Annette R. Kaufman

Quit Attempts and Intention to Quit Cigarette Smoking Among Young Adults in the United States

OBJECTIVES We investigated variables associated with quitting behaviors among current, daily, and nondaily young adult smokers in the United States. METHODS Data from the national 2003 Tobacco Use Special Cessation Supplement to the Current Population Survey were analyzed to identify factors associated with quit attempts and serious intention to quit among young adult smokers aged 18 to 30 years (n=7912). RESULTS Daily smokers who smoked 20 or more cigarettes per day, had their first cigarette within 30 minutes of waking, and smoked no usual type were less likely than were their comparison groups to have 1 more or quit attempts. Nondaily smokers who were male, Hispanic, and smoked no usual type of cigarette were also less likely than were their comparison groups to report 1 or more quit attempts. Although unemployed nondaily smokers were more likely than were the employed to report intention to quit, nondaily smokers with an annual family income of

Tobacco-Product Use by Adults and Youths in the United States in 2013 and 2014.

25,000 to

Design and methods of the Population Assessment of Tobacco and Health (PATH) Study

49,000 were less likely than were higher-income families to report intention to quit. CONCLUSIONS Nicotine dependence measures were significantly associated with quitting and intention to quit among daily smokers, but sociodemographics were associated with quitting and intention to quit among nondaily smokers.

Influence of the Dietary Supplement Health and Education Act on Consumer Beliefs About the Safety and Effectiveness of Dietary Supplements

Background Noncigarette tobacco products are evolving rapidly, with increasing popularity in the United States. Methods We present prevalence estimates for 12 types of tobacco products, using data from 45,971 adult and youth participants (≥12 years of age) from Wave 1 (September 2013 through December 2014) of the Population Assessment of Tobacco and Health (PATH) Study, a large, nationally representative, longitudinal study of tobacco use and health in the United States. Participants were asked about their use of cigarettes, e‐cigarettes, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah, snus pouches, other smokeless tobacco, dissolvable tobacco, bidis, and kreteks. Estimates of the prevalence of use for each product were determined according to use category (e.g., current use or use in the previous 30 days) and demographic subgroup, and the prevalence of multiple‐product use was explored. Results More than a quarter (27.6%) of adults were current users of at least one type of tobacco product in 2013 and 2014, although the prevalence varied depending on use category. A total of 8.9% of youths had used a tobacco product in the previous 30 days; 1.6% of youths were daily users. Approximately 40% of tobacco users, adults and youths alike, used multiple tobacco products; cigarettes plus e‐cigarettes was the most common combination. Young adults (18 to 24 years of age), male adults and youths, members of racial minorities, and members of sexual minorities generally had higher use of tobacco than their counterparts. Conclusions During this study, 28% of U.S. adults were current users of tobacco, and 9% of youths had used tobacco in the previous 30 days. Use of multiple products was common among tobacco users. These findings will serve as baseline data to examine between‐person differences and within‐person changes over time in the use of tobacco products. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration.)

Unraveling the Relationship between Smoking and Weight: The Role of Sedentary Behavior

Background This paper describes the methods and conceptual framework for Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study data collection. The National Institutes of Health, through the National Institute on Drug Abuse, is partnering with the Food and Drug Administrations (FDA) Center for Tobacco Products to conduct the PATH Study under a contract with Westat. Methods The PATH Study is a nationally representative, longitudinal cohort study of 45 971 adults and youth in the USA, aged 12 years and older. Wave 1 was conducted from 12 September 2013 to 15 December 2014 using Audio Computer-Assisted Self-Interviewing to collect information on tobacco-use patterns, risk perceptions and attitudes towards current and newly emerging tobacco products, tobacco initiation, cessation, relapse behaviours and health outcomes. The PATH Studys design allows for the longitudinal assessment of patterns of use of a spectrum of tobacco products, including initiation, cessation, relapse and transitions between products, as well as factors associated with use patterns. Additionally, the PATH Study collects biospecimens from consenting adults aged 18 years and older and measures biomarkers of exposure and potential harm related to tobacco use. Conclusions The cumulative, population-based data generated over time by the PATH Study will contribute to the evidence base to inform FDAs regulatory mission under the Family Smoking Prevention and Tobacco Control Act and efforts to reduce the Nations burden of tobacco-related death and disease.

Predictors of regular cigarette smoking among adolescent females: Does body image matter?

The authors conducted two studies to examine the influence of the U.S. Dietary Supplement Health and Education Act (DSHEA) on consumer beliefs about the safety and effectiveness of dietary supplements. Study 1 manipulated information about Food and Drug Administration (FDA) approval in the context of a dietary supplement designed to improve immune system functioning. Study 2 tested the effect of an educational intervention designed to improve knowledge about the DSHEA. Results of Study 1 highlighted deficits in consumer knowledge about FDA regulation of dietary supplements. Results also showed that information about FDA approval failed to have a statistically significant effect on beliefs about safety or effectiveness of the dietary supplement. Results of Study 2 showed that participants who were educated about the regulation of dietary supplements under the DSHEA rated dietary supplements as less safe and less effective than did participants in the control condition. The authors discuss the implications for consumers in the United States and for public policy.

Awareness and Use of Tobacco Quitlines: Evidence from the Health Information National Trends Survey

Research has shown that current smokers have a lower mean body mass index (BMI) than never and former smokers, with former smokers having the highest mean BMI. A number of physiological mechanisms have been hypothesized to explain this pattern, but few studies have explored the possible role of behavioral factors. Using data from the cross-sectional National Health and Nutrition Examination Survey 1999–2006, this descriptive study explored the associations among smoking status, sedentary behavior, and two anthropometric measures (BMI and waist circumference (WC)). Sedentary behavior was significantly higher among current smokers compared to never and former smokers; former smokers had higher levels of sedentary behavior compared to never smokers. The association between smoking status and anthropometric outcomes was moderated by sedentary behavior, with current smokers evidencing higher BMI and WC at higher levels of sedentary behavior compared to lower levels of sedentary behavior. Results are discussed in terms of their implications for interventions, particularly with respect to postcessation weight gain.

What makes consumers think dietary supplements are safe and effective? The role of disclaimers and FDA approval.

This study examined how factors associated with body image predict regular smoking in adolescent females. Data were from the National Longitudinal Study of Adolescent Health (Add Health), a study of health-related behaviors in a nationally representative sample of adolescents in grades 7 through 12. Females in Waves I and II (n = 6,956) were used for this study. Using SUDAAN to adjust for the sampling frame, univariate and multivariate analyses were performed to investigate if baseline body image factors, including perceived weight, perceived physical development, trying to lose weight, and self-esteem, were predictive of regular smoking status 1 year later. In univariate analyses, perceived weight (p<.01), perceived physical development (p<.0001), trying to lose weight (p<.05), and self-esteem (p<.0001) significantly predicted regular smoking 1 year later. In the logistic regression model, perceived physical development (p<.05), and self-esteem (p<.001) significantly predicted regular smoking. The more developed a female reported being in comparison to other females her age, the more likely she was to be a regular smoker. Lower self-esteem was predictive of regular smoking. Perceived weight and trying to lose weight failed to reach statistical significance in the multivariate model. This current study highlights the importance of perceived physical development and self-esteem when predicting regular smoking in adolescent females. Efforts to promote positive self-esteem in young females may be an important strategy when creating interventions to reduce regular cigarette smoking.

Judgments, Awareness, and the Use of Snus Among Adults in the United States

Smoking quitlines, with their demonstrated efficacy and convenience, have become integral to tobacco control efforts in the United States. However, use of quitlines in smoking cessation remains low relative to their potential. To increase quitline use in the United States, a better understanding of current awareness of quitlines is needed. We analyzed data from the 2007 Health Information National Trends Survey (n = 7,674) to identify factors associated with awareness and use of quitlines. Data were weighted to provide representative estimates of the adult U.S. population. Of those surveyed, approximately 50% were aware of quitlines (65% of current smokers) and 3.5% had called a quitline (9% of current smokers). Current and former smokers were significantly more likely to be aware of quitlines than never smokers (p < .01). Age, ethnicity, and education were significantly related to quitline awareness. Looking for health information (OR = 1.40, CI = 1.14–1.73) and having more trust in the government as a source of health information (OR = 1.25, CI = 1.05–1.48) were associated with awareness. Current smoking status was strongly associated with quitline use (OR = 9.25, CI = 3.18–26.85). Respondents who looked for health or medical information from any source, had a personal or family history of cancer, and reported psychological distress were more likely to have called a quitline. While awareness of quitlines appears to be high, quitline utilization is low. Implications and future research directions are discussed.

Receptivity to Tobacco Advertising and Susceptibility to Tobacco Products

OBJECTIVE The present study was designed to examine the effect of the Food and Drug Administrations (FDA) regulatory framework on beliefs about the safety and effectiveness of a dietary supplement. DESIGN An experimental study was conducted with a sample of college students (N = 262). Participants read a description of a dietary supplement, and the experimental manipulations were embedded in the product description. MAIN OUTCOME MEASURES Primary measures of interest included overall knowledge of the FDAs role in regulating dietary supplements and safety and effectiveness ratings of the dietary supplement. RESULTS Results demonstrated that individuals were not very knowledgeable about the FDAs role in regulating dietary supplements. Making participants explicitly aware that the FDA did not approve a dietary supplement lowered safety ratings of the supplement but had no influence on effectiveness ratings. The opposite results were obtained for a structure-function disclaimer in which the presence of the disclaimer lowered effectiveness ratings of the supplement but did not affect safety ratings. CONCLUSION Results highlight the importance of educating individuals about the FDAs role in regulating dietary supplements.