Kristen L. McCausland

A Closer Look at Smoking Among Young Adults: Where Tobacco Control Should Focus Its Attention

OBJECTIVES We sought to fill gaps in knowledge of smoking behaviors among college-educated and non-college-educated young adults. METHODS We used data from the 2003 Tobacco Use Supplement of the Current Population Survey to analyze smoking behaviors among young adults aged 18-24 years and older young adults aged 25-34 years by college status (enrolled, or with a degree, but not enrolled) and other measures of socioeconomic position. RESULTS Current smoking prevalence among US young adults aged 18-24 years who are not enrolled in college or who do not have a college degree was 30%. This was more than twice the current smoking prevalence among college-educated young adults (14%). Non-college-educated young adults were more likely than were college-educated young adults to start smoking at a younger age and were less likely to have made a quit attempt, although no differences were found in their intentions to quit. Higher rates of smoking in the non-college-educated population were also evident in the slightly older age group. CONCLUSIONS Non-college-educated young adults smoke at more than twice the rate of their college-educated counterparts. Targeted prevention and cessation efforts are needed for non-college-educated young adults to prevent excess morbidity and mortality in later years.

Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis

Abstract Objectives To describe the prevalence of obesity, smoking, and both health risk factors together among adults in the United States. Design Cross sectional analysis of a national health interview survey. Setting United States. Participants 29 305 adults (aged ≥ 18) in 2002. Main outcome measures Prevalence of adults who are obese (body mass index ≥ 30), who smoke, and who are obese and smoke. Prevalence was stratified by age, sex, ethnic group, education, and income. Results 23.5% of adults were obese, 22.7% smoked, and 4.7% smoked and were obese. Conclusions Although the proportion of adults who smoke and are obese is relatively low, this subgroup is concentrated among lower socioeconomic groups.

Prevalence of Trial of Snus Products Among Adult Smokers

A 2008 survey assessed the proportion of smokers in 8 geographic areas who reported trying snus. In test markets, 10% of smokers had tried snus in the past year. Among young adult men, the trial rate was 29%. Trial was more likely among Whites than among minorities, among respondents with lower education than among those with higher education, and among those without immediate plans to quit smoking than among those intending to quit in the next 30 days. The association between trial and low cessation motivation is an important target for research.

The Path to Quit: How Awareness of a Large-Scale Mass-Media Smoking Cessation Campaign Promotes Quit Attempts

INTRODUCTION Although awareness of mass-media smoking cessation campaigns is hypothesized to affect quit behavior through changes in cessation-related attitudes, intentions, and motivation (cognitions), this has yet to be formally tested. METHODS Structural equation modeling was used to examine whether changes in cessation-related cognitions mediate the relationship between awareness of a national mass-media smoking cessation campaign, the EX campaign, and quit attempts in a cohort of 3,571 current smokers drawn from eight U.S. Designated Market Areas and followed over an approximate six-month period. Models were examined in the total sample and within racial/ethnic, gender, age, and educational strata. RESULTS Data suggest that there are both a direct effect of confirmed awareness of EX on quit attempts as well as an indirect effect mediated by positive changes in cessation-related cognitions. Results are not uniform across subgroups; stratified analyses reveal that awareness of EX is significantly associated with positive changes in cessation-related cognitions and quit attempts only in Blacks, males, and those with less than a high-school education. CONCLUSIONS Those developing health communication mass-media campaigns need to consider how media messages might differentially impact U.S. subpopulations in order to elicit desired behavioral change across target subgroups.

Women's Knowledge of the Leading Causes of Cancer Death

This paper describes adult womens knowledge of the leading causes of cancer mortality among women. Exposure to antismoking advertisements or media messages also is examined as a potentially effective mechanism for changing inaccurate beliefs. We used data from the 2002 and 2003 American Smoking and Health Survey (ASHES), a national telephone survey of adults, to measure womens knowledge about cancer mortality. Logistic regression models were used to estimate the likelihoods of women indicating either breast or lung cancer as the leading cause of cancer mortality among women. The independent influence of individual characteristics such as race, smoking status, education, and awareness of antismoking messages or advertising on womens knowledge of cancer mortality was assessed. Overall, 66.7% of women inaccurately indicated breast cancer as the leading cause of cancer death among women, whereas 29.7% of women correctly indicated lung cancer. Black women were 43% less likely than White women to indicate lung cancer as the leading cause of cancer mortality among women. Current smokers were 35% less likely than noncurrent smokers to state that lung cancer is the leading cause of cancer mortality among women. Awareness of antismoking messages or advertisements was associated with a higher probability of correctly indicating lung cancer as the leading cause of cancer mortality among women. Our evidence suggests that antismoking media messages may help to correct inaccurate beliefs about the leading causes of cancer death among women.