Changes in smoking prevalence in Russia, 1996-2004

Objectives

In Russia, smoking prevalence has historically been high in men and relatively low in women. Female smoking prevalence is predicted to rise but assessment of changes has been limited by the lack of comparable data. Changes in the prevalence of smoking in Russia between 1996 and 2004, and whether theses changes differed by sociodemographic groups, were investigated.

Design

Repeated national interview surveys in 1996 (731 men and 868 women) and 2004 (727 men and 864 women) aged 18 years or more.

Main outcome measure

Prevalence of current smoking.

Results

The age standardised prevalence of smoking in 1996 and 2004 was 61% and 63%, respectively in men and 15% and 16%, respectively in women (both p values > 0.4). In men, the prevalence of smoking seemed to decline in those with university education (from 51% to 40%, p  =  0.085). Among women, smoking appeared to increase in those with university education (from 10% to 17%, p  =  0.071) and low levels of self‐reported material deprivation (from 11% to 18%, p  =  0.053). There was a pronounced increase in prevalence among women living in villages (from 8% to 14%, p  =  0.049); the strong urban/rural gradient seen in 1996 became considerably weaker by 2004.

Conclusions

Overall smoking prevalence in both men and women in Russia remained stable between 1996 and 2004 but, given the sample size, a moderate increase in female smoking cannot be ruled out. In men, smoking increased among the least educated and declined in the most educated. In women the opposite appeared to occur, in addition to an increase in smoking in rural areas. More long term monitoring of smoking patterns in Russia, especially among women, using sufficiently large surveys, is required.     

Cigarette and waterpipe smoking among Lebanese adolescents, a cross-sectional study, 2003-2004.

Waterpipe or "argileh" is a form of smoking other than cigarettes that is currently spreading among people of all ages. The objective of the present study was to assess tobacco smoking practices (waterpipe and/or cigarette) among public and private adolescent school students in Beirut, Lebanon. A sample of 2,443 students selected from 10 private and 3 public schools with intermediate/secondary classes filled out a self-administered anonymous questionnaire that inquired about sociodemographic characteristics, and behavior about tobacco smoking. Binary analysis was performed as well as three regression models for the relationship between exclusive cigarettes smoking, exclusive waterpipe smoking and both cigarettes and waterpipe as the dependent variables and gender, type of school, and class as the independent variables. The current prevalence of cigarettes smoking was 11.4%, and that of waterpipe smoking was 29.6%. Gender was significantly associated with cigarettes (OR=3.2, 95% CI 1.8-5.6) but not waterpipe smoking. Public school students were, respectively, 3.2 (95% CI 1.8-5.6) and 1.7 (95% CI 1.4-2.1) times more likely to be exclusive cigarettes smokers, and exclusive waterpipe smokers. Class was not significantly associated with exclusive cigarette smoking; however, students attending secondary classes were 1.3 (95% CI 1.1-1.6) times more likely to be exclusive waterpipe smokers. The reasons behind the high prevalence of both types of smoking are presented and discussed. The present study calls for school-based prevention programs and other types of interventions such as tax increases, and age-restrictions on tobacco sales. More aggressive interventions to disseminate education and awareness among parents and students altogether are warranted.     

Cigarette smoking and smoking cessation among older adults: United States, 1965-94

OBJECTIVE: To characterise patterns of cigarette smoking and smoking cessation among older adults in the United States. DESIGN: Data from the National Health Interview Surveys (NHIS) 1965-94 were analysed. The NHIS is a cross-sectional survey using a representative national sample. SETTING: In most cases interviews were conducted in the home; telephone interviews were conducted when respondents could not be interviewed in person. PARTICIPANTS: Participants were from a representative sample of the American civilian, non-institutionalised population aged 18 and older. Sample sizes for the years analysed ranged from n = 19,738 to n = 138,988 overall, and n = 3806 to n = 12,491 for those aged 65 years and older. MAIN OUTCOME MEASURES: Using the NHIS data from 1965-94, trends in current smoking and the prevalence of smoking cessation by demographic characteristics among older adults (65 years and older) were assessed and compared with trends among younger adults. A logistic regression analysis was conducted to determine the demographic characteristics of former smokers compared with current smokers among those aged 65 and older. RESULTS: The prevalence of current smoking among 65 year olds and older declined from 1965 to 1994 (17.9% to 12.0%). Although smoking prevalence was lower among older adults than younger adults (aged 18- 64), the rate of decline in smoking was slower among older adults. Among older adults, the prevalence of cessation rose with increasing educational attainment, and was consistently higher for men than for women and for whites compared with blacks. After adjustment for demographic factors among older adults who had ever smoked, increasing age and educational attainment were strongly related to the likelihood of being a former smoker. Although there were no racial differences among women, older white (OR = 2.6) and Hispanic (OR = 3.67) men were significantly more likely to be former smokers than older black men. Also, the gender difference in smoking cessation was noted only for whites. CONCLUSIONS: Given the projected increase in the elderly population, the medical and economic consequences of smoking will become a greater burden in the next decades. Therefore, focusing attention on cessation among the elderly is an immediate and urgent priority for public health professionals and clinicians.


     

中国造纸行业的贸易绩效：1996-2004

应用比较优势原理,引入显示比较优势系数RCA和RC两个指标对我国造纸行业1996-2004年的贸易绩效进行了横向、纵向的分析计算,结果表明,这一时期我国的造纸行业具有显示比较劣势和显示竞争劣势,与芬兰、加拿大等造纸强国相比差距显著.     

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.     

烤烟主要数量性状的配合力研究

按Griffing (Ⅱ)方法对5个烤烟品种及其10个F1组合的10个数量性状进行了配合力分析。结果表明,烤烟亲本的株高、叶数、腰叶长、腰叶宽及总氮等性状的GCA方差均达极显著差异,组合间的产量、烟碱、总糖、还原糖、节距等性状GCA方差和SCA方差达显著或极显著差异,多数性状GCA方差大于SCA方差;5个亲本品种的GCA效应存在差异,云烟87在化学成分性状上GCA效应较优,岩烟97在增加产量方面GCA作用明显,K346在烟叶化学性状上GCA表现较差;K346×云烟87的SCA效应较高。GCA与SCA间不存在直接联系。      

Prevalence of high-risk food consumption and food-handling practices among adults: a multistate survey, 1996 to 1997. The Foodnet Working Group

Risk factors for foodborne diseases include consumption of high-risk foods and unsanitary food-handling practices; however, little is known about the prevalence of these risk factors in the general population. A survey was done in five FoodNet sites (California, Connecticut, Georgia, Minnesota, Oregon) to determine the prevalence of these risk factors in the population. A total of 7,493 adults were interviewed by telephone between 1 July 1996 and 30 June 1997. Results showed that 1.5% drank raw milk, 1.9% ate raw shellfish, 18% ate runny egg, 30% preferred pink hamburger, 93% said they almost always washed their cutting board after cutting raw chicken, and 93% said they almost always washed their hands after handling raw meat or poultry, during 5 days before interview. The results differed by state and demographic group. Consumption of raw shellfish (3.2%) and undercooked hamburger (43%) were more common in Connecticut than other states. Raw milk consumption was more common among people who lived on a farm (8.6%) compared with people who lived in a city or urban area (1.1%). Preference for undercooked hamburger was more common among men (35%), young adults (18 to 25 years, 33%), people with college education (38%), and among people with household income of more than $100,000/year (49%). African-Americans were less likely to prefer undercooked hamburger compared to other racial groups (10% versus 30%). Young adults compared to older adults were less likely to wash their hands after handling raw chicken (88% versus 95%), and men washed their hands less often than women (89% versus 97%). Although there were statistical differences between demographic groups, they are insufficient to warrant targeted educational programs.     

School smoking policies and smoking prevalence among adolescents: multilevel analysis of cross-sectional data from Wales

OBJECTIVE: To examine the association between school smoking policies and smoking prevalence among pupils. DESIGN: Multilevel analysis of cross-sectional data from surveys of schools and pupils. SETTING: 55 secondary schools in Wales. SUBJECTS: 55 teachers and 1375 pupils in year 11 (aged 15-16). MAIN OUTCOME MEASURES: Self-reported smoking behaviour. RESULTS: The prevalence of daily smoking in schools with a written policy on smoking for pupils, teachers, and other adults, with no pupils or teachers allowed to smoke anywhere on the school premises, was 9.5% (95% confidence interval (CI) 6.1% to 12.9%). In schools with no policy on pupils' or teachers' smoking, 30.1% (95% CI 23.6% to 36.6%) of pupils reported daily smoking. In schools with an intermediate level of smoking policy, 21.0% (95% CI 17.8% to 24.2%) smoked every day. School smoking policy was associated with school level variation in daily smoking (p = 0.002). In multilevel analysis, after adjusting for pupils' sex, parents' and best friends' smoking status, parental expectations, and alienation from school, there was less unexplained school level variation, but school smoking policy remained significant (p = 0.041). The association of smoking policy with weekly smoking was weaker than for daily smoking, and not significant after adjustment for pupil level variables. Both daily and weekly smoking prevalence were lower in schools where pupils' smoking restrictions were always enforced. Enforcement of teacher smoking restrictions was not significantly associated with pupils' smoking. CONCLUSIONS: This study demonstrates an association between policy strength, policy enforcement, and the prevalence of smoking among pupils, after having adjusted for pupil level characteristics. These findings suggest that the wider introduction of comprehensive school smoking policies may help reduce teenage smoking.     

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

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

Prevalence and determinants of smoking in three regions of Saudi Arabia

OBJECTIVES: To study the prevalence and determinants of cigarette smoking among Saudi nationals in three regions of Saudi Arabia. PARTICIPANTS: A sample of 8310 individuals aged 15 years and above from both sexes, randomly selected from the three regions, using a stratified cluster sampling technique. DESIGN: A cross-sectional, household, community-based survey. Using a predesigned and tested questionnaire, the participants were interviewed by primary care physicians. The interview covered personal, social, and educational characteristics of the respondents, and also included questions about their smoking status, duration of smoking, and daily cigarette consumption. MAIN OUTCOME MEASURES: Association between current smoking and sociodemographic variables, in univariate and multivariate analysis. Degree of interaction between the different determinants of cigarette smoking. RESULTS: The overall prevalence of current smoking was 21.1% for males and 0.9% for females. Most smokers (78%) were young to middle-aged (21-50 years old). Smoking prevalence was higher among married people, among uneducated people, and among those in certain occupations: manual workers, businessmen, army officers, and office workers. CONCLUSIONS: Cigarette smoking is an important public health problem in Saudi Arabia. A more intense and comprehensive tobacco control effort is needed.     

Prevalence and correlates of smoking on the roof of the world

OBJECTIVE—To determine the prevalence and correlates of cigarette smoking among adults in high mountain rural areas of northern Pakistan.
DESIGN—Cross sectional survey.
PARTICIPANTS—A sample of 4203 adults (aged 18 years and over) were selected by stratified random sampling from 16 villages.
MAIN OUTCOME MEASURE—Self reported smoking prevalence; age of smoking initiation; daily cigarette consumption and association between current smoking and sociodemographic variables, use of snuff, wine, body mass index, blood pressure, family history of stroke, and hypertension.
RESULTS—614/1406 men (43.7%) and 154/2797 (5.5%) women reported smoking cigarettes. The age standardised prevalence of smoking was 40.5% for men and 6.3% for women. Men were more likely (odds ratio (OR) 6.5, 95% confidence interval (CI) 4.75 to 8.79) to be smokers. Smokers were more likely to use snuff (OR 1.39, 95% CI 1.12 to 1.73), drink wine (OR 3.47, 95% CI 2.81 to 4.29), and were more likely to work as farmers (OR 1.55, 95% CI 1.05 to 2.29) or shopkeepers (OR 2.63, 95% CI 1.67 to 4.14). Individuals with college level education and with desirable body mass index were less likely to smoke (OR 0.55, 95% CI 0.35 to 0.87; OR 0.74, 95% CI 0.57 to 0.96).
CONCLUSION—Cigarette smoking is a major public health problem in this high mountain community of Pakistan, particularly among the male population, the majority of whom begin to smoke quite early in life. A comprehensive tobacco control effort incorporated into the existing community based health infrastructure is needed.


Keywords: Pakistan; prevalence of smoking     

Reconsidering stress and smoking: a qualitative study among college students

Background

Although it is widely acknowledged among adult smokers that increases in smoking are often precipitated by stressful events, far less attention has been given to smoking during times of stress among youth.

Aims

To address this gap by drawing attention to the social utility of smoking in contexts associated with stress among college students.

Design

Face‐to‐face semistructured interviews with college freshmen at a large midwestern university in the US.

Participants

Male and female low‐level smokers (n = 24), defined as those who reported regular weekday smoking (typically 3–4 cigarettes a day) and smoking at parties on weekends, were interviewed once in person. In addition, 40 brief interviews with smokers were conducted during final examination.

Measurements

Interviews focused on a range of issues including current smoking behaviour and reasons for smoking. As part of the interview, students were given a deck of cards that listed a range of reasons for smoking. Participants were asked to select cards that described their smoking experience in the past 2 weeks. Those who selected cards that indicated smoking when stressed were asked to explain the reasons why they did so.

Results

A review of qualitative responses reveals that smoking served multiple functions during times of stress for college students. Cigarettes are a consumption event that facilitates a brief social interaction during study times when students feel isolated from their friends. Cigarettes also serve as an idiom of distress, signalling non‐verbally to others that they were stressed. Students described smoking to manage their own stress and also to help manage “second‐hand stress” from their friends and classmates.

Conclusions

Moving away from an individual‐focused analysis of stress to a broader assessment of the social contexts of smoking provides a more nuanced account of the multifunctionalilty of cigarettes in students'' lives. Qualitative research draws attention to issues including the need for smoking and socialising during examination time, smoking as a way to take a break and refocus, notions of second‐hand stress and smoking to manage social relationships.In the past decade, several US‐based studies have reported significant levels of smoking among college students, with approximately 30% of college students reporting having smoked in the past 30 days, and 40% reporting having smoked in the past year.^1,2 Studies have found that a majority of college students who smoke are social smokers, meaning that they smoke more often with others than when alone, particularly when drinking, and that they smoke at low levels.^3,4 To understand better the patterns of low‐level tobacco use, qualitative research was conducted to examine closely the contexts in which students smoked. It has been suggested that a better understanding of the social context of smoking may help enhance tobacco control research and practice.⁵ Two broad contexts that begged consideration were positive social contexts in which tobacco use occurred (such as parties where alcohol was consumed), and contexts associated with stress, be this stressful life events (such as the taking of exams) or stressful events related to the management of social relationships and shifts in identity at this time of transition in life.This article highlights major findings of qualitative research on smoking in contexts associated with stress among college students. It is well established in the general population that increases in smoking are often precipitated by stressful events.^6,7 We draw attention to the social utility of smoking in contexts associated with stress, acknowledging that tobacco use also has psychological and physiological effects when used as a form of stress management and self‐medication.Three major issues guided the research: (1) to explore the extent to which students use smoking as a multifunctional tool for stress management; (2) to determine whether students use smoking as an idiom of distress and a means of showing empathy when a friend is under stress; and (3) to provide details on the complex of motivations that lead students to smoke during examination time.     

Argileh smoking among university students: a new tobacco epidemic.

The recent global increase in argileh use represents the modern renaissance of an old public health threat and a new tobacco epidemic. This study examined argileh smoking knowledge and attitudes in a sample of university students in Beirut as determinants of argileh smoking. Data were collected cross-sectionally through self-administered questionnaires from 416 students at the American University of Beirut through stratified cluster sampling. The proportion of ever-smokers in this study was 43%, compared with the 30% reported 4 years ago. A total of 28.3% of the surveyed students were current argileh smokers, and the average initiation age was 16 years. Compared with argileh smokers, significantly greater proportions of nonsmokers had positive attitudes about argileh banning and more accurate knowledge about argileh. Argileh smoking among Lebanese young is on the rise. Students demonstrated partial knowledge and moderate to favorable attitudes concerning argileh smoking. Possible public health interventions are discussed in light of the social and cultural context of argileh use to neutralize this emerging global public health threat.