Molly Green

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.

Evidence for truth®: the young adult response to a youth-focused anti-smoking media campaign.

BACKGROUND Previous studies have shown that exposure to truth® and similar countermarketing campaigns is associated with an increase in anti-smoking attitudes and beliefs in those aged 12-17 years and a decrease in youth smoking. However, it is unclear how such campaigns influence young adults aged 18-24 years. PURPOSE To examine levels of awareness and the effect of the national truth campaign on smoking-related attitudes, beliefs, and intentions in young adults. METHODS Data on respondents, aged 18-24 years, from the Legacy Media Tracking Surveys-eight cross-sectional nationally representative telephone surveys administered from 2000 to 2004-were combined and analyzed in 2009. Logistic regression analyses were used to examine the associations between confirmed awareness of the truth campaign and smoking-related attitudes, beliefs, and intentions. A second set of models was used to examine the association of attitudes and beliefs targeted by the campaign with smoking intentions. RESULTS A majority of young adults showed confirmed awareness of the truth campaign. Awareness was associated with roughly half of the anti-smoking attitudes and beliefs, and it was associated marginally with the intention to quit among smokers (p=0.06). Several of the attitudes and beliefs targeted by the campaign were associated with the intention to not smoke (among nonsmokers) and to quit (among smokers). CONCLUSIONS Messages contained in youth-focused anti-smoking campaigns may promote attitudinal and behavioral change in young adults. Young adults are at risk for both initiation and establishment of smoking, while also being targeted specifically by the tobacco industry, so it is critical to consider this audience when developing and implementing anti-smoking interventions.

Research articleEvidence for truth®: The Young Adult Response to a Youth-Focused Anti-Smoking Media Campaign

BACKGROUND Previous studies have shown that exposure to truth® and similar countermarketing campaigns is associated with an increase in anti-smoking attitudes and beliefs in those aged 12-17 years and a decrease in youth smoking. However, it is unclear how such campaigns influence young adults aged 18-24 years. PURPOSE To examine levels of awareness and the effect of the national truth campaign on smoking-related attitudes, beliefs, and intentions in young adults. METHODS Data on respondents, aged 18-24 years, from the Legacy Media Tracking Surveys-eight cross-sectional nationally representative telephone surveys administered from 2000 to 2004-were combined and analyzed in 2009. Logistic regression analyses were used to examine the associations between confirmed awareness of the truth campaign and smoking-related attitudes, beliefs, and intentions. A second set of models was used to examine the association of attitudes and beliefs targeted by the campaign with smoking intentions. RESULTS A majority of young adults showed confirmed awareness of the truth campaign. Awareness was associated with roughly half of the anti-smoking attitudes and beliefs, and it was associated marginally with the intention to quit among smokers (p=0.06). Several of the attitudes and beliefs targeted by the campaign were associated with the intention to not smoke (among nonsmokers) and to quit (among smokers). CONCLUSIONS Messages contained in youth-focused anti-smoking campaigns may promote attitudinal and behavioral change in young adults. Young adults are at risk for both initiation and establishment of smoking, while also being targeted specifically by the tobacco industry, so it is critical to consider this audience when developing and implementing anti-smoking interventions.

The importance of location for tobacco cessation: rural-urban disparities in quit success in underserved West Virginia Counties.

CONTEXT Adults who live in rural areas of the United States have among the highest smoking rates in the country. Rural populations, including Appalachian adults, have been historically underserved by tobacco control programs and policies and little is known about their effectiveness. PURPOSE To examine the end-of-class quit success of participants in A Tobacco Cessation Project for Disadvantaged West Virginia Communities by place of residence (rural West Virginia and the urban area of Greater Charleston). METHODS This collaborative program was implemented in 5 underserved rural counties in West Virginia and consisted of 4 intervention approaches: (1) a medical examination; (2) an 8-session educational and behavioral modification program; (3) an 8-week supply of pharmacotherapy; and (4) follow-up support group meetings. FINDINGS Of the 725 program participants, 385 (53.1%) had successfully quit using tobacco at the last group cessation class they attended. Participants who lived in rural West Virginia counties had a lower end-of-class quit success rate than those who lived in the urban area of Greater Charleston (unadjusted odds ratio [OR]= 0.69, 95% confidence interval [CI]= 0.48, 0.99), even after taking into account other characteristics known to influence quit success (adjusted OR = 0.58, 95% CI = 0.35, 0.94). CONCLUSIONS Tobacco control programs in rural West Virginia would do well to build upon the positive aspects of rural life while addressing the infrastructure and economic needs of the region. End-of-class quit success may usefully be viewed as a stage on the continuum of change toward long-term quit success.

Boosting Online Response Rates Among Nonresponders A Dose of Funny

Online data collection has become an extremely popular survey mode given its reduced cost, ease of administration, and timeliness. Although extensive research exists on the influence of e-mail invitation design characteristics to prompt survey participation, less is known about the effectiveness of e-mail reminders in prompting survey completion among nonresponders. The purpose of this study was to determine whether incorporating humor into e-mail reminders improved survey completion rates. Respondents from the Truth Initiative Young Adult Cohort (n = 2,963) who did not respond to the first standard e-mail invitation to complete their follow-up survey were randomly assigned to one of the three e-mail reminder groups: control (standard), humor only, or humor plus statistics. Those who received an initial humor plus statistics reminder e-mail received the humor only e-mail as their second reminder and vice versa. Logistic regression was used to generate the odds ratios (OR) for the probability of completing the survey after the first reminder. Results of multivariable models showed that, when collapsed together, the humor only and humor plus statistics e-mails were more effective than the control [adjusted OR (AOR) = 1.23, 95% confidence interval (CI) [1.01, 1.49], p = .05]. Receiving the humorous e-mail as the first reminder increased the odds of response to the survey by 24% (AOR = 1.24, 95% CI [1.00, 1.54], p = .04). Those entering the study at an earlier wave, nonsmokers and those living in smaller households were more likely to respond after the first reminder. A humorous reminder tailored to the voice of the audience is an easy, efficient, and effective way to increase response rates among young adults.

Language Barriers and Health of Syrian Refugees in Germany

The article discusses various aspects of the health of the Syrian refugees in Germany, and it mentions the authors claim that language barriers often prevent refugees from obtaining quality health care. The authors personal experiences with Syrian refugees in Bayreuth, Germany during a 2016 internship are addressed, along with language translation problems. Refugee population health strategies are examined, along with prevention-oriented programs to lessen physical and mental health problems.

The Association Between Menthol Perceptions and Support for a Policy Ban among US Smokers

Objective To examine the relationship between menthol perceptions and support for a national menthol ban. Participants Data were collected from a nationally representative probability-based panel of adults aged ≥18 years during June 21, 2016 through July 18, 2016. A total of 1,303 respondents, including an oversample of 300 African Americans, completed the survey. Main Outcome Measures Weighted logistic regression models examined the relationship between menthol perceptions, specifically related to health and addiction, and the outcome measure: support for a menthol ban, by menthol smoking status. All models controlled for age, sex, education level, and race/ethnicity. Results The association between reporting accurate menthol health perceptions differed by menthol preference. Among non-menthol smokers, there was no association between accurate menthol health perceptions and support of a menthol ban while more accurate menthol perceptions of addiction were associated with greater support of a menthol ban (aOR=2.83, CI=1.19-6.72). Among menthol smokers, more accurate health-related menthol perceptions were associated with increased odds of supporting a menthol ban (aOR=3.90, CI=1.02-14.79) while more accurate menthol addiction perceptions were not. Conclusions Fewer current menthol smokers support a menthol ban than current non-menthol smokers given its effect on their preferred product. Given the large proportions of smokers who have misperceptions of the health consequences and addictive properties of menthol, there is a moral imperative to inform those who use these products. Findings suggest the need for tailored messaging strategies targeted to reach menthol smokers who will be most impacted by a ban, but also have the most to gain from such a policy change.