Is concern about post-cessation weight gain a barrier to smoking cessation among pregnant women?

Women who quit smoking during pregnancy gain more weight than women who continue to smoke. Concern about weight gain is a barrier to smoking cessation in the general population, but whether attitudes about weight are associated with failure to stop smoking during pregnancy or to maintain abstinence postpartum is unknown. Thus, attitudes about weight were assessed in 412 pregnant smokers recruited from obstetric practices in Massachusetts for a smoking cessation intervention trial. Smoking cessation outcomes (7-day point-prevalence abstinence by self-report and by cotinine-validation) were assessed at end-of-pregnancy and 3 months postpartum. Bivariate and multivariable analyses assessed the relationship between attitudes about weight and smoking cessation. In bivariate analyses, a high level of concern about post-cessation weight gain was associated with older age (p = .01), smoking more cigarettes/day (p<.001), not making a quit attempt in pregnancy (p = .02), being less likely to self-report tobacco abstinence at end of pregnancy (p = .01) and postpartum (p = .02), and having less cotinine-validated abstinence at 3 months postpartum (p = .05). In multivariable analyses that adjusted for cigarettes/day, a low level of concern about post-cessation weight gain was associated with more self-reported abstinence at end-of-pregnancy (OR = 1.77, 95% CI 1.01-3.09) and postpartum (OR = 2.09, 95% CI 1.05-4.14), but not with cotinine-validated abstinence at end-of-pregnancy (OR = 1.30, 95% CI 0.63-2.68) or postpartum (OR = 2.18, 95% CI 0.93-5.10). In conclusion, women who are more concerned about post-cessation weight gain may be less likely to quit smoking during pregnancy or remain abstinent in the postpartum period.     

The demand for health insurance coverage for tobacco dependence treatments: support for a benefit mandate and willingness to pay.

One solution for reducing tobacco use is to expand health insurance coverage for tobacco dependence treatments (TDTs), but the public demand for a coverage mandate is unknown. This study finds that demand for coverage of TDTs among a random sample of adult Californians with employer-sponsored health insurance is strong, with 62% indicating that health insurers should be required to offer coverage as part of their standard plans and a majority (56%) indicating a willingness to pay $3 more for their annual health insurance premium to finance cessation coverage. Compared to never smokers, current and former smokers are no more likely to support a benefit mandate to require coverage of cessation treatments, but the adjusted odds are approximately three times greater that current and former smokers are willing to pay $3 more toward their annual premium to finance cessation coverage. Liberals had higher adjusted odds of supporting a benefit mandate and of being willing to pay a higher premium compared to conservatives. Non-whites had higher adjusted odds of supporting a mandate compared to whites, with no differences by race/ethnicity in willingness to pay a higher premium. There were no differences in preferences for a benefit mandate or willingness to pay a higher premium as a function of age, gender or income. These findings have important policy implications for a state health insurance mandate to cover tobacco dependence treatments.     

Public perceptions of antibiotic use on dairy farms in the United States

There has been a global push for improved antimicrobial stewardship, including in animal agriculture, due to growing concerns about antimicrobial resistance. However, little is known about the general public's perceptions of antimicrobial use in animal agriculture. The aim of this study was to explore the US public's perceptions of antibiotic use in dairy farming and how these perceptions influence purchasing decisions. Data from the 2017 Cornell National Social Survey developed in collaboration with the Cornell Survey Research Institute were used to assess the public's perceptions. The Survey Research Institute of Cornell University (Ithaca, NY) administered the survey by telephone to a random sample of 1,000 adults in the continental United States. The survey collected information about perceptions of threat to human health posed by antibiotic use in cows on dairy farms and willingness to pay more for milk from cows raised without antibiotics, as well as several presumed explanatory variables, including respondents' knowledge of antibiotics, beliefs regarding cattle treatment in dairy farming, and 18 sociodemographic characteristics. Data were analyzed using logistic regression. Among respondents, 90.7% (n = 892/983) reported that antibiotic use on dairy farms posed some level of threat to human health and 71.5% (n = 580/811) indicated they would be willing to pay more for milk produced from cows raised without antibiotics. Respondents who believed that antibiotic use in dairy farming posed a moderate to high threat to human health were more likely to be female and report willingness to pay more for milk or not purchase milk. Additionally, consumers' willingness to pay more for milk from cattle raised without antibiotics was associated with the belief that antibiotic use posed some threat to human health, the belief that cows are treated better on organic dairy farms, an annual household income of $50,000 or greater, being born outside the United States, having a liberal social ideology, and being currently or formerly married. These results suggest that the general public's decisions as consumers of dairy products are associated with demographic factors in addition to perceptions of antibiotic use and cattle treatment in dairy farming. The rationale behind such perceptions should be further explored to facilitate consumers' informed decision making about antibiotic use in agriculture, links to cattle treatment, and associated willingness-to-pay attitudes.     

Heterogeneous preferences with respect to food preparation time: Foodies and quickies

Time scarcity is an important driver for food choices. Despite this, little research has been conducted on the preferences of consumers and their willingness to pay for reduced food preparation times. We have explored consumer preferences with respect to saving time in cooking, using a payment card technique with an online survey on a sample of German (486 in number) and Italian (494) consumers. Our findings differ from those of other studies on the same context of daily duties, such as commuting, which note a general willingness to pay for time-saving. Indeed, latent class analysis shows three segments: the ‘quickies’, who are willing to pay a premium for saving time; the ‘foodies’, who receive utility in cooking; and the ‘indifferent’, for whom the time needed to prepare meals is not a choice factor. Profiling within our sample indicates that Italians, young people, and large families show a higher willingness to pay for saving time in cooking. Consumer heterogeneity calls on convenience food producers for targeted marketing strategies to create value, from product development to communication and distribution.     

Consumer willingness to pay for beef meat in a developing country: The effect of information regarding country of origin,price and animal handling prior to slaughter

Considering the importance that animal welfare has attained in developed countries, a personal interview of 770 regular meat buyers in the Bio-Bio and Araucanía regions of Chile was conducted to determine the importance of information regarding animal treatment prior to slaughter in the decision-making process when buying beef, to discover the willingness to pay more for this attribute and to distinguish different buyer segments. Using a conjoint analysis design, those surveyed were asked to put eight products in order according to their preference, given the following alternatives: domestic or imported beef, with or without information on animal treatment prior to slaughter and two price options. Origin and information regarding animal treatment were more important than price. Animal welfare is perceived as a desirable condition, but consumers are not willing to pay significantly more when buying meat in order to gain information about animal handling. Through a cluster analysis, four segments were distinguished in each region, with consumers who consider origin as the most important attribute predominating.     

CONSUMER PREFERENCES FOR PATHOGEN‐REDUCING TECHNOLOGIES IN BEEF1

Two surveys were conducted by mail to evaluate consumers’ preferences for beef treated by the steam and hot‐water pasteurization technologies, in a comparison with beef treated by irradiation and nontechnology treated “regular” beef. More than 64% of the respondents reported that they preferred ground beef treated by irradiation to that treated by the two pathogen‐reducing technologies. More than 87% of the respondents stated that they preferred ground beef treated by the two technologies to nontechnology treated beef. Sixty percent of the respondents reported that they were willing to pay for beef treated by the two pathogen‐reducing technologies with an averaged willingness‐to‐pay of 0.36/lb over nontechnology treated beef. Compared with their counterparts; women, those having a better self‐reported health status, and those with children at home (≥ 18 years of age) were more likely to report a preference for beef treated by the two heat‐related pasteurization technologies. The income level of the respondents was negatively associated with their preference for beef treated by the two heat‐related pasteurization technologies. The strong consumer preference coupled with willingness‐to‐pay for beef treated by the two pathogen‐reducing technologies, suggest that consumers are willing to bear the cost of using these technologies if beef packers would invest in such technologies as a means of improving the quality of their products.     

Learning to dislike safe water products: results from a randomized controlled trial of the effects of direct and peer experience on willingness to pay

Low-cost point-of-use (POU) safe water products have the potential to reduce waterborne illness, but adoption by the global poor remains low. We performed an eight-month randomized trial of four low-cost household water treatment products in Dhaka, Bangladesh. Intervention households (n = 600) received repeated educational messages about the importance of drinking safe water along with consecutive two-month free trials with each of four POU products in random order. Households randomly assigned to the control group (n = 200) did not receive free products or repeated educational messages. Households' willingness to pay for these products was quite low on average (as measured by bids in an incentive-compatible real-money auction), although a modest share was willing to pay the actual or expected retail price for low-cost chlorine-based products. Furthermore, contrary to our hypotheses that both one's own personal experience and the influence of one's peers would increase consumers' willingness to pay, direct experience significantly decreased mean bids by 18-55% for three of the four products and had no discernible effect on the fourth. Neighbor experience also did not increase bids. Widespread dissemination of safe water products is unlikely until we better understand the preferences and aspirations of these at-risk populations.     

Smoking behavior and risk perception among the parents of infants in the neonatal intensive care unit.

The goal of this study was to explore the prevalence of smoking and attitudes and behaviors relevant to smoking cessation among parents of babies treated in a neonatal intensive care unit (NICU). Participants were 235 mothers and 83 fathers of infants admitted to the NICU of a large, university-based hospital. The 38-item survey included questions that assessed smoking status (current, former, never-smoker), motivation to quit, perceived health risks from smoking, and whether or not they received smoking cessation advice or counseling from a health care provider. A total of 26% of all participants were current smokers. Compared with mothers, fathers were more likely to be current smokers (22% vs. 31%) and smoked more cigarettes per day (11.3% vs. 17.2%). Among participants, 57% reported that smoking affected their own health "a little" or "not at all," and 70% believed that others' smoking would affect the baby's health "a little" or "somewhat." Mothers were more likely than fathers to report health care provider intervention for smoking cessation. Indeed, none of the fathers in this study reported being offered assistance with quitting smoking. More than half of smokers were willing to receive counseling for smoking cessation, and health care provider intervention was positively associated with both motivation to quit and perceived health risk to their infant (p<.01). The NICU may provide a teachable moment in which parents can be assisted with quitting smoking, thus improving their own health and the health of their babies.     

Consumer preferences and willingness to pay for value-added chicken product attributes

A growing demand for convenient and ready-to-eat products has increased poultry processors' interest in developing consumer-oriented value-added chicken products. In this study, a conjoint analysis survey of 276 chicken consumers in Edmonton was conducted during the summer of 2009 to assess the importance of the chicken part, production method, processing method, storage method, the presence of added flavor, and cooking method on consumer preferences for different value-added chicken product attributes. Estimates of consumer willingness to pay (WTP) premium prices for different combinations of value-added chicken attributes were also determined. Participants'"ideal" chicken product was a refrigerated product made with free-range chicken breast, produced with no additives or preservatives and no added flavor, which could be oven heated or pan heated. Half of all participants on average were willing to pay 30% more for a value-added chicken product over the price of a conventional product. Overall, young consumers, individuals who shop at Farmers' Markets and those who prefer free-range or organic products were more likely to pay a premium for value-added chicken products. As expected, consumers' WTP was affected negatively by product price. Combined knowledge of consumer product attribute preferences and consumer WTP for value-added chicken products can help the poultry industry design innovative value-added chicken products. Practical Application: An optimum combination of product attributes desired by consumers for the development of a new value-added chicken product, as well as the WTP for this product, have been identified in this study. This information is relevant to the poultry industry to enhance consumer satisfaction of future value-added chicken products and provide the tools for future profit growth.     

The effects of household and workplace smoking restrictions on quitting behaviours

OBJECTIVE: To assess the association of household and workplace smoking restrictions with quit attempts, six month cessation, and light smoking. DESIGN: Logistic regressions identified the association of household and workplace smoking restrictions with attempts to quit, six month cessation, and light smoking. SETTING: Large population surveys, United States. SUBJECTS: Respondents (n = 48,584) smoked during the year before interview in 1992-1993, lived with at least one other person, and were either current daily smokers or were former smokers when interviewed. MAIN OUTCOME MEASURES: The outcome measures were an attempt to quit during the last 12 months, cessation for at least six months among those who made an attempt to quit, and light smoking (< 15 cigarettes a day). RESULTS: Smokers who lived (odds ratio (OR) = 3.86; 95% confidence interval (CI) = 3.57 to 4.18) or worked (OR = 1.14; 95% CI = 1.05 to 1.24) under a total smoking ban were more likely to report a quit attempt in the previous year. Among those who made an attempt, those who lived (OR = 1.65, 95% CI = 1.43 to 1.91) or worked (OR = 1.21, 95% CI = 1.003 to 1.45) under a total smoking ban were more likely to be in cessation for at least six months. Current daily smokers who lived (OR = 2.73, 95% CI = 2.46 to 3.04) or worked (OR = 1.53, 95% CI = 1.38 to 1.70) under a total smoking ban were more likely to be light smokers. CONCLUSIONS: Both workplace and household smoking restrictions were associated with higher rates of cessation attempts, lower rates of relapse in smokers who attempt to quit, and higher rates of light smoking among current daily smokers.     

Credence quality coordination and consumers' willingness-to-pay for certified halal labelled meat

This paper reports on halal credence quality coordination and Muslim consumers' willingness to buy and pay for certified halal labelled meat at the supermarket and the Islamic butcher. Cross-sectional data were collected through a survey with 202 Muslim consumers in Belgium. Findings indicate that more acculturated and female consumers are more in favour of purchasing certified halal labelled meat in a supermarket. Important conditions are that supermarkets can provide a guarantee of separating halal from non-halal meat and of the organisation of adequate verification and control. Results further show that more Muslim consumers are willing to pay a price premium (of 13% on average) for halal labelled meat at the Islamic butcher shop than at the supermarket. The higher the importance attached to a certified halal label and the more distrust in the actual halal meat status, the higher the likelihood that a Muslim consumer is willing to pay a higher price for certified halal labelled meat at the Islamic butcher shop. Gender and generation determine the actual premium Muslim consumers are willing to pay.     

Rural adolescent attitudes toward smoking and weight loss: relationship to smoking status.

Perceptions that smoking contributes to weight loss are widespread among youth. We examined the association between weight loss and smoking to determine whether supportive attitudes were associated with smoking status and whether this is a particular problem in rural areas. High school students (N=730) completed a survey assessing smoking-related characteristics and behaviors. Attitudes assessed included perceptions of whether weight concerns were the reasons others smoke and personal beliefs about tobacco's effect on weight gain. Smoking status was categorized as never (44%), experimental (42%), and current (14%). Multinomial logistic regressions investigated relationships between attitudes and smoking, adjusting for weight goals, gender, ethnicity, parent/peer smoking, and body mass index. Both attitudinal measures were associated with smoking (p< .05). Nonsmokers and experimental smokers were more likely than current smokers to believe that people smoke to lose weight. Although current smokers were less likely to report that others smoke for weight control, they believed they would gain weight if they quit. Conversely, nonsmokers and experimental smokers were less likely to believe they would gain weight if they do not smoke compared with current smokers. Thus personal attitudes differ from attitudes toward others with respect to weight loss and smoking. Moreover, endorsement of these attitudes can reliably distinguish current versus experimental smokers and may help better clarify the transition to current smoker. Because weight concerns are a significant factor in youth smoking, these issues should be included in intervention efforts, particularly in rural communities where smoking rates are higher and age at initiation is earlier.     

Influence of physician and patient gender on provision of smoking cessation advice in general practice

OBJECTIVE: To examine the association between physician and patient gender and physicians' self-reported likelihood of providing smoking cessation advice to smokers using hypothetical case scenarios in primary care. DESIGN: Cross-sectional analysis of a self-administered questionnaire. SUBJECTS: National random sample of Australian general practitioners (GPs). MAIN OUTCOME MEASURES: Self-reported likelihood of advising hypothetical male and female smokers to stop smoking during a consultation for ear-syringing ("opportunistic" approach) or a dedicated preventive health "check up". RESULTS: 855 GPs returned questionnaires (67% response rate). Significantly more respondents indicated they would be "highly likely" to initiate an opportunistic discussion about smoking with a male smoker (47.8% (95% confidence intervals (CI) = 44.5 to 51.2)) than a female smoker (36.3% (95% CI = 33.1 to 39.5]). Older, male GPs were less likely to adopt an opportunistic approach to smoking cessation for patients of either sex. Respondents were more likely to recommend that a male patient return for a specific preventive health check up. Furthermore, in the context of a health check up, a greater proportion in total of respondents indicated they would be "highly likely" to discuss smoking with a man (86.9%, 95% CI = 84.5 to 89.0) than a female smoker (82.5%, 95% CI = 79.8 to 84.9). CONCLUSIONS: As measured by physician self-report, the likelihood of advising smokers to quit during primary care consultations in Australia appears to be influenced by gender bias. Gender-sensitive strategies to support cessation activities are recommended.     

Do health claims add value to nutritional claims? Evidence from a close-to-real experiment on breakfast biscuits

Nutritional claims (NCs) and health claims (HCs) on food products have been introduced as interpretative aids to simplify the information provided on food labelling. However, HCs have been criticised for being unappealing and an information overload on food packages. We aimed to explore whether adding a HC to the associated NC is a good strategy or information overload in a close-to-real non-hypothetical choice experiment with real products and real payments. Consumers’ valuation of two NCs and HCs in breakfast biscuits is measured in two treatments. Treatment A communicates NCs and tests for the external ecological validity of the experiment, while treatment B communicates both, the NC and the associated HC. Results from the willingness to pay estimates showed that consumers are willing to pay premiums for the fat-related HC in addition to the NC while not for the claims related to the fibre content.     

The effectiveness of a nurse-managed perinatal smoking cessation program implemented in a rural county.

The present study (a) examined the effectiveness of a nurse-managed smoking cessation program, that was totally integrated into routine perinatal care, on the cessation rates of pregnant smokers in a rural community, and (b) assessed the subject characteristics associated with smoking cessation success. Data were collected from a convenience sample of 194 pregnant women who stated that they were smokers at the onset of their pregnancies. The study compared the effects of usual care (n = 93) versus the Smoke Free Baby & Me program (n = 101), which included the American Cancer Society's Make Yours a Fresh Start Family program. Smoking status was measured by self-report and urinary cotinine at four points during pregnancy and postpartum. At the postpartum visit, more women in the experimental group reported that they were not smoking compared with those in the control group (37.3% vs. 16.7%), Pearson's chi2 (n = 87) = 4.37, p = .037, and they had higher validated (urinary cotinine <200 ng/ml) smoking cessation rates (n = 80, t = 2.449, p = .017) if they had quit smoking by the first prenatal visit. Smoking cessation was positively associated with level of education and negatively associated with gravidity, parity, the number of smokers in the household, and the number of cigarettes smoked per day at the first prenatal visit. Significant discordance was found between self-report and urinary cotinine assays at all prevalence points, regardless of group. In conclusion, this nurse-delivered program integrated into perinatal care influenced the smoking behaviors of "recent quitters" but had no effect on those who reported smoking at the first prenatal visit. Implications for clinical practice are discussed.     

How does animal welfare taste? Combining sensory and choice experiments to evaluate willingness to pay for animal welfare pork

Although consumers show considerable interest in higher animal welfare, the market share for such products remains low. To provide consumers with a choice regarding different levels of animal welfare, animal welfare labels have been developed. Such product options are intended to serve as intermediate products between conventional products and more expensive organic options that are often associated with high animal welfare standards. This study aims to evaluate whether information about animal welfare practices affects consumers’ liking and willingness to pay (WTP) for a pork product. Using a within-subject design with three evaluation rounds (blind, expectation, and full information) we combine hedonic liking where subjects rate four different types of ham with a choice experiment. Hams differ in the animal husbandry conditions during the rearing and fattening process: conventional rearing, a specific treatment of mother sows, a general animal welfare label, and organic production. Results show an effect of information on consumers’ sensory evaluation of the different products, although products were evaluated to be similar in the blind condition. Consumers rated the organic product higher than those with animal welfare labels while the conventional option had the lowest liking scores. Results from the choice experiment concur with the hedonic rating. Estimates indicate that consumers are willing to pay more for ham bearing a general animal welfare or organic label in the expectation and full information condition. Consequently, information regarding animal welfare affects both consumers’ hedonic liking and WTP for ham.     

The influence of depressive symptoms on smoking cessation among African Americans in a randomized trial of bupropion.

The influence of depressive symptoms on smoking cessation was examined among 600 African American smokers who participated in a randomized, placebo-controlled trial of sustained-release bupropion hydrochloride. Depressive symptoms were assessed at baseline, at week 6 (end of treatment), and at 6-month follow-up. The study examined three separate questions: (a) Whether depressive symptom levels were related to smoking cessation, (b) whether bupropion was more effective for smokers who had higher depressive symptoms at baseline (i.e., a moderator model), and (c) whether changes in depressive symptoms would account for the efficacy of bupropion for smoking cessation (i.e., a mediator model). Depressive symptoms at baseline were not predictive of cessation; however, increases in depressive symptoms from baseline predicted reduced cessation at the end of treatment, and higher depressive symptoms at week 6 and month 6 were associated with a reduced likelihood of smoking cessation at those time points. The moderator model was not supported, but the mediation analyses indicated that alleviation of depressive symptoms partly accounted for bupropion-assisted smoking cessation at end of treatment. Results extend prior findings to African American smokers and suggest that clinicians consider increases in depressive symptoms after quitting rather than baseline depressive symptoms in predicting risk of treatment failure. Results also suggest that even though bupropion may facilitate cessation in part by reducing depressive symptoms, it appears to be no more effective for more depressed smokers, and that mechanisms other than depressive symptom alleviation account for most of its efficacy.