Lower rates of successful quitting among low-income populations in the United States may be from slower dissemination of smoke-free homes, a predictor of cessation. A recently published study explored the role of smoke-free homes in cessation behavior across income levels. Researchers analyzed data from the 2002-2003 (n = 2801) and 2010-2011 (n = 2723) Tobacco Use Supplements to the Current Population Survey.
- Between the two surveys, heavy smoking (≥ 1 pack/day) declined by 17%, and smoking prevalence declined by 15% among those with higher-incomes.
- Although similar in 2002, the prevalence of smoke-free homes was 33% lower among individuals living <300% FPL than those living ≥300% FPL.
- Whereas smoking ≥ 1 pack/ day was associated with lower odds of 30+ days abstinence, having a higher income and a smoke-free home were associated with greater odds of 30+ day abstinence.
The researchers concluded that increasing the diffusion of smoke-free homes among low-income populations may attenuate at least a third of the income disparities in smoking cessation, highlighting the need for interventions to increase adoption of smoke-free homes among low-income households.
Source: Vijayaraghavan et al. (2018). Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. PloS One, Jul 27;13(7):e0201467. doi: 10.1371/journal.pone.0201467. eCollection 2018.
A newly published study whether self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures).
· Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures.
· Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school.
The researchers concluded that rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.
Source: Burgoon et al. (2019). Exposures to the tobacco retail environment among adolescent boys in urban and rural environments. American Journal of Drug and Alcohol Abuse, Jan 2:1-10. doi: 10.1080/00952990.2018.1549562. [Epub ahead of print]
Three cigarette smoking behaviors influence lung cancer rates: how many people start, the amount they smoke, and the age they quit. California has reduced smoking faster than the rest of the US and trends in these 3 smoking behaviors should inform lung cancer trends. A newly published study examined trends in smoking behavior (initiation, intensity, and quitting) in California and the rest of US by regression models using the 1974-2014 National Health Interview Surveys (n=962,174).
· Among those aged 18- 35 years, California had much larger declines than the rest of the US in smoking initiation and intensity, and increased quitting.
· In 2012-14, among this age group, only 19% had ever smoked; smokers consumed only 6.3 cigarettes/day; and 46% of ever-smokers had quit by age 35.
· Each of these metrics was at least 24% better than in the rest of the US.
· There was no marked California effect on quitting or intensity among seniors. From 1986-2013, annual lung cancer mortality decreased more rapidly in California and by 2013 was 28% lower than in the rest of the US.
· California’s tobacco control efforts were associated with a major reduction in cigarette smoking among those under age 35 years.
The researchers concluded that these changes will further widen the lung cancer gap that already exists between California and the rest of the US.
Source: Pierce et al. (2018). Trends in lung cancer and cigarette smoking: California compared to the rest of the United States. Cancer Prevention Research, Oct 10. pii: canprevres.0341.2018. doi: 10.1158/1940-6207.CAPR-18-0341. [Epub ahead of print]
A newly published study compared support for secondhand smoke (SHS) restrictions across rural and urban areas. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids.
· Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%].
· Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive.
· Rural residents were least likely to support SHS in homes, in cars, on playgrounds and in bars.
· South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds.
Source: Stillman et al. (2018). Variations in support for secondhand smoke restrictions across diverse rural regions of the United States. Preventive Medicine, Sep 24;116:157-165. doi: 10.1016/j.ypmed.2018.09.014. [Epub ahead of print]
Read the paper at: https://www.sciencedirect.com/science/article/pii/S0091743518302925?via%3Dihub
A newly published study examined factors related to self-imposed indoor household tobacco restrictions, with emphasis on children in the household and associations with combustible and noncombustible product use. Researchers analyzed data from a cross-sectional survey of urban and rural Ohio adult tobacco users classified participants as exclusive combustible users, smokeless tobacco (SLT) users, e-cigarette users, or dual users.
- 1210 tobacco users participated, including 25.7% with children living in the home. Half allowed combustible and two thirds allowed noncombustible tobacco use indoors.
- Urban location, younger age, male sex, college education, household income of more than $15,000, and being married were associated with a higher likelihood of banning combustible products indoors.
- SLT and e-cigarette users were more likely to have indoor bans compared to combustible users.
- Children in the household, older age, and nonwhite race were associated with a higher likelihood of banning noncombustible products indoors.
- Combustible and e-cigarette users were more likely than SLT users to have indoor bans.
The researchers concluded that indoor restrictions on tobacco use remain infrequent in homes with children and are associated with user type and socioeconomic factors. Recommendations included targeting modifiable risk factors for in-home secondhand smoke exposure through public policy.
Source: Kopp et al. (2018). Impact of Presence of Children on Indoor Tobacco Restrictions in Households of Urban and Rural Adult Tobacco Users. Academic Pediatrics, Apr 10. pii: S1876-2859(18)30165-7. doi: 10.1016/j.acap.2018.04.002. [Epub ahead of print]
A recently published study examined patterns of cigarette smoking (current, former, never) by sociodemographic, household, and chronic disease characteristics and correlates among US adults receiving housing assistance from the US Department of Housing and Urban Development (HUD) during 2007-2012.
- Overall, 48% of HUD-assisted adults were never smokers, 33% were current smokers, and 19% were former smokers.
- The percentage of never smokers was significantly higher among adults aged 18 to 44 (54%) or 65 years or older (50%) than among adults aged 45 to 64 (38%).
- The percentage of never smokers was significantly higher among women (51%) than men (41%).
- The percentage of never smokers was significantly higher among Hispanic adults (59%) and non-Hispanic black adults (55%) than non-Hispanic white adults (37%)
Source: Wang et al. (2018). Characteristics and Correlates of Cigarette Smoking Status Among US Adults Receiving Federal Housing Assistance. Preventing Chronic Disease, Mar 22;15:E48. doi: 10.5888/pcd15.170395.
Did You Know? African American And Low SES Children With Asthma Have More Exposure To Passive Tobacco Smoke
A newly published study examined the risk of asthma in children exposed to passive tobacco smoke. Researchers analyzed National Health and Nutrition Examination Survey (NHANES) data collected from 2003 to 2014 (n = 8064).
- The proportion of children living with household smokers decreased from 24.9% in the 2003-2004 cycle to 11.4% in the 2013-2014 cycle.
- Highly exposed asthmatic children were primarily Non-Hispanic Black and whose family incomes were below poverty guidelines.
- Overall results reveal passive smoke exposure level among children ages 3-11 in the US decreased over the study period.
- Nevertheless, higher exposure to passive smoke is still associated with higher odds of childhood asthma.
The researchers concluded that targeted smoking cessation interventions in clinical practices are needed to reduce tobacco smoke exposure and related asthma risk in children, particularly in low-income and minority groups.
Source: Zhang et al. (2018). Decreasing trend in passive tobacco smoke exposure and association with asthma in U.S. children. Environmental Research, May 31;166:35-41. doi: 10.1016/j.envres.2018.05.022. [Epub ahead of print]