Michelle O'Hegarty

Small-group discussions on menthol cigarettes: listening to adult African American smokers in Atlanta, Georgia.

Objective. In 2002, the First Conference on Menthol Cigarettes brought together researchers from diverse backgrounds to summarize what is known about menthol cigarettes and the people who smoke them, and to identify areas of needed research on menthol cigarettes. Since the conference, PubMed reports 24 articles, including the conference proceedings, on menthol cigarettes and African Americans. Many of the articles address epidemiological or biomedical topics. While there has been some focus on social influences and marketing issues, more research and a greater focus on this topic are needed. Design. To stimulate research on a population disproportionately burdened by the health effects of smoking, we conducted small-group discussions in 2005 with adult African American smokers in Atlanta, Georgia. Each group discussion focused on a different topic: smoking behavior and preferences, perceptions of social influences, health effects and perceived harmfulness of menthol, quitting menthol cigarette smoking, or the influence of marketing and advertising of menthol cigarettes. Results. Themes emerged from the discussions: (1) emulation of black culture by white youth and racial integration of neighborhoods and communities may have modified the perception that African Americans smoke menthol cigarettes and whites smoke non-menthol cigarettes; (2) non-menthol cigarette smokers were thought to be ‘hardcore’ smokers with less interest in quitting; (3) switching to non-menthol cigarettes was discussed as a way of quitting cigarettes for habitual menthol smokers; and, (4) smoking menthol cigarettes was thought to lead to fewer negative health effects. Conclusion. Some topics suggested by the participants warrant further investigation. More research is needed to assess the pervasiveness of these beliefs and their potential utility for smoking cessation interventions.

How are lifetime polytobacco users different than current cigarette-only users? Results from a Canadian young adult population

Current cigarette smoking combined with ever use of other tobacco products (lifetime polytobacco use) is important to examine as users may be at greater risk for illicit drug use, nicotine addiction, and adverse health outcomes. We determined estimates and patterns of lifetime polytobacco use and conducted multivariable analyses to determine demographic, family and friend, psychosocial, and lifestyle factors associated with use among a sample of Canadian young adults. Overall prevalence was 36.3% for current cigarette use; 10.1% for current cigarette use only and 26.2% for lifetime polytobacco use. Among polytobacco users, current cigarette use and ever cigar use was most frequent (67.2%). For males, the final model contained demographic, family and friends, and lifestyle factors. For females, the final model also included psychosocial factors. Illicit drug use was the strongest significant predictor for lifetime polytobacco use among males. We found gender specific differences when comparing lifetime polytobacco users to current cigarette-only users, in particular; male lifetime polytobacco users were more likely to use drugs and alcohol. Interventions focusing on individual substances should consider addressing combinations of use.

Customizing Survey Instruments and Data Collection to Reach Hispanic/Latino Adults in Border Communities in Texas

OBJECTIVES We sought to modify an instrument and to use it to collect information on smoking knowledge, attitudes, beliefs, and behaviors among Hispanics/Latinos, and to adapt survey methods to obtain high participation levels. Methods. Promotoras (outreach workers) conducted face-to-face interviews with 1485 Hispanic adults (July 2007-April 2008). The project team used GeoFrame field enumeration methods to develop a sampling frame from households in randomly selected colonias (residential areas along the Texas-Mexico border that may lack some basic necessities (e.g. portable water), in El Paso, Texas. RESULTS The revised questionnaire included 36 unchanged items from the State Adult Tobacco Survey, 7 modified items, and 17 new items focusing on possible culturally specific quitting methods, secondhand smoke issues, and attitudes and knowledge about tobacco use that might be unique for Hispanic/Latino groups. The eligibility rate was 90.2%, and the conservative combined completed screener and interview response rate was 80.0%. CONCLUSIONS Strategic, targeted, carefully designed methods and surveys can achieve high reach and response rates in hard-to-reach populations. Similar procedures could be used to obtain cooperation of groups who may not be accessible with traditional methods.

Are Adolescent Cigarette Smokers Who Use Smokeless Tobacco More Likely to Continue Smoking in the Future than Cigarette-Only Smokers: Results from Waves I and II of the Adolescent Health Survey

We explored whether dual use of smokeless and cigarettes among adolescents predicts continued smoking. Data came from Waves I (1994-95) and II (1996) of the National Longitudinal Study of Adolescent Health, using information from 3,284 Wave I current smokers. Multivariate models were used to assess whether use of smokeless tobacco at Wave I was associated with continuation of cigarette smoking at Wave II, controlling for possible confounders. The prevalence of current cigarette smoking at Wave 1 was 27.9%; among this group of adolescents and young adults, 14.5% also used smokeless tobacco. At Wave II, 73.6% of dual product users and 78.4% of cigarette-only users in Wave I reported continued smoking (OR=0.71 [95% CI 0.52–0.98]). Combined use of cigarette and smokeless tobacco does not appear to be related to continued smoking one year later. Longer-term followups are needed to determine the stability of this relationship for ≥1 year.

Tobacco use, cessation, and home smoking rules in a Hispanic community.

OBJECTIVE To determine prevalence of smoking, quit ratios, and home smoking rules among Hispanics residing in colonias in El Paso, Texas. METHODS Face-to-face interviews with 1485 Hispanic adults. GeoFrame™ field enumeration methods were used to develop a sampling frame from households in randomly selected colonias. RESULTS The overall percent of current cigarette smoking was 14.6% (95% CI 12.4 to 16.8); Over 55% of smokers reported a serious quit attempt. Participants overwhelmingly reported that smoking was not allowed in their homes. CONCLUSIONS Prevalence estimates for current smoking and restriction in the home were similar to those reported for recent national surveys.