James Nonnemaker

Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study

OBJECTIVE To identify predictors of attempts to stop smoking and predictors of relapse. METHODS This study included 2431 smokers from pre-existing Internet panels in the United States, United Kingdom, Canada, France, and Spain. These panel members are Internet users who have registered voluntarily and agreed to participate in various online research studies. Respondents were aged 35-65 years, smoked >or= five cigarettes per day and intended to stop smoking in the next 3 months. They were followed every 3 months for up to 18 months via Internet contact on measures relating to quit attempts, smoking status, motivation to quit, nicotine cue, weight and weight concern, health-related factors, withdrawal symptoms, and smoking cessation aids. RESULTS In this study, recent quit attempts strongly predicted future attempts, but also predicted subsequent relapse. Motivation to quit was predictive of future attempts but not of relapse/abstinence following the attempts. Relapse to smoking was associated with nicotine dependence, exposure to smoking cues, craving, withdrawal symptoms, and lack of smoking cessation aids. CONCLUSIONS The findings lend support to a model of cessation in which level of motivation to stop generates quit attempts but plays little role in relapse. Dependence, social smoking cues, and a recently failed quit attempt are important factors in relapse.

Public and private domains of religiosity and adolescent health risk behaviors: evidence from the National Longitudinal Study of Adolescent Health

The purpose of this study was to examine the association of public and private domains of religiosity and adolescent health-related outcomes using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of American adolescents in grades 7-12. The public religiosity variable combines two items measuring frequency of attendance at religious services and frequency of participation in religious youth group activities. The private religiosity variable combines two items measuring frequency of prayer and importance of religion. Our results support previous evidence that religiosity is protective for a number of adolescent health-related outcomes. In general, both public and private religiosity was protective against cigarettes, alcohol, and marijuana use. On closer examination it appeared that private religiosity was more protective against experimental substance use, while public religiosity had a larger association with regular use, and in particular with regular cigarette use. Both public and private religiosity was associated with a lower probability of having ever had sexual intercourse. Only public religiosity had a significant effect on effective birth control at first sexual intercourse and, for females, for having ever been pregnant. However, neither dimension of religiosity was associated with birth control use at first or most recent sex. Public religiosity was associated with lower emotional distress while private religiosity was not. Only private religiosity was significantly associated with a lower probability of having had suicidal thoughts or having attempted suicide. Both public and private religiosity was associated with a lower probability of having engaged in violence in the last year. Our results suggest that further work is warranted to explore the causal mechanisms by which religiosity is protective for adolescents. Needed is both theoretical work that identifies mechanisms that could explain the different patterns of empirical results and surveys that collect data specific to the hypothesized mechanisms.

Peer effects in adolescent overweight

This study is the first to estimate peer effects for adolescent weight. We use data from the National Longitudinal Study of Adolescent Health (Add Health) and define peer groups using nominated friends within schools. Endogenous peer groups are accounted for using a combination of school fixed effects, instrumental variables, and alternative definitions of peers (i.e., grade-level peers). Mean peer weight is correlated with adolescent weight, even after controlling endogenous peer groups. The impact of peer weight is larger among females and adolescents with high body mass index. The results are consistent with social multipliers for adolescent overweight policies.

Changes in hospitality workers’ exposure to secondhand smoke following the implementation of New York’s smoke-free law

Objective: To assess the impact on hospitality workers’ exposure to secondhand smoke of New York’s smoke-free law that prohibits smoking in all places of employment, including restaurants, bars, and bowling facilities. Design: Pre-post longitudinal follow up design. Settings: Restaurants, bars, and bowling facilities in New York State. Subjects: At baseline, 104 non-smoking workers in restaurants, bars, and bowling facilities were recruited with newspaper ads, flyers, and radio announcements. Of these, 68 completed a telephone survey and provided at least one saliva cotinine specimen at baseline. At three, six, and 12 month follow up studies, 47, 38, and 32 workers from the baseline sample of 68 completed a telephone survey and provided at least one saliva cotinine specimen. Intervention: The smoke-free law went into effect 24 July 2003. Main outcome measures: Self reported sensory and respiratory symptoms and exposure to secondhand smoke; self administered saliva cotinine specimens. Analyses were limited to subjects in all four study periods who completed a telephone survey and provided at least one saliva cotinine specimen. Results: All analyses were limited to participants who completed both an interview and a saliva specimen for all waves of data collection (n  =  30) and who had cotinine concentrations ⩽ 15 ng/ml (n  =  24). Hours of exposure to secondhand smoke in hospitality jobs decreased from 12.1 hours (95% confidence interval (CI) 8.0 to 16.3 hours) to 0.2 hours (95% CI −0.1 to 0.5 hours) (p < 0.01) and saliva cotinine concentration decreased from 3.6 ng/ml (95% CI 2.6 to 4.7 ng/ml) to 0.8 ng/ml (95% CI 0.4 to 1.2 ng/ml) (p < 0.01) from baseline to the 12 month follow up. The prevalence of workers reporting sensory symptoms declined from 88% (95% CI 66% to 96%) to 38% (95% CI 20% to 59%) (p < 0.01); there was no change in the overall prevalence of upper respiratory symptoms (p < 0.16). Conclusion: New York’s smoke-free law had its intended effect of protecting hospitality workers from exposure to secondhand smoke within three months of implementation. One year after implementation, the results suggest continued compliance with the law.

Exposure to Electronic Cigarette Television Advertisements Among Youth and Young Adults

BACKGROUND AND OBJECTIVE: Currently, the US Food and Drug Administration does not regulate electronic cigarette (e-cigarette) marketing unless it is advertised as a smoking cessation aid. To date, the extent to which youth and young adults are exposed to e-cigarette television advertisements is unknown. The objective of this study was to analyze trends in youth and young adult exposure to e-cigarette television advertisements in the United States. METHODS: Nielsen data on television household audiences’ exposure to e-cigarette advertising across US markets were examined by calendar quarter, year, and sponsor. RESULTS: Youth exposure to television e-cigarette advertisements, measured by target rating points, increased 256% from 2011 to 2013. Young adult exposure increased 321% over the same period. More than 76% of all youth e-cigarette advertising exposure occurred on cable networks and was driven primarily by an advertising campaign for 1 e-cigarette brand. CONCLUSIONS: E-cigarette companies currently advertise their products to a broad audience that includes 24 million youth. The dramatic increase in youth and young adult television exposure between 2011 and 2013 was driven primarily by a large advertising campaign on national cable networks. In the absence of evidence-based public health messaging, the current e-cigarette television advertising may be promoting beliefs and behaviors that pose harm to the public health. If current trends in e-cigarette television advertising continue, awareness and use of e-cigarettes are likely to increase among youth and young adults.

Poverty and child emotional and behavioral problems: Racial/ethnic differences in processes and effects:

Using a sample of four to nine year-old children from the 1992 wave of the Children of the National Longitudinal Surveys of Youth data set, we evaluated racial and ethnic differences in the effects of current poverty and the persistence of poverty on child emotional and behavioral problems, and in the variables responsible for those effects. We considered three sets of variables in the latter analysis-mothers early characteristics and behaviors; correlated sociodemographic characteristics; and mediators (neighborhood problems, mothers psychological resources, and characteristics of the home environment) -and evaluated their relevance across three racial/ethnic subgroups (blacks, Hispanics, and non-Hispanic whites). Consistent with our expectations, we observed a significantly stronger effect of the persistence of poverty on child problems for whites than for blacks, an effect that is attributable to the relatively strong association between poverty and mothers prior history of delinquency and current marital status among whites. The effect of poverty on child problems was substantially explainedfor blacks by mother s early self-esteem, whereas mediating processes took on greater relevance for Hispanics and non-Hispanic whites. Our results support the conclusion that there are racial/ethnic differences in the selection processes and proximal conditions that are responsible for the diminished psychological well-being ofpoor children.

Impact of Targeted Beverage Taxes on Higher- and Lower-Income Households

BACKGROUND Sugar-sweetened beverage (SSB) taxes are increasingly being considered as a strategy for addressing the obesity epidemic. We sought to investigate the differential impact of targeted beverage taxes on higher- and lower-income households. METHODS This analysis relied on data from the 2006 Nielsen Homescan panel, which included a national sample of households that scan and transmit their store-bought food and beverage purchases weekly for a 12-month period. We assessed associations among beverage prices, energy intake, and weight using multivariate regression models. RESULTS A 20% and 40% tax on carbonated SSBs only would reduce beverage purchases by a mean (SE) of 4.2 (1.6) and 7.8 (2.8) kcal/d per person, respectively. Extending the tax to all SSBs generates mean (SE) reductions of 7.0 (1.9) and 12.4 (3.4) kcal/d per person, respectively. Estimated mean (SE) weight losses resulting from a 20% and 40% tax on all SSBs are 0.32 (0.09) and 0.59 (0.16) kg/y per person, respectively. The 40% tax on SSBs, which costs a mean (SE) of

Multiple tobacco product use among adults in the United States: Cigarettes, cigars, electronic cigarettes, hookah, smokeless tobacco, and snus

28.48 (

The Influence of the National truth® Campaign on Smoking Initiation

0.87) per household per year, would generate

Are menthol cigarettes a starter product for youth

2.5 billion (