were reviewed, and carbon monoxide in expired air was measured. RESULTS: Seventeen of 18 subjects completed the follow-up assessment. More subjects were abstinent (22% [N = 4]) at the 2-year follow-up than were abstinent at the end of the trial (6% [N = 1]). Subjects who achieved significant smoking reduction during the trial were more likely to be abstinent at 2 years (4/7) than those who did not significantly reduce smoking during the trial (0/11) (chi(2) = 8.1, p <.005). Most subjects who achieved > or = 50% reduction in smoking at the end of the trial maintained at least that level of reduction at 2 years. Smoking reduction during the treatment intervention was correlated with smoking reduction at follow-up (r = 0.60, p =.01). CONCLUSION: The results from this naturalistic study suggest that behavior changes achieved in smoking cessation programs for patients with schizophrenia may be durable and may predict future smoking behavior. We conclude that further investigation into the relationship between smoking reduction and future smoking cessation in special populations is indicated.

Adult↗
PubMedDate not supplied

[Factors associated with smoking and the intention to smoke in secondary school pupils: results of the ESFA project in Barcelona, Spain].

OBJECTIVE: To describe the factors asssociated with smoking and intention to smoke among a representative sample of first-grade pupils of secondary education (12-13 years old) in Barcelona. SUBJECTS AND METHODS: 37 secondary schools were randomly selected to evaluate the impact of a European-wide smoking prevention program (European Smoking prevention Frame Approach, ESFA project). In these schools, 1041 pupils of first grade of secondary education responded to a questionnaire designed at the University of Maastricht to study life-style attitudes and behaviours, mainly smoking. RESULTS: 9.8% of boys and 12.6% of girls declared to smoke either regulary or ocasionally. Among the no-smokers, 61.4% of the boys and 73.3% of the girls reported to have the intention to smoke in the future. Among the boys, factors associated with smoking included social norms (odds ratio [OR] = 2.5; 95% confidence interval [CI]: 1.2-5.2), smoking by siblings (OR = 2.4; 95% CI, 1.1-5.2), attitudes against smoking (OR = 0.3; 95% CI, 0.1-0.6), practicing some sports in the leisure time (OR = 0.3; 95% CI, 0.1-0.7) and having more available pocket money (OR = 3.2; 95% CI, 1.5-6.8). Intention to smoke was only related to attitudes (OR = 0.3; 95% CI, 0.2-0.5). Among girls, smoking was associated to perceived pressure to smoke (OR = 2.5; 95% CI, 1.2-5.0), consumption by friends (OR = 6.0; 95% CI, 2.4-15.4) and attitudes against smoking (OR = 0.2; 95% CI, 0.1-0.4), while intention was only associated to attitudes (OR = 0.4; 95% CI, 0.2-0.6) and hanging out in the street in the leisure time (OR = 2.2; 95% CI, 0.3-3.5). CONCLUSIONS: The results stress the need to deal simultaneoulsy with the different factors associated to smoking initiation and attitude shaping, including cognitive factors, environmental factors, and patterns of leisure time utilization.

Adolescent↗
PubMed2003

Smoke-free schools? Results of a secondary school smoking policies survey 2002.

AIM: To describe the cigarette-smoking policies of a sample of New Zealand secondary schools. METHODS: Schools randomly selected from six geographical regions for participation in the Health Sponsorship Council's 2002 Youth Lifestyle Study (YLS) were invited to also participate in the School Smoking Policies Survey (SSPS). RESULTS: Eighty one of 82 schools responded (response rate 98.8%); 64 schools (79.0%) provided copies of smoking policies. Of the schools that provided policies, only 31 (50.8%) were totally smoke free, ie, banned smoking 24 hours a day, seven days a week. Five schools (8.2%) were both smoke free and fully compliant with existing legislation. Seventy eight schools (96.3%) provided education about smoking and imposed sanctions on students caught smoking. Most respondents (74.1%) considered school staff would support proposed changes to the Smoke-free Environments Act that would make all school buildings and grounds totally smoke free. CONCLUSIONS: Most secondary schools are not smoke free, but most staff are likely to support smoke-free status. Existing inconsistency among educational messages, school practice and staff actions may undermine tobacco-smoking-prevention efforts. Proposed strengthening of smoke-free legislation is both timely and necessary to ensure that all New Zealand students are provided with totally smoke-free school environments, consistent with health education messages.

Data Collection↗
PubMed1996

Paced smoking in the laboratory and in the natural smoking setting: differential situation-specific effects in light and heavy smokers.

The present study examined the situation-specific effects of smoking using a paced regimen of smoking to control the smoke intake. The subjects were first required to sham smoke and then actually smoke one of their cigarettes in two different test contexts: 1) in the laboratory where they had never previously smoked and 2) at home, alone in a quiet room where they regularly smoke. Light (< 10 cigarettes/day) and heavy smokers (> 15 cigarettes/day) were studied to test for a possible effect of the paced regimen itself. In the light smokers, smoking produced a larger increase in heart rate (HR) in the laboratory than in the natural smoking environment; however, in the heavy smokers the smoking had a larger effect in the normal smoking environment than in the laboratory. There were no significant group or test situation differences for baseline HR, skin conductance and finger temperature. The groups also did not differ in the intensity of drawing on the cigarette or inhaling, as indicated by a puff sensor and a respiratory belt, respectively. It was concluded that differences between the effects of a cigarette in a laboratory setting and in a natural smoking environment may reflect pharmacodynamic effects of smoking that are modified by the subjects' prior experience with smoking. The data are discussed with regard to conditioned tolerance to the effect of smoking.

Adult↗
PubMed2005

Effect of local restaurant smoking regulations on progression to established smoking among youths.

BACKGROUND: While smoke-free restaurant laws are intended to protect the public from secondhand smoke exposure, they may also discourage smoking among adolescents. There is no evidence from longitudinal studies to test this hypothesis. OBJECTIVE: To examine the effect of local restaurant smoking regulations on progression to established smoking among adolescents. DESIGN, SETTING, AND SUBJECTS: A cohort of 2623 Massachusetts youths, ages 12-17 years at baseline, was interviewed via random digit dial telephone survey in 2001-2002 and followed up two years later. A generalised estimating equations (GEE) logistic regression analysis was used and controlled for potential individual, household, and town level confounding factors. MAIN OUTCOME MEASURE: Progression to established smoking during the two year follow up period (defined as having smoked 100 or more cigarettes in one's life). RESULTS: Compared to youths living in towns with weak regulations, those living in towns with strong regulations (complete restaurant smoking bans) had less than half the odds of progression to established smoking (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.24 to 0.66). The association was stronger for youths in towns with strong regulations in effect for two or more years (OR 0.11, 95% CI 0.03 to 0.37), although it was still present for those in towns with strong regulations in effect for less than two years (OR 0.55, 95% CI 0.33 to 0.90). No relationship was found between living in a town with a medium restaurant smoking regulation (restriction of smoking to enclosed, separately ventilated areas) and rates of progression to established smoking. CONCLUSIONS: Local restaurant smoking bans may be an effective intervention to prevent youth smoking.

Adolescent↗
PubMed2006

State-specific prevalence of current cigarette smoking among adults and secondhand smoke rules and policies in homes and workplaces--United States, 2005.

Smoking causes premature death and disease in children and adults who do not smoke but are exposed to secondhand smoke (SHS). To assess the state-specific prevalence of current smoking among adults in the United States and the proportions of adults who report having smoke-free home rules and smoke-free policies in their workplace, CDC analyzed data from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicated a threefold difference (from lowest to highest) in self-reported cigarette smoking prevalence in 50 states, the District of Columbia (DC), Puerto Rico (PR), and the U.S. Virgin Islands (USVI) (range: 8.3%-28.7%). Wide variations also were observed in USVI and the 14 states that assessed prevalence of smoke-free home rules (from 63.6% [Kentucky] to 82.9% [Arizona]) and smoke-free workplace policies (from 54.8% [Nevada] to 85.8% [West Virginia]). Evidence-based, comprehensive tobacco prevention and control programs that focus on decreasing smoking initiation, increasing smoking cessation, and establishing smoke-free workplaces, homes, and other venues should be continued and expanded to reduce smoking prevalence, exposure of nonsmokers to SHS, and smoking-related morbidity and mortality.

Adult↗
PubMed1996

Hospital smoking bans and employee smoking behavior: Results of a national survey.

OBJECTIVE: To examine the impact of workplace smoking bans on smoking behavior of employees. PARTICIPANTS: A total of 1469 current or former smokers (intervention group) employed in smoke-free hospitals and 920 current or former smokers (comparison group) employed in non-smoke-free workplaces were surveyed to determine smoking behavior. DESIGN: This cross-sectional study is part of a larger, ongoing prospective study. The study design was quasi-experimental. We randomly selected sites consisting of a hospital and a corresponding community. Furthermore, we randomly selected subjects from hospitals and their corresponding communities. MAIN OUTCOME MEASURES: Postban quit ratio and progression along the stages-of-change continuum. METHODS: The Cox proportional hazards model was used to compare the postban quit ratio between the intervention and comparison groups. The Cochran-Mantel-Haenszel analysis of variance statistic was used to compare groups on the stages-of-change variables. RESULTS: Beginning with the smoking ban and continuing for 5 years after implementation, statistically significant differences in the postban quit ratio were observed between employees of smoke-free hospitals who were smokers and counterparts in the community (P<.001). Despite preban differences in smoking intensity, the overall difference in postban quit ratios remained significant even after multivariate adjustment for socioeconomic, demographic, and smoking intensity variables. For those sites that were 5 years postban, the quit ratio was 0.506 in smoke-free workplaces compared with 0.377 in workplaces where smoking was permitted. In all but 1 category, the intervention group was further along the stages-of-change continuum toward quitting smoking than the comparison group (P<.001). CONCLUSION: American hospitals' experiences with smoking bans, which directly affect more than 5 million workers, should be examined by other industries as a method of improving employee health. Workplace smoking bans could also be effective in saving lives, reducing health care costs, addressing safety concerns, and decreasing operating and maintenance expenses of employers.

Analysis of Variance↗
PubMed1998

[Exposure to tobacco smoke in a Japanese urban population. An analysis using biochemical markers of smoking].

An epidemiological study in an urban population was conducted to investigate exposure to tobacco smoke using two biochemical markers of smoking. In 1993 and 1994, expired air carbon monoxide (EACO) concentrations were determined with a small portable CO monitor for 4,619 subjects aged 30 and over, who had been randomly selected from residents of S-city in Osaka Pref, and who had received a health examination for cardiovascular disease at the National Cardiovascular Center. Urinary cotinine (UCOT) concentrations were determined using gas chromatography for 480 subjects, who were nonsmokers, and who had received a health examination during Sep. and Nov. in 1994. They also completed a questionnaire about smoking habits and potential of passive smoking. In this study smoking prevalences were 45% in men and 11% in women according to the questionnaire. Among nonsmokers 55% of men and 46% of women reported some degree of exposure to tobacco smoke. The EACO levels were related to the number of cigarettes smoked per day in a dose-response fashion. The time elapsed since last smoked and the usual depth of inhalation, in addition to the number of cigarettes, had effects to EACO level. The optimal EACO cut-off points selected to differentiate smokers and nonsmokers were between 6 and 7 ppm for men, and 5 and 6 ppm for women with a sensitivity and a specificity of about 90%. The hours spent with tobacco smoke at home, whether there was a smoking spouse or not, and the time elapsed since last inhalation of smoke affected EACO level in nonsmokers. The frequency of going to an amusement place, a bar or a restaurant, and the hours spent with tobacco smoke in a work place had effects on UCOT level in non-smokers. The proper use of biochemical markers for tobacco smoke may be of value in developing more effective strategies for smoking problems control.

Adult↗
PubMed2000

Community interventions for preventing smoking in young people.

BACKGROUND: Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. OBJECTIVES: To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. SEARCH STRATEGY: The Tobacco Addiction group specialised register, Medline and 21 other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. SELECTION CRITERIA: Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. DATA COLLECTION AND ANALYSIS: Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. MAIN RESULTS: Thirteen studies were included in the review, 44 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with four using random allocation of schools or communities. Of nine studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group receiving the media component only REVIEWER'S CONCLUSIONS: There is some limited support for the effectiveness of community interventions in helping prevent the uptake of smoking in young people.

Adolescent↗
PubMed2004

Longitudinal study of smoking patterns in relation to the development of smoking-related secondary primary tumors in patients with upper aerodigestive tract malignancies.

BACKGROUND: The authors set out to assess the correlation between smoking-related second primary tumor (SPT) development and cigarette smoking habits after diagnosis and definitive treatment in patients with early-stage head and neck squamous cell carcinoma who were enrolled in a placebo-controlled randomized chemoprevention trial of 13-cis-retinoic acid. METHODS: Longitudinal data collected for 10 years after the index diagnosis are presented for 1190 patients. Cox proportional hazards regression models were used to examine the effects of changes in smoking behavior on smoking-related SPT development. RESULTS: One-third of all patients who quit smoking within 12 months before randomization experienced recurrence, compared with 6.9% and 10.4% of all never-smokers and former smokers, respectively. Approximately 16% of all current smokers stopped smoking, and nearly 22% of current smokers developed SPTs, compared with 14.5%, 13.2%, and 8.8% of all recent smokers, former smokers, and never-smokers, respectively. The probability of developing a smoking-related SPT was highest among patients who were current smokers at randomization. These patients, regardless of whether they ceased smoking during follow-up, were nearly three times more likely than patients who had never smoked to develop a smoking-related SPT. In contrast, former smokers and recent quitters who continued to abstain from smoking during follow-up were approximately 1.5 times more likely to develop an SPT compared with patients who had never smoked. CONCLUSIONS: Patients who continue to smoke after the successful treatment of their index head and neck malignancies have a substantially higher risk of developing smoking-related SPTs.

Follow-Up Studies↗
PubMed1995

Need to smoke in the context of workplace smoking bans.

BACKGROUND: Workplace smoking bans are now widespread in a number of countries and are generally well accepted by smokers. Little is known about smokers who do not cope well with smoking bans. METHOD: A survey of 669 smokers was conducted 2 years after the introduction of a workplace smoking ban. Variables associated with four different levels of need to smoke were examined. RESULTS: Nine percent reported experiencing a strong need to smoke at work, 26% a mild need, 45% occasional need, and 19% reported no need. Stronger need was related to (P < 0.01): an index of addiction (higher daily smoking rates and fewer minutes to first cigarette of the day), violating smoking bans, going outside to smoke more, reducing consumption less since the bans, being less approving of the ban, and seeing it as inconvenient, seeing smoking as having less disadvantages (cons) and more advantages (pros), being less ready to quit, lower in confidence of quitting, and having less intention to quit. All of the above effects persisted after controlling for addiction, and the index of addiction only had independent relationships with going outside to smoke, reducing consumption less since the bans, higher pros of smoking and lower self-efficacy (P < 0.01). CONCLUSIONS: There is a small subgroup of smokers who have not adapted well to workplace smoking bans, as well as the much larger subset who report less difficulty. While nicotine addiction plays a role in perceived need to smoke, a number of potentially changeable cognitive characteristics were independently related to need. Workplace smoking policies and programs could take such characteristics into account in addressing the problems these smokers face.

Adult↗
PubMed1995

"Marriage to a smoker" may not be a valid marker of exposure in studies relating environmental tobacco smoke to risk of lung cancer in Japanese non-smoking women.

There is no direct evidence that workplace environmental tobacco smoke (ETS) increases lung cancer risk. Demands for regulation of workplace smoking are based on studies reporting increased risk in non-smoking women whose husbands smoke. Although denying smoking can artificially elevate risk estimates, and although many studies reporting an increase have been conducted in Asia, no previous study of smoking habit misclassification has been conducted there. In this study 400 married Japanese women answered questions on smoking and ETS exposure and supplied urine for cotinine analysis. Of 106 with a cotinine/creatinine ratio (CCR) indicating current smoking (> 100 ng/mg), 22 reported never smoking. These misclassified smokers had a median CCR (1408 ng/mg) similar to the 78 self-reported current smokers (1483 ng/mg). Of current smokers, 89.7% had a currently smoking husband, while this was true of 51.0% of non-smokers. Among 264 confirmed non-smokers (with CCR < 100 ng/mg), CCR was non-significantly lower if the husband smoked (11.51 vs 17.98 ng/mg) and was unrelated to various indices of smoking by the husband. Japanese epidemiological studies using "marriage to a smoker" to index ETS exposure may therefore have compared groups with similar ETS exposure, suggesting that associations reported between lung cancer and this index in some of these studies may result from bias. While other biases, including confounding, may also be important, bias resulting from smoking misclassification combined with husband/wife smoking concordance is shown to be of major concern. The high misclassification rates in Japan, much higher than in Western populations, undermine conclusions from epidemiological studies conducted there.

Adult↗
PubMed2004

Genotoxicity of tobacco smoke and tobacco smoke condensate: a review.

This report reviews the literature on the genotoxicity of mainstream tobacco smoke and cigarette smoke condensate (CSC) published since 1985. CSC is genotoxic in nearly all systems in which it has been tested, with the base/neutral fractions being the most mutagenic. In rodents, cigarette smoke induces sister chromatid exchanges (SCEs) and micronuclei in bone marrow and lung cells. In humans, newborns of smoking mothers have elevated frequencies of HPRT mutants, translocations, and DNA strand breaks. Sperm of smokers have elevated frequencies of aneuploidy, DNA adducts, strand breaks, and oxidative damage. Smoking also produces mutagenic cervical mucus, micronuclei in cervical epithelial cells, and genotoxic amniotic fluid. These data suggest that tobacco smoke may be a human germ-cell mutagen. Tobacco smoke produces mutagenic urine, and it is a human somatic-cell mutagen, producing HPRT mutations, SCEs, microsatellite instability, and DNA damage in a variety of tissues. Of the 11 organ sites at which smoking causes cancer in humans, smoking-associated genotoxic effects have been found in all eight that have been examined thus far: oral/nasal, esophagus, pharynx/larynx, lung, pancreas, myeoloid organs, bladder/ureter, uterine cervix. Lung tumors of smokers contain a high frequency and unique spectrum of TP53 and KRAS mutations, reflective of the PAH (and possibly other) compounds in the smoke. Further studies are needed to clarify the modulation of the genotoxicity of tobacco smoke by various genetic polymorphisms. These data support a model of tobacco smoke carcinogenesis in which the components of tobacco smoke induce mutations that accumulate in a field of tissue that, through selection, drive the carcinogenic process. Most of the data reviewed here are from studies of human smokers. Thus, their relevance to humans cannot be denied, and their explanatory powers not easily dismissed. Tobacco smoke is now the most extreme example of a systemic human mutagen.

DNA Damage↗
PubMed2004

Lifetime parental smoking history and cessation and early adolescent smoking behavior.

BACKGROUND: Associations are examined between parental smoking and smoking onset by their children. Smoking parents are more likely to have children who start smoking in their teenage years; however, less is known about whether parental quitting is related to adolescent smoking. METHODS: A cross-sectional national sample of 2,206 adolescents, ages 10-14 years, living in two-parent households were interviewed for the DEFACTO annual report on Dutch youth smoking behavior. Adolescent smokers reported that they have tried smoking, even one puff. Respondents indicated whether their parents were never, former, or current smokers, and provided, in the case a parent had quit, their age at that time. RESULTS: Logistic regression analyses revealed that likelihood increased gradually: adolescents with both parents being current smokers were four times more likely to be a smoker compared to adolescents with parents who had never smoked. Additionally, within the group of adolescents whose parents quit smoking, the findings demonstrated that the earlier the parents stopped smoking in the life of their offspring, the less likely their children were to start smoking in adolescence. CONCLUSIONS: Parental smoking history is associated with smoking initiation in early adolescence. Parental cessation at an early age of their offspring reduces the likelihood of adolescent smoking initiation. Preventive efforts, therefore, should focus on the benefits of parental cessation as early as possible.

Adolescent↗
PubMed1996

Partner's smoking: a major determinant for changes in women's smoking behaviour during and after pregnancy.

To study determinants for changes in maternal smoking behaviour during and after pregnancy, questionnaire information on smoking habits was recorded in a cohort of 3710 Norwegian women during early pregnancy, at delivery, and one year later. Of 3039 cohabiting women with complete information on smoking at all three occasions 31% smoked in early pregnancy 23% in the late pregnancy and 28% one year after delivery. Among the cohabiting mothers who smoked in early pregnancy, 44% stopped during pregnancy. After adjusting for confounding factors, the odds ratio for smoking cessation among these women who had cohabitants who smoked as opposed to not smoking was 0.2 (95% CI: 0.1-0.2). Among cohabiting non-smoking women during late pregnancy the odds ratio for being a smoker one year after child birth was 3.0 (95% CI: 2.2-4.0), if their cohabitants smoked as opposed to not smoking. The women's smoking behaviour changes considerably during and after pregnancy and their cohabitants' smoking seems to be a major determinant for changes in their smoking behaviour.

Adult↗
PubMed1997

Parental smoking behavior and passive smoke exposure in children with asthma.

BACKGROUND: Smoking parents of children with asthma frequently report modifying their smoking behavior to reduce their child's smoke exposure. Research has not analyzed the association between parental efforts and the child's smoke exposure. OBJECTIVE: To determine passive smoke exposure and the relationship of self-reported parental modifications in smoking behavior to smoke exposure in children with asthma. METHODS: Parents of children seen in an inner-city Asthma and Allergy Outpatient Clinic completed questionnaires to evaluate their smoking behavior and modifications they made to decrease their child's exposure to cigarette smoke. Urine specimens were collected from the children to determine smoke exposure as measured by urinary cotinine/creatinine ratios. RESULTS: Children from homes with smokers had higher mean urinary cotinine/ creatine ratios than children from smoke free homes (30 versus 4 ng/mg; P = .0005). Cotinine/creatinine ratios increased with the number of smokers in the home. When the parent was the only smoker in the home, the mean urinary cotinine/creatine ratio of children whose parent smoked outside the house was lower than the mean of children whose parent smoked inside (21 versus 51 ng/mg; P = .038). With only one smoker in the home, there was no difference in mean cotinine/creatinine ratios when the primary caregiver was not the smoker versus when the primary caregiver was not the smoker (27 versus 15 ng/mg; P = .10). CONCLUSION: Smoking outside the house was associated with lower urinary cotinine/creatinine ratio only when the parent was the only smoker in the home.

Adult↗