Raees A. Shaikh

It is better to be a fat ex-smoker than a thin smoker: findings from the 1997-2004 National Health Interview Survey-National Death Index linkage study.

Objective The aim of this research was to compare the risk of all-cause mortality and mortality from all cancers combined, lung cancer, respiratory diseases, cardiovascular diseases and diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Methods Data were from 1997 to 2004 National Health Interview Survey (with response rates ranging from 70% to 80%) which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2006. The sample was limited to normal-weight smokers and overweight/obese ex-smokers 25 years of age and older (n=52 819). HR from Cox regression was computed to represent mortality effect. Results Results showed that in both women and men, normal-weight smokers, relative to overweight or obese ex-smokers, had a higher risk of mortality from all causes combined, all cancers combined, lung cancer, cardiovascular and respiratory diseases. Among women, there was no difference in mortality risk from diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Among men, there was some evidence that the risk of mortality was higher in obese ex-smokers than normal-weight smokers. Conclusions This article concludes that, overall, mortality risk is smaller in overweight or obese ex-smokers than normal-weight smokers. Smoking cessation interventions can tailor messages that highlight the greater reduction in mortality associated with quitting, compared with potential weight gain.

Association between duration of use of pharmacotherapy and smoking cessation: findings from a national survey

Objective To investigate the association of the duration of use of prescription medications and nicotine replacement therapy (NRT) with smoking cessation using a national sample of the general population in the USA, controlling for nicotine dependence and sociodemographic variables. Setting USA. Participants We used data from the 2010–2011 Tobacco Use Supplement to the US Current Population Survey. We limited the analysis to current daily smokers who made a quit attempt in the past year and former smokers who were a daily smoker 1 year prior to the survey (n=8263). Respondents were asked about duration of use of prescription medication (varenicline, bupropion, other) and NRT (nicotine patch, gum/lozenges, nasal spray and inhaler) for smoking cessation. Primary outcome measure Successful smoking cessation. Individuals who reported to have smoked at least 100 cigarettes in their lifetime but were not smoking at all at the time of the interview and were a daily smoker 1 year prior to the interview were considered to have successfully quit smoking. Results After adjusting for daily cigarette consumption and sociodemographic covariates, we found evidence for an association between duration of pharmacotherapy use and smoking cessation (p<0.001). Adjusted cessation rates for those who used prescription medication or NRT for 5+ weeks were 28.8% and 27.8%, respectively. Adjusted cessation rates for those who used prescription medication or NRT for less than 5 weeks varied from 6.2% to 14.5%. Adjusted cessation rates for those who used only behavioural counselling and those who attempted to quit smoking unassisted were 16.1% and 16.4%, respectively. Conclusions Use of pharmacotherapy for at least 5 weeks is associated with increased likelihood of successful smoking cessation. Results suggest that encouraging smokers who intend to quit to use pharmacotherapy and to adhere to treatment duration can help improve chances of successful cessation.

Prolonged financial stress predicts subsequent obesity: Results from a prospective study of an Australian national sample

The aim of this research was to assess the association of prolonged financial stress (FS) with subsequent obesity.

The association of point-of-sale cigarette marketing with cravings to smoke: results from a cross-sectional population-based study

Objective To examine the association between recalled exposure to point-of-sale (POS) cigarette marketing (ie, pack displays, advertisements and promotions such as discounts) and reported cravings to smoke while visiting a store. Methods Data were collected using a telephone survey of a cross-sectional sample of 999 adult smokers in Omaha, Nebraska. Recalled exposure to POS cigarette marketing was measured by asking respondents about noticing (a) pack displays, (b) advertisements and (c) promotions in store in their neighbourhood. A 3-item scale indicating the frequency of experiencing cravings to smoke in locations where cigarettes are sold was created by asking respondents: (1) “feel a craving for a cigarette?” (2) “feel like nothing would be better than smoking a cigarette?” and (3) “feel like all you want is a cigarette?” The association between recalled exposure to POS cigarette marketing and cravings was estimated using ordinary least squares linear regression models, controlling for nicotine dependence, gender, age, race/ethnicity, income, education, frequency of visiting stores in ones neighbourhood and method of recruitment into the study. Results Recalled exposure to POS cigarette displays (p<0.001) and advertisements (p=0.002), but not promotions (p=0.06), was associated with more frequent cravings to smoke. Conclusions Recalled exposure to POS cigarette marketing is associated with cravings to smoke as predicted by laboratory studies on the effects of smoking cues on cigarette craving. Policies that reduce or eliminate POS cigarette marketing could reduce cigarette cravings and might attenuate impulse buying of cigarettes.

The Association of Exposure to Point-of-Sale Tobacco Marketing with Quit Attempt and Quit Success: Results from a Prospective Study of Smokers in the United States

The aim was to assess the association of exposure to point-of-sale (POS) tobacco marketing with quit attempt and quit success in a prospective study of smokers in the United States. Data were collected via telephone-interview on exposure to POS tobacco marketing, sociodemographic and smoking-related variables from 999 smokers in Omaha, Nebraska, in the United States. Exposure to POS tobacco marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions in their respective neighborhoods stores. These three variables were combined into a scale of exposure to POS tobacco marketing. About 68% of the respondents participated in a six-month follow-up phone interview and provided data on quit attempts and smoking cessation. At the six-month follow-up, 39.9% of respondents reported to have made a quit attempt, and 21.8% of those who made a quit attempt succeeded in quitting. Exposure to POS marketing at baseline was not associated with the probability of having made a quit attempt as reported at the six-month follow-up (p = 0.129). However, higher exposure to POS marketing was associated with a lower probability of quit success among smokers who reported to have attempted to quit smoking at six-month follow-up (p = 0.006). Exposure to POS tobacco marketing is associated with lower chances of successfully quitting smoking. Policies that reduce the amount of exposure to POS marketing might result in higher smoking cessation rates.

Social Disparities in Unaided Quit Attempts Among Daily Current and Former Smokers: Results From the 2010-2011 Tobacco Use Supplement to the Current Population Survey.

INTRODUCTION There are well-documented inverse relationships between smoking and smoking cessation with measures of socioeconomic status. This study used nationally representative data to examine unaided quit attempts and their sociodemographic determinants among daily current and former smokers who made a quit attempt in the last 12 months. METHODS We used data from the 2010-2011 Tobacco Use Supplement to the Current Population Survey. We limited the analysis to current daily smokers who made a quit attempt in the past year and former smokers who were daily smokers 1 year prior to the survey (N = 8201). RESULTS Nearly 62% (n = 5078) of the sample made an unaided quit attempt. Adjusted results indicated unaided quit attempts were more likely among males compared to females (P < .001), younger age groups compared to older age groups (P < .001), non-Hispanic blacks compared to non-Hispanic whites (P < .001), among people with lower income compared to people with higher income (P < .001), and among people with lower nicotine dependence compared to those with higher nicotine dependence (P < .001). CONCLUSIONS Most quit attempts were unaided and there were significant sociodemographic disparities in unaided quit attempts. Considering that cessation aids enhance the likelihood of quitting, policies and programs should target populations which are more likely to attempt quitting without an aid and encourage them to use or provide subsidized cessation aids. Healthcare providers should advise their patients about approaches to quitting. IMPLICATIONS This study used the most recent nationally representative data for the United States to examine sociodemographic disparities in unaided quitting among current and former daily smokers who made a quit attempt in the last 12 months. Most quit attempts were unaided. People who were male, younger, non-Hispanic black, had lower nicotine dependence, and those who were low income were more likely to make an unaided quit attempt. These results could be used by policy makers and program planners to develop cessation interventions directed at specific populations to improve smoking cessation rates.

Occupational variations in obesity, smoking, heavy drinking, and non-adherence to physical activity recommendations: findings from the 2010 National Health Interview Survey.

BACKGROUND Understanding occupational variations in health risks is necessary to identify high risk groups. We examined the recent prevalence of obesity, heavy alcohol consumption, smoking, and leisure time physical activity (PA) across occupations. METHODS Data from the 2010 National Health Interview Survey were used. Analysis was limited to adults, 18 and older who had a job or business the week before the interview (n = 14,754). Adjusted prevalences of outcomes across occupations were calculated using logistic regression. RESULTS The highest prevalence of obesity was within community and social services and morbid obesity was in computer and mathematical occupations. That of smoking was highest in healthcare support, heavy drinking in food preparation and serving related, and non-adherence to PA recommendations in the farming, fishing, and forestry occupations. CONCLUSION Important health risk factors vary across occupations. Worksite and public health interventions need to be designed and modified to address such occupational health disparities.

Dieting Increases the Likelihood of Subsequent Obesity and BMI Gain: Results from a Prospective Study of an Australian National Sample

BackgroundDiet is a major determinant of obesity; however, findings from the studies examining how dieting to lose weight affects weight gain have been inconclusive.PurposeOur aim was to examine the longitudinal association of frequency of dieting for weight loss with (a) obesity status and (b) body mass index (BMI) change.MethodsWe used data from Waves 9 (2009) and 10 (2010) of the Household Income and Labour Dynamics in Australia (HILDA) survey. Binominal logistic regression estimated the association of frequency of dieting in 2009 on probability of obesity in 2010. Multinomial logistic regression estimated the association of frequency of dieting in 2009 on the probability of BMI gain versus BMI maintenance and BMI loss between 2009 and 2010. The analysis sample size was 8824.ResultsCompared to those who were never on a diet in the previous year, the odds of obesity were 1.9, 2.9, and 3.2 times higher among those who were on a diet once, more than once, and always, respectively. Similarly, the odds of BMI gain versus BMI maintenance and also versus BMI loss were higher among those who dieted than those who did not.ConclusionsDieting to lose weight can contribute to the risk of future obesity and weight gain. Losing weight requires a commitment to change one’s lifestyle and a sustained effort to maintain a healthy diet and engage in physical activity.

Point-of-sale cigarette marketing and smoking-induced deprivation in smokers: results from a population-based survey

BackgroundStrict restrictions on outdoor cigarette marketing have resulted in increasing concentration of cigarette marketing at the point-of-sale (POS). The association between POS cigarette marketing and smoking-induced deprivation (SID) has never been studied. The aim of this study was to examine this association and how it is mediated by cravings to smoke, urges to buy cigarettes, and unplanned purchases of cigarettes.MethodsData from a telephone survey of 939 smokers were collected in Omaha, Nebraska. POS cigarette marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions such as cigarette price discounts within their respective neighborhoods. SID was measured with the following question: “In the last six months, has there been a time when the money you spent on cigarettes resulted in not having enough money for household essentials such as food? [yes/no]” We used structural equation modeling to examine the study aim.ResultsThere was overwhelming evidence for an association between higher levels of POS cigarette marketing and a higher probability of SID (p < 0.001). This association was partly mediated by cravings to smoke, urges to buy cigarettes, and unplanned purchases of cigarettes during a visit to a neighborhood store (p < 0.001).ConclusionGiven that POS cigarette marketing is associated with a higher probability of experiencing SID, policies that ban POS cigarette marketing might help some smokers afford essentials household items such as food more easily and thus have better standards of living.

Voluntary STD Testing and Treatment Program at a Metropolitan Correctional Facility: Evaluation of Test Acceptability and Associated Risk Factors

Few studies have addressed challenges of diagnosis and treatment of sexually transmitted diseases (STDs) within correctional facilities. Initiatives that screen all inmates can be cost-prohibitive, while symptom-based screening undoubtedly fails to recognize significant numbers of asymptomatically infected persons. This study discusses a voluntary STD screening and treatment program developed at the Douglas County (Nebraska) Department of Corrections where student volunteers interviewed, screened, and educated 456 inmates. Inmate urine samples and interview responses about risk behaviors and motivators for participation in the screening program were analyzed. The results support the ongoing project method to screen and treat inmates in the community correctional facility. Risk factor analysis suggests that targeted testing and treatment efforts may have a role in providing cost-effective care for STD among the incarcerated population.