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Biomedical subjects

K M Cummings

Publications and source records attributed to K M Cummings.

At least 55 records · Page 3Linked to original sources
PubMed2000

A simulation of the effects of youth initiation policies on overall cigarette use.

OBJECTIVES: We developed a simulation model to predict the effects of policies aimed at reducing smoking initiation by youths younger than 18 years. METHODS: The model projected the number of smokers, never smokers, and ex-smokers by age, sex, and racial/ethnic group and the effects of reductions in youth initiation. RESULTS: The model predicted that even if tobacco policies eliminated youth initiation, the number of smokers would not be halved for more than 30 years. If initiation were halved and some of the initiation were delayed rather than eliminated, substantially smaller reductions would result. CONCLUSIONS: Policies that increase cessation rates are needed to reduce the number of current smokers and the more near-term health problems.

Adolescent↗
PubMed2000

Consumer perception of risk associated with filters contaminated with glass fibers.

The filters in Eclipse, a new cigarette-like smoking article marketed by R. J. Reynolds Tobacco Company, are contaminated with glass fibers, fragments, and particles. Reported herein are the results of a study in which consumers were questioned about their opinions as to whether exposure to glass fibers in such a filter poses an added health risk beyond that from smoking and whether the manufacturer has an obligation to inform consumers about the glass contamination problem. The study queried 137 adults who were interviewed while waiting at a Division of Motor Vehicles office in Erie County, New York in 1997. All but one person expressed the view that the presence of glass fibers on the filters poses an added health risk beyond that associated with exposure to tobacco smoke alone. Nearly all expressed the position that the cigarette manufacturer has a duty to inform the public about the potential for glass exposure.

Adult↗
PubMed1999

Ability of smokers to reduce their smoking and its association with future smoking cessation.

AIMS: We examined whether cigarette smokers in the United States can significantly reduce their smoking and maintain this reduction and, if so, whether this predicts an increase or decrease in the probability of smoking cessation in the future. DESIGN: Longitudinal observation study. SETTING: The 22 US cities of the Community Intervention Trial for smoking cessation (COMMIT). PARTICIPANTS: The 1410 subjects who smoked at both baseline and at 2-year follow-up. INTERVENTION: Public health efforts to prompt cessation in half the communities. MEASUREMENTS: Self-reported cigarettes/day and abstinence at baseline, 2-year and 4-year follow-ups. FINDINGS: At 2-year follow-up, 60% of the subjects had either not changed or increased their smoking, 17% had decreased their smoking by 5-25%, 15% by 24-49% and 8% by > or = 50%. Among the 40% who had reduced > or = 5% at 2-year follow-up, 52% reported maintaining that reduction at 4-year follow-up. Reduction in smoking at year 2 did not prospectively predict an increase or decrease in the probability of making a quit attempt; nor did it predict eventually quitting by year 4. CONCLUSIONS: A substantial minority of US smokers are able to reduce their smoking and maintain this for long periods of time. Smoking reduction neither promotes nor undermines cessation.

Adult↗
PubMed1999

Community-wide interventions for tobacco control.

This article describes the rationale and evidence supporting community-wide interventions for tobacco control. Data were collected from published evaluation studies, government reports, and commentaries that describe the use of community-based approaches to tobacco control. Community-wide interventions attempt to change tobacco use in populations--not just individuals--and have increasingly begun to focus on influencing policies that promote and/or tolerate tobacco use. Examples of community-based tobacco-control activities include organizing community groups to advocate adoption of tobacco-control ordinances (e.g., smoke-free restaurants, ban on self-service tobacco displays); media advocacy to raise public awareness about illegal tobacco sales to minors; paid counter-advertising; and sponsorship of community-wide stop-smoking events such as a quit-and-win contest. Evidence in support of the effectiveness of community-based interventions to reduce smoking is found in the consistently sharper decline in tobacco consumption observed in states that have invested in comprehensive tobacco-prevention and control programs compared to those that have not. However, the results from several randomized controlled trials of community-based tobacco-control interventions have been disappointing in demonstrating large-scale changes in tobacco use. Although there appears to be a wide consensus that community-based approaches to tobacco control are an important part of a comprehensive program to reduce tobacco use, the essential elements and methods of implementation of some community-based tobacco-control efforts are less well defined. Also, given the dynamic nature of community tobacco-control interventions, the traditional randomized controlled trial model probably is not applicable for evaluation purposes. It is more likely that research models based on time-series designs will be most applicable for evaluating the impact of community-based interventions.

Community Participation↗
PubMed1999

The campaign to enact New York City's Smoke-Free Air Act.

On January 10, 1995, New York City's mayor signed into law a bill restricting smoking in most public facilities including restaurant dining areas, workplaces, and sports stadiums. This law was the subject of extensive public debate and was considered quite controversial at the time it was enacted. Passage of the smoking law (known as the New York City Smoke-Free Air Act) helped pave the way for other localities in New York to enact similar restrictions on smoking in public facilities. This article documents the process of enacting the New York City Smoke-Free Air Act.

Health Policy↗
PubMed1999

Analysis of taxable sales receipts: was New York City's Smoke-Free Air Act bad for restaurant business?

This article examines the results of a study to determine if the New York City Smoke-Free Air Act has had an adverse economic impact on the taxable sales receipts from the city's restaurant and hotel industries. The study found that real taxable sales from eating and drinking places and hotels in New York City increased by 2.1 percent and 36.9 percent, respectively, compared with levels two years before the smoke-free law took effect. During the same period, real taxable sales for eating and drinking establishments and hotels in the rest of the state experienced a 3.8 percent decrease and a modest 2.4 percent increase in sales, respectively.

Health Policy↗
PubMed1999

Restaurant employment before and after the New York City Smoke-Free Air Act.

The purpose of this study was to observe trends in the number of restaurants and restaurant employees two years before and two years after the New York City Smoke-Free Air Act took effect in April, 1995. Between April 1993 and April 1997, New York City added 19,347 new restaurant jobs (18% increase) while the rest of the state outside the immediate metropolitan area added 7,423 new jobs (5% increase). The rate of growth in the number of restaurants was comparable among New York City, neighboring counties, and the rest of the state. The data suggest that the New York City Smoke-Free Air Act did not result in job losses for the city's restaurant industry.

Employment↗
PubMed1999

Consumer response to the New York City Smoke-Free Air Act.

The objective of this study was to assess consumer response to the New York City Smoke-Free Air Act. The overwhelming majority of respondents reported they were largely unaffected by the law or dined out more frequently since the law took effect; however, there was a small percentage of consumers that reported dining out less frequently. There were few reports of consumers who stopped dining out altogether or left or entered the city with the specific purpose of dining in a place that suited their smoking preference. The New York City Smoke-Free Air Act appears to have had little impact on the dining out patterns of consumers.

Adult↗
PubMed1999

Restaurateur reports of the economic impact of the New York City Smoke-Free Air Act.

The objective of this study was to determine the extent to which restaurateurs have reported a change in business since the New York City Smoke-Free Air Act took effect. A population-based cross-sectional telephone survey of 434 owners/managers of restaurants located in New York City was conducted by an independent survey firm during November and December 1996. There is no evidence to suggest that the smoke-free law has had a detrimental effect on the city's restaurant business.

Chi-Square Distribution↗
PubMed1999

Compliance with the New York City Smoke-Free Air Act.

This study's objective was to determine the level of compliance with the New York City Smoke-Free Air Act. Three data sources were used: (1) a population-based telephone survey of 251 New York City restaurant owners/managers; (2) independent inspections of the 251 surveyed restaurants; and (3) complaint records from the New York City Department of Health from April 1995 to March 1997. Ninety percent of restaurant owners/managers reported their indoor dining area was smoke-free in compliance with the law. Most New York City restaurants were able to comply with the smoke-free law with relative ease and little expense.

Chi-Square Distribution↗
PubMed1998

Community Intervention Trial for Smoking Cessation (COMMIT): changes in community attitudes toward cigarette smoking.

The success of the Community Intervention Trial for Smoking Cessation (COMMIT) in changing smoking attitudes is examined by testing two primary hypotheses: (1) the priority of smoking as a public health problem increased more in the intervention communities than in the comparison communities, and (2) norms and values that support non-smoking increased more in the intervention than in the comparison communities. One community within each of 11 matched pairs was randomly assigned to receive a 4-year (1989-92) community-based smoking control intervention. Community attitudes towards smoking were measured primarily by cross-sectional surveys in 1989 (n = 9875) and 1993 (n = 14117) but a cohort (n = 5450) also provided attitude information. The main trial effect was on heavy smokers in the intervention communities who showed significantly more change in their beliefs about smoking as a public health problem. Despite the absence of an intervention-comparison difference, the magnitude of change in community-wide norms and values was related to the level of smoking control activities. In the cohort, light-to-moderate smokers in the intervention communities came to have stronger beliefs about smoking as a serious public health problem. COMMIT's impact on the beliefs of heavy smokers about the seriousness of smoking as a public health problem has important public health implications.

Adult↗
PubMed1998

Evaluation of an enforcement program to reduce tobacco sales to minors.

OBJECTIVES: This study evaluated an active enforcement program to increase retailers' compliance with the law prohibiting tobacco sales to minors. METHODS: Tobacco sales to minors were monitored in 319 outlets in 6 pairs of communities in Erie County, New York. One community in each pair was randomly assigned to an enforcement intervention. RESULTS: Retailers' compliance with the law increased from 35% in 1994 to 73% in 1995. However, the change in compliance rates was roughly the same for stores in the enforcement and nonenforcement communities. CONCLUSIONS: Active compliance checking of retail outlets as a strategy to reduce illegal tobacco sales to minors may only be necessary insofar as it contributes to an increase in retailers' perception that the threat of enforcement is real.

Adolescent↗
PubMed1998

Prevalence of cigar use in 22 North American communities: 1989 and 1993.

OBJECTIVES: This study examined the prevalence rate of and characteristics associated with cigar use. METHODS: Data were derived from population-based telephone surveys of adults conducted in 22 North American communities in 1989 and 1993 as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. RESULTS: Averaged across the 22 communities, the prevalence rate of regular cigar use increased 133% from 1989 to 1993. Regular cigar use increased in every gender, age, race, income, education, and smoking status category. CONCLUSION: These results confirm other data indicating that cigar use is increasing.

Adult↗
PubMed1998

Glass fiber contamination of cigarette filters: an additional health risk to the smoker?

We report here the results of studies documenting the contamination of a cigarette-appearing smoking article labeled Eclipse with glass fibers, fragments, and particles. Eclipse, a product of the R. J. Reynolds Tobacco Company (RJR), was commercialized in June of 1996. Eclipse is unlike conventional cigarettes in that, like its predecessor Premier, it is designed to heat and not burn tobacco. The purpose of Eclipse was to simplify the chemical composition and reduce the biological activity of the mainstream and sidestream smoke and to achieve a significant reduction of environmental tobacco smoke. In Eclipse, tobacco pyrolysis is reduced by a carbon fuel rod that serves as a heat source for generating an aerosol having nicotine and tobacco flavor. The carbon rod, at the tip of the cigarette, is insulated and bound with two wrapping mats of glass fibers. Recently, Eclipse has been modified to address consumer complaints of burdensome draw and off-taste. The redesigned Eclipse, which we have termed the NEW Eclipse, has an unconventional filter-appearing mouthpiece that consists of a cellulose acetate cylindrical bundle with a central hollow tunnel. In our analysis of Eclipse, glass fibers (length:width aspect ratio, > or = 3:1) were: (a) observed protruding from the tip; (b) identified on the white cigarette wrapping paper; (c) viewed on the surface of the cork-appearing tipping paper; (d) found in the pack residue; (e) discovered lying freely on the cut surface of the filter by both light and electron microscopy; (f) harvested from the filter with adhesive tape; and (g) displaced when Eclipse was smoked mechanically. In a study of Eclipse that had not been removed from carefully opened packs, we observed that > or = 95% of the filters were contaminated with glass fibers (Eclipse: Regular, n = 114/120, 95%; Milds, n = 118/120, 98%; Menthol, n = 120/120, 100%). Likewise, 99% of NEW Eclipse had glass fibers on the redesigned filter (Regular, n = 119/120). In contrast, glass fibers were never observed on the filters of conventional United States filter cigarettes that had been used as controls (n = 0/120, 0%). In a study of Eclipse (n = 60), the number of glass fibers contaminating the filter surface ranged from 5 to 55. Glass fibers as well as fiber fracture items [aspect ratio, < 3:1 (e.g., particles, fragments, bits, chips, flakes, specks, and dust)] were discovered in the pack residue. The average number of glass fibers in the residue of a pack of Eclipse was 7,548 (SE +/- 3443; range, 1,164 to 26,725 glass fibers/pack; n = 7 packs). The thin and fragile glass fibers of the insulation mats had most likely been broken and fragmented in the high-speed multiple-step Eclipse manufacturing operation. Invariably, puffing on Eclipse discharged glass fibers and glass particles from the filter into the smoker's mouth. Subsequently, the bioresistant glass fibers and microscopic glass dust are inhaled and/or ingested. Contamination of Eclipse filters with glass fibers and glass dust poses a potential and unnecessary health hazard to uninformed consumers. Eclipse is a paradigm of the health danger that may be imposed by technically complex tobacco articles and nicotine delivery devices promoted by an unregulated industry to smokers worldwide, many of whom are addicted to nicotine and who seek a less hazardous cigarette.

Drug Contamination↗
PubMed1997

Effect of proxy-reported smoking status on population estimates of smoking prevalence.

The use of proxy respondents in surveys designed to provide population estimates of smoking prevalence offers an inexpensive way to obtain these data. The accuracy of this information is examined in analyzing data from tobacco use surveys of adults conducted in 22 North American communities as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. Proxy-reported smoking status was obtained in a cross-sectional telephone survey conducted from August 1993 to January 1994 (n = 99,682). Self-reported smoking status was obtained from an in-depth interview of a sample of the respondents aged 25-64 years enumerated from the telephone survey (n = 31,417). Discrepancy rates were calculated by comparing the proxy-reported and self-reported smoking statuses of a given individual (n = 10,226). In both surveys, respondents were categorized as current smokers (those who currently smoke and have smoked at least 100 cigarettes in their lifetime), recent quitters (< or = 8 years since cessation), long-term quitters (> 8 years since cessation), and never smokers. The overall discrepancy rate between the self-report and the proxy report was 5.4%. Self-respondents who were black, Hispanic, Asian, recent quitters, or aged 25-34 years were more likely to have inconsistent proxy reports. The authors estimate that the screener interview underestimated the true smoking prevalence by 0.1% when they corrected for smoking status discrepancies. These results confirm that proxy-reported smoking status is an accurate and effective means to monitor populationwide smoking prevalence of adults.

Adult↗
PubMed1997

Price, public policy, and smoking in young people.

OBJECTIVE: To examine the effect of cigarette taxes, limits on public smoking, laws regulating access to tobacco by young people, and exposure to pro-tobacco and anti-tobacco messages on smoking participation and the intention to smoke among ninth-grade students (aged 13-16). DATA SOURCES: Two cross-sectional, school-based surveys (total of 15432 responses) of ninth-grade students conducted in 21 North American communities in 1990 and 1992 in conjunction with the Community Intervention Trial for Smoking Cessation. OUTCOME MEASURES: A ninth-grader was classified as a smoker if he or she reported smoking a whole cigarette on at least one of the 30 days preceding the survey. Among non-smokers, a positive intention to smoke was attributed to those who claimed they probably or definitely would be smoking within a year. RESULTS: Both smoking participation and the intent to smoke were related to differences in cigarette prices, with estimated price elasticities of -0.87 and -0.95, respectively. Boys were far more sensitive to price than girls with respect to smoking participation (elasticities of -1.51 and -0.32, respectively); however, the effect of price on the intent to smoke was similar for boys and girls. Policies limiting minors' access to tobacco (a minimum purchase age of 18 years, a ban on cigarette vending machines, and a ban on giving away free samples of tobacco products) were associated with reductions in participation and intention to smoke. Exposure to tobacco education in school was associated with decreased participation and intention to smoke. Policies that prohibited smoking in public places and in schools were not significantly related to the smoking patterns of ninth-graders. Frequency of exposure to pro-tobacco advertisements was marginally associated with increased participation and intention to smoke; paradoxically, frequency of exposure to anti-tobacco advertisements was correlated with an increased likelihood of smoking. CONCLUSIONS: Policies limiting access to tobacco by young people, increasing education about the effects of tobacco use, and a sharp and sustained increase in real cigarette excise taxes are likely to be most successful in accomplishing the US Food and Drug Administration's goal of cutting the smoking prevalence of adolescents in half over the next seven years.

Adolescent↗
PubMed1997

Use of discount cigarettes by smokers in 20 communities in the United States, 1988-1993.

OBJECTIVE: To examine characteristics of smokers associated with the use of discount and generic cigarettes. DESIGN: Data for this analysis come from two population-based cross-sectional telephone surveys (1988 survey n = 32952; 1993 survey n = 11783) and a cohort tracking survey (n = 11966) of smokers aged 25-64 years conducted in 20 communities in the United States between 1988 and 1993 as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. OUTCOME MEASURES: In each survey, current smokers were asked to report the six-digit UPC code displayed on the side of the pack of their current cigarettes. Respondents who did not have a pack available or who could not locate the UPC code number were asked to report their usual brand of cigarettes smoked. A master list of UPC code numbers was developed so that reported UPC codes could be associated with specific cigarette brand names. Brand name cigarettes were categorised as either premium or discount brands using information from the Maxwell consumer report. Respondents who reported smoking "no name" generic cigarettes were classified as smoking a discount cigarette. RESULTS: The reported use of discount/generic cigarettes increased from 6.2% in 1988 to 23.4% in 1993. The trend toward increased use of lower priced cigarettes was evident in all 20 communities studied. The use of low priced cigarettes was associated with lower household income, higher daily cigarette consumption, and residence in an area with higher average cigarette prices. Respondents using discount/generic cigarettes were less likely to stop smoking or to reduce cigarette consumption between 1988 and 1993 compared with those using premium brand cigarettes. CONCLUSIONS: The availability of discount/generic cigarettes has made smoking more affordable, which most likely has helped the cigarette industry retain customers sensitive to price, who might have otherwise reduced consumption or stop smoking altogether.

Adolescent↗