Richard S. Riggs

Saliva cotinine and thiocyanate: Chemical indicators of smokeless tobacco and cigarette use in adolecents

Recent attempts to measure smoking behavior using chemical tests may have been confounded by the use of smokeless tobacco. An objective measure of smokeless tobacco use is needed, particularly among adolescents who may not provide accurate self-reports of tobacco usage. Saliva cotinine was used to distinguish self-reported tobacco users from nonusers and a combination of saliva cotinine and thiocyanate (SCN) tests was used to distinguish smokers from smokeless tobacco users. The subjects were 471 students in grades 7 through 11 who lived in a high-tobacco production area. Approximately 89% of reported nonusers had no detectable cotinine and 99% of nonusers had levels <25 ng/ml. Of those who had used tobacco within the last 12 hr, 95% had detectable levels of cotinine. Samples that tested positive for cotinine were also tested for SCN. Eighty-six percent of smokers and 74% of mixed users had SCN values of >1000 μmol/liter, while only 14% of smokeless users had SCN values at that level. The combination of cotinine and SCN was effective in distinguishing smokers from smokeless users but was not effective in distinguishing mixed use from the other two types of use.

Relationship of personal tobacco-raising, parental smoking, and other factors to tobacco use among adolescents living in a tobacco-producing region

This study examined factors related to tobacco use among youth from tobacco-raising (TRH) and nonraising households (NRH). The subjects were 3,851 seventh-grade students from 19 middle schools located in a tobacco-raising region. Valid self-reports of tobacco use were encouraged by the use of a test for carbon monoxide in expired air. Cigarette use was higher when (a) at least one parent smoked, and/or (b) the student personally raised tobacco. A boy who personally raised tobacco and had at least one parent who smoked was 10.2 times more likely to have smoked in the last 7 days than a boy from a nonraising household in which neither parent smoked. For girls, the odds ratio was 5.6:1. Tobacco use among students in this high-risk group was higher than rates reported in national or regional studies. Other results were: (1) use began very early--16% of the students had tried cigarettes and 13% of the boys had tried smokeless tobacco (SLT) in Grade 3 or earlier; and (2) users reported more lenient rules at home regarding tobacco use than did nonusers. Years from now, these high-risk students are likely to be major contributors to increased morbidity and mortality due to tobacco use. Implications for tobacco prevention in tobacco-raising areas are discussed.

Relationships Among Health Knowledge, Health Locus of Control, and Health Status in Secondary Special Education Students

Relationships among health knowledge, health locus of control, and health status domains were investigated using 181 learning disabled (LD) and educable mentally retarded (EMR) high school students as subjects. A health knowledge test, the Childrens Health Locus of Control (CHLC) scale, and six health status measures were administered. In general, students who had higher knowledge scores tended to be more internal (believed they had control over their health). Lower scores on the health knowledge test tended to be associated with beliefs that their health was controlled by chance or powerful others. Internal and Powerful Others scales of the CHLC were the best predictors of health knowledge for EMR students. For LD students, only the Internal scale made a significant contribution to the prediction. Health status was significantly related to the health knowledge of the EMR students, but the proportion of variance explained was relatively low. Other results were nonsignificant. The implications for health education programming were discussed.

Student and Principal Perceptions of School Tobacco Policy

Abstract Background: Enforcement of no-tobacco policies is critical to providing a safe, healthy environment for students. Purpose: The purposes of the study were to: (1) describe and compare student and principal perceptions of enforcement of school tobacco policy in a school district with a tobacco-free policy, and (2) explore perceived barriers to enforcement and factors related to enforcement beliefs and perception of smoking. Methods: Students (N = 774) in five high schools in a southeastern city completed a survey. Administrators from those schools were interviewed. Results: Student and principal perceptions varied dramatically concerning tobacco policy enforcement. Only 8% of students said students followed the rules about smoking all/most of the time. Many students reported problems with secondhand smoke. The percentage of smokers was overestimated by nearly three-quarters of students (73%). Predictors of beliefs about number of tobacco rules were: smoking status, number of places students were seen smoking and number of problems reported with smoking. Barriers identified by principals included lack of supervisory help and that tobacco is physically addicting. Discussion: Student perception of how well tobacco policies are enforced should not be ignored by administrators because it is related to smoking behavior. Teachers, students, staff, administrators and parents must be enlisted to help enforce tobacco policy. Translation to Health Education Practice: To change the culture in schools, teachers, students, staff, administrators and parents must be educated about the tobacco policy, and tobacco rules must be consistently enforced.

Factors related to adolescent drinking in Appalachia

OBJECTIVES To examine the relationships among parental monitoring, perceptions of peer drinking, and adolescent alcohol consumption. METHODS Tenth- and 12th-grade students (N=648) in a rural, Appalachian county were surveyed. RESULTS A binomial logistic regression revealed a composite of those who had perceptions that many peers drank, low parental monitoring, and no biological male guardian in the home were 8.496 times more likely to have ever been drunk. Other characteristics resulted in lower odds. CONCLUSIONS Parental monitoring and perceptions of peer drinking were important predictors of drinking in this rural sample. Prevention efforts in school and at home should address both variables.