A review of the health impact of smoking control at the workplace

Purpose. To summarize and provide a critical review of worksite health promotion program evaluations published between 1968 and 1994 that addressed the health impact of worksite smoking cessation programs and smoking policies. Methods. A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 53 smoking cessation program evaluation reports, of which 41 covered worksite single-topic cessation programs. Nine additional reports were located through manual search of citations from published reports and reviews. These 50 reports covered 52 original data-based studies of cessation programs. The search produced 19 reports for tobacco policy evaluations, of which 12 addressed health impact. An additional 17 reports were located by the authors. These 29 reports covered 29 studies of policy impact. Summary of Important Findings. Smoking cessation group programs were found to be more effective than minimal treatment programs, although less intensive treatment, when combined with high participation rates, can influence the total population. Tobacco policies were found to reduce cigarette consumption at work and worksite environmental tobacco smoke (RTS) exposure. Conclusions. The literature is rated suggestive for group and incentive interventions; indicative for minimal interventions, competitions, and medical interventions; and acceptable for the testing of incremental effects. Because of the lack of experimental control, the smoking policy literature is rated as weak, although there is strong consistency in results for reduced cigarette consumption and decreased exposure to ETS at work. (Am J Health Promot 1998;13[2]:83-104.

Transitioning Health Educators to Clinical Settings

Objective: A support model consisting of a local health educators’ network, a technical assistance team with academic and practice experts, and an evolving sequence of professional continuing education activities supported health educators transitioning from community or school health education sites to health care sites as part of the Clinic Health Education and Life Style Promotion Project (Clinic HELP) designed to increase health education options for individuals within the Paso del Norte Region of the United States-Mexico Border. Methods: Focus groups, interviews and surveys were used to evaluate intervention activities designed to assist in the transition. Results/Conclusions: Lack of familiarity with health care settings and role delineation were identified as barriers while “expert” sounding boards, professional development activities, and advanced education assisted in the transition. Use of the professional network was less than anticipated. Practice Implications: Based on the Clinic HELP experience, recommendations are provided for professional education and support for health educators within clinical practice settings

Integrating Health Education into Clinical Settings

In the United States, health concerns such as food insecurity and obesity continue to rise among American households (Centers for Disease Control and Prevention, 2003). Poor dietary intake can result in poor health outcomes as well as negatively impact student academic performance (Sigman-Grant, 2003). Despite the growing health concerns among the youth, limited studies have examined the dietary patterns of the Mexican-American adolescent population. This study aims to fill that void by describing the dietary intake of predominantly Mexican-American adolescents 13-18 years of age (n=532). The study design was cross-sectional and randomly selected high school participants based on their enrollment in physical education classes. Results of a one day 24-hour dietary recall showed both males and females in this study were below the national recommendations for total calories per day and reported poor eating behaviors. Further research is needed to investigate food insufficiency in this population who has high prevalence of overweight

Ecological impacts of non-native Pacific oysters (Crassostrea gigas) and management measures for protected areas in Europe

Pacific oysters are now one of the most ‘globalised’ marine invertebrates. They dominate bivalve aquaculture production in many regions and wild populations are increasingly becoming established, with potential to displace native species and modify habitats and ecosystems. While some fishing communities may benefit from wild populations, there is now a tension between the continued production of Pacific oysters and risk to biodiversity, which is of particular concern within protected sites. The issue of the Pacific oyster therefore locates at the intersection between two policy areas: one concerning the conservation of protected habitats, the other relating to livelihoods and the socio-economics of coastal aquaculture and fishing communities. To help provide an informed basis for management decisions, we first summarise evidence for ecological impacts of wild Pacific oysters in representative coastal habitats. At local scales, it is clear that establishment of Pacific oysters can significantly alter diversity, community structure and ecosystem processes, with effects varying among habitats and locations and with the density of oysters. Less evidence is available to evaluate regional-scale impacts. A range of management measures have been applied to mitigate negative impacts of wild Pacific oysters and we develop recommendations which are consistent with the scientific evidence and believe compatible with multiple interests. We conclude that all stakeholders must engage in regional decision making to help minimise negative environmental impacts, and promote sustainable industry development

The effects of peer and parental smoking and age on the smoking careers of college women: A sex-related phenomenon

In the United States, smoking for women has followed a different pattern for women than for men, and the literature suggests that it, as a 'masculine' behavior, may serve as a role-delineating function for women. This research examines the relationship between sex of smoking parents and peers and the smoking behavior of college women. Having a mother who smokes was significantly related to whether or not the daughter smokes, the age of onset, and the frequency of the daughter's smoking; the proportion of female friends who smoke, to the frequency and amount of the woman's smoking and to the degree of difficulty of quitting. Smoking by the father and male friends was not important. Also, the age of the woman was significantly related to whether or not she ever smoked and to the age of onset of smoking. This likely reflects her experience of social norms regarding smoking by women and the publication of the first surgeon general's report on smoking and health. These findings support the notion of smoking as a role-related behavior for women. Further research is needed to extend these findings to men and to other health behaviors.

Age and Utilization of Preventive Health Services among the Elderly in Five Texas Sites

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Sociocultural correlates of childhood sporting activities: Their implications for heart health

The relative contribution of sex, ethnicity, social class, parental exercise and heart health knowledge to the variability of sporting activities reported by Texas 7th and 8th grade students in 1980 was examined to study the cultural patterns of exercise that might relate to future risk for heart disease. Girls were more likely than boys to participate in activities with high aerobic potential. Relative to Mexican-Americans and Blacks. Anglos were more likely to engage in individual, non-competitive, aerobic-type activities. Multivariate analysis showed heart knowledge, parental exercise, sex, father's occupation and ethnicity to be significantly related to the overall frequency of exercise. Parental exercise had a stronger influence on the frequency of excercise among girls than boys. These findings suggest possible cultural mechanisms in the epidemiology of heart disease.

The relative influence of health beliefs, parental and peer behaviors and exercise program participation on smoking, alcohol use and physical activity

This research specifies a model for lifestyle health behavior which includes socialization, social environmental and cognitive influences on smoking, alcohol use and exercise. Survey respondent were participants in university conditioning classes, academic health classes and a community fitness program. Of the socialization influences, drinking by both parents was directly related to drinking by females and drinking by the mother to that of males. Physical activity level of the father was associated with the activity of both genders. Parental smoking was not related to that of the respondents. Income was positively correlated with alcohol consumption in both genders and with smoking among women. In the immediate environment, drinking and smoking by male and female friends were directly associated with that of both male and female respondents with congruent gender relationship being strongest. Exercise by male friends was positively associated with activity level for both genders, as was exercise by female friends for women only. For college students, program participation was related to lower alcohol consumption among men only and higher activity level for women only. It was not related to the likelihood of smoking. For cognitive factors, belief in the efficacy of lifestyle change was inversely related to alcohol consumption for both genders and to smoking for women. Susceptibility to heart disease was associated with a low exercise frequency and smoking, while generalized susceptibility was directly related to activity level and to smoking. Self control over health was positively related to activity level. With exception, the peer modeling variables had the strongest relationships of any of the model elements in the multivariate analyses. Gender specificity for modeling of behavior was found for peers, but not for parents. These findings suggest that prevention programs incorporate strategies to maximize peer supporrt for healthful behavior and to counteract the effects of unhealthful behavior modeled by peers. Interventions to increase beliefs in the efficacy of lifestyle change to reduce risk are appropriate to encourage behavior change. When the change is underway, discussion of lowered susceptibility as a function of program compliance should reinforce the new behavior.lifestyle health beliefs smoking alcohol use physical activity