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PubMed2005

Passive cannabis smoke exposure and oral fluid testing. II. Two studies of extreme cannabis smoke exposure in a motor vehicle.

Two studies were conducted to determine if extreme passive exposure to cannabis smoke in a motor vehicle would produce positive results for delta-tetrahydrocannabinol (THC) in oral fluid. Passive exposure to cannabis smoke in an unventilated room has been shown to produce a transient appearance of THC in oral fluid for up to 30 min. However, it is well known that such factors as room size and extent of smoke exposure can affect results. Questions have also been raised concerning the effects of tobacco when mixed with marijuana and THC content. We conducted two passive cannabis studies under severe passive smoke exposure conditions in an unventilated eight-passenger van. Four passive subjects sat alongside four active cannabis smokers who each smoked a single cannabis cigarette containing either 5.4%, 39.5 mg THC (Study 1) or 10.4%, 83.2 mg THC (Study 2). The cigarettes in Study 1 contained tobacco mixed with cannabis; cigarettes in Study 2 contained only cannabis. Oral fluid specimens were collected from passive and active subjects with the Intercept Oral Specimen Collection Device for 1 h after smoking cessation while inside the van (Study 1) and up to 72 h (passive) or 8 h (active) outside the van. Additionally in Study 1, Intercept collectors were exposed to smoke in the van to assess environmental contamination during collection procedures. For Study 2, all oral fluid collections were outside the van following smoking cessation to minimize environmental contamination. Oral samples were analyzed with the Cannabinoids Intercept MICRO-PLATE EIA and quantitatively by gas chromatography-tandem mass spectrometry (GC-MS-MS). THC concentrations were adjusted for dilution (x 3). The screening and confirmation cutoff concentrations for THC in neat oral fluid were 3 ng/mL and 1.5 ng/mL, respectively. The limits of detection (LOD) and quantitation (LOQ) for THC in the GC-MS-MS assay were 0.3 and 0.75 ng/mL, respectively. Urine specimens were collected, screened (EMIT, 50 ng/mL cutoff), and analyzed by GC-MS-MS for THCCOOH (LOD/LOQ = 1.0 ng/mL). Peak oral fluid THC concentrations in passive subjects recorded at the end of cannabis smoke exposure were up to 7.5 ng/mL (Study 1) and 1.2 ng/mL (Study 2). Thereafter, THC concentrations quickly declined to negative levels within 30-45 min in Study 1. It was found that environmentally exposed Collectors contained 3-14 ng/mL in Study 1. When potential contamination during collection was eliminated in Study 2, all passive subjects were negative at screening/confirmation cutoff concentrations throughout the study. Oral fluid specimens from active smokers had peak concentrations of THC approximately 100-fold greater than passive subjects in both studies. Positive oral fluid results were observed for active smokers 0-8 h. Urine analysis confirmed oral fluid results. These studies clarify earlier findings on the effects of passive cannabis smoke on oral fluid results. Oral fluid specimens collected in the presence of cannabis smoke appear to have been contaminated, thereby falsely elevating THC concentrations in oral fluid. The risk of a positive test for THC was virtually eliminated when specimens were collected in the absence of THC smoke.

Adolescent↗
PubMedDate not supplied

Effects of cigarette smoke generated by different smoking machines on pulmonary macrophages of mice and rats.

C57BL/6 male mice and Sprague Dawley male rats were exposed to cigarette smoke generated by different smoking machines. Animals inhaled 20% smoke from the Kentucky 2A1 Reference cigarette twice daily 7 days per week for 1 to 5 weeks. Microscopic assessment of lung tissue revealed no abnormal manifestations in animals exposed to smoke in the different smoking machines. However, pulmonary macrophages from lungs of animals exposed to smoke in one of the machines contained crystalline material resembling aluminum silicate. It was determined that this material originated from a structural component of the machine and not from cigarette smoke. It was also observed that smoke generated in the different smoking machines did not elevate equally the intraspecie and interspecie population size of the pulmonary macrophages. The present study points out the need in research dealing with tobacco smoke inhalation for careful evaluation and monitoring of the smoke generation and delivery systems, as well as for awareness of inherent differences in biological responses to smoke among species.

Animals↗
PubMed1990

Impact of a restrictive work site smoking policy on smoking behavior, attitudes, and norms.

Three successive cross-sectional surveys were used to measure the impact of a restrictive smoking policy on employee smoking patterns, perceived exposure to environmental tobacco smoke, attitudes about the policy, and smoking-related norms in a large decentralized state agency. No significant change was detected in smoking prevalence, the proportion of smokers attempting to quit, or the total daily consumption of cigarettes by smokers. The daily consumption of cigarettes at work decreased significantly, from 16.9% to 4.9% smoking 15 or more cigarettes per day. The proportion of respondents bothered every day by coworkers' smoke dropped from 21.8% to 3.8%. Following policy implementation, the interaction between smokers and nonsmokers about smoking decreased. The findings suggest that restrictive work site smoking policies are effective at decreasing exposure to environmental tobacco smoke, but not, at least in the short run, at lowering smoking prevalence. Also, the decreased interaction regarding smoking may have the unintended consequence of reducing the perceived pressure on smokers to quit.

Black or African American↗
PubMed2005

The participation of health professionals in a smoking-cessation programme positively influences the smoking cessation advice given to patients.

This study assessed the degree of smoking cessation advice given by health professionals, before and after their participation in a smoking cessation study using bupropion-sustained release (bupropion SR, Zyban). A total of 690 physicians and nurses who had smoked an average of 10 cigarettes/day over the previous year and were motivated to quit smoking, were randomised in a double-blind manner to receive bupropion SR (days 1-3, 150 mg/day; days 4-49, 150 mg twice daily) or placebo for 7 weeks, with follow-up to week 52. All subjects received regular follow-up and brief motivational support throughout the study. Questions regarding their smoking cessation advice formed part of the study, with the aim of determining whether study participants became more proactive with their smoking cessation advice. A positive shift from baseline to end of study was observed with respect to the advice and support they gave to their smoking patients. These changes were not related to study treatment or current smoking status. An increase in advising patients to quit smoking and in offering cessation counselling was observed. Participation in a smoking-cessation study by physicians and nurses who smoke has a positive effect, regardless of study medication, in smoking cessation advice and counselling given to their patients.

Bupropion↗
PubMed2005

The relationship between student smoking in the school environment and smoking onset in elementary school students.

This study examined how perceptions of student smoking in the school environment and the actual smoking rate among senior students at a school are related to smoking onset. Multilevel logistic regression analysis was used to examine correlates of ever smoking in a sample of 4,286 grade 6 and 7 students from 57 elementary schools in Ontario, Canada. Students are at increased risk for smoking if they (a) often see students smoking near their school, (b) report that students at their school smoke where they are not allowed, and (c) attend a school with a relatively high senior student smoking rate. Each 1% increase in the smoking rate among grade 8 students increased the odds that a student in grades 6 or 7 was an ever smoker versus never smoker (odds ratio, 1.05; 95% confidence interval, 1.02-1.08). A low-risk student (no family or friends who smoke) was over twice as likely to try smoking if he/she attended a high-risk school. Prevention programs should target both at-risk schools and at-risk students, and strongly enforced policies preventing students from smoking on or near school property should be implemented.

Adolescent↗
PubMed1990

Effects of cigarette smoke dose and time after smoke exposure on uptake of asbestos fibers by rat tracheal epithelial cells.

We have previously shown that exposure of excised rat tracheal segments to cigarette smoke followed by exposure to a solution of amosite asbestos increases uptake of asbestos fibers compared to exposure to air followed by asbestos. To learn more about the mechanism of smoke-enhanced fiber uptake, we evaluated the effects of amount of smoke and time delay between smoke exposure and asbestos exposure on fiber penetration into the epithelium. To determine whether amount of smoke exposure affected this process, we exposed tracheal segments to 1, 3, or 6 puffs of smoke and subsequently to 5 mg/ml amosite asbestos for 1 h. The segments were then maintained in organ culture for up to 7 d. Asbestos uptake was evaluated by counting fibers in the epithelium by light microscopy. Exposure to increasing numbers of puffs of smoke produced a dose-related increase in fiber uptake at 1 d, 3 d, and 7 d after exposure. To determine whether asbestos exposure needed to occur immediately after smoke exposure for enhanced uptake of fibers to occur, we exposed tracheal segments to 6 puffs of smoke and then delayed exposure to asbestos for 0 (immediate exposure), 3, 18, or 48 h. Tracheas were again maintained in organ culture for up to 7 d after asbestos exposure. Delayed exposure to asbestos after 6 puffs of smoke produced an increase in fiber uptake, even with an interval as long as 48 h between smoke and asbestos exposure; however, the absolute magnitude of fiber uptake was less than that seen with immediate postsmoke asbestos exposure. If catalase was added to the asbestos solution, the smoke-enhanced uptake was abolished, no matter what the time delay.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

The incidence of smoking and risk factors for smoking initiation in medical faculty students: cohort study.

BACKGROUND: Medical education requires detailed investigation because it is a period during which the attitudes and behaviors of physicians develop. The purpose of this study was to calculate the yearly smoking prevalence and incidence rates of medical faculty students and to identify the risk factors for adopting smoking behaviour. METHODS: This is a cohort study in which every student was asked about their smoking habits at the time of first registration to the medical faculty, and was monitored every year. Smoking prevalence, yearly incidence of initiation of smoking and average years of smoking were calculated in analysis. RESULTS: At the time of registration, 21.8% of the students smoked. At the end of six years, males had smoked for an average of 2.6 +/- 3.0 years and females for 1.0 +/- 1.8 years (p < 0.05). Of the 93 medical students who were not smokers at the time of registration, 30 (32.3%) were smokers at the end of the 6 years of the course. CONCLUSION: The first 3 years of medical education are the most risky period for initiation of smoking. We found that factors such as being male, having a smoking friend in the same environment and having a high trait anxiety score were related to the initiation of smoking. Targeted smoking training should be mandatory for students in the Medical Faculty.

Adult↗
PubMed1999

Prenatal effects of maternal smoking on daughters' smoking: nicotine or testosterone exposure?

OBJECTIVES: The purpose of this study was to specify the effect of prenatal fetal exposure to maternal cotinine and testosterone on daughters' smoking in adolescence and adulthood. METHODS: Longitudinal causal models were estimated among 240 White mother-daughter pairs from the Child Health and Development Study. Mothers and daughters were reinterviewed when daughters were aged 15 to 17 years, and daughters were interviewed at 27 to 30 years of age. Blood samples were obtained from both parents during pregnancy and from adult daughters. RESULTS: Testosterone and smoking were positively correlated among mothers during their pregnancy and among adult daughters. Maternal prenatal cotinine had no direct effect on daughters' smoking; self-reported smoking in pregnancy did have a direct effect. Smoking among daughters during adolescence was determined by maternal prenatal testosterone and self-reported maternal smoking during pregnancy and postnatally. Smoking among adult daughters reflected chronic smoking since adolescence and the continuing effect of postnatal maternal smoking. Prenatal maternal testosterone affected adult daughters' testosterone. CONCLUSIONS: Estimates of the impact of prenatal maternal smoking depend on the measure of smoking. Prenatal testosterone exposure is a previously unrecognized risk factor for smoking among female offspring.

Adolescent↗
PubMed2003

Parental smoking and related behaviours influence adolescent tobacco smoking: results from the 2001 New Zealand national survey of 4th form students.

AIMS: To investigate whether parental smoking and other parental behaviours are risk factors for smoking in 14- and 15-year-old children. METHODS: National cross-sectional survey of 14 930 female and 14 341 male 4th form students who answered an anonymous, self-administered questionnaire in November 2001. RESULTS: The effect of both parents smoking on the risk of daily smoking by students varied significantly (p <0.0001) between ethnic groups, being strongest for Asian students (adjusted relative risk (RR) = 6.64 compared with students of non-smoking parents), intermediate for European (RR = 3.11) and Pacific (RR = 3.05) students, and weakest for Maori (RR = 1.74). Adolescent smoking was also positively associated with pocket money amount and living in a home where people smoked. Two thirds of daily smoking could be explained by the combined exposure to one or more of the following factors: parental smoking, pocket money >5 dollars per week, and smoking in the house. CONCLUSIONS: Parental behaviour is a key determinant of smoking by New Zealand adolescents. Efforts that target the role of parents should be pursued, such as health promotion strategies that advise parents about the possible benefits of banning smoking in the home, limiting pocket money, and not providing cigarettes to their children.

Adolescent↗
PubMed1991

[Standardization of definitions concerning smoking behavior among Japanese adolescents--results from the Japan Adolescent Smoking Survey (JASS)].

The aim of the Japan Adolescent Smoking Survey (JASS) is to standardize the definitions of smoking behavior among Japanese adolescents together with measurement methods and questionnaires concerned. A study of 9921 school children aged 9 to 18 years in 17 elementary schools, 16 junior high schools and 18 senior high schools in 9 prefectures, was conducted between June and July of 1989, to determine the relationship between actual smoking behavior during the past month or year and the "self-referent label" concerning their smoking status. The main results were as follows: 1) The percentage of those who smoked at least one cigarette during the past month showed a high degree of similarity to the percentage of those who referred to themselves as "regular smokers" or "occasional smokers". 2) Less than 10% of students who identified themselves as "never smokers" or "ex-smokers" smoked at least one cigarette during the past month, while more than 80% of students who referred to themselves as "regular smokers" or "occasional smokers" smoked during the past month. 3) On the whole, those who smoked 20 or more cigarettes during the past month referred to themselves as "regular smokers"; those who smoked between 2 and 19 cigarettes as "occasional smokers"; those who smoked 1 cigarette as "ex-smokers"; those who did not smoke during the past month as "never smokers". 4) The definition where students who smoked one cigarette during the past month are classified as a category of smoker, displayed a high level of sensitivity and specificity for all school-level groups and for both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Cigarette smoking among school children in Singapore. Part III--Knowledge and attitudes towards smoking.

In the third article in this series which mainly assesses the knowledge of school children on the harmful effects of smoking, findings showed that the majority (90%) of school children surveyed were aware of the harmful effects. Current smokers appeared to be the least knowledgeable (69.4%) whilst non-smokers (89.3%) and experimenters (93.7%) were the most knowledgeable. Lung cancer (49%), smoking is bad for health (25%), smoking is bad for passive smokers (7%) and for heart disease (6%) were the most common responses given by the children on the specific ill effects caused by smoking. Smokers and non-smokers alike agreed that smoking is addictive, the proportions agreeing, once again, being lowest among smokers and highest among non-smokers. This trend was also observed when respondents were asked for their attitudes towards smoking--whether cigarette smoking was harmful and whether smoking made a person popular. The majority of respondents felt that a boy or girl who smoked "looked bad"--39% thought so of boys, while a higher proportion (55%), had the same impression of girls. The main reasons for giving up smoking given by ex-smokers were its harmful effects on health (49%), there being no more "kick" to it (16%), peer pressure (13%) and the disapproval of parents and teachers (13%). Among current smokers, at least half stated that they would like to stop smoking. Most of them had tried to kick the habit before but failed in their attempts. Finally, among the non-smokers, only 0.4% of boys and 0.1% of girls indicated that they might smoke in the future.

Adolescent↗
PubMed1976

DNA content of cultured mammalian cells exposed to smoke and smoke fractions from cigarettes containing tobacco or NSM, a tobacco substitute.

The effects of smoke and smoke fractions from tobacco and a substitute smoking material (NSM) on the DNA content of mammaliam cells in culture were measured. Tobacco smoke caused significant (P less than 0.001) changes in the DNA content of all the mammalian cells exposed compared with controls. NSM smoke did not have a significant effect on the DNA content of the exposed cells (P less than 0.95). Smoke from blends of NSM and tobacco caused changes in DNA content in proportion to the amount of tobacco in the mixtures. Condensate from cigarettes containing tobacco or blends of tobacco and NSM caused significant (P less than 0.001) changes in DNA content of mammalian cell populations in culture, whereas equal weights of condensate from NSM alone or NSM containing nicotine did not cause significant changes (P less than 0.05). NSM produces 28% of the weight of condensate per cigarette in comparison with tabacco and would, therefore, be expected to be far less biologically active than tobacco. Filtered smoke from cigarettes containing tobacco caused significant (P less than 0.001) changes in the DNA content of mammalian cells in culture. These changes were quantitatively similar to those caused by whole smoke suggesting that the gas phase of cigarette smoke is biologically more reactive than the particulate phase. The filtered smoke from the substitute smoking material NSM did not cause significant (P less than 0.95) changes in DNA content of cultured mammalian cells. Filtered smoke from blends of NSM and tobacco caused changes in DNA content in proportion to the amount of tobacco in the mixture.

Animals↗
PubMed1998

Personal smoking habit and attitude toward smoking among the health staff of a general hospital.

Tobacco smoke (TS) is the single most important cause of preventable death in industrialized countries. Health staff have great responsibility in its control, but the smoking habits of health staff may influence their attitude toward patients. The aim of the study was to evaluate: 1) the prevalence of smoking among health staff at different professional levels; 2) the knowledge of smoking-related damage; and 3) how personal smoking habits influence behaviour in the workplace. A questionnaire was sent to all health staff of the Morelli Hospital (Sondalo, Italy) asking information about age, activity, smoking habits and attitude toward smoking: the Fagerstrom test was also administered to smokers. A total of 959 valid questionnaires were collected (57% of the whole sample). Results were analyzed by means of Chi-squared and Student t-tests, where appropriate. The prevalence of smokers was 44% former smokers 24% and lifetime nonsmokers 32%. The highest prevalence of TS was found in nursing students and auxiliaries (47%) and the lowest among doctors (39%). A clear cohort-effect due to age was evidenced: the youngest age-group (< 30 yrs old) presents the highest prevalence of lifetime nonsmokers and of light smokers, and the lowest of heavy smokers; the oldest age-group (> 40 yrs old) presents the highest prevalence of quitters and of heavy smokers, and the lowest of smokers and lifetime nonsmokers; the intermediate age-group (31-40 yrs old) presents the highest prevalence of smokers. The knowledge of smoking-related damage was poor, with significant differences between smokers and nonsmokers and the different professional categories. Tobacco smoking proved to be common behaviour (even when on duty) among health staff. A minority of health staff seem fully aware of personal and social smoking related aspects. Smoking habits influence the attitude of health staff toward patient counselling about tobacco smoking.

Adult↗
PubMed2002

Understanding people who smoke and how they change: a foundation for smoking cessation in primary care, part 1.

The purpose of this article is to develop an understanding of people who smoke and how they change as a foundation for the delivery of smoking cessation interventions in primary care. Central to our approach is the transtheoretical model of change (TMC). The TMC is an evidence-based model of behavior change that has been developed and tested during the past 2 decades by Prochaska and his colleagues in the context of smoking cessation. We use a review of the literature, in-depth interviews of people who successfully quit smoking, and our experience applying the TMC in the context of primary care and a smoking cessation clinic to explore the clinical work of smoking cessation. This article on smoking cessation will be presented in 2 issues. Part 1 describes the theoretical information known about smoking cessation: why smoking is a powerful behavior, the scientific background of the TMC, and the building-block constructs of the TMC. The first section of part 2 is a review of the Public Health Service clinical practice guideline, Treating Tobacco Use and Dependence, published in 2000. The second section of part 2 is a discussion of clinical assessments and strategies for working with smokers, which is grounded in the Public Health Service practice guideline, our understanding of people who smoke, and the TMC. Woven throughout are transcripts of interviews with 4 people in which they describe their smoking experiences and their pathways to cessation.

Adaptation, Psychological↗
PubMedDate not supplied

Stigmatizing smokers: public sentiment toward cigarette smoking and its relationship to smoking behaviors.

Public sentiment in the United States has been evolving against cigarette smoking. Providing support for stronger tobacco control legislation, unfavorable public sentiment has contributed to the decrease in the size of the smoking population in this country. The present study hypothesizes that the unfavorable public sentiment may also discourage cigarette smoking by creating an unfavorable "smoking climate" in which smoking is socially rejected as a deviant behavior. Analyses of several secondary data-sets provided evidence that smoking rates are lower in the states where the public holds relatively unfavorable sentiment toward cigarette smoking. The relationship between public sentiment and smoking rates was significant even after controlling for the effects of state-level tobacco control measures, such as cigarette taxes and smoking restrictions in private workplaces and restaurants. We also found that smokers who have experienced unfavorable public sentiment are more willing to quit smoking than those who have not, supporting the hypothesized effects of antismoking public sentiment on smoking behaviors.

Health Behavior↗
PubMed2003

How does individual smoking behaviour among hospital staff influence their knowledge of the health consequences of smoking?

AIMS: This study examined associations between individual smoking habits among hospital staff and their knowledge of the health consequences of smoking and passive smoking. The a priori hypothesis was a higher level of knowledge among non-smokers compared with smokers. METHODS: A survey was undertaken, based on self-administered questionnaires at a Danish hospital (Frederikssund Hospital) in the Copenhagen area. Descriptive statistics, chi-square test and multiple logistic regression analyses were used. A backward stepwise elimination of variables at a 5% level of significance was performed and 95% confidence intervals were calculated. Main outcome measures were knowledge of the health consequences of smoking, passive smoking and other lifestyle factors. RESULTS: A total of 445 of 487 employees (91%) from all professional groups returned the questionnaire. Compared with ex- and never smokers, smokers systematically underestimate the health consequences of smoking and passive smoking independent of profession, department, sex, and age. There is no consistent association between knowledge of the health consequences of smoking and profession and department. There are significant inverse associations between smoking and knowledge of the health effects of excess use of alcohol and lack of physical activity. CONCLUSION: Individual smoking habits among hospital staff strongly influence smoking-related knowledge. No other variables are of consistent importance. These findings are supported by the literature. The validity of the study is good, but a similar study in a bigger population would strengthen the evidence.

Adult↗
PubMed1993

Smoking habits of Grampian school children and an evaluation of the Grampian Smoke Busters campaign.

To determine the effect of a Smoke Busters club in reducing the numbers of children recruited to smoking, levels of smoking in Grampian amongst 11-14 year olds were determined at the launch of the club and again 22 months later, using a self-completion questionnaire. Initial smoking levels were similar to Scottish Office of Population Censuses and Surveys (OPCS) 1986 figures taken 2 years prior to the first Grampian survey. OPCS findings indicated that in Scotland smoking levels had remained fairly stable among girls and had increased among boys between 1986 and 1990. At the second survey in Grampian, smoking levels among girls and boys were lower than in Scotland generally, but it is not possible to know whether this was a result of the campaign or not. There was evidence of a relationship between the smoking habits of children and parents, particularly their mothers. Life-style questions showed that smokers were more likely to take part in activities characteristic of older teenagers and to prefer music which was associated with alternative, rebellious attitudes. Smoke Busters clubs aim to promote a non-smoking life-style amongst young teenagers. After 22 months of a Smoke Busters club, it was evident that at least 32.9% of the target group had joined the club at some point and that it was very popular with its members. Those who joined Smoke Busters were more than twice as likely to remain non-smokers as those who were non-members, but this might not be a function of cause and effect. A further survey is to be undertaken at 4 years after the launch of the club and may allow assessment of any longer-term effects of the club in Grampian.

Adolescent↗
PubMed2005

Parent reported home smoking bans and toddler (18-30 month) smoke exposure: a cross-sectional survey.

AIMS: To study the relation between the use of parent reported home smoking bans and smoke exposure among children aged 18-30 months. METHODS: A total of 309 smoking households with children aged 18-30 months, who were part of the Coventry Cohort study, consented to participate in this cross-sectional survey. RESULTS: Although parents in almost 88% of smoking households reported using harm reduction strategies to protect their toddlers from smoke exposure, only 13.9% reported smoking bans in the house. Mean log urinary cotinine:creatinine ratio was significantly lower for those children whose parents reported no smoking in the house (1.11, 95% CI 0.64 to 1.49) compared with none/less strict strategies (1.87, 95% CI 1.64 to 2.10). In linear regression models fitted on log cotinine:creatinine ratio, no smoking in the house was independently associated with a significant reduction in cotinine:creatinine ratio (B = -0.55, 95% CI -0.89 to -0.20) after adjusting for mother's and partner's average daily cigarette consumption, housing tenure, and overcrowding. The final model accounted for 44.3% of the variance. CONCLUSIONS: Not smoking in the house was associated with a reduction in mean urinary cotinine:creatinine ratio in children aged 18-30 months; the relation persisted after adjustment for levels of mother's and partner's daily cigarette consumption and sociodemographic factors. Results suggest that home smoking bans in this age group have a small but significant effect on smoke exposure independent of levels of parental tobacco consumption.

Child, Preschool↗