Linda Crossett

Smoking initiation and smoking patterns among US college students.

The ages at which 18- to 24-year-old college students started smoking and its relationship to subsequent smoking were explored, using data from the 1995 National College Health Risk Behavior Survey. Most students (70%) had tried smoking; among those who had tried, 42% were current smokers, 19% were current frequent smokers, and 13% were current daily smokers. The majority (81%) who had ever smoked daily began doing so at age 18 years or younger, and 19% began smoking daily at age 19 years or older. Women were as likely as men to report ever having smoked a whole cigarette or ever having smoked daily. Most students (82%) who had ever smoked daily had tried to quit, but 3 in 4 were still smokers. Policies and programs designed to prevent the initiation of smoking and to help smokers quit are needed at both the high school and the college levels to reduce the proportion of young adults who smoke cigarettes.

Other substance use among high school students who use tobacco

PURPOSE To examine relationships between tobacco use and use of other substances among U.S. high school students, by gender and racial/ethnic subgroups. METHODS Data about tobacco and other substance use were analyzed from the 1995 national Youth Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. RESULTS Compared to nonsmokers, current smokers were significantly more likely to report use of all other substances we examined, including lifetime use of cocaine, inhalants, other illegal substances, and multiple substances and current alcohol use, episodic heavy drinking, marijuana use, and cocaine use. A strong dose-dependent relationship between current cigarette smoking and other substance use was identified. Among smokeless tobacco users, a strong dose-dependent relationship was found for all examined substances with the exception of lifetime and current cocaine use. Finally, a pattern of risk emerged suggesting that the likelihood of other substance use increases as students move from no tobacco use to smokeless tobacco use only, to cigarette smoking only, and to use of both smokeless tobacco and cigarettes. CONCLUSIONS Programs designed to prevent tobacco or other substance use should consider that such use often occurs concomitantly.

Cigarette acquisition and proof of age among US high school students who smoke.

Objective: To determine how US high school students who are under 18 years of age and who smoke obtain their cigarettes and whether they are asked for proof of age. Design and setting: Data from the Centers for Disease Control and Preventions 1995, 1997, and 1999 national Youth Risk Behavior Surveys which employed national probability samples of students in grades 9–12 (ages 14–18 years). Main outcome measures: Associations of usual source of cigarettes and request for proof of age with variables such as sex, race/ethnicity, grade, and frequency of smoking. Results: In 1999, among current smokers under age 18 years, 23.5% (95% confidence interval (CI), −4.5% to +4.5%) usually purchased their cigarettes in a store; among these students, 69.6% (95% CI −5.7% to +5.7%) were not asked to show proof of age. As days of past month smoking increased, reliance on buying cigarettes in a store (p < 0.001) and giving someone else money to buy cigarettes (p < 0.001) increased, and usually borrowing cigarettes decreased (p < 0.001). From 1995 to 1999, relying on store purchases significantly decreased (from 38.7% (95% CI −4.6% to + 4.6%) to 23.5% (95% CI −4.5% to +4.5%)); usually giving someone else money to buy cigarettes significantly increased (from 15.8% (95% CI −3.6% to +3.6%) to 29.9% (95% CI −4.5% to + 4.5%)). Conclusions: Stricter enforcement of tobacco access laws is needed to support other community and school efforts to reduce tobacco use among youth. Furthermore, effective interventions to reduce non-commercial sources of tobacco, including social, need to be developed and implemented.

Trends and differentials in mortality from cancers of the oral cavity and pharynx in the United States, 1973–1987

Background. This analysis consisted of an examination of trends and differentials in mortality from cancers of the oral cavity and pharynx in the United States for a recent 15‐year period.

An integrated framework for the analysis of adolescent cigarette smoking in middle school latino youth

A framework based on five major theories of health behavior was used to identify the correlates of adolescent cigarette smoking. The framework emphasizes intentions to smoke cigarettes, factors that influence these intentions, and factors that moderate the intention—behavior relationship. Five hundred sixteen randomly selected Latino middle school youth in New York completed self-administered questionnaires. Adolescents reported their intentions to smoke, smoking-related expectancies, normative pressures to smoke, image implications of smoking, emotional reactions to smoking, and self-efficacy with respect to smoking. The framework yielded high levels of association with intentions to smoke. Specific smoking-related emotions, norms, and expectancies were associated with the likelihood of smoking. The framework can help guide the development of effective interventions tailored to specific populations.