Smoking behavior, knowledge, attitudes and practice among health care providers in Changsha city, China.

With the smoking epidemic in China, the role that health care providers (HCPs) could play in tobacco control will be critical. As a preliminary step, this study identified smoking behavior, knowledge, attitudes, and practice (KAP) regarding smoking and smoking control among HCPs in Changsha city, China. The study design was cross-sectional. The instruments - Demographic Information Scale and KAP Scale - were distributed to 420 physicians and 400 nurses in four hospitals in Changsha city. The effective response rate was 77.56% (636/820). Among the respondents, 20.8% were current smokers, which represented 35.7% of the physicians and 1.4% of the nurses, and 43.0% of the males and 1.2% of the females. The mean knowledge score was 22.3+/-4.4 (n = 30). Knowledge regarding smoking's harmful effects and smoking-related respiratory system diseases was high. Nonetheless, tobacco addiction was underestimated. The mean attitudes and practice score was 17.7+/-2.3, 15.1+/-3.4 (n = 20). Eighty-seven percent approved their role in smoking control, but only 45% HCPs practically informed patients about methods of smoking cessation. Smoking behavior was negatively associated with KAP, and 59.7% of the HCPs thought that inadequate knowledge affected their practice. In conclusion, HCPs had some knowledge and positive attitudes regarding the cessation of smoking, but were relatively unoptimistic regarding putting smoking control into practice. The high smoking rate among male HCPs and knowledge insufficiency about smoking may pose barriers in tobacco control efforts for HCPs. As such, interventions for the cessation of smoking, and continual education on smoking control for HCPs, are indicated in China.     

Smoking behavior among hospital staff still influences attitudes and counseling on smoking.

Smoking among health professionals has been shown to influence smoking-related knowledge and counseling in clinical practice. The evidence regarding smoking as a risk factor has increased in the past decade. The present study was carried out in 2000 and investigated the associations between individual smoking behavior among hospital staff and (a). smoking-related knowledge, (b). attitudes toward counseling on smoking, and (c). self-reported smoking-related counseling provided by the staff. The study was based on a survey using self-administered questionnaires given to all hospital staff in a large university hospital in Denmark. Altogether, 82% of staff (2561) returned a completed questionnaire. Analyses focused on a subsample consisting of health professionals in the clinical wards (1429). Multivariate analyses were performed in which smoking-related knowledge, attitudes toward smoking-related counseling, smoking-related counseling practices, and self-rated qualifications for counseling were main outcome measures. Health professionals who were current smokers systematically underestimated the health consequences of smoking and differed significantly from nonsmokers in their assessments of smoking as a risk factor. Nonsmokers might overestimate smoking as a risk factor. Nonsmokers gave patients advice on smoking cessation significantly more often than did current smokers (ex-smokers, OR=2.5, 95% CI=1.8-3.4; never-smokers, OR=1.5, 95% CI=1.1-2.0). Ex-smokers and smokers felt significantly more qualified to counsel patients about smoking than did never-smokers (ex-smokers, OR=1.8, 95% CI=1.3-2.5; smokers, OR=1.4, 95% CI=1.0-1.9). Individual smoking behavior among hospital staff was strongly associated with smoking-related knowledge, attitudes, and counseling practices. Lack of self-rated qualifications was a major barrier to professional counseling on smoking in a hospital framework.     

Smoking practices, risk perception of smoking, and environmental tobacco smoke exposure among 6th-grade students in Ciudad Juárez, Mexico.

This study assessed the smoking practices, risk perception of smoking, and environmental tobacco smoke (ETS) exposure among adolescents in Ciudad Juárez, Mexico. We used a cross-sectional method to examine the smoking practices, risk perception of smoking, and ETS exposure of 6th-grade students (N=506), aged 11-13 years, attending six randomly selected middle schools. Schools were classified by school setting (i.e., public vs. private) and socioeconomic status (SES; i.e., low, middle, or high). The results indicated that 6th-grade students attending a public, low-SES school setting in Ciudad Juárez not only exhibited significantly higher rates of ETS exposure at home and in public places (p<.01) but also were more likely to have tried smoking (p<.01) and to be current smokers (p<.01), and were less likely to support a ban on smoking in public places (p<.01), compared with students who attended a private school or a public, middle- or high-SES school setting. These results provide further evidence that public health interventions to prevent initiation of smoking and to assist in smoking cessation among adolescents and to reduce their ETS exposure at home and in public need to target all school-aged students, especially those attending school in a low-SES settings.     

Compliance with orthokeratology care among parents of young children in Taiwan

ObjectivesTo evaluate compliance with orthokeratology (Ortho-K) care and its influencing factors among parents of 6–13-year-old myopic children in Taiwan.MethodsParents who are responsible for the care of the Ortho-K lenses of their myopic children were recruited through a closed Facebook peer support group to answer an online compliance questionnaire, including the wear and care behaviours and follow-up visits of Ortho-K.ResultsA total of 253 online questionnaires were analysed after excluding those with wrong information. Most participants (89.7%) were mothers and had university-level or higher education (72.3%); 67.6% of them could achieve a score equal or higher than 60% correct rate on knowledge items. In addition, 39.3% of participants had high myopia (spherical equivalent ≦ 6.0 diopters). The mean age at onset of myopia was 7.75 years for children, and 57.4% wore Ortho-K lenses for less than a year. Full compliance rate was 22.8%, as reported by fathers or mothers. The compliance rate for follow-up visits significantly increased with provision of axial length information in follow-up visits, knowledge of axial length changes as an effect of myopia control, and Ortho-K use for less than 6 months. The compliance rate for wear and care was significantly associated with high myopia in one of parents, high education level, early onset of myopia in children, knowledge of Ortho-K and myopia control, and Ortho-K use for less than 6 months.ConclusionThese results indicate the need for a comprehensive education programme for parents with young myopic children to ensure strict adherence to fitting and wear protocols and good follow-up of Ortho-K lenses.     

Smoking cessation pharmacotherapy preferences in rural primary care.

Pharmacotherapy is a critical adjunct to smoking cessation therapy. Little is known about relative preferences for these agents among smokers in primary care settings. In the context of a population-based clinical trial, we identified 750 smokers in primary care practices and independent of their readiness to quit offered them a free treatment course of either bupropion or transdermal nicotine replacement (TNR). Smokers opting for pharmacotherapy completed standardized contraindication screens that were reviewed by the patient's primary care physician. Most participants (67%) requested pharmacotherapy. Use of pharmacotherapy was positively associated with higher nicotine dependence and readiness to quit. Of the smokers requesting pharmacotherapy, 51% requested bupropion and 49% requested TNR. Choice of bupropion was related to no history of heart disease and no previous use of bupropion. Although potential contraindications to treatments were identified for 21.7% of bupropion and 6.6% of TNR recipients, physicians rarely felt that these potential contraindications precluded the use of these agents. When cost is removed as a barrier, a large proportion of rural smokers are eager to use smoking cessation pharmacotherapy, especially agents that they have not tried before. Although some comorbid conditions and concurrent drug therapies were considered contraindications, particularly to bupropion, physicians rarely considered these clinically significant risks enough to deny pharmacotherapy.     

Discordance in risk perception between children,parents, and teachers in terms of consumption of cheap and poorly nutritious food sold around schools

Little is known about the eating behavior of Asian children when faced with a range of poorly nutritious foods sold around schools, and whether they appreciate the risks involved in consuming such foods. To provide adequate education regarding proper food consumption, it is essential to understand how children perceive the potential risks and to examine their actual eating behaviors. The perceptions of adults and children should also be compared. This study selected children from the most populous primary schools (n = 166) in 36 of the national capital regions of the Republic of Korea. A total of 443 children were randomly selected from each school and they, their parents (n = 425), and nutrition teachers (n = 166) were asked to complete a questionnaire (total 11 questions) designed to examine how children and adults perceived the risks associated with the consumption of cheap and poorly nutritious foods sold around schools. Most children (>70%) consumed these foods more than once per week, even though they were aware that they may be potential hazardous. Children were significantly less concerned about the risks associated with their eating behaviors than their parents and teachers (p < 0.05), particularly regarding snacks prepared and cooked under unhygienic conditions. Although parents and teachers were very concerned about children’s food consumption, they misunderstood the level of children’s awareness, their preferences, and their actual eating behaviors. This study generated a database of information about children’s actual eating behavior around schools, and the perception (by children, parents, and teachers) of the risks. This database may contribute to the design of suitable educational programs for children, parents, and teachers.     

Smoking cessation patterns and predictors among adult Californians of Korean descent.

This paper describes smoking cessation among adult California residents of Korean descent, based on a telephone survey (N = 2,830). The overall quit rate (number of former smokers divided by number of ever-smokers) was 55.0% (55.8% among males and 49.6% among females). Acculturation was negatively associated with 90-day abstinence after controlling for demographic, social support, health belief, environmental, lifestyle, and respiratory illness history variables (OR = 0.59, 95% CI = 0.38-0.91). Those with lower acculturation, higher body mass index, a social network discouraging smoking, home smoking restriction, correct beliefs about smoking harm, and significant concern about one's health were most likely to quit smoking for 90 days or longer. Results suggest that social and situational conditions should be included in the design of smoking cessation interventions among Koreans.     

数字与感知:风险事件特征在食品安全风险交流中的重要性

当前,食品安全问题燃点低、炸点多,容易引起人们强烈的情绪反应;笔者认为,在突发事件中,理性很难穿透情绪的厚墙。本文归纳了专家与非专家在风险认知模式上的主要区别,强调食品安全工作者需要跳出技术的框框,运用社会学的成果,将公众的风险认知特点纳入风险交流策略中;最后从风险交流操作层面提出几项工作建议,“急人民之所急”,可为早期危机预警争取主动,以期引起更深入的讨论。     

海拉尔城镇居民吸烟和饮酒现况调查

目的:了解海拉尔城镇居民吸烟、饮酒现状与影响因素。方法:采用整群抽样的方法,对海拉尔18岁以上城镇居民吸烟和饮酒状况进行问卷调查。结果:被调查居民吸烟率为26.2%,其中男性为62.4%,女性为4.2%;被调查居民饮酒率为29.1%,其中男性为61.8%,女性为9.3%。非条件Logistic回归分析表明,居民吸烟的影响因素为性别、年龄、文化程度和家庭月人均收入;饮酒的影响因素为性别、年龄和职业。男性开始吸烟饮酒的年龄低于女性(P0.05),每日吸烟量、饮酒频率和每日酒精摄入量均高于女性(P0.01)。现在饮酒者中,60.0%的男性每日酒精摄入量超过25g;33.3%的女性每日酒精摄入量超过15g。结论:海拉尔城镇居民吸烟和饮酒率较高,饮酒量大,过量饮酒者较多,应开展多种形式的健康教育,倡导健康的生活方式。     

Smoking cessation by socioeconomic status and marital status: the contribution of smoking behavior and family background.

We studied socioeconomic status and marital status as predictors of smoking cessation, adjusting for previous smoking behavior and family background by using a large Finnish prospective twin dataset unselected for smoking behavior. The data were collected by postal surveys in 1981 and 1990, and the sample comprised 3,069 current smokers, of whom 20% had quit smoking by 1990. Logistic regression analyses of all twin individuals and conditional logistic regression analysis of discordant pairs were used to predict smoking cessation. High education predicted smoking cessation among both men (OR=2.32, 95% CI=1.31-4.10) and women (OR=3.98, 95% CI=1.85-8.51) as did high social class among women. Additionally, starting at a late age, smoking a small number of cigarettes per day, and a low level of nicotine per cigarette predicted cessation. Socioeconomic differences in cessation diminished only slightly when we adjusted for smoking behavior factors. Among the twin pairs who were discordant in terms of smoking cessation, the twin who continued smoking also smoked more on average at baseline (men: OR=.94, 95% CI=.89-.99; women: OR=.82, 95% CI=.71-.94). The male twins who continued smoking had a smaller probability of getting married during the follow-up than had the cotwin who had quit smoking (OR=3.91, 95% CI=1.02-15.02). Indicators of socioeconomic status were important predictors of smoking cessation even when we adjusted for previous smoking behavior. For men, marriage was associated with an increased probability of cessation     

Smoking cessation interventions among Chinese Americans: the role of families, physicians, and the media.

This article describes the results from two studies of Chinese Americans. In one study, a convenience sample of patients completed face-to-face interviews to assess smoking patterns in the home, knowledge of tobacco, and ways in which health interventions could be communicated to the community. The other study involved two focus group discussions with the primary purpose of learning how spouses, health care workers, and the media can participate in smoking cessation interventions. A convenience sample of 795 patients at the Charles B. Wang Community Health Center in New York City's Chinatown was interviewed using face-to-face interviews. The focus group discussions were conducted using 15 volunteers. One discussion was conducted in Mandarin and the other in Cantonese. Although 92.7% of the respondents prefer people not smoke in the home, only 21% ban smoking with few exceptions. The focus group participants indicated that often the smoker is the oldest male and he also is the person who establishes the rules. Nearly half of the respondents receive most of their health-related information from their physician, and the focus group participants stated that physicians are highly regarded in their culture. Finally, the majority of respondents receive health-related information from Chinese language media. These results will assist in the planning of a smoking cessation intervention targeting Chinese Americans. The physician represents a key player in any intervention, and public health antismoking messages may be communicated effectively through Chinese language media.     

我国农村居民对食品添加剂的风险感知及影响因素

目的了解我国农村居民对食品添加剂风险感知的现状,并分析核心影响因素。方法运用心理学测量方法设计调查表,对全国7省份农村居民进行随机抽样调查。结果农村居民对于食品添加剂有较高的风险感知,65.5%的受访者存在概念误区,将三聚氰胺等违法添加物视为食品添加剂,但公众对食品添加剂风险的高感知,主要影响因素是政府信任而非概念知识的缺乏。结论要促进农村居民科学、理性的看待食品添加剂,应以政府信任培育为交流工作的核心策略目标。     

Prevalence and predictors of smoking behavior among Vietnamese men living in California.

Vietnamese populations in Vietnam and the United States have a high prevalence of smoking. The associations among behavioral risk factors, acculturation, and smoking among the Vietnamese population living in the United States are not well documented. The present study aimed to identify the factors associated with smoking behavior among Vietnamese men living in Santa Clara County, California. A cross-sectional random-digit-dialed telephone survey was conducted. The sampling frame consisted of 27 Vietnamese surnames from the Santa Clara County telephone directory. A total of 660 adult respondents were interviewed to collect information on general health status, alcohol and tobacco use, HIV/AIDS, sexual behavior, injury control, hypertension, cholesterol screening, and acculturation. Of the 660 adults interviewed, 364 (55.2%) were male and 296 (44.8%) were female. Among males, 31.9% were current smokers, and among females, only one woman reported smoking. Univariate analyses revealed that having less than a college education, having poor English language skills, using Vietnamese at home and with friends, being less acculturated, not having a routine physical or blood cholesterol check, and being a binge drinker were significantly associated with an increased likelihood of smoking. Multivariate analysis revealed two independently associated factors: Respondents who were more acculturated were less likely to smoke (OR = 0.38, 95% CI = 0.18-0.83), and those not having cholesterol checked were more likely to smoke (OR = 2.48, 95% CI = 1.30-4.71). Acculturation level was inversely associated with smoking among Vietnamese adult men in Santa Clara County. Other health risk behaviors coexisted with smoking behavior and should be considered in prevention programs.