Unemployment and smoking: does psychosocial stress matter?

Aim: Research indicates that cigarette smoking is strongly associated with unemployment. However, little is known regarding the underlying mechanisms explaining this relationship. The aim of this study is to examine the role of psychosocial factors as potential mediators between unemployment and smoking. Participants: 4002 non-institutionalised, civilian adults living in the Veneto region of Italy. Design: The study was based on a computer assisted telephone interview (CATI). Linear by linear association tests were used to examine bivariate associations between unemployment, psychosocial factors, and smoking. Logistic regression models were developed to analyse the relationship between unemployment and smoking when adjusting for psychological factors. Results: The odds of smoking among the unemployed was 2.78 times (95% confidence interval (CI) 1.68 to 4.62) greater than that of higher managers and professionals controlling for demographic factors. The relationship between unemployment and smoking weakened (odds ratio 2.41, 95% CI 1.43 to 4.05) when psychosocial factors were entered into the analysis. The odds of the inability to control important things in life was 1.39 times (95% CI 1.11 to 1.75) greater, and the odds of emotional isolation was 1.45 times (95% CI 1.06 to 1.99) greater, among smokers compared to non-smokers controlling, for all other factors. Conclusions: Given that the data were cross sectional, firm conclusions cannot be drawn regarding the causal pathway connecting unemployment and smoking. However, this study suggests that psychosocial factors such as the inability to control and emotional isolation may be plausible mediators for the relationship.     

What public health strategies are needed to reduce smoking initiation?

Smoking initiation is a key behaviour that determines the future health consequences of smoking in a society. There is a marked difference in smoking patterns around the world, driven by initiation rates. While a number of high-income countries have seen smoking prevalence decline markedly from peak, many low-income and middle-income countries appear to still be on an upward trend. Unlike cessation where changes are limited by nicotine dependence, rates of smoking initiation can change rapidly over a short time span. Interventions that can be effective in achieving this include increases in the price of tobacco products, mass media anti-smoking advertising, smoke-free policies, smoking curricula in schools, restrictions on marketing opportunities for the tobacco industry as well as social norms that lead to restrictions on adolescents' ability to purchase cigarettes. Comprehensive tobacco control programmes that aim to denormalise smoking behaviour in the community contain all of these interventions. Rapid reductions in smoking initiation in adolescents have been documented in two case studies of comprehensive tobacco control programmes in California and Australia. Consistent and inescapable messages from multiple sources appear to be key to success. However, the California experience indicates that the rapid decline in adolescent smoking will not continue if tobacco control expenditures and the relative price of cigarettes are reduced. These case studies provide strong additional evidence of the importance of countries implementing the provisions of the Framework Treaty on Tobacco Control.     

Why does smoking so often produce dependence? A somewhat different view

The usual explanation for why smoking produces dependence focuses on the effects of nicotine on dopamine and other neurobiological explanations. This review offers four somewhat different explanations: (1) nicotine can offer several psychopharmacological benefits at the age when such benefits are especially needed; (2) cigarettes provide for a rapid, frequent, reliable and easy-to-obtain reward; (3) nicotine is not intoxicating, allowing chronic intake; and (4) the long duration of the nicotine withdrawal syndrome effectively undermines cessation. This article reviews the evidence for the above views and the tobacco control activities these views suggest.     

Public health measures to reduce smoking prevalence in the UK: how many lives could be saved?

Objective: To estimate the number of deaths that could be prevented in the UK by implementing population strategies to reduce smoking prevalence. Design: A prospective analysis of future mortality using recent national smoking prevalence data and relative risks of mortality in current smokers, ex-smokers, and never-smokers. Population: Smokers in the UK. Interventions: Population measures of proven effectiveness assumed to reduce smoking prevalence by 1 percentage point per year for 10 years, or alternatively by 13% over 19 years (1 percentage point per annum for seven years, 0.5 percentage point per annum for 12 years) as considered to be achievable in a recent report to the UK Chancellor of the Exchequer. Main outcome measure: Estimated deaths from smoking prevented in the 35–75 year age group. Results: Reducing the prevalence of smoking by 1 percentage point each year for 10 years would prevent 69 049 deaths at ages between 35 and 74 years during that period. The model of reduction by 13% over 19 years would prevent 54 308 and 194 493 deaths in 10 and 19 years, respectively. Continued prevalence reductions at the current rate of 0.4 percentage points each year will prevent 23 192 deaths over 10 years. Conclusions: Full implementation of simple population measures to encourage smoking cessation could prevent substantial numbers of deaths in the UK.     

The sediment-water flux of HOCs due to "diffusion" or is there a well-mixed layer? If there is, does it matter?

In most present modeling of the sediment-water flux of hydrophobic organic chemicals (HOCs), the flux due to sediment erosion/deposition is described explicitly by means of a sediment transport model, while the remaining components of the flux (molecular diffusion, bioturbation, and groundwater flow) are lumped together and modeled as a "diffusive" flux. This diffusive flux is usually described by means of a mass transfer approximation with the implicit assumption of a well-mixed contaminant layer of thickness h in the sediments. On the basis of recent experiments and theoretical modeling, the justification forthis assumption and the quantification of this diffusive flux are discussed here. In particular, for HOCs with large partition coefficients, it is argued that a well-mixed layer often may not exist, and, when it does, it is slow to form; that h is difficult to define and even harder to quantify; and that, as far as long-term predictions (up to 100 years) of this diffusive flux are concerned, the exact value for h probably does not matter. What does matter are the magnitudes and time dependencies of each of the components of the flux and the interactions between the diffusive flux and the flux due to erosion/deposition.     

Women infant school teachers: how does society view them and how do they consider their professional role?

'Feminine professions', such as infant school teachers, nurses, social workers and others, which emerged and grew as a consequence of a second stage in industrial development, through welfare state policies in times of postwar consensus, are under challenge because of liberal policies. In this article we want to reflect and clarify the contradictory situation of infant school working women, how they feel about their professional role, and their role as women and as workers. In order to make these points clear, we refer to research developed mainly with infant school teachers and nurses in Navarra, Spain, from 1993 to 1996. In this article, however, we are going to concentrate on women infant school teachers and, in particular, their professional perception, personal esteem, social role and satisfaction at work.     

Out of the Smokescreen: does an anti-smoking advertisement affect young women's perception of smoking in movies and their intention to smoke?

Objective: To evaluate the effect of an anti-smoking advertisement on young women's perceptions of smoking in movies and their intention to smoke.

Subjects/setting: 2038 females aged 12–17 years attending cinemas in New South Wales, Australia.

Design/intervention: Quasi-experimental study of patrons, who were surveyed after having viewed a movie at their local cinema. The control group was surveyed during week 1 and the intervention group, during week 2. Before seeing the movie in week 2, a 30 second anti-smoking advertisement was shown, which featured a well known female actor drawing attention to the prevalence of smoking in movies.

Outcomes: Attitude of current smokers and non-smokers to smoking in the movies; intention of current smokers and non-smokers to be smoking in 12 months time.

Results: Among non-smokers, 48.2% of the intervention subjects thought that the smoking in the movie they viewed was "not OK" compared with 28.3% of the control subjects (p < 0.0001). However, there was no difference among smokers in the intervention (26.4%) and control (16.9%) groups (p = 0.28). A higher percentage of current smokers in the intervention group indicated they were unlikely to smoke in 12 months time (47.8%) than smokers in the control condition (31.9%) (p = 0.03). For non-smokers, there was no difference in smoking intentions between conditions, with 95% saying they would be unlikely to be smoking in 12 months time.

Conclusions: This "real world" study suggests that placing an anti-smoking advertisement before movies containing smoking scenes can help to "immunise" young women against the influences of film stars smoking.

     

Which smokers use the smoking cessation Quitline in Hong Kong,and how effective is the Quitline?

Objective: To describe the characteristics of the Chinese subjects who utilised the first telephone smoking cessation service in Hong Kong, and to evaluate its effectiveness.

Methods: The Quitline provided Hong Kong residents with free telephone smoking cessation services which was publicised through a press conference, media reports, pamphlets, and posters at public and private hospitals and clinics. Callers who completed an initial interview from 13 December 2000 to 31 May 2002 were included. Smokers were interviewed using a structured record sheet and provided with stage matched counselling. A follow up interview was carried out after six months. Analysis was conducted by intention-to-treat.

Results: Of the 1120 callers who completed initial assessments, 1047 were current smokers and 872 consented to follow ups. Compared to the general smoking population, the Quitline attracted more of those who were female, younger, single, unemployed, higher educated, smoking more than 20 cigarettes per day, and those with quitting experience. At six months, 12% (95% confidence interval 10% to 15%) of the participants reported that they had not smoked a cigarette for the past seven days. A stepwise logistic regression model showed that the use of nicotine replacement therapy at the present attempt to quit, having made one or more serious attempts to quit in the past, perceiving less difficulties in quitting, and smoking the first cigarette at age 15 years or above were significant predictors of quitting.

Conclusion: This first Quitline in Asia appears to be acceptable to Chinese smokers, with quit rate comparable to those of better funded Quitlines in the West. A low cost Quitline is a promising model for smoking cessation services in the East.

     

Smoking,social class,and gender: what can public health learn from the tobacco industry about disparities in smoking?

Objective: To discover how the tobacco industry considers social class and gender in its efforts to market cigarettes in the USA, particularly to socially disadvantaged young women. Methods: A systematic on-line search of tobacco industry documents using selected keywords was conducted, and epidemiological data on smoking rates reviewed. Results: The two largest cigarette manufacturers in the USA consider "working class" young adults to be a critical market segment to promote growth of key brands. Through their own market research, these companies discovered that socially disadvantaged young women do not necessarily desire a "feminine" cigarette brand. Conclusions: Considering the tobacco industry''s efforts, alongside the persistent and growing disparities in cigarette smoking by social class, and the narrowing of differences in smoking by gender, it is concluded that additional tobacco control resources ought to be directed toward working class women.     

Nutraceutical intervention with colostrum replacer: Can we reduce disease hazard,ameliorate disease severity,and improve performance in preweaned dairy calves?

The objective of this randomized clinical trial was to determine if an intervention with colostrum replacer (CR; Premolac Plus, Zinpro; 125 g/d fed for 3 d) or a placebo milk replacer (Cows Match, Land O'Lakes Inc.; 125 g/d for 3 d) following a triggered alarm could ameliorate disease bouts in dairy calves. The alarm was set to detect negative deviations of milk intake (20% reduction) or drinking speed (30% reduction) in relation to a calf's 12-d rolling average feeding behavior. Calves were enrolled on this study (n = 42 CR, n = 42 placebo) when they triggered an alarm from d 14 to 50 on the feeder before weaning. Once calves were enrolled, calves received a bottle of either 125 g of CR or milk replacer mixed with 1 L of water for 3 d. Calves were enrolled on the automated milk feeder at age 4.0 ± 2.0 d (mean ± SD), were offered 10 L/d of the same milk replacer fed as a placebo, and had ad libitum access to calf starter measured by automated feeders. Weaning began at d 50, with 50% reduction of milk replacer across 14 d, and an additional 20% reduction for another 7 d before weaning at d 70. Calves were health scored from birth to 2 wk postweaning (88 ± 2.0 d of age) daily for bovine respiratory disease (BRD) and diarrhea, and were weighed and scored using lung ultrasonography twice weekly. A BRD score ≥5 and an area of consolidated lung ≥3.0 cm² was considered BRD positive; diarrhea was defined as a watery fecal consistency that sifted through the bedding. The effect of CR on BRD and diarrhea likelihood were calculated with logistic models; the 7 d before and after an alarm were fixed effects, with milk intake as a covariate. A Cox proportional hazards model evaluated the effect of CR on the hazard of being positive for BRD and diarrhea following enrollment, with sex as a fixed effect in the diarrhea model. The effect of CR on average daily gain the week following intervention was evaluated with linear modeling with repeated measures, and birth date was a random effect. After intervention, placebo calves had 1.64 (95% CI: 1.11–2.43) times greater odds of having a BRD bout compared with CR calves for the 7 d following intervention. Moreover, placebo calves had 1.50 (95% CI: 1.11–2.08) times greater odds of having lobar lung consolidation in the 7 d after intervention than CR calves. No difference was found in the likelihood of diarrhea in the 7 d after intervention (odds ratio: 0.91; 95% CI: 0.71–1.16). However, placebo calves had a 2.38 (95% CI: 1.30–4.33) times greater hazard of incurring BRD in the 14 d after intervention. Average daily gain was not associated with an intervention with CR for the 7 d after intervention (placebo: 0.73 ± 0.07 kg/d; CR: 0.70 ± 0.08 kg/d; LSM ± SEM). These results suggest CR may reduce BRD likelihood but did not influence growth in calves offered high allowances of milk. Future research should examine which properties of CR ameliorate BRD in calves.     

Is household smoking status associated with expenditure on food at restaurants,alcohol, gambling and insurance? Results from the 1998–99 Household Expenditure Survey,Australia

Aim: To examine how household expenditure on food at restaurants, alcohol, gambling and insurance vary between smoking and non-smoking households.