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Biomedical subjects

E Gilpin

Publications and source records attributed to E Gilpin.

At least 19 recordsLinked to original sources
PubMed2001

Postnatal cytokines and boosts improve chimerism and hematological parameters in beta-thalassemic mice transplanted in utero.

We have developed a murine model of in utero transplantation in nonanemic, beta-thalassemic mice to study chimerism, tolerance, and changes in hematological parameters in response to cytokines and postnatal boosts with donor cells. We have documented improved survival of homozygous fetuses by 40% as compared with controls. Low-level, mixed chimerism was improved by postnatal cytokine therapy and boosts and was associated with improvement in hemoglobin levels, reticulocyte counts, and iron stores. Cytotoxicity assays demonstrated higher responses to donor cells in control mice as compared with in utero transplanted animals (at 50:1 effector to target ratios, transplanted mice showed 8.66% target lysis and control mice showed 51.85% target lysis, P=0.0003), indicating tolerance. The combination of prenatal tolerance to allogeneic cells with postnatal boosts in primed hosts may become an effective, nontoxic strategy for the improvement of hemolytic anemia in beta-thalassemic patients.

Animals↗
PubMed2001

Microchimerism does not induce tolerance and sustains immunity after in utero transplantation.

BACKGROUND: To date, over 40 in utero transplants have been performed in humans; the only successes were documented in the treatment of severe combined immunodeficiency syndromes. Hemoglobinopathies and metabolic disorders are candidate diseases for this approach; however, when applied clinically, the results have been discouraging. To address the role of the fetal immune system in the outcome of in utero transplantation, we have developed a murine model of in utero transplantation in immunologically intact murine recipients and have studied chimerism and tolerance/immunity to allogeneic donor cells through the lives of the animals. METHODS: We have performed experiments in which purified murine sca-1+/lin- cells and c-kit+/lin- cells of C57BL/6 (H2b) mice were injected into Balb/c (H2d) fetal recipients at early gestational ages. Chimerism was tested by highly sensitive semiquantitative polymerase chain reaction assay and tolerance/immunity to donor cells was studied by in vivo (skin grafts, responses to postnatal boosts) and in vitro (mixed lymphocyte culture, cytotoxicity, and cytokine release) assays. RESULTS: One hundred percent (10/10) of mice transplanted with c-kit+ cells and 44% (4/9) of mice transplanted with sca+ cells showed circulating donor cells within the first 6 months of life (P=0.031). Mice in the sca+ group rejected donor skin grafts at a mean time of 9.1+/-0.2 days, whereas mice in the c-kit+ group rejected donor skin grafts at a mean time of 15.1+/-0.7 days (P=0.001). The difference between the transplanted groups and non-transplanted controls was also significant (P<0.05). All mice transplanted with sca+/lin- cells showed greater response to donor cells than to third-party cells at all effector to target ratios (P=0.002). Differences in response to donor alloantigen between sca+ and c-kit+ groups were significant (P=0.003). Cytokine quantification demonstrated higher TH1 than TH2 cytokine release in all groups, and the response to donor cells was higher in the sca+ compared with c-kit+ mice (P=0.031). CONCLUSION: These results demonstrate a low level of chimerism and tolerance in mice transplanted in utero with sca+/lin- and c-kit+/lin- cells. The possibility of active in utero immunization to donor cells is supported by accelerated skin graft rejection in mice transplanted with sca+ cells and enhanced in vitro immune responses in mice with persistent microchimerism.

Animals↗
PubMed2000

Cytotoxicity, apoptosis, and viral replication in tumor cells treated with oncolytic ribonucleotide reductase-defective herpes simplex type 1 virus (hrR3) combined with ionizing radiation.

The viral ribonucleotide reductase (rR)-defective herpes simplex type-1 (HSV-1) virus (hrR3) has been shown previously to preferentially replicate in and kill tumor cells. This selectivity is associated with tumor cell up-regulation of mammalian rR. Ionizing radiation (IR) is currently used in the therapy of many malignancies, including glioblastoma, cervical carcinoma, and pancreatic carcinoma. IR has been shown to up-regulate mammalian rR in tumor cells and appears to increase the efficacy of at least one non-rR-deleted HSV-1 strain in an in vivo tumor model. Here, we test the hypothesis that a single therapeutic radiation fraction will increase the replication and toxicity of hrR3 for malignant cell lines in vitro. PANC-1 pancreatic carcinoma, U-87 glioblastoma, and CaSki cervical carcinoma cell lines were treated with varying doses of IR and subsequently infected with hrR3 or KOS (wild-type HSV-1 strain). Cell survival was then measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay and trypan blue exclusion cytometry. At 72 hours posttreatment, irradiation with 2 Gy reduced survival from 100% to 76% in noninfected cells, from 61% to 48% in KOS-infected cells, and from 39% to 27% in hrR3-infected PANC-1 cells. As such, analysis of variance indicated that the toxicity of the two modalities was additive. Similar additivity was seen in U-87 MG and CaSki cells. Absolute survival of hrR3-infected or KOS-infected PANC-1 cells decreased as a function of time after treatment (24-72 hours) and multiplicity of infection (MOI) (0.05-5.0). However, the relative decrease in survival with the addition of IR to hrR3 or KOS in PANC-1 cells was not markedly affected by altering MOI (0.05-5.0), time (24-72 hours), radiation dose (2-20 Gy), or cell culture conditions (confluent/growth arrested). We used fluorescence-activated cell sorter analysis with the cationic lipophilic dye DiOC6 to quantify a reduction in mitochondrial membrane potential that'is associated with apoptosis. Fluorescence-activated cell sorter analysis indicated increased apoptosis in both hrR3- and IR-treated cells at 48-72 hours, with hrR3 alone producing the most induction. Viral yields from PANC-1 cells after irradiation and infection were examined. No significant differences were seen between irradiated and nonirradiated cells in viral replication, with hrR3 producing single-step titers of 3.1 +/- 0.9 x 10(5) and 4.0 +/- 1.2 x 10(5) plaque-forming units/mL in nonirradiated and irradiated cells. Thus, complementary toxicity was seen between IR and hrR3 or KOS, regardless of cell type, time, MOI, IR dose, or culture conditions, without evidence of augmented apoptosis or viral replication.

Apoptosis↗
PubMed2000

Microchimerism does not induce tolerance after in utero transplantation and may lead to the development of alloreactivity.

In utero transplantation is a new technology that may provide non-toxic treatment for congenital disorders. However, a decade of research on in utero transplantation has demonstrated a low degree of chimerism and tolerance in small and large animal models as well as in human beings. We hypothesized that if large numbers of purified stem cells/progenitors were injected, a higher degree of tolerance would be induced. We have performed a 2-year experiment designed to study chimerism and tolerance after in utero transplantation with large numbers of cytokine-recruited C-kit+ cells. Chimerism in the blood and tissues was tested through the lifespan of the animals, and in vitro immunologic assays were performed at the end of life. C-kit+ cells obtained from the peripheral blood of C57BL/6 mice were injected intraperitoneally into 12- to 13-day-old Balb/c murine fetuses. The injected populations contained 5% to 20% of Sca-1+ and 1% to 5% of CD3+ cells. Twenty-three percent of mice that received transplants showed circulating donor cells in the blood, and 7% to 14% showed donor cells in the tissues. The percent of donor cells in the blood and tissues was low (<0.01%). Timing of injection or cell dose did not affect chimerism or tolerance. Fifty percent (13 of 26) showed accelerated skin graft rejection and 5 of 26 (19%) had prolonged acceptance as compared with control mice not receiving transplants in utero. All mice that rejected skin grafts showed significantly increased natural killer function as compared with the mice with delayed graft acceptance. Fifty percent of tested recipient mice showed reactivity against donor cells in the cytotoxicity assay, which could be related to the prenatal sensitization. We conclude that microchimerism does not lead to the induction of a high degree tolerance after in utero transplantation and instead may lead to the development of alloreactivity to donor cells.

Animals↗
PubMed2000

Simultaneous administration of G-CSF and GM-CSF for re-mobilization in patients with inadequate initial progenitor cell collections for autologous transplantation.

BACKGROUND: A proportion of candidates for high-dose chemotherapy with autologous PBPC support (HDC-PBPCS) will not provide an adequate PBPC yield from their first mobilization. The value of re-mobilization and the best regimen for re-mobilization in these patients is unclear. METHODS: In 23 patients who failed to provide > or = 3 x 10(6) CD34+ cells/kg after their first mobilization, PBPC were re-mobilized using a regimen of simultaneous administration of G-CSF and GM-CSF (10 microg/kg/day each) with leukaphereses (LP) starting Day 4 or 5 of CSF administration. Yields of WBC/kg, MNC/kg and CD34+ cells/kg/L of processed blood were compared between the first and second mobilization in each patient. The ability of the combined yield from the two mobilizations to achieve the desired threshold PBPC yield and the tolerability of the re-mobilization were determined. RESULTS: The re-mobilization regimen was well-tolerated and no patient discontinued the regimen because of toxicity. Median collected WBC/kg/L (1.37 x 10(7) versus 2.62 x 10(7), p = 0.0065), MNC/kg/L (0.77 x 10(7) versus 1.97 x 10(7), p = 0.0003), CD34+ cells/kg/L (1.64 x 10(7) versus 4.18 x 10(7), p = 0.001) were significantly higher after the second mobilization (G-CSF/GM-CSF combination). Percentage of CD34+ cells in the leukapheresis was also significantly higher after the second mobilization (median 0.104% versus 0.195%, p = 0.036). Twelve of 22 patients achieved the target PBPC dose (> 3 x 10(6)/CD34+ cells/kg) after two mobilizations (six patients achieved the target from the second mobilization alone). A further eight underwent HDC-PBPCS without achieving the target PBPC dose. These patients experienced a significant delay in neutrophil and platelet engraftment when compared with those patients achieving the target dose. DISCUSSION: This study demonstrates that the combination of G-CSF and GM-CSF is an effective and tolerable method for re-mobilization of PBPC in patients who fail to provide an adequate yield from their first mobilization.

Adult↗
PubMed1999

The American Stop Smoking Intervention Study. Conceptual framework and evaluation design.

Reducing tobacco use, especially cigarette smoking, is a public health priority. The American Stop Smoking Intervention Study (ASSIST) was initiated in 1991 to prevent and reduce tobacco use primarily through policy-based approaches to alter the social-political environment. This article describes the conceptual design, research framework, evaluation components, and analytic strategies that are guiding the evaluation of this demonstration research endeavor. The ASSIST evaluation is a unique analysis of the complex relationships between the social context, public health activity at the state level, tobacco use, and individual behavior. The measures of tobacco control activity developed for this evaluation may be useful in ongoing national cancer control surveillance efforts, and the lessons learned will enhance the development of tobacco control programs.

Humans↗
PubMed1997

Adult smokers who do not smoke daily.

Almost 20% of Californian smokers do not smoke daily. Although occasional (non-daily) smoking occurs during uptake, a stable pattern of occasional smoking may imply a milder level of nicotine addiction. We use a longitudinal population sample of smokers interviewed in both 1990 and 1992 to evaluate the stability of occasional smoking. Further, we use 1992 data, including smokers only interviewed in 1992, to compare occasional smokers who have (ever-daily) and have not (never-daily) smoked daily for at least 6 months, and contrast them to daily smokers for key variables associated with addiction. All our analyses exclude uptake smokers. Two-thirds of never-daily occasional smokers in 1992 also smoked occasionally in 1990, compared to only about 40% of ever-daily occasional smokers. Never-daily occasional smokers smoke less than ever-daily ones. They are more often under age 40 years, of Hispanic origin, and were more likely to begin regular smoking beyond their teen years. Demographically, ever-daily occasional smokers were similar to daily smokers except for being more educated. However, both ever-daily and never-daily smokers differed from daily smokers with respect to long-term quitting history, plans to quit, confidence they could quit, and belief they are addicted to cigarettes. Our findings suggest that occasional smoking can be a stable pattern for long periods. Occasional smokers, particularly never-daily ones, appear to be much less addicted to nicotine than daily smokers.

Adult↗
PubMed1996

How long will today's new adolescent smoker be addicted to cigarettes?

This study estimated the expected smoking duration for young smokers who have started recently. Data from National Health Interview Surveys were combined to model the ages at which smoking prevalence will decline to various percentages of the peak smoking prevalence for each successive birth cohort. Smoking-cessation ages were then estimated for the males and females born from 1975 through 1979. The median cessation age for those in this cohort who start smoking as adolescents is expected to be 33 years for males and 37 years for females. Thus, 50% of these adolescent males may smoke for at least 16 years and 50% of these adolescent females may smoke for at least 20 years, based on a median age of initiation of 16 to 17 years. Despite the decline in the median age of US smokers who quit, these data predict that smoking will be a long-term addiction for many adolescents who start now.

Adolescent↗
PubMed1995

Influence of tobacco marketing and exposure to smokers on adolescent susceptibility to smoking.

BACKGROUND: Today the uptake of smoking is primarily an adolescent pursuit. Awareness of tobacco advertising and promotion is high, and evidence suggests that it plays a role in adolescent smoking uptake. PURPOSE: We evaluated the influence of tobacco advertising and promotion and exposure to smokers on never-smoking adolescents' susceptibility to smoking. METHODS: We used data on 3536 adolescent never smokers (those who had never even puffed on a cigarette) from the 1993 California Tobacco Survey. That survey questioned adolescents about smoking history and inclinations. For this analysis, we defined as susceptible to smoking those never smokers who said on the survey that they could not rule out independently deciding to try a cigarette soon or smoking one offered by a friend. Also for this analysis, we devised two indices: 1) a 5-point index of an individual's receptivity to tobacco advertising as determined by the number of positive responses to five survey items (recognition of advertising messages, having a favorite advertisement, naming a brand he/she might buy, owning a tobacco-related promotional item, and willingness to use a tobacco-related promotional item) and 2) an index classifying an individual's reported exposure to family and peer smoking into one of four levels. Using logistic regression, we assessed the independent importance of our indices in predicting susceptibility to smoking after adjustment for sociodemographic variables, including age, sex, and race/ethnicity, and for perceived school performance. Tests of statistical significance were two-sided. RESULTS: Receptivity to tobacco advertising and exposure to smokers were independently associated with susceptibility to smoking, but the relationship appeared stronger for receptivity to advertising. Adolescents exposed to family members and peers (n = 489) who smoked were 1.89 (95% confidence interval [CI] = 1.30-2.74) times as likely to be susceptible, whereas adolescents who scored 4 or more on the Index of Receptivity to Tobacco Marketing (n = 361) were 3.91 (95% CI = 2.38-6.42) times as likely to be susceptible as those who scored 0. Even adolescents who scored 2 (n = 1090) were 2.03 (95% CI = 1.31-3.15) times as likely to be susceptible. There was no interaction effect between score on the Index of Receptivity to Tobacco Marketing and exposure to smokers. CONCLUSION: Our results support the hypothesis that tobacco marketing may be a stronger current influence in encouraging adolescents to initiate the smoking uptake process than exposure to peer or family smokers or sociodemographic variables including perceived school performance.

Adolescent↗
PubMed1995

Nicotine patch use in the general population: results from the 1993 California Tobacco Survey.

BACKGROUND: Evidence from controlled clinical trials indicates that use of a transdermal nicotine patch improves abstinence rates up to a year after initial smoking cessation. Whether these results can be generalized to the general population has not been extensively investigated. PURPOSE: We sought to determine what characteristics of smokers trying to quit are associated with nicotine patch use in the general population and whether there is evidence that patch use promotes successful smoking cessation. METHODS: As part of the 1993 California Tobacco Survey, 3281 respondents who had attempted to quit smoking cigarettes within the last year were asked whether they had used a prescribed medication to help them quit smoking and, if so, what type of medication it was. They were also asked whether they used other assistance. RESULTS: Compared with nonusers, patch users (nearly 11% of quitters) were more likely to be female, white or Asian, middle-aged, and to smoke more heavily. Many people relapsed to smoking while they were still using a patch. However, no evidence suggested that the patch was addictive. Use of a nicotine patch did not result in a statistically significant difference in abstinence rates among those who did not also use some other form of assistance (logrank test, P = .466). It did make a statistically significant difference when used in combination with another aid (logrank test, P = .017). At 6 months, abstinence rates were 15% for those without other forms of assistance whether or not they used a patch, 10.9% (95% confidence interval [CI] = 5.1-16.8) for those with other assistance who did not use a patch, and 18.8% (95% CI = 5.7-31.8) for those with other assistance who did use a patch. CONCLUSIONS: The nicotine patch appears to be an important aid to smokers who want to quit, primarily when used as an adjuvant to other forms of assistance. IMPLICATIONS: Further studies are needed to determine what factors are associated with quitting success among patch users.

Actuarial Analysis↗
PubMed1995

Adolescents' perceptions of their peers' health norms.

OBJECTIVES: The purpose of this study was to determine the relative importance adolescents place on preventive health behaviors. METHODS: Data were from a survey of California adolescents (n = 5040). Respondents were asked how important it was to their peers to avoid drugs, marijuana, cigarettes, heavy drinking, and drinking and driving and to maintain seat belt use, fitness, weight control, and healthy eating habits. Results were compared with data from a similar national survey (n = 6126). RESULTS: California teenagers perceived that their peers gave top priority to weight control: 85% of California teenagers believed that weight control was of high concern to girls in their age group. Avoiding drugs, not drinking and driving, and maintaining fitness ranked in the top five behaviors. The lowest ranked health behaviors were seat belt use, heavy drinking, and, last, eating healthily. In the national survey, healthy eating also ranked last. Although not identical in rank, teenage priorities for other health behaviors were consistent with the California results. CONCLUSION: Efforts are needed to bring adolescent health norms more into line with the objective risks of their health choices during this critical period of socialization.

Adolescent↗
PubMed1994

Force-frequency relations during heart failure in pigs.

In isolated cardiac muscle from patients with severe heart failure (HF) the force-frequency relation (FFR) is often negative, but the characteristics of the FFR under basal conditions and its responsiveness to adrenergic stimulation have not been studied in the intact, failing heart. Severe HF was produced in pigs (n = 6) by continuous rapid left ventricular (LV) pacing (225 beats/min). In the conscious resting state, high-fidelity LV pressure and its maximum first derivative (LV dP/dtmax) were obtained over a range of atrial pacing rates (100-225 beats/min) before (control) and after HF. Before HF, the relationship between increased heart rate and LV dP/dtmax (a measure of the FFR) was flat, but during dobutamine infusion the FFR showed a significant positive slope (P < 0.003). After HF, the basal FFR was depressed, but the slope of the FFR was not increased by dobutamine. After HF, responses of dP/dtmax to slowing of HR by a specific sinus node inhibitor confirmed the absence of a negative basal FFR. In conclusion, the basal LV FFR in conscious pigs with severe HF was not negative. Unlike the normal heart, in HF beta-adrenergic receptor stimulation did not amplify the FFR, a phenomenon that could play an important role in the impaired response to exercise in patients with HF.

Animals↗
PubMed1993

Outcome after acute myocardial infarction in patients with prior coronary artery bypass surgery.

Little is known concerning the influence of remote prior coronary artery bypass grafting (CABG) on the outcome of patients with acute myocardial infarction (AMI). Therefore, this study evaluated 2,494 patients with AMI of whom 219 (8.8%) had a history of CABG a mean of 7.1 +/- 3.7 years before the index AMI. Compared with all other patients, those with a history of CABG had an increased prevalence of a history of prior AMI (153 [70%] vs 547 [24%]), congestive heart failure (48 [22%] vs 236 [10%]), and angina pectoris (165 [75%] vs 787 [35%]), all p < 0.001. There was no difference in age, but patients with prior CABG were more often men (192 [88%] vs 1,702 [75%], p < 0.001). During the hospitalization for AMI, patients with prior CABG had more recurrent ischemic pain (100 [46%] vs 732 [32%, p < 0.001]), and more frequently developed non-Q-wave AMI (72 [33%] vs 514 [23%], p < 0.01). In-hospital mortality did not differ among patients with or without prior CABG (15 [7%] vs 195 [9%]). At hospital discharge, more patients with prior CABG had complex ventricular ectopic activity on 24-hour ambulatory electrocardiographic monitoring (48 of 74 [65%] vs 327 of 797 [41%], p < 0.0001), and radionuclide ejection fraction < 0.45 (53 of 99 [54%] vs 430 of 1,024 [42%], p < 0.01). Among patients undergoing coronary angiography during the first 2 months, multivessel coronary artery disease was more prevalent among patients with prior CABG (78 of 107 [73%] vs 508 of 959 [53%], p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1993

Altered left ventricular remodeling with beta-adrenergic blockade and exercise after coronary reperfusion in rats.

BACKGROUND: beta-Adrenergic blockade is known to improve the survival of patients after acute myocardial infarction and to reduce myocardial infarct size in experimental coronary occlusion. However, the effects of beta-blockade on global and regional left ventricular (LV) remodeling have not been characterized after coronary occlusion with reperfusion. In rats subjected to coronary occlusion and reperfusion, we have demonstrated beneficial effects of reperfusion in sedentary rats with a hypertrophic response to exercise in the surviving outer wall of the infarcted zone, and in this study we investigated whether such remodeling is modified by beta-blockade in both sedentary and exercised rats. METHODS AND RESULTS: Female Sprague-Dawley rats were randomized into groups at 5 days after 45 minutes of left coronary artery occlusion followed by reperfusion to produce nontransmural infarction. Animals completing the experiment included a propranolol-treated sedentary group (750 mg/l drinking water) (n = 20) and a propranolol-treated exercised group (n = 19), and these groups were compared with two groups of simultaneously randomized rats (which were also part of a separate study): an untreated sedentary group (n = 21) and an untreated exercised group (n = 20). After 3 weeks of intervention, global and regional LV morphological changes were analyzed in 78 completed experiments from midventricular transverse slices of hearts after perfusion fixation. Compared with sedentary untreated rats, propranolol-treated sedentary rats showed significantly increased LV cavity area (41.6 versus 31.5 mm2, p < 0.001) and reduced wall thicknesses in the noninfarcted (1.77 versus 1.95 mm, p < 0.01) and infarcted regions (1.29 versus 1.36 mm, p < 0.01) (two-way ANOVA). In the propranolol-treated rats, exercise further increased the LV cavity area (44.6 versus 39.1 mm2, p < 0.001), reduced the noninfarcted wall thickness (1.62 versus 1.81 mm, p < 0.01), and increased the LV dimension/wall thickness ratio in the noninfarcted region (4.7 versus 3.95 mm, p < 0.001). Whereas exercise in the reperfused group in the absence of beta-blockade significantly increased the viable subepicardial area of the infarcted zone, as reported elsewhere, propranolol treatment prevented this exercise-induced increase of subepicardial area (7.8 rest versus 7.7 mm2 exercise, NS), and there was a significant reduction of total myocardial area in the propranolol-treated exercised group compared with the untreated exercised group (p < 0.05). Corresponding trends in LV weights were not statistically significant. CONCLUSIONS: These findings provide evidence for altered LV remodeling, including LV cavity dilation and reduced wall thickness, after 3 weeks of propranolol treatment in sedentary rats after coronary artery occlusion and reperfusion to produce nontransmural infarction. In addition, after 3 weeks of exercise together with propranolol treatment, morphological changes were consistent with suppression of exercise-induced myocardial hypertrophy globally and in the viable outer wall of the infarcted region, accompanied by further LV cavity dilation.

Adrenergic beta-Antagonists↗
PubMed1992

Protection from environmental tobacco smoke in California. The case for a smoke-free workplace.

OBJECTIVE: To determine the extent of exposure of nonsmoking indoor workers to environmental tobacco smoke (ETS) according to type of work-site smoking policy, work area, workplace size, and demographic characteristics. DESIGN AND PARTICIPANTS: Participants included 7162 adult, nonsmoking, indoor workers who were interviewed as part of the 1990 California Tobacco Survey. Respondents were asked whether anyone had smoked in their work area within the past 2 weeks. RESULTS: An estimated 2.2 million California nonsmokers were exposed to tobacco smoke at indoor work sites in 1990. Nonsmoker exposure to ETS was 9.3% for those working in a smoke-free worksite, 23.2% for those working where there was only a work-area restriction, 46.7% for those working where there was a policy that did not include the work area, and 51.4% for those working where there was no work-site smoking policy. After adjustment for type of work area (eg, office, open area), workplace size, and demographic factors, it was determined that nonsmokers working where there was only a work-area ban were 2.8 times more likely to be exposed to ETS than those working in a smoke-free work site. In workplaces with no policy or a policy not covering the work area, nonsmokers were over eight times more likely to be exposed to ETS than those who worked in a smoke-free work site. Nonsmokers who were 18 to 24 years of age, male, or Hispanic, and those with less than a high school education had more exposure to ETS. CONCLUSION: These results indicate that adequate protection of nonsmokers from ETS exposure requires a smoke-free work site.

Adolescent↗
PubMed1991

Does tobacco advertising target young people to start smoking? Evidence from California.

OBJECTIVE: To evaluate whether tobacco advertising encourages teenagers younger than 18 years to start smoking. DESIGN: Comparison of 1990 California telephone survey data with data from a 1986 national telephone survey (both used a random-digit dialing system); 95% confidence intervals were calculated. To test our hypothesis, we considered whether the perception of advertising was related to age, whether the pattern of market share across age and sex groups followed the pattern of perceived advertising, and whether changes in market share paralleled changes in advertising as perceived by the youngest age group. PARTICIPANTS: There were 24,296 adults and 5040 teenagers. RESULTS: The most advertised brands of cigarettes were Marlboro, according to 33.6% of adults and 41.8% of teenagers, and Camel, according to 13.7% of adults and 28.5% of teenagers--named most often by 12- to 13-year-olds (34.2%). The brands that were purchased most often were Marlboro and Camel. Together these were the brands of choice of 79.9% of males and 85% of females aged 12 through 17 years. Marlboro's market share increased in youths and young adults up to age 24 years and then decreased gradually with age; Camel's market share decreased abruptly with age: it was the brand of choice of 24.5% +/- 5.8% of males aged 12 through 17 years but was chosen by only 12.7% +/- 3.6% of males aged 18 through 24 years; for females, 21.7% +/- 13.7% aged 12 through 17 years chose Camels, while only 5.5% +/- 3.2% aged 18 through 24 years preferred this brand. Both Marlboro and Camel brands had a higher market share in California in 1990 compared with that for the United States in 1986. Of interest is that the market share for Camel increased among the younger smokers but was more evenly distributed for Marlboro. CONCLUSIONS: Perception of advertising is higher among young smokers; market-share patterns across age and sex groups follow the perceived advertising patterns; and changes in market share resulting from advertising occur mainly in younger smokers. Cigarette advertising encourages youth to smoke and should be banned.

Adolescent↗
PubMed1991

Smoking initiation in the United States: a role for worksite and college smoking bans.

Data from four National Health Interview Surveys were combined, and a birth-cohort analysis was undertaken to determine the age when regular smoking is initiated. By the age of 25 years, most smokers have already become regular smokers. Among men, the proportion of each birth cohort who become regular smokers has declined at a rate of about 1.0% for each year of birth since 1945. There has been no identifiable decline in successive birth cohorts of women. For those born in the most recent birth cohorts, there was no sex difference in the proportion who became regular smokers. The proportion of smokers beginning to smoke during the secondary-school years (less than or equal to 18 years of age) has increased steadily, especially among people with a high-school education or less. However, in the latest birth cohort (1960-1962), over 18% of ever smokers with at least a high-school education did not start to smoke regularly until their young-adult years (19-24 years of age). If the effect of tobacco-education programs in the schools is to postpone the uptake of regular smoking, it is important to have tobacco policies in place in other areas of society that will maintain non-smoking behavior through the young-adult years. Accordingly, the banning of smoking in colleges, universities, and worksites, as well as in secondary schools, may significantly decrease the proportion of young people who eventually become regular smokers.

Adult↗