Differences in reproductive risk factors for breast cancer in middle-aged women in Marin County, California and a sociodemographically similar area of Northern California

<p>Abstract</p> <p>Background</p> <p>The Northern California county of Marin (MC) has historically had high breast cancer incidence rates. Because of MC's high socioeconomic status (SES) and racial homogeneity (non-Hispanic White), it has been difficult to assess whether these elevated rates result from a combination of established risk factors or other behavioral or environmental factors. This survey was designed to compare potential breast cancer risks and incidence rates for a sample of middle-aged MC women with those of a demographically similar population.</p> <p>Methods</p> <p>A random sample of 1500 middle-aged female members of a large Northern California health plan, half from Marin County (MC) and half from a comparison area in East/Central Contra Costa County (ECCC), were mailed a survey covering family history, reproductive history, use of oral contraceptives (OC) and hormone replacement therapy (HRT), behavioral health risks, recency of breast screening, and demographic characteristics. Weighted data were used to compare prevalence of individual breast cancer risk factors and Gail scores. Age-adjusted cumulative breast cancer incidence rates (2000–2004) were also calculated for female health plan members aged 40–64 residing in the two geographic areas.</p> <p>Results</p> <p>Survey response was 57.1% (n = 427) and 47.9% (n = 359) for MC and ECCC samples, respectively. Women in the two areas were similar in SES, race, obesity, exercise frequency, current smoking, ever use of OCs and HRT, age at onset of menarche, high mammography rates, family history of breast cancer, and Gail scores. However, MC women were significantly more likely than ECCC women to be former smokers (43.6% vs. 31.2%), have Ashkenazi Jewish heritage (12.8% vs. 7.1%), have no live births before age 30 (52.7% vs. 40.8%), and be nulliparous (29.2% vs. 15.4%), and less likely to never or rarely consume alcohol (34.4% vs. 41.9%). MC and ECCC women had comparable 2000–2004 invasive breast cancer incidence rates.</p> <p>Conclusion</p> <p>The effects of reproductive risks factors, Ashkenazi Jewish heritage, smoking history, and alcohol consumption with regard to breast cancer risk in Marin County should be further evaluated. When possible, future comparisons of breast cancer incidence rates between regions should adjust for differences in income and education in addition to age and race/ethnicity, preferably by using a sociodemographically similar comparison group.</p

Economic and Health Effects of a State Cigarette Excise Tax Increase in California

The Coalition for a Healthy California is sponsoring a comprehensive statewide ballot initiative to raise the tobacco excise tax by $2.60 per pack of cigarettes in order to provide funding to qualified hospitals for emergency services, nursing education and health insurance to eligible children. This paper uses the best possible science to estimate the effect of a new tax on cigarette consumption, adult and youth smoking rates, tax revenues, and long term health outcomes. The additional tax would raise the average price of cigarettes to$6.55 per pack

Economic and Health Effects of a State Cigarette Excise Tax Increase in California

The Coalition for a Healthy California is sponsoring a comprehensive statewide ballot initiative to raise the tobacco excise tax by $2.60 per pack of cigarettes in order to provide funding to qualified hospitals for emergency services, nursing education, and health insurance to eligible children. This paper uses the best possible science to estimate the effect of a new tax on cigarette comsuption, adult and youth smoking rates, tax revenues, and long term health outcomes. The additional tax would raise the average price of cigarettes to$6.55 per pack

Economic and Health Effects of a State Cigarette Excise Tax Increase in California

The Coalition for a Healthy California is sponsoring a comprehensive statewide ballot initiative to raise the tobacco excise tax by $2.60 per pack of cigarettes in order to provide funding to qualified hospitals for emergency services, nursing education and health insurance to eligible children. This paper uses the best possible science to estimate the effect of a new tax on cigarette consumption, adult and youth smoking rates, tax revenues, and long term health outcomes. The additional tax would raise the average price of cigarettes to$6.55 per pack.Excise, Tax, California

E-Cigarettes and Similar Devices.

Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among youth. The 2016 US Surgeon General's Report on e-cigarette use among youth and young adults concluded that e-cigarettes are unsafe for children and adolescents. Furthermore, strong and consistent evidence finds that children and adolescents who use e-cigarettes are significantly more likely to go on to use traditional cigarettes-a product that kills half its long-term users. E-cigarette manufacturers target children with enticing candy and fruit flavors and use marketing strategies that have been previously successful with traditional cigarettes to attract youth to these products. Numerous toxicants and carcinogens have been found in e-cigarette solutions. Nonusers are involuntarily exposed to the emissions of these devices with secondhand and thirdhand aerosol. To prevent children, adolescents, and young adults from transitioning from e-cigarettes to traditional cigarettes and minimize the potential public health harm from e-cigarette use, there is a critical need for e-cigarette regulation, legislative action, and counterpromotion to protect youth

Workplace secondhand smoke exposure: a lingering hazard for young adults in California

OBJECTIVE: To examine occupational differences in workplace exposure to secondhand smoke (SHS) among young adults in California. METHODS: Data are taken from the 2014 Bay Area Young Adult Health Survey, a probabilistic multimode cross-sectional household survey of young adults, aged 18–26, in Alameda and San Francisco Counties. Respondents were asked whether they had been exposed to SHS ‘indoors’ or ‘outdoors’ at their workplace in the previous 7 days and also reported their current employment status, industry and occupation. Sociodemographic characteristics and measures of health perception and behaviour were included in the final model. RESULTS: Young adults employed in service (p<0.001), construction and maintenance (p<0.01), and transportation and material moving (p<0.05) sectors were more likely to report workplace SHS exposure while those reporting very good or excellent self-rated health were less likely (p<0.001). CONCLUSIONS: Despite California’s clean indoor air policy, 33% of young adults in the San Francisco Bay Area still reported workplace SHS exposure in the past week, with those in lower income occupations and working in non-office environments experiencing the greatest exposure. Closing the gaps that exempt certain types of workplaces from the Smoke-Free Workplace Act may be especially beneficial for young adults