Biomedical subjects

H Lando

Publications and source records attributed to H Lando.

At least 19 recordsLinked to original sources

PubMed2001

Evidence that smokeless tobacco use is a gateway for smoking initiation in young adult males.

BACKGROUND: This study was designed to test the hypothesis that smokeless tobacco (SLT) serves as a gateway drug for smoking among young adult males. Methods. A cohort (n = 7,865) of U.S. Air Force recruits who claimed to have never smoked cigarettes was followed prospectively for 1 year. The participants were male, 32.9% were ethnic minorities, and their average age was 19.84 years (SD = 2.29). Among recruits entering basic military training, 403 (5.1%) reported current SLT use and 198 (2.5%) reported a past history of SLT use. RESULTS: At the 1-year follow-up current SLT users were 233% more likely to have initiated smoking than nonusers (odds ratio = 2.33, 95% CI = 1.84-2.94). Similarly, recruits who reported past SLT use were 227% more likely to begin smoking than participants who had never used SLT (odds ratio = 2.27, 95% CI = 1.64-3.15). SLT use remained a potent predictor of smoking initiation in a multivariate logistic model that included demographic factors and other risk factors for initiation. CONCLUSIONS: SLT use appears to be an important predictor of smoking initiation among young adult males. This study suggests that smoking prevention and cessation programs should also include strategies related to SLT use.

Adolescent↗

PubMed2001

Motivation for smoking cessation among pregnant women.

The authors evaluated an expanded measure of intrinsic and extrinsic motivation for smoking cessation in a population-based sample of 897 pregnant smokers (500 current smokers and 397 recent quitters). The measure assessed motivation related to pregnancy and parenthood in addition to general intrinsic and extrinsic dimensions. Current smokers at baseline who quit smoking by 28 weeks of pregnancy (n = 102) had significantly higher baseline levels of pregnancy-related motivation than continuing smokers. Extrinsic and pregnancy motivation dropped between baseline and 28 weeks of pregnancy among continuing smokers. Higher levels of intrinsic relative to extrinsic motivation at baseline were associated with sustained abstinence during the first 2 months postpartum. Results suggest that both general and pregnancy-specific motivation are important for smoking cessation and relapse prevention during pregnancy. Interventions to enhance the salience of health benefits over and above those related to pregnancy and other intrinsic benefits of a greater sense of self-control could protect against postpartum relapse.

Female↗

PubMed2001

Women's perceived and partners' reported support for smoking cessation during pregnancy.

Studies of the influence of social support on successful smoking cessation have been based on the smoker's perceptions only. In this pilot study of 58 couples, pregnant women who had smoked in the 30 days before pregnancy and their partners reported the positive and negative support for cessation they had received (women) or provided (partners). Mean levels of the women's and partners' perceptions of support were compared, and correlations of the two reports were analyzed while controlling for the effect of the couple's smoking status. Women's and partners' reports were similar except partners reported wanting the women to stop smoking more than women perceived. Women's and partners' perceived negative support were moderately correlated (r approximately equal to .48, p approximately equal to .001). Partner-reported positive support also was associated with women's perceived negative support (r approximately equal to .30, p approximately equal to .03). These relationships remained signif cant after controllingfor partners' and women's smoking status. Generally, partners reported giving more positive and less negative support than women perceived. Results suggest the need for further examination of couples' perceptions of support and the impact on smoking cessation during pregnancy.

Adult↗

PubMed2000

Tobacco, alcohol, and caffeine use and cessation in early pregnancy.

OBJECTIVES: Little is known about what happens when individuals attempt to make multiple behavior changes simultaneously. Pregnant women in particular are often in the position of needing to change several behaviors at once, including giving up more than one pleasurable substance. We investigated the success of pregnant women in spontaneously quitting tobacco, alcohol, or caffeine, alone or in combination. METHODS: Pregnant women (n = 7489) were identified in the practices of large health maintenance organizations in Seattle and Minneapolis and were interviewed by telephone. Analyses examined the patterns of using and quitting more than one substance, and the extent to which using more than one substance predicts ability to quit other substances. RESULTS: Use of the three substances tended to cluster within individuals. Users of multiple substances were less likely to quit each substance than users of single substances. However, in the subgroup of multiple substance users who had quit one substance, having quit a second substance was more, rather than less, common. In multivariate analyses predicting quitting, demographic variables, and not having been pregnant previously were significant predictors of quitting each substance; being a nonsmoker predicted quitting alcohol, and being a nonsmoker and nondrinker predicted quitting caffeine. CONCLUSIONS: The reasons for difficulty in quitting more than one substance are unknown but may include the difficulty of formulating appropriate behavioral strategies or less concern about healthy behavior in pregnancy. Many women in the study successfully quit using two substances, however, and counseling should focus on achieving that outcome.

Adult↗

PubMed2000

Demographic, lifestyle, and psychosocial predictors of frequency of intoxication and other indicators as estimates of alcohol-related problems in Air Force basic military recruits.

This study examined demographic, lifestyle, and psychosocial variables to determine predictors of Air Force recruits who are likely to have alcohol-related problems. Subjects were all Air Force recruits (N = 32,144) entering basic training from August 1995 to September 1996. The dependent measures were self-reported frequency of eight or more drinks per occasion, frequency of fighting while drinking, and typical frequency of alcohol consumption. Demographic analysis revealed that individuals high on any dependent variable were more likely to be male, older, non-Hispanic whites with some college. Lifestyle predictors included positive attitudes toward drug use and smoking status, with risk greater for females than males and for non-whites than non-Hispanic whites at the same smoking level. Psychosocial predictors included positive rebellious attitudes, decreased seatbelt use, and positive risk-taking attitudes, with risk greater for females than males at the same risk attitude level. These findings suggest that problem drinking falls into a broader category of risky problem behaviors.

Adolescent↗

PubMed2000

Relapse to smoking after basic military training in the U.S. Air Force.

This study examined predictors of smoking relapse in the year after the mandatory smoking ban during basic military training (BMT) in the U.S. Air Force. Participants were all smokers who completed BMT from August 1995 to August 1996 and relapsed to smoking in the subsequent year (N = 4,303). Results demonstrated that the vast majority of airmen (69.8%) returned to smoking within 1 month after BMT and that most (90%) were still in training status when they smoked their first cigarette after BMT. Relapsed smokers appeared more motivated to quit smoking at 1-year follow-up compared with when they were in BMT. Individuals making serious quit attempts after BMT were younger and had greater levels of physical activity, more confidence in quitting, and more favorable perceptions of the BMT ban than individuals not attempting to quit. Based on these findings, recommendations are discussed for improving abstinence rates after BMT.

Adolescent↗

PubMed1999

An examination of cigarette brand switching to reduce health risks.

This study examined cigarette brand switching to reduce health risks in a population of young smokers (N = 7,998) entering United States Air Force Basic Military Training. Because of a comprehensive tobacco ban during training, all smokers were abstinent during the study. Results from this investigation suggested that brand switching to reduce health risks was common among current smokers (31.3% of males; 32.3% of females). Brand switchers smoked fewer cigarettes, were more likely to smoke low-yield brands, had lower scores on a measure of nicotine dependency, and were more confident they could remain abstinent following training. Other discriminators of smokers who had switched brands from other smokers included using smoking to control appetite, greater proclivity to attempt smoking cessation, engaging in fewer safety risks, and healthier dietary composition. Finally, brand switchers quit smoking at a higher rate than other smokers (12.5% versus 11.1%) during the year following basic military training. However, a multivariate logistic regression model that controlled for demographic factors and smoking history suggested that brand switching was not a statistically significant predictor of smoking cessation during the follow-up period.

Adaptation, Psychological↗

PubMed1999

Efficacy of forced smoking cessation and an adjunctive behavioral treatment on long-term smoking rates.

This study evaluated the efficacy of a 6-week forced ban on smoking and brief behavioral counseling on long-term smoking rates. Participants were active-duty enrollees in U.S. Air Force basic military training over a 1-year period (N = 25,996). All participants were under a 6-week ban from tobacco products, and 75% were randomized to a brief smoking cessation intervention, with the other 25% randomized to a control condition. At 1-year follow-up, 18% of smokers were abstinent; women, ethnic minorities, and those intending to stay quit at baseline were more likely to be abstinent. Among smokers not planning to remain abstinent at baseline, those receiving the intervention were 1.73 times more likely to be abstinent. Over time, substantial smoking initiation occurred among nonsmokers (8% of never smokers, 26% of experimental smokers, and 43% of ex-smokers). Forced cessation is associated with good levels of long-term cessation, and brief behavioral interventions enhance cessation in certain subgroups.

Adult↗

PubMed1999

A study of the psychometric and predictive properties of the Fagerström Test for Nicotine Dependence in a population of young smokers.

This study examined the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND) in a population (N = 7998) of young smokers entering US Air Force Basic Military Training (BMT). An exploratory factor analysis suggested that the FTND is comprised of two factors. The first factor, labeled Smoking Pattern, included items assessing the number of cigarettes smoked per day, time to first cigarette, difficulty refraining from smoking, and smoking when ill. The second factor, labeled Morning Smoking, consisted of two items measuring whether one smokes more in the morning and whether one would rather give up the first cigarette of the day or all others. The Smoking Pattern factor proved to have adequate internal consistency, impressive criterion-related validity, and was strongly related to smoking cessation 1 year following BMT. In contrast, the Morning Smoking factor demonstrated questionable psychometric properties and was not supported by a confirmatory factor analysis.

Adolescent↗

PubMed1999

Prevalence and predictors of discharge in United States Air Force Basic Military Training.

The purpose of the current investigation was to determine the prospective predictors of discharge in a population of individuals entering U.S. Air Force Basic Military Training (BMT). Subjects were 32,144 consecutive individuals entering Air Force BMT. In the first week, subjects filled out a comprehensive lifestyle and behavioral assessment. Over time, a total of 1,999 subjects (6.2%) dropped out of BMT for a variety of reasons, the most common being medical (33.6%), psychiatric (21.3%), legal (20%), and poor performance (13.1%). Overall, discharges by gender were equal, but the reasons for discharge varied by gender. Ethnicity predicted for medical, psychiatric, and legal discharge. Results suggest that women and ethnic minorities are not biased in favor of discharge and that both lifestyle and psychosocial variables are consistent predictors of discharge. Future research could potentially yield other significant predictors of success versus discharge in the U.S. military.

Adolescent↗

PubMed1999

An examination of body weight standards and the association between weight and health behaviors in the United States Air Force.

This study examined the weight standards used by the U.S. Air Force and tested whether Air Force personnel who exceed the maximum allowable weight standard are more likely to engage in health risk behaviors compared with individuals who do not exceed current Air Force weight standards. Participants were 32,144 individuals who completed basic military training from August 1995 to August 1996. Compared with body mass levels known to predict increased health risks, the Air Force maximum allowable weight standards were found to be more stringent for women than for men. Furthermore, exceeding the maximum allowable weight standard of the weight management programs did not consistently indicate that an individual engaged in a less healthy lifestyle than other airmen. Perhaps other risk factors, such as cigarette smoking, may be more closely linked to negative health consequences than body weight.

Adolescent↗

PubMed1998

Relationships between stages of change in cigarette smokers and healthy lifestyle behaviors in a population of young military personnel during forced smoking abstinence.

This study evaluated the relationships between stages of change and related health behaviors in a population of smokers forced to quit smoking. Participants were 10,136 Air Force recruits who were in basic military training (BMT) and who were not allowed to smoke because of a ban on smoking during BMT. Participants were surveyed about their smoking history, their motivation and readiness to remain smoke free after BMT, and their behavior on 5 target health areas. Results indicated that smoking history best predicted stage of change. Though there were few gender differences, several ethnic differences emerged. These results suggest that, although stages of change involve both a cognitive and behavioral component, removing the behavioral component (smoking) through a smoking ban does not reduce the construct validity of the transtheoretical model.

Adolescent↗

PubMed1998

Partner smoking status and pregnant smoker's perceptions of support for and likelihood of smoking cessation.

Perceptions of support for cessation of smoking during pregnancy, likelihood of quitting, and partner smoking status were explored in a sample of 688 pregnant smokers (372 baseline smokers and 316 baseline quitters). Women with nonsmoking partners were significantly more likely to be baseline quitters than women with partners who smoked. Baseline quitters reported significantly more positive support from their partners than did continuing smokers (p = .02). Neither partner smoking status nor partner support at baseline was associated with cessation or relapse later in pregnancy. Women reported greater support, both positive and negative, from nonsmoking partners than from partners who smoked (p = .001). Among partner smokers, those who were trying to quit were perceived to be particularly supportive. Cessation interventions for expectant fathers may increase pregnant women's success at quitting.

Adult↗

PubMed1998

Smoking prevalence and risk factors for smoking in a population of United States Air Force basic trainees.

OBJECTIVE: To provide a comprehensive assessment of smoking prevalence and risks for smoking in an entire population of United States Air Force (USAF) military basic trainees (n = 32,144). DESIGN: Population-based survey with every individual entering the USAF enlisted force from August 1995 to August 1996. SETTING: USAF Basic Military Training (BMT) facility at Lackland Air Force Base, Texas. All trainees were assessed during the first week of BMT. MAIN OUTCOME MEASURES: A 53-item questionnaire was developed to assess four domains: demographics, smoking history, risk factors for smoking, and other health behaviours. RESULTS: Approximately 32% of the trainees smoked regularly before basic training and a small percentage of the trainees (7.6%) described themselves as ex-smokers. Men, Euro-Americans, and those from lower educational backgrounds were more likely to smoke than other trainees. On average, smokers had smoked for approximately four years and had low nicotine dependence scores. Individuals who had smoked before BMT were more likely to use other drugs (such as alcohol, binge drinking, smokeless tobacco), and were less physically active than never-smokers. These findings were particularly strong for those who smoked up to basic training but were also evident for ex-smokers. CONCLUSIONS: Smoking is a prevalent risk factor among individuals entering the USAF. Furthermore, smoking was related to other risk factors believed to lower military readiness, including alcohol use and decreased physical activity. Comprehensive tobacco control policies aimed at reducing smoking among military trainees are needed.

Adult↗

PubMed1996

Prevalence of tobacco use among first-term Air Force personnel before and after basic military training.

To support the goal of a tobacco-free Air Force, a longitudinal study of 3,531 first-term airmen was conducted during basic military training (BMT) at Lackland Air Force Base, Texas. Tobacco use is currently prohibited during the 6-week period of BMT. Three self-reported surveys to determine tobacco use prevalence and behaviors were administered at the beginning, end, and 90 days post-BMT. Results indicate that 36% of men and 29% of women used some form of tobacco prior to BMT. Within 90 days after completing BMT, 74% of matched males and females resumed tobacco use and 6% of matched males and females initiated tobacco use. Regression analysis found that several survey questions could predict 85% of tobacco use and 88% of non-tobacco use after BMT. We conclude that tobacco prohibition during BMT has a small, beneficial effect on post-BMT tobacco use. Further efforts, however, are needed to meet the goal of a tobacco-free Air Force.

Adult↗

PubMed1993

A stop-smoking telephone help line that nobody called.

The purpose of this study was to evaluate the reach of a smoker's hotline that provided a variety of services to over 2100 health maintenance organization members. Formative evaluation procedures identified topics of concern, and repeated promotions advertised the service via multiple channels. Excluding a special giveaway promotion, an average of less than three calls per month were made during the 33 months of operation. To be cost-effective, smoker's hotlines should be offered to large populations and should be consistently and intensively publicized.

Hotlines↗

PubMed1993

Promoting smoking cessation at the workplace. Results of a randomized controlled intervention study.

This paper presents results from a preliminary short-term work-site intervention study aimed at smoking cessation. The 3-month intervention included consultation for employers on the adoption of a nonsmoking policy, training for nonsmokers to provide assistance to smokers attempting to quit, and cessation classes for smokers. Eight work sites from Bloomington, Minnesota were recruited to the study and randomly assigned to an intervention or comparison condition after a baseline survey of all employees. To assess the effect of the intervention, smokers were surveyed 1 and 6 months after the intervention was completed. At the 1-month follow-up, the overall quit rate in the intervention group was 12% compared to 5% in the control group (P < .05). At the 6-month follow-up, 12% of smokers in the intervention group reported quitting, compared to 9% in the control group (P < .05). Co-worker support for quitting was higher in the intervention group compared to the comparison group. Cessation was highest overall among smokers whose co-workers frequently asked them not to smoke and among those who worked with a high proportion of nonsmokers. These results indicate that a short-term, multifaceted smoking cessation program implemented in work sites can affect smoking cessation rates as well as the work-site norms about smoking.

Follow-Up Studies↗

PubMed1992

Smoking status and dietary fats.

BACKGROUND: There have been several recent reports of differences in the diet of smokers versus that of nonsmokers. This has broad implications for assessment of disease risk associated with diet or smoking. METHODS: We examined dietary fats for several categories of smoking status in a large cross-sectional data set. The annual risk factor survey of a cardiovascular disease prevention trial in three pairs of upper Midwest communities includes 3,495 subjects ranging in age from 24 to 75. Smoking was assessed by self-report and thiocyanate, and diet by the Willett questionnaire. Dietary comparisons of smokers, recent quitters, long-term (over 1 year) quitters, and never-smokers were conducted. RESULTS: Previous findings of lower polyunsaturated fat intake in smokers were confirmed and extended by finding significantly elevated polyunsaturate intake among those who had quit smoking within the last year. The source of these differences is unclear, but the differences are large enough to constitute a significant contribution to disease risk for smokers or a protective effect for recent quitters. CONCLUSIONS: Future research examining risks associated with smoking or diet should control for the interaction of the two factors. The dietary differences in recent quitters, whether caused by a conscious decision to improve diet, a change in taste perception as a result of quitting, or simply the habits of those smokers who are able to quit, need further exploration.

Adult↗