Biomedical subjects

Cheryl Higbee

Publications and source records attributed to Cheryl Higbee.

11 recordsLinked to original sources

PubMed2006

The role of public policies in reducing smoking prevalence in California: results from the California tobacco policy simulation model.

Tobacco control policies are examined utilizing a simulation model for California, the state with the longest running comprehensive program. We assess the impact of the California Tobacco Control Program (CTCP) and surrounding price changes on smoking prevalence and smoking-attributable deaths. Modeling begins in 1988 and progresses chronologically to 2004, and considers four types of policies (taxes, mass media, clean air laws, and youth access policies) independently and as a package. The model is validated against existing smoking prevalence estimates. The difference in trends between predicted smoking rates from the model and other commonly used estimates of smoking prevalence for the overall period were generally small. The model also predicted some important changes in trend, which occurred with changes in policy. The California SimSmoke model estimates that tobacco control policies reduced smoking rates in California by an additional 25% relative to the level that they would have been if policies were kept at their 1988 level. By 2004, the model attributes 59% of the reduction to price increases, 28% of the overall effect to media policies, 11% to clean air laws, and only a small percent to youth access policies. The model estimates that over 5000 lives will be saved in the year 2010 alone as a result of the CTCP and industry-initiated price increases, and that over 50,000 lives were saved over the period 1988-2010. Tobacco control policies implemented as comprehensive tobacco control strategies have significantly impacted smoking rates. Further tax increases should lead to additional lives saved, and additional policies may result in further impacts on smoking rates, and consequently on smoking-attributable health outcomes in the population.

California↗

PubMed2006

Internet cigarette purchasing among 9th grade students in western New York: 2000-2001 vs. 2004-2005.

OBJECTIVE: To assess trends and correlates of youth cigarette purchasing behavior on the Internet. METHODS: In 2000-2001, Roswell Park Cancer Institute conducted a survey asking 7,019 ninth grade students in Erie and Niagara Counties in New York State about their tobacco use and purchasing habits, including use of the Internet to buy cigarettes. The 2004-2005 survey is a replication of the 2000-2001 survey. Both surveys used an anonymous, self-administered questionnaire survey. These data were combined in order to examine trends in youth smoking behavior. RESULTS: Students surveyed in 2004-2005 were 2.6 times more likely (95% CI: 1.5, 4.6) to have purchased cigarettes over the Internet in the 30 days prior to the survey than those surveyed in 2001 (5.2% to 1.6%); however, the intention to use the Internet as a cigarette source in the future did not change between survey periods. CONCLUSION: Youth online cigarette purchasing has increased but intention to use the Internet to purchase cigarettes in the future has remained the same, suggesting that this trend may be reaching a plateau. Recent public efforts to reduce online cigarette sales will need to be evaluated in order to determine which policy or combination of policies are most effective.

Adolescent↗

PubMed2006

Anti-tobacco television advertising and indicators of smoking cessation in adults: a cohort study.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with 2000-01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased 'a lot' between 1993 and 2001 (RR = 1.19, 95% CI = 1.03-1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.

Adult↗

PubMed2006

Secondhand smoke and indoor public spaces in Paducah, Kentucky.

INTRODUCTION: Secondhand smoke (SHS) is the third leading cause of preventable death in the United States. It is responsible for an estimated 3,000 lung cancer deaths annually in never-smokers in the US. It also accounts for over 35,000 deaths annually from coronary heart disease in never-smokers. It increases the number and severity of asthmatic attacks in over 300,000 asthmatic children each year, and is associated with Sudden Infant Death Syndrome and middle ear infections, in addition to other illnesses in children. The purpose of this study was to examine indoor air quality in a sample of hospitality venues in Paducah, Kentucky. The relation between indoor air pollution and the presence of on premises smoking was assessed. METHODS: A Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles in the air. The SidePak uses a built-in sampling pump that draws air through the device and the particulate matter in the air scatters the light from a laser. Based on this light scattering, the device determines to assess the real-time concentration of particles smaller than 2.5 microm in micrograms per cubic meter, or PM2.5. RESULTS: The average PM2.5 concentration in the eleven locations sampled in Paducah, Kentucky, was 177 microg/m3. The average fine particle pollution level in the non-smoking sections tested was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. The average PM2.5 level across all nine smoking-permitted hospitality locations sampled in Paducah was 200 microg/m3. For a full-time employee in the venues sampled in this study, the average annual PM2.5 exposure would be 46 microg/m3 (assuming exposure to 200 microg/m3 on the job, exposure to zero particles off the job, and a 40-hour work week). The EPA average annual PM2.5 limit is exceeded by 3.1 times due solely to occupational exposure. Of the ten locations visited that permit indoor smoking, the air monitoring was done in the non-smoking section of six of them. These locations included five restaurants and one public government office. The average fine particle pollution level in these non-smoking sections was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. It is also interesting to note that the average fine particle pollution level in the smoking section of one restaurant was actually less than the average fine particle pollution level in the "no smoking" section of two other restaurants. CONCLUSIONS: The effects of secondhand smoke are substantial and rapid, explaining the relatively large health risks associated with secondhand smoke exposure that have been reported in epidemiological studies. This study shows that physically separating smokers and non-smokers is not an effective way to protect non-smoking patrons from tobacco smoke pollution. "No smoking" sections provided protection to nonsmokers that can be characterized as trivial at best. In fact, patrons in Paducah cannot be certain that their exposure will not be higher in the "no smoking" sections of certain venues when compared to the smoking sections of other venues. It is imperative that physicians and other healthcare providers actively and aggressively lobby local policymakers to pass regulatory and/or public health ordinances, which have been demonstrated to be effective in controlling exposure to secondhand smoke.

Air Pollutants↗

PubMed2005

Anti-tobacco television advertising and indicators of smoking cessation in adults: a cohort study.

The objective of this study was to assess the relationship between exposure to state-sponsored anti-tobacco advertising and smoking cessation. Cessation rates in 2001 among a cohort of 2061 smokers who participated in the Community Intervention Trial for Smoking Cessation between 1988 and 1993 and completed a follow-up survey in 2001 were merged with the 2000-01 television advertising exposure data from Nielsen Media Research. The relative risk for quitting was estimated to be 10% higher for every 5000 units of exposure to state anti-tobacco television advertising over the 2-year period, although this did not quite achieve statistical significance. The association was even larger among those who reported that the level of information in the media about the dangers of smoking had increased 'a lot' between 1993 and 2001 (RR = 1.19, 95% CI = 1.03-1.38). These data are consistent with the finding that increased exposure to state anti-tobacco media increases smoking cessation rates.

Adult↗

PubMed2005

Access to low-taxed cigarettes deters smoking cessation attempts.

We examined whether smokers who purchased low-taxed cigarettes from American Indian reservations had lower quit attempt and cessation rates than did smokers who purchased cigarettes from full-price outlets. Smokers who bought cigarettes from American Indian reservations were half as likely to make a quit attempt and had a nonsignificant trend toward lower cessation rates (20% vs 10%) compared with those who bought full-priced cigarettes. Interventions that reduce price differentials are suggested to maximize the public health benefit of cigarette excise taxes.

Adult↗

PubMed2004

Perceptions about cigarette smoking and risks among college students.

The objective of the present study was to describe how college students perceive the risks of cigarette smoking and addiction to nicotine. Data came from a self-administered survey of 1,020 college students enrolled in two 4-year liberal arts colleges in the United States. The survey was conducted in the fall of 2001. Smokers and nonsmokers differed markedly in their perceptions about the health risks associated with short-term exposure to smoking. College students in this sample who smoked did not fully comprehend the risks associated with smoking. Smokers were half as likely as nonsmokers to believe that there are health risks from smoking only on weekends or a couple of days a week. Anti-tobacco messages for young adult smokers need to communicate more effectively the concept that each cigarette they smoke is doing them damage.

Adult↗

PubMedDate not supplied

Cigarette purchasing behaviors when prices are high.

The objective of this study was to assess the cigarette purchase patterns of smokers in Erie and Niagara Counties following recent increases in the state excise tax for cigarettes. Data were collected with telephone interviews of a sample of 1,548 randomly selected people in Erie and Niagara Counties between October 2002 and March 2003. Purchase patterns were assessed for the 908 smokers in the sample who responded to questions about cigarette purchasing patterns. Thirty-three percent reported that their usual source of cigarettes is from a small store, large store, pharmacy, or vending machine, while 67% reported that their usual source is from an Indian reservation. Only one smoker reported the Internet was a usual source of cigarettes. The average price paid per pack was $4.80 in a small store and $1.91 on an Indian reservation. Price influences smoking behavior; however, the majority of smokers are taking advantage of readily available venues where less expensive, untaxed cigarettes are sold. This may undermine the public health benefit of higher prices and cause lost revenue to state and local governments.

Adult↗

PubMedDate not supplied

Avoidance of smoky establishments: findings from Erie and Niagara Counties in New York.

The objective of this study was to determine the extent to which people avoid smoky restaurants, bars, bowling alleys, casinos, and bingo halls because of secondhand smoke. Data were collected with telephone interviews of a sample of 1,548 randomly selected adults in Erie and Niagara Counties between October 2002 and March 2003. Most nonsmokers (71%) reported that they are bothered by secondhand smoke. Thirty-four percent of nonsmokers and 10% of smokers responded that they had avoided patronizing a smoky establishment in the past 12 months. The places that were most often avoided were restaurants (17%), bars or taverns (13%), and bingo halls (9%).

Adolescent↗

PubMedDate not supplied

Disparity in the use of smoking cessation pharmacotherapy among Medicaid and general population smokers.

BACKGROUND: The prevalence of smoking remains higher among the Medicaid population compared with the general population. To reduce this disparity, the majority of state Medicaid programs now provide coverage for smoking cessation pharmacotherapy. The objectives of this study were to (1) assess awareness of this benefit among Medicaid smokers and (2) compare the use of pharmacotherapy among a sample of Medicaid smokers with smokers in the general population of western New York. METHODS: This report summarizes findings from two cross-sectional studies conducted in western New York State during 2002 to 2003: (1) Medicaid smokers (n = 1,174) completed an interviewer-administered questionnaire in the Office of Medicaid Management and (2) smokers from the general population (n = 852) completed a telephone survey. RESULTS: The majority of Medicaid smokers (54%) remain unaware of the program benefit providing coverage for smoking cessation pharmacotherapies. Medicaid smokers were much less likely (odds ratio = 0.33, 95% confidence interval = 0.25-0.44) than the general population to report having ever used pharmacotherapies. CONCLUSIONS: Highlighting the availability of the smoking cessation pharmacotherapy benefit to Medicaid program participants may be one strategy to enhance quit attempts among this population. Future research should identify other potential barriers to the use of effective pharmacotherapies among poorer smokers.

Adolescent↗

PubMedDate not supplied

Concurrent quit & win and nicotine replacement therapy voucher giveaway programs: participant characteristics and predictors of smoking abstinence.

This study compares the participant characteristics, program costs, and outcomes of a Quit & Win contest and a nicotine replacement therapy (NRT) voucher giveaway promotion. Both programs were conducted simultaneously so that smokers could enroll in either one program alone (n = 849 and 690, respectively) or both programs (Combination group; n = 230). A follow-up telephone survey of a random sample of participants was conducted 4 to 7 months after enrollment to evaluate smoking status. At enrollment, participants in the three groups were comparable on most smoking and demographic variables, although Quit & Win participants were, on average, younger than those who signed up to get the NRT voucher. Compared with the characteristics of smokers in the region, those who enrolled in the intervention programs were heavier smokers and had more years of formal education. At follow-up, the self-reported quit rates were similar across the three intervention groups, ranging between 25 percent and 30 percent. The only evidence for a higher quit rate among those in the Combination group was among younger smokers. On a simple estimated cost per quit basis, the Quit & Win (130 dollars) and NRT (179 dollars) voucher interventions appear roughly comparable. In all groups, abstinence rates were higher among lighter smokers (<21 cigarettes per day), participants who did not live with another smoker, and those who were married. Both the Quit & Win and NRT voucher giveaway programs were effective in recruiting smokers to make a quit attempt, although combining both interventions did not generally increase abstinence rates.

Adult↗