Sociocultural Risk Factors for Elevated Perceived Stress among African American Smokers

Introduction: African Americans experience unique stressors that may inhibit smoking cessation and enhance relapse rates. Few studies, however, have focused on risk factors for perceived stress among treatment seekers. Because African Americans are less likely to quit compared to the larger community, understanding factors associated with perceived stress among smokers has the potential to improve intervention outcomes. This study examined psychosocial and cultural correlates of stress in a sample of African American participants in a randomized controlled trial. Methods: At baseline, participants reported demographic factors and completed assessments of smoking history, alcohol use, friend and household smoking, weight concerns, acculturation, depressive symptoms, and perceived stress (N = 325). Bivariate associations were examined, followed by multiple regression analyses to test independent relationships. The sample was comprised of mostly middle-aged males, with at least a high school education, who were single, and reported low household income. Participants were moderately nicotine dependent and smoked 18 cigarettes per day for 26 years. Results: Perceived stress was inversely associated with age (r = -.16, p = .004), education (r = -.11, p = .04), household income (r = -.11, p = .047), and positively associated with being male (r = .13, p = .02). Stress perceptions were positively related to cigarettes per day (r = .11, p = .049), nicotine dependence (r = .20, p = .001), drinking frequency (r = .15, p = .008), drinking intensity (r = .14, p=.02), and inversely related to smoking duration (r = -.12, p = .03). We found positive associations between perceived stress and household smokers (r = .18, p = .004), and friends who smoke (r = .15, p = .01). Perceived stress was also positively associated with post-cessation weight concern (r = .14, p = .01), a traditional African American cultural orientation; r = .12, p = .04), and depressive symptoms (r = .65, p Conclusion: These findings have important intervention implications. Many of the risk factors for distress among African American smokers are modifiable. Interventions should prioritize addressing depression, household smoking environment, and stress among younger smokers, in addition to managing other stress-enhancing concerns like alcohol use

Adult awareness of a youth-focused anti-tobacco campaign: does having children matter?

Data from a survey of tobacco use conducted in 2001 was used to examine if Florida’s youth-focused anti-tobacco media campaign, which focused on cigarette smoking, reached adults. The majority of the sample was white (87%), high school or college edu- cated (85%), and over half with children (56%). Differences in awareness and intentions to quit among adult smokers with and without children were examined. About 50% of adults were aware of the campaign and the awareness of the tobacco industry manipula- tion theme was associated with intentions to quit, independent of having children. These findings provide evidence that youth-targeted anti-tobacco media campaigns can reach adults; however, to change the behavior of adults who smoke, it may not be appropriate to have a “one-size-fits-all” program. The study’s limitations are noted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78088/1/adultawareness.pd

Changes in Youth Cigarette Use Following the Dismantling of an Antitobacco Media Campaign in Florida

We examined the association of the termination of a successful youth-targeted antitobacco media campaign ("truth") and changes in smoking rates among youths aged 12-17 years in Florida. Six telephone-based surveys were completed during the active media campaign (1998-2001), and 2 postcampaign surveys were completed in 2004 and 2006 (each n ~1,800). Prevalence of current smoking among youth observed during the campaign continued to decrease in the first postcampaign survey; however, by the second follow-up survey, youth smoking rates had increased significantly for youth aged 16 years or older. Our findings support the need for consistent antitobacco messaging to reduce the prevalence of youth smoking

Correlates of smoking quit attempts: Florida Tobacco Callback Survey, 2007

<p>Abstract</p> <p>Objective</p> <p>The public health burden of tobacco-associated diseases in the USA remains high, in part because many people's attempts to quit are unsuccessful. This study examined factors associated with having lifetime or recent attempts to quit smoking among current smokers, based on a telephone survey of Florida adults.</p> <p>Methods</p> <p>Data from the 2007 telephone-based Florida Behavioral Risk Factor Surveillance System (BRFSS) and its follow-up survey, the Tobacco Callback Survey, were used to assess determinants of having ever attempted to quit smoking and attempted to quit smoking in the past 12 months. All analyses were conducted using SAS.</p> <p>Results</p> <p>Among 3,560 current smokers, 41.5% reported having tried to quit smoking in the past 12 months while 83.4% reported having ever tried to quit. Having a history of a tobacco-related medical condition was significantly associated with both recent (Adjusted Odds Ratio (AOR) 1.41 [Confidence Interval 1.19–1.65]) and lifetime quit attempts (AOR 1.43 [1.15–1.79]). Greater nicotine dependence and being advised by a physician to quit smoking were also positively associated with lifetime quit attempts.</p> <p>Receipt of healthcare provider advice to quit smoking in the past 12 months and a strong belief that quitting following a long history of regular smoking would not result in health benefits and belief that there are health benefits to quitting smoking were associated with lifetime quit attempts.</p> <p>Conclusion</p> <p>Targeted smoking cessation interventions are needed for smokers with selected medical conditions and with high nicotine dependence. The importance of physician advice in encouraging individuals to quit is further highlighted.</p

Trends in smokeless tobacco use in the us workforce: 1987-2005

The primary aim was to examine whether increasing workplace smoking restrictions have led to an increase in smokeless tobacco use among US workers. Smokeless tobacco exposure increases the risk of oral cavity, esophageal, and pancreatic cancers, and stroke. The prevalence of smokeless tobacco use decreased from 1987-2000, except among men 25-44. While smokeless tobacco use has declined in the general population, it may be that the prevalence of smokeless tobacco use has increased among workers due to workplace smoking restrictions, which have been shown to have increased over the years. Using the most current nationally representative National Health Interview Survey (NHIS) data, we examined whether increasing workplace smoking restrictions have led to an increase in smokeless tobacco use among US workers (n = 125,838). There were no significant changes in smokeless tobacco use prevalence from 1987-2005 (pooled prevalence = 3.53%); rates also were lower in smoke free workplaces. Worker groups with high rates of smokeless tobacco use included farm workers (10.51%) and blue collar workers (7.26%). Results indicate that smokeless tobacco prevention strategies targeting particular worker groups are warranted

Effect of childhood victimization on occupational prestige and income trajectories

Background Violence toward children (childhood victimization) is a major public health problem, with long-term consequences on economic well-being. The purpose of this study was to determine whether childhood victimization affects occupational prestige and income in young adulthood. We hypothesized that young adults who experienced more childhood victimizations would have less prestigious jobs and lower incomes relative to those with no victimization history. We also explored the pathways in which childhood victimization mediates the relationships between background variables, such as parent’s educational impact on the socioeconomic transition into adulthood. Methods A nationally representative sample of 8,901 young adults aged 18–28 surveyed between 1999–2009 from the National Longitudinal Survey of Youth 1997 (NLSY) were analyzed. Covariate-adjusted multivariate linear regression and path models were used to estimate the effects of victimization and covariates on income and prestige levels and on income and prestige trajectories. After each participant turned 18, their annual 2002 Census job code was assigned a yearly prestige score based on the 1989 General Social Survey, and their annual income was calculated via self-reports. Occupational prestige and annual income are time-varying variables measured from 1999–2009. Victimization effects were tested for moderation by sex, race, and ethnicity in the multivariate models. Results Approximately half of our sample reported at least one instance of childhood victimization before the age of 18. Major findings include 1) childhood victimization resulted in slower income and prestige growth over time, and 2) mediation analyses suggested that this slower prestige and earnings arose because victims did not get the same amount of education as non-victims. Conclusions Results indicated that the consequences of victimization negatively affected economic success throughout young adulthood, primarily by slowing the growth in prosperity due to lower education levels

Urban Women’s Preferences for Learning of Their Mammogram Result: A Qualitative Study

Research suggests that communication of mammogram results is flawed for many low-income ethnic minority women. This study conducted four focus groups with low-income inner-city minority women (n = 34). The goals of our project were: (1) to elucidate women's experiences learning of their result; (2) to elicit their preferences as to how this communication could be improved; and (3) to gather information to help inform the development of a new tool for communicating mammogram results. Salient themes included dissatisfaction with result communication; difficulty elucidating the meaning of a typical results notification letter; a preference for direct verbal communication of results and for print materials that included pictures, testimonials, and an action plan including a hotline to call with questions; and a strong interest in advance education about the likelihood of having to return for additional follow up. Video and other programs to inform patients before the test about what happens after may improve patient satisfaction and enhance women's understanding of their personal result and follow up plan

Women Who Are Stalked Questioning the Fear Standard

The authors use logistic regression with the National Violence Against Women Survey sample (N = 8,000) to explore patterns in fear reported by women who were stalked. One fourth of our sample felt no fear, with Black women significantly less likely to report fear (compared to White women). Women who were frequently stalked, stalked by an intimate or family member or acquaintance, or stalked by physical or communicative means reported feeling fearful more than did others. Requiring a woman to feel fearful before accepting her experience as an instance of stalking risks, the authors conclude, a miscarriage of justice, an undercount of the crime, and an abandonment of women (and others) who need validation from the state and protection from stalkers

Smoking Urges During Treatment and Long-Term Cessation among Low-Income African Americans

The urge to smoke is a predictor of smoking relapse. Little research has focused on the impact of acute urges during treatment among African Americans. This study examined the relationship between smoking urges and long-term abstinence among treatment seekers. Longitudinal prospective investigation. Urges to smoke were assessed at the initial (session 1) and final (session 8) sessions among adult smokers (N=308) enrolled in a 4-week group intervention trial. Nicotine patch use was assessed over 30 days. Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention, and at 3-, 6-, and 12-month follow-ups. Hierarchical logistic regressions tested associations between session 1 and session 8 urges and 7-day ppa at each smoking status assessment. There was a significant overall decrease in smoking urges (M=29, SD=15 at session 1; M=17, SD=11 at session 8). After controlling for covariates, urges to smoke at session 1 were unrelated to 7-day ppa at any of the assessment points. However, session 8 urges were inversely associated with 7-day ppa post-intervention (AOR=.94, CI:.92-.97), at 3-months (AOR=.93, CI: .89-.97), 6-months (AOR=.93, CI: .90-.97), and 12-months (AOR=.96, CI: .96-.99). Nicotine patch use was positively associated with 7-day ppa at each assessment. The most robust predictors of abstinence through 12-months post-intervention were decreased urges over the 4-week, 8-session group intervention and the frequency of nicotine patch use. Interventions aimed at addressing the needs of African American smokers should address urges and encourage nicotine replacement adherence to increase abstinence rates