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Lynn T Kozlowski

Publications and source records attributed to Lynn T Kozlowski.

17 recordsLinked to original sources

Changes in nicotine intake and cigarette use over time in two nationally representative cross-sectional samples of smokers.

Population surveys have observed decreases in cigarette use over time among smokers. These decreases have probably been influenced by tobacco control measures implemented over the past several decades, but few data exist on whether smokers have also reduced their nicotine intake. The authors examined data from two cross-sectional National Health and Nutrition Examination Surveys (NHANES), conducted in 1988-1994 and 1999-2002. Laboratory, examination, and interview data from current smokers not reporting nicotine intake from other sources were examined. From NHANES III (1988-1994) to NHANES 1999-2002, the average number of cigarettes smoked per day (CPD) fell by nearly 15% (three cigarettes), while the mean serum cotinine level fell by 13% (30 ng/ml). Finer breakdowns of CPD data in each time period suggested that most of the change occurred in the lower (<10 CPD) and higher (>or=20 CPD) smoking categories. These data suggest that CPD may represent a proxy for exposure to nicotine and perhaps other tobacco smoke constituents on the population level, since the decline in serum cotinine levels observed among smokers closely paralleled the decline in self-reported CPD between 1988-1994 and 1999-2002. In addition, these data are inconsistent with the hypothesis that the remaining population of smokers is becoming more dependent on nicotine over time.

Adult↗

The effect of filter vent blocking and smoking topography on carbon monoxide levels in smokers.

Two studies were conducted to examine the effect of filter vent blocking and smoking topography on carbon monoxide (CO) levels in smokers. In Study 1, 12 participants smoked two types of cigarettes (Marlboro Light and Carlton 100) under two types of blocking conditions (unblocked and half-blocked) while using a smoking topography device. Participants were restricted to 8 puffs, separated by 45 s. Significant main effects of CO boost for cigarette type and blocking condition replicated previous findings. A significant increase in CO boost for the Marlboro Light blocked condition is a novel finding for this best-selling brand. That result and the finding that topography measures did not predict CO boost made us question the reliability of CO boost. In Study 2, we examined the reliability of CO boost by recruiting 12 participants to smoke three unblocked Carlton 100 cigarettes in one session and three half-blocked in another. CO boost was significantly greater for the blocked sessions compared to the unblocked and CO boost did not differ within session, thus supporting the reliability of the measure. When participants do not switch brands within a session, smoking topography measures are predictive of CO boost.

Adolescent↗

Most smokeless tobacco use does not cause cigarette smoking: results from the 2000 National Household Survey on Drug Abuse.

Those who either never progress from smokeless tobacco (SLT) to smoking or smoked before using SLT logically cannot have smoking caused by SLT use. The prevalence of such use permits strong inferences about the overall importance of the potential causal effects of SLT on cigarette smoking. We found that the majority of SLT ever users (66%) in the 2000 National Household Survey on Drug Abuse (NHSDA) were noncausal users. For these individuals, SLT use cannot have caused them to smoke. We also compared our results in 2000 with a similar sample in 1987, using current SLT users only. Potentially, the causal uses of SLT were in the minority and had not increased significantly over time (24% in 1987 to 29% in 2000, P>.05). Logistic models showed that, when noncausal users were removed, SLT was a minor predictor of current smoking. This is likely due to linked experimentation. We argue that that the majority of SLT use cannot cause smoking, such that SLT effects on smoking initiation are minimal at best. Policy implications of these findings are discussed.

Adult↗

An examination of early smoking experiences and smoking status in a national cross-sectional sample.

AIMS: To extend previous work showing lightheadedness from and liking for smoking to be associated with continued smoking while controlling for demographics and social influences that can also contribute to progression to established smoking. DESIGN AND SETTING: Random digit dialing telephone survey conduced on 3383 never smokers, non-smokers, former smokers and current smokers in the continental United States. MEASUREMENTS: Demographic information (sex, race, age, education level), smoking history, reactions to early experiences with smoking (lightheadedness, liking), whether parents, siblings or friends smoked when respondent was a teenager. FINDINGS: Lightheadedness and liking interacted-those who liked smoking (regardless of lightheadedness) were very likely to progress to established smoking, while non-likers who experienced lightheadedness were more likely than non-likers who did not experience lightheadedness to progress. These results held even after adjusting for demographic (sex, age, race, education) and social influences (parents, siblings and friends smoking). CONCLUSIONS: Lightheadedness from early smoking appears to be associated with having smoked 100 cigarettes only among those who report not liking early smoking. Overall, this study supports the literature suggesting that early experiences, particularly liking smoking, are associated with becoming a regular smoker.

Adolescent↗

A digital image analysis system for identifying filter vent blocking on ultralight cigarettes.

Filter ventilation is the dominant design feature on modern cigarettes, diluting the mainstream smoke with air and reducing tar and nicotine yields in the standard assay. Smokers are generally unaware of vent holes and often cover them with lips or fingers while smoking, reducing or eliminating the air dilution effect and increasing intake of tar and nicotine particularly on ultra-low tar brands. A digital imaging and analysis system for the detection of vent blocking was developed. Two studies were designed to evaluate the effectiveness of three color measures (hue, saturation, and value) at discriminating whether at least 50% blocking had occurred. In study 1, saturation showed perfect discrimination between unblocked Carlton butts and butts with at least 50% of the vents blocked during syringe smoking. In study 2, saturation showed 95% accuracy at identifying Marlboro Ultra Light butts with at least four puffs blocked by smokers' lips. The results indicate that the pattern of color saturation is related to vent blocking. Implications for tobacco control research and policy are discussed.

Filtration↗

What smokers believe about light and ultralight cigarettes.

OBJECTIVES: To assess the knowledge of smokers and ex-smokers about light cigarettes and nicotine yields and their perception of the risk of lung cancer, and to identify the characteristics of smokers of light cigarettes. METHODS: Mail survey in a population sample of 494 smokers and exsmokers in Geneva, Switzerland, in 1999. RESULTS: Participants were on average 40 years old, and 49% were men. They estimated that one would have to smoke two light cigarettes or four ultralight cigarettes in order to inhale the same amount of nicotine as that in one regular cigarette. Most participants (60%) answered that the risk of lung cancer was the same, but 27% answered that this risk was lower in smokers of light cigarettes than in smokers of regular cigarettes. The most frequent answer (41% of answers) to an open-ended question on the meaning of the number of milligrams of nicotine printed on cigarette packs was that this number indicated the nicotine content in cigarettes, rather than a machine-determined yield in smoke. In a multivariate model, smoking mild, light, or ultralight (vs regular) cigarettes was associated with females, a lower Fagerström dependence score, an intention to quit smoking, and an intention to decrease cigarette consumption. CONCLUSIONS: Many smokers choose light cigarettes because they think that such cigarettes are safer or less addictive. The public should be further informed of the meaning and purpose of cigarette labels.

Adolescent↗

Most smokeless tobacco use is not a causal gateway to cigarettes: using order of product use to evaluate causation in a national US sample.

AIMS: To evaluate non-causal and causal patterns of smokeless tobacco (SLT) and cigarette use; to assess the prevalence of 'non-gateway' and possible 'gateway' patterns of SLT use. DESIGN AND SETTING: Data from the Cancer Control Supplement to the 1987 National Health Interview Survey, a representative survey of non-institutionalized adults in the United States. From reported age at first use, participants were categorized by type and sequence of tobacco product use. SUDAAN 8.0.1 was used for statistical analyses. PARTICIPANTS: Males aged 18-34 (n = 3454), weighted to provide estimates of the US population. A subsample of males aged 23-34 (n = 2614) was analyzed to minimize the possibility of future product switching. MEASUREMENTS: Smoking status, smokeless tobacco (snuff, chewing tobacco, both) use status, age at regular use of cigarettes, age at first use of smokeless tobacco. FINDINGS: Of those 23-34-year-olds who had ever used SLT with or without cigarettes, 77.2% (95% CI: 71.3, 83.3) were classifiable as non-gateway users in that 35.0% (95% CI: 29.9, 40.1) had only used SLT and 42.2% (95% CI: 36.8, 47.7) had used cigarettes first. Cigarette use in younger cohorts was less common, despite increased SLT use. Those who used cigarettes before moist snuff were 2.1 times more likely to have quit smoking (95% CI 1.21,6.39) than cigarette-only users. CONCLUSIONS: The large majority of SLT users are non-gateway users. Causal gateway effects should be of minor concern for policy. SLT may be more likely to prevent smoking than cause it.

Adolescent↗

Regular smokeless tobacco use is not a reliable predictor of smoking onset when psychosocial predictors are included in the model.

Tomar analyzed the CDC's Teenage Attitudes and Practices Survey (TAPS) and reported smokeless tobacco may act as a starter product for or gateway to cigarettes. Regular smokeless tobacco users at baseline were said to be 3.45 times more likely than never users of smokeless tobacco to become cigarette smokers after 4 years (95% CI=1.84-6.47). However, this analysis did not take into account well-known psychosocial predictors of smoking initiation. We reanalyzed TAPS to assess whether including psychosocial predictors of smoking affected the smokeless tobacco gateway effect. Experimenting with smoking, OR=2.09 (95% CI=1.51-2.90); below average school performance, OR=9.32 (95% CI=4.18-20.77); household members smoking, OR=1.49 (95% CI=1.13-1.95); frequent depressive symptoms, OR=2.19 (95% CI=1.25-3.84); fighting, OR=1.48 (95% CI=1.08-2.03); and motorcycle riding, OR=1.42 (95% CI=1.06-1.91) diminished the effect of both regular, OR=1.68 (95% CI=.83-3.41), and never regular smokeless tobacco use, OR=1.41 (95% CI=.96-2.05), to be statistically unreliable. Analyzing results from a sample of true never smokers (never a single puff) showed a similar pattern of results. Our results indicate that complex multivariate models are needed to evaluate recruitment to smoking and single factors that are important in that process. Tomar's analysis should not be used as reliable evidence that smokeless tobacco may be a starter product for cigarettes.

Adolescent↗

African Americans' attitudes toward cigarette excise taxes.

OBJECTIVES: This study examined African Americans' opinions regarding cigarette excise taxes and other tobacco control issues. METHODS: A stratified cluster sample of US congressional districts represented by African Americans was selected. African Americans from 10 districts were interviewed. RESULTS: Forty-seven percent of respondents stated that taxes on tobacco products should be increased, whereas about 30% believed that they should be reduced. Almost 75% disagreed that raising taxes on tobacco products is unfair to African Americans, and 57.9% reported that they would not be opposed to increasing taxes on cigarettes even if low-income smokers would be hit the hardest. CONCLUSIONS: The present results indicate substantial support for cigarette excise taxes among African Americans.

Adolescent↗

Using a telephone survey to acquire genetic and behavioral data related to cigarette smoking in "made-anonymous" and "registry" samples.

In the Smokers and Nonsmokers Study, the authors investigated the feasibility of using random digit dialing telephone interviews to locate adults in the continental United States who were willing to provide DNA from buccal swabs through the mail. Interviews with 3,383 adults regarding their smoking-related behaviors (response rate = 70%) were conducted in 1999-2000; swab returns continued into early 2001. Overall, 57% of interviewees agreed to receive mailed information explaining the study. Better-educated persons (odds ratio (OR) = 1.3, 95% confidence interval (CI): 1.1, 1.6), younger persons (OR = 0.988, 95% CI: 0.983, 0.992), persons with symptoms of depression (OR = 1.8, 95% CI: 1.4, 2.4), and current smokers (OR = 2.25, 95% CI: 1.8, 2.8) were likelier to agree to receive a mailing. Approximately 26% of interviewees (45% of those receiving kits) returned buccal swabs, and 18% were successfully genotyped. Older (OR = 1.02, 95% CI: 1.01, 1.03), better-educated (OR = 1.4, 95% CI: 1.1, 1.7), and White (OR = 1.8, 95% CI: 1.4, 2.5) participants were more likely to return DNA samples, but current smokers (OR = 0.6, 95% CI: 0.5, 0.8) were less likely to do so. Participants were randomly assigned to one of two forms of participation: the "registry" group (names were kept on file) or the "made-anonymous" group (names were unassociated with samples). The two groups were equally likely to return kits, but registry respondents were more likely to nominate siblings for participation in the study (OR = 1.6, 95% CI: 1.2, 2.1). The participants in this study were similar demographically to the national population. The authors conclude that random digit dialing surveys coupled with mail collection of DNA may constitute a practical method of obtaining DNA samples for biobehavioral research.

Adult↗

Harm reduction, public health, and human rights: smokers have a right to be informed of significant harm reduction options.

Public health policy needs to be assessed for effects on human rights as well as public health. Although promoting harm reduction products to cigarette smokers might lead to greater total public health harm, if the products become too popular, human rights issues also need to be considered. Avoiding, or objecting to, the fair presentation of information on effective harm reduction products to smokers to allow them to make an informed choice to reduce health risk can represent a violation of a human right - the right to information. The necessary conditions are not met for protecting public health by restricting information on certain risk reduction products. As examples, based on current evidence, smokers have a right to information on snus (Swedish moist snuff) and medicinal nicotine as harm reduction options that would reduce substantially the risk of death to individuals. Smokers also have a right to truthful information about lower-tar cigarettes that have been erroneously promoted as risk reducing.

Access to Information↗

Smoking status and the human dopamine transporter variable number of tandem repeats (VNTR) polymorphism: failure to replicate and finding that never-smokers may be different.

Cigarette smoking, like many addictive behaviors, has been shown to have a genetic component. The dopamine transporter (DAT) gene (SLC6A3) encodes a protein that regulates synaptic levels of dopamine in the brain and is a candidate gene for addictive behaviors. We have collected smoking information from a national probability sample of 3383 adult volunteers contacted via a random-digit dialing telephone interview. A subset of individuals provided DNA from cheek swabs returned via the mail for subsequent genetic analysis of self-reported smoking behavior. DNA samples were genotyped at a variable number of tandem repeats (VNTR) polymorphism in the 3'-untranslated region of the DAT gene. If we classify smokers as non- (<100 cigarettes), former and current, we fail to replicate both Lerman et al. (Health Psychology 18:14-20, 1999) and Sabol et al. (Health Psychology 18:7-13, 1999) and support the absence of effects found by Jorm et al. (American Journal of Medical Genetics (Neuropsychiatric Genetics) 96:331-334, 2000). When we distinguish between never-smokers (no cigarettes ever) and non-smokers (1-99 in lifetime), we find a reliable trend essentially in the opposite direction from Lerman et al. (1999), with the 10-copy allele being more frequent in never-smokers. Biobehavioral research on cigarette smoking should distinguish between never- and non-smokers. We have also developed an improved set of polymerase chain reaction conditions to increase the frequency of successful amplification of DAT'sw VNTR, which is a long, G+C-rich repeat.

Adult↗