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Smoking reduction among high school seniors: a test of selected indicators.

PURPOSE: To examine differences in the explanatory power of variables thought to discriminate between students who smoke and students who have reduced (or quit). METHOD: The design is a two-group test of differences on 33 variables identified from previous studies of adolescent smoking and cessation as potential discriminators, which represent a variety of perceptual, behavioral, social, and psychological factors. Data are from a national survey of U.S. high school students administered in 1997 by the Monitoring the Future project. RESULTS: The most effective variables involve smoking-related beliefs and perceptions, particularly in anticipated future smoking status, attempted quitting, number of smoking friends, and perceptions of other smokers. Personality and psychological variables were not effective at discriminating between the two groups.

Adolescent↗

Smoking reduction during pregnancy by a program of self-help and clinical support.

This study investigated the impact of a low-cost, pregnancy-specific self-help smoking-cessation program on patient smoking behavior both pre- and postpartum. The population consisted of 274 English-speaking women enrolled in a large health maintenance organization who reported smoking at the time of the baseline survey or had quit within the previous 3 months. A control group receiving standard obstetric care was compared with two experimental groups, one receiving the self-help materials and standard care and the other receiving the materials plus brief regular clinician interactions and counseling about smoking. Smoking data were obtained from two additional self-reported surveys conducted at 6 months' gestation and approximately 8 weeks postpartum. Self-reported smoking behavior was verified using a urine cotinine test, which revealed no significant differences between the groups. Among baseline smokers, although neither intervention yielded significantly higher 6-month nonsmoking rates compared with controls, both interventions significantly increased the proportion of women who were not smoking postpartum. Among those who had quit smoking at baseline, only the more intensive intervention significantly increased maintenance of non-smoking postpartum. Brief counseling, a simple charting system, and improved access to educational materials allowed the program to be integrated easily into routine prenatal care at a cost of $50-111 per patient.

Adolescent↗

Smoking reduction does work: resulting alterations in the incidence and histological subtypes of lung cancer in New South Wales in the last 20 years.

BACKGROUND: There is irrefutable evidence of the association between lung cancer and smoking. The effects of public health campaigns to reduce population-smoking rates on the incidence and the histological distribution of lung cancer were examined. METHODS: The data held in the New South Wales Cancer Registry from 1972 to 2001 was accessed. RESULTS: The data revealed a decreasing incidence of lung cancer amongst males and a rate that continued to increase amongst females. Interestingly, there was also an effect on the histological distribution of lung cancers, with falling rates of small cell lung cancer and squamous cell cancer, both of which have a high association with smoking; and an increasing incidence of adenocarcinomas. CONCLUSIONS: These trends reveal patterns seen worldwide. The increasing proportion of adenocarcinomas in particular may be related to the changing composition of cigarettes and filters.

Carcinoma, Small Cell↗

Outcome evaluation of a high school smoking reduction intervention based on extracurricular activities.

BACKGROUND: An outcome evaluation of a high school tobacco control intervention using extracurricular activities developed by teachers and students is reported. METHODS: Eligible subjects (n = 3,028) had participated in a randomized trial of an elementary school smoking prevention curriculum. Their high schools were matched in pairs; one school in each pair was randomly assigned to the intervention condition, the second to a "usual-care" control condition. Data were collected at the end of Grades 9 and 10. RESULTS: For Grade 8 never smokers, regular smoking rates were significantly lower for males from intervention schools (9.8 vs 16.2%, P = 0.02) at the end of Grade 10. There were no significant differences among Grade 10 smoking rates for females, or for students of either gender with previous smoking experience in Grade 8. CONCLUSIONS: The extracurricular activities approach to tobacco control is practical to implement and has promise.

Adolescent↗

Effect of smoking reduction on later cessation: a pilot experimental study.

It is unclear whether reducing the number of cigarettes in smokers not trying to quit increases or decreases the likelihood of future quitting. In a pilot study, smokers not currently interested in quitting (n=67) were randomized to two groups. Experimental participants received behavioral treatment and nicotine replacement therapy (choice of gum, patch, or inhaler) to reduce smoking by 50% over 4 weeks, followed by brief advice to quit. Usual-care participants received only brief advice to quit and nicotine replacement if they decided to quit. During the 4-week treatment period, nonabstaining reduction participants decreased from 23 to 14 cigarettes per day (p<.01) and maintained their reduction over the 6-month follow-up period. At the 6-month follow-up, 35% of usual-care and 41% of reduction participants (nonsignificant [ns]) moved forward in their stage of change. Over the 6 months, 34% of usual-care participants had at least one 24-h quit attempt, compared with 25% of reduction participants (ns). A total of 9% of usual-care participants remained quit at 6 months vs. 13% in the reduction group (ns). These preliminary results suggest that adding a reduction option neither increases nor undermines interest in cessation. Higher than expected rates of attempted cessation and quitting in the usual-care group suggest that we recruited smokers whose motivation to quit was above average. Thus, a replication test in a less-motivated group of smokers is needed.

Administration, Cutaneous↗